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Time for Baby!

Your Guide to Birthing in Indianapolis

February 01, 2011
Nothing is more exciting and more terrifying than realizing you are expecting a child. Discovering a pregnancy positive brings an immediate rush of emotions and, inevitably, a lot of questions. What do I need to do? Where should I have my baby? Will my baby be Healthy? How can I be sure?

There are so many options for child birthing methods, doctors, baby products, etc. that making decisions about what's best for you and your baby can seem like a daunting task. It's important to research all options and make informed decisions. Below is a guide to local options to aid in this process.

Choosing a birthing method

Most women, around 70%, deliver vaginally each year. Some opt for pain reduction with medication or an epidural. However, there are many other options for pain management with a natural birth, including, to name a few, the Lamaze Method, Bradley Method, water birth and hypno birth.

The Lamaze Method, created by Dr. Fernand Lamaze in the 1950s, usually involves six to eight weeks of training classes for the mother and a partner. Pain management is achieved with controlled breathing, focusing on an external object and relaxation techniques such as massage or soft music. The Lamaze Method is sometimes used in combination with pain medication.

The Bradley Method was developed by Dr. Robert Bradley as an alternative to pain management drugs. This method involves more intensive study and classes typically last for 12 weeks. The basic idea behind the process is that women instinctively know how to give birth and it teaches women to relax and focus internally on their bodies. Topics such as health, nutrition, newborn care and post partum care are also discussed.

Water birth or water labor is becoming more popular and many hospitals are beginning to offer it as an option in their Maternity centers. Mothers will labor and/or deliver in water that is approximately 90-100 degrees. The water temperature relaxes and eases the pain of the mother and the baby is born into a comfortable environment that mimics the temperature and feel of the mother's womb. Physically, the placenta is still supplying the baby with oxygen until it begins to separate. The baby is immediately removed from the water and placed in the mother's arms. For the mother, benefits of water birth include easing of pain and anxiety.

Another natural childbirth choice, hypnobirthing, is a form of self-hypnosis that strives to reduce pain and anxiety. The hypnosis is not a form of 'mesmerizing' but rather relaxation obtained through imagery, positive suggestion and deep breathing. Mothers practice the technique for several weeks before labor and/or attend classes.

Doctors, midwives and doulas…oh my!

The majority of women still feel most comfortable seeking the advice and care of their OB/GYN for their prenatal care, labor and delivery. There are however, other types of support available for women who would like additional or alternative care.

Midwives are registered nurses who are educated in nursing and midwifery. They may work through a hospital, in private practice or in collaboration with a physician. According to Penny Lane, CNM and owner of Believe Midwifery Services, LLC, "There are many routes to becoming a midwife in the United States, which leads to a great deal of confusion among both consumers and medical providers. Indiana currently recognizes only the Certified Nurse Midwife (CNM). The CNM credential means that the midwife is a registered nurse who has graduated from a nurse-midwifery educational program accredited by the Accreditation Commission for Midwifery Education (ACME), most often has a master's degree in nursing, and has passed a national certification examination to receive the professional designation of certified nurse-midwife."

Believe Midwifery specializes in natural home births but also offers a wide range of gynecological and maternity services. "Indiana licenses Nurse Midwives as independent practitioners, meaning we are primary health care providers to women throughout their lifespan and newborns through the neonatal period," says Penny. "We perform physical exams, prescribe medications (although Indiana requires a written collaboration with a physician for prescription privileges), order laboratory tests as needed, provide prenatal care, gynecological care, labor and birth care, as well as health education and counseling to women of all ages."

Group question and answer sessions and tours of the office are offered to provide potential patients with answers to all their questions and to determine if birthing families and the midwife are comfortable working together. For more information visit believemidwiferyservices.com.

Doulas (from the Greek for 'female servant') are more like pregnancy and delivery "coaches" and do not provide medical care like midwives and doctors. They are basically there to help with the birthing plan and offer support before, during and after the birth of the baby.

Doulas are usually practiced in relaxation techniques and can aid in making mothers more comfortable during the labor process. They are also trained in lactation procedures and post partum issues that may arise.

Doulas of North America (DONA) is an international association of trained doulas. DONA doulas are specially trained and certified by the organization. You can find local DONA doulas in your area by sending an email to referrals@dona.org.

Where to have your baby

Though hospital births with an obstetrician are still the most common, more and more mothers are employing midwives and doulas. Most hospitals today welcome this and have professional midwives and doulas on staff. In addition, home births with midwives and/or doulas are also becoming more popular.

