How to Prepare for Labor and Delivery

James N. Martin, Jr, MD

By James N. Martin, Jr, MD
President, The American Congress of Obstetricians and Gynecologists

For some women, the thought of labor and delivery causes a lot of anxiety. However, preparing mentally and physically early in pregnancy can help you have a smoother delivery.

Many women choose a childbirth partner. This person can be a spouse, partner, friend, or relative who can provide support through your pregnancy, labor, and delivery. He or she can accompany you to prenatal visits and childbirth classes. You can practice breathing or relaxation exercises together, and on delivery day, your partner can coach you through contractions and help carry out what you’ve learned in your classes.

Some women also choose to have a doula, or professional labor assistant. Doulas support both women and their childbirth partners and can take some of the pressure off during a long labor.

Childbirth education classes help prepare women for what to expect in labor and delivery. The techniques taught in popular classes, such as Lamaze, Bradley, and Read, can vary, but the idea is the same—that fear and tension make pain worse. They aim to relieve pain through education, emotional support, relaxation techniques, and touch. Your doctor can give you information on the different types of classes available.

During childbirth classes, you will learn about a number of different ways to approach labor and delivery. Topics that may be addressed include having a natural childbirth vs. using pain relief medication during labor, episiotomy, breastfeeding after delivery, and who will be in the delivery room.

If you choose to work with a midwife, ACOG recommends using a certified nurse-midwife (CNM) or certified midwife (CM). Unlike lay midwives, CNMs and CMs are accredited, have passed a national certification exam, and are trained professionals. They work with qualified doctors to care for women and their babies through early pregnancy, labor, delivery, and the weeks after birth.

Women must also consider where they will deliver. It is important to be in a setting where trained emergency medical staff are available in case any complications arise that threaten the life or health of the mother or baby. Therefore, ACOG recommends that all births take place in a hospital setting or a birthing center within a hospital complex.

Discussing these details beforehand can ease confusion at the time of your delivery. You can make a list of options that appeal to you and share them with your doctor for review. He or she can let you know if your preferences conflict with hospital policy. ?

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3 comments for “How to Prepare for Labor and Delivery

  1. Paramedic
    November 25, 2011 at 8:03 pm

    I am really disappointed. I would like to think that a doctor with as much experience as Dr Martin would have the intelligence or at least the staff to make sure that he doesnt make statements that are untrue.

    Certified Professional Midwives (CPMs) are Nationally certified thru NARM who’s testing process is accredited thru NCCA. NCCA also accredits Nurse Midwives and hundreds of other nursing and medical programs and their testing process.

    CPM’s are highly trained professionals who go thru a 3-5 year clinical internship prior to taking a National Exam. They are the ONLY Midwife program that requires out of hospital birth attendance.

    If Doctors where willing or able to read the requirements which are clearly posted on NARMs webpage, they would see what the requirements are and be able to start the process of understanding this profession.

    The reason why CPM’s dont have a good relationship with Doctors is because of the blantent unprofessionalism shown by doctors when transfers occur. If OB’s where willing to work with CPM’s then you’d see this profession work well in the maternity system… as is evident in the 26 states that license CPM’s as independent Professional Maternity Care Providers.

    Dr Martin, If you are going to lead your organization you should at the very least be professional and make sure you know what you are talking about.

    Jeremy Galvan
    NREMT- Paramedic
    President of MFSB

  2. Dr. Ed
    November 25, 2011 at 4:54 pm

    Of course “lay” midwives are not accredited. The very definition of the word “lay” means a non-professional, and most women, I suspect, are not the least bit interested in hiring a lay person to deliver their baby. In fact, it is illegal in the United States for lay people to provide health care.

    As President of the professional society for OB/GYNs, it’s no surprise that Dr. Martin would recommend against out-of-hospital birth. But the fact is that recommendation is not evidence-based, as numerous studies have shown.

    Moreover, Dr. Martin neglects to mention another type of accredited midwife, Certified Professional Midwives, who undergo specialized training in out-of-hospital deliveries. Women who choose out-of-hospital birth typically deliver under the care of a CPM so that they can be assured that their midwife has the necessary training to provide the safest care possible at a home birth or in an independent birthing center.

  3. kreisman
    November 25, 2011 at 3:03 pm

    ACOG has determined that 75% of its obstetrical policies and procedures are not based on science. With Dr. Martin’s article, that percentage goes up. While it is Dr. Martin’s opinion that birth should take place in a hospital setting (or a birth center attached to a hospital), several years ago the British Journal of Medicine (BMJ) published a study of births in the U.S. which found that outcomes for mothers and babies were not different between delivers made in hospitals and those made at home (except that there were less interventions at home). Just this week the BMJ published an article that came to the some conclusions for home birth in the United Kingdom. While Dr. Martin is entitled to his opinions, he is not entitled to his facts. The facts are that in New Jersey CPMs are accredited, have passed a national certification exam, and are trained professionals.

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