5 Questions to Consider Before and After Delivery
Helpful answers for new parents
An informed parent is an empowered parent. Since having a baby generates a lot of questions, here are answers to five questions many parents consider before and after their baby’s birth.
1. Who do I want to deliver my baby?
Obstetricians/gynecologists are trained to handle non-pregnant and pregnant women’s health issues, including high-risk pregnancies. OB-GYNs also perform cesarean sections and other gynecological surgical procedures.
Family medicine doctors are also trained to deliver babies. Not all family medicine practitioners do, however, so find out if yours does before you count on it.
Certified nurse midwives are registered nurses who have obtained advanced education in nurse-midwifery and are certified by the American College of Nurse-Midwives. They provide well-woman care, prenatal and labor care, and newborn care up to 1 month of age. Certified nurse midwives work in hospitals, birth centers and homes, but most prefer one type of setting.
Certified professional midwives are trained, independent midwives certified by the North American Registry of Midwives. Direct-entry midwives have been trained through apprenticeship or a direct-entry midwifery school. Other types of midwives include certified midwives, licensed midwives, registered midwives and lay midwives. North Carolina currently approves only certified nurse midwives to practice and does not recognize or license other types of midwives, according to the American College of Nurse-Midwives.
Doulas do not offer medical care, but can provide physical and emotional support during and after labor and birth in any setting.
Learn more about local labor and delivery resources by visiting our Labor/Childbirth Education and Support directory.
2. What options do I have for managing pain during and after delivery?
The most common way to cope with labor pain is anesthesia. An epidural enables the continuous administration of pain medication through a small catheter into the area outside the spinal cord but inside the vertebral canal of the spinal column. The medication is usually an anesthetic and narcotic.
A spinal block is delivered directly into the spinal fluid via a one-time injection rather than a continuous flow. Pain relief comes fast, but only lasts a few hours.
Many doctors now provide a combined spinal-epidural, which offers quick and continuous relief. All of these options are only available in a hospital setting.
Systemic medications, which can dull or lessen pain, but not completely eliminate it, are given intravenously or injected directly into a muscle. Narcotics provide the pain relief and are sometimes used with an anti-anxiety or anti-nausea medicine. Narcotics affect the whole body and may make you sleepy.
Some women choose medication-free alternatives to mask pain. For example, doulas can teach pain-reducing labor positions and offer other coping tools. “Hypnobirthing” consists of self-hypnosis techniques that facilitate a more relaxed birth. Other alternative pain relievers include acupuncture, reflexology, patterned breathing, aromatherapy and meditation.
3. What should I consider when deciding about circumcision?
Some parents choose to circumcise their son based on tradition or because it feels like the “normal” thing to do. Others may choose it for religious reasons or because they believe it is more hygienic or helpful in preventing sexually transmitted diseases. Parents may oppose circumcision for religious reasons, to prevent pain, or because they feel it violates human rights or isn’t medically necessary.
According to a National Center for Health Statistics report, circumcision decreased in the U.S. between 1995 and 2008 from 64 to 58 percent. In 2009, the American Journal of Public Health reported lower rates of circumcision in states where Medicaid does not cover the procedure, so this may partially explain the drop.
In 2005, the American Academy of Pediatrics reaffirmed the following 1999 statement in support of circumcision: “Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision.”
Ashley Marshall, a certified nurse midwife with Carrboro Midwifery, says circumcision is no longer considered as necessary as it once was. “Routine infant circumcision is a cosmetic procedure and is not needed for the health and well-being of the baby as it was once thought in previous decades,” Marshall says.
Consider discussing circumcision’s pros and cons with your health care provider to determine what is best for your family.
4. Can I find out my baby’s blood type after he or she is born?
A newborn metabolic screen does not identify blood type. However, some health care providers routinely collect blood from the baby’s umbilical cord for various reasons, while others do not.
“A mother’s midwife or OB will collect a small sample of blood from the cord after it is cut for several reasons, one being if the mother has a negative Rh blood type,” Marshall says.
Other reasons include checking bilirubin levels, determining blood gas levels or the blood sugar level, obtaining a complete blood count or platelet count, or taking a blood culture.
Check with your health care provider before your child’s birth to see if he or she plans to collect a cord blood sample at delivery, and whether you will be able to find out your child’s blood type. If blood is not collected at birth, you can always request a blood-type test from your baby’s pediatrician via a heel stick.
5. What happens to my baby’s umbilical cord blood?
After your baby is born and the cord is still attached, blood continues to flow between baby and mom for a few minutes. Once the cord is cut and clamped, the placenta detaches from the uterus, is delivered and is later discarded as biomedical waste, along with the cord.
You may be able to donate or bank your baby’s cord and placenta blood. There are two types of cord blood banks: public and private. A public bank makes your baby’s blood available to anyone who needs a transplant. It is not reserved for your family and there is no cost to donate. The Carolinas Cord Blood Bank (americordblood.com) works with Americord, an organization that collects, processes and stores stem cells for future medical or therapeutic use by the family who saves them.
If you deliver at a hospital not associated with CCBB but would like to donate your baby’s cord blood, call 866-389-3448 or visit the website to find out how to do this.
You can also privately bank your child’s cord and placenta blood so it will be stored exclusively for your family (collection and annual storage fees apply). Search online for private banks across the country that will allow you to ship your baby’s cord blood to them.