For hospital births, it is important to find out as much information as possible about local maternity wards before making a choice. Most maternity centers and OB units offer regular tours and classes and are happy to answer any questions. Visiting the hospital and knowing what to expect can do wonders to alleviate fears and concerns of expectant parents.

According to Lisa Crane, childbirth education coordinator for Clarian Health, tours are scheduled twice a month and can be arranged to fit busy schedules (evening and weekend tours are available). Many classes are also available including Lamaze, "Hypno Baby," sibling birth classes and refresher courses at a number of locations (a full list of classes and online registration is available at iuhealth.org/childbirth). Clarian is open to many birthing methods and will work with parents' special needs and desires. According to Joyce Reynolds, Shift Coordinator for Labor and Delivery, water birth and therapy is an option and certified midwives and doulas are on staff. Doulas also offer Spanish interpretation as 20% of patients at Clarian require this service.

One unique service offered by Clarian is the Clarian Home Connection, available to those who live in Marion and surrounding counties. A few days after new mothers arrive home with their babies, a nurse will visit the home to provide follow up examinations of both mother and child and to answer any questions parents may have. This service is provided free of charge.

St. Francis Hospitals offer prenatal birthing classes, sibling classes and breastfeeding classes as well as tours of the OB units on Wednesday nights at 6pm.

Fifteen private rooms for labor, delivery and recovery (LDR) are available, as well as 21 private post partum rooms and 8 private antepartum rooms. Visiting hours are open during labor, with 3 people allowed to visit at one time. Two people are allowed to attend deliveries (children must be 14 years or older to visit during this time).

Despite open visitation, security in nursery and maternity areas is taken very seriously at St. Francis. "We use HUGS® as our security system," explains Shelley Spate of the St. Francis Hospital-Indianapolis Labor and Delivery Unit. "Each baby is banded immediately after birth with ID bands that are compared to parents. They are also banded with a HUGS device which alarms if tampered with or if the infant is removed from the unit."

Umbilical cord blood is special because it contains stem cells; specialized cells that can be used in the treatment of many diseases. Cord blood banking is often done at St. Francis, however, patients are responsible for making their own arrangements and supplying their own cord blood kits. "We do have some kits available if they decide at the last minute to bank the cord blood," explains Shelley. "We also work with Endgenitor, which is a research company doing research on cord blood stem cells. Each patient is asked if they would like to participate in this program and at that point consents are signed."

Riverview Hospital of Noblesville offers tours every other Sunday at 6 p.m. Many classes are also offered. "We offer a standard five week childbirth education class, as well as a condensed version that meets on one weekend on Friday night and Saturday morning," says Susan Herzog, Interim Manager of Maternity Services at Riverview. "We also offer a positive positioning class that is geared towards mothers wanting to have a natural childbirth, a class named 'Mommy's Having a Baby' to help prepare siblings to welcome their new brother or sister, and we also offer a breastfeeding class."

Standard visiting hours are from 11 a.m. to 8 p.m. and visitation during labor and delivery are left up to the discretion of mothers and physicians. There are no specific restrictions regarding visitation and siblings are allowed to visit at any time before, during and after delivery.

Despite open visitation policies, Riverview uses multiple security measures. "We have a locked, secure unit that is constantly monitored," says Susan. "We also use the KidMatch system, which uses barcodes on bands that the mother and baby wear to ensure that they are matched properly."

St. Vincent Hospital offers community tours at 6 p.m. every Tuesday night in the OB waiting room at Carmel. Private tours through the Monogram Maternity Program are available with a pre-delivery appointment with an OB nurse. Many classes from baby care to Lamaze and sibling classes are also offered.

Patients deliver in an LDR (Labor, Delivery and Recovery) room, then are transferred to a new post partum room. "We find our families enjoy moving to a new room after they have completed their delivery process where they focus on resting and learning to care for their newborn and selves the next couple of days," says Michelle Slayman, Clinical Director of OB Services at St.Vincent Carmel. Visitation is open during labor and the amount of visitors is left up to the discretion of the family and the attending physician. "We encourage our families to include those in their experience that are appropriate for them and their particular situation," says Michelle.

Home births account for only a very small percentage of births in the United States and many of those home births are unplanned. However, home birth may be a viable option for healthy, pregnant women, but it is important to do your research and surround yourself with the support of people you trust.

Joni Heredia was drawn to the idea of a homebirth when she and her husband took a Bradley birth preparation class and heard their presenter talk about homebirths. "I researched and talked to lots of people and I concluded that homebirth was safe and natural," she says. "I knew there was less chance of complication and that I would be more comfortable in my own surroundings."

At first Joni's husband was leery of the process and preferred that their first child not be born at home. "By the second birth, we both agreed," she says. "We met with several midwives and my husband trusted the midwives we chose and that conversation made him comfortable with homebirth."

To prepare, Joni and her husband read several books, met with midwives and looked up statistics about safety and outcomes of homebirth. She recommends that anyone considering homebirth do their research, as well.

Joni has had two of her children at home and says she would do it again. "After experiencing the homebirth, I can say it was the most amazing thing to happen to me and my family," she says. "It brought us closer as a couple, it was a relatively simple birth and when it was over we were already home in our 'nest,' free to enjoy our new family. The few hours after the birth when you can go to sleep in your own bed with your own family and no one meddling, that is priceless."

Common Pregnancy Fears

Fear is a common emotion in expectant women as questions and concerns constantly arise. One of the most common fears is the loss of the pregnancy. Fortunately, according to recent statistics, only 10 to 20% of pregnancies end in miscarriage, most of these occurring very early in the pregnancy. After about week 8, the incidence rate drops even further.

Another common pregnancy fear is a premature delivery. The scenario is often depicted in movies and on television: the woman goes into immediate, unexpected labor at an inconvenient time followed by a mad dash to the hospital. The fact is this type of labor, especially for first time mothers, is extremely rare. Premature births happen only about 12% of the time and even then, a mad dash is not usually necessary. When my water broke 3 weeks early with my first child, my first instinct was to rush immediately to the hospital. After a call to my doctor, however, I was assured that I still had plenty of time, did not need to rush, and would be more comfortable resting at home until labor pains became more intense. In fact, the average length of labor for first time pregnancies is 12 to 18 hours. Second births, however, will most likely be quicker.

As a woman's belly begins to grow, she will inevitably begin to be concerned about regaining her figure after the baby is born. The best way to get back into shape after baby is to stay in shape before baby. Don't make your pregnancy become an excuse to pig out. Instead, follow your doctor's advice, eat healthy and try to stay in the recommended weight gain recommendations (usually 25-35 pounds). Breast-feeding may also help new moms shed the pounds as it burns calories and tightens the abdominal muscles.

Doing research and taking steps to alleviate fears and insecurities will help ensure a healthy pregnancy and future for you and your family. Having a plan and knowing the facts will empower you on the journey that lies ahead. Relax and enjoy the ride.

Rebecca Todd is a freelance writer and author of the book "What's the Point? -- Looking for Logic in Modern America."

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Must-Haves For Mommies (and the things you really DON'T need)

Bed and Bedding:Though the family bed is popular with some, most pediatricians recommend parents do not sleep with small infants for safety reasons. Therefore, baby really needs a bed of his own. Be aware, however, that national regulations and safety standards for cribs are changing and it is important to do your research before making a purchase.

What you DON'T need: Fluffy quilts and pillows, which can pose a suffocation hazard for infants. Simple bedding is best. Local mom Catherine Dixon, mother of 18 month old Lucy with another child on the way, recommends the HALO® SleepSack®, a wearable blanket that replaces loose blankets in the crib that could cover your baby's face and interfere with breathing.

Diapering Needs

Obviously, diapers are a priority for new moms. Diapering creams will also be important, as well. Arbonne offers a line of baby products that are botanically based and pH correct. Their herbal diaper ointment is a water-repelling cream formulated to relieve the sore, dry, chapped skin that can occur with diaper use.

What you DON'T need: Most moms, even the ones who have purchased one, agree; you don't really need a big, fancy changing table. Many times they end up being stacked up and used for storage. Instead, "a large supply of waterproof changing pads is a must," says Catherine.


Obviously, your needs will vary depending on whether you are breast or bottle feeding. But as your child grows, a high chair will be a must. "High chairs are one of our top sellers," says Kate Finger of Once Upon a Child, which buys and sells second-hand quality, safe child and baby items. "They never stay in the store long."

What you DON'T need: A fancy upholstered or wooden high chair. "They're impossible to clean," says Catherine. "Get a plastic one that you can hose down if you need to!"

Tags: In This Issue, Health, Maternity

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