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Cleared for takeoff Labor & Delivery

Cleared for takeoff

With baby on board, you're almost ready to jet off into motherhood. But you're bound to have a much smoother flight through labor and delivery with a bit of preparation before you hit the skies.

As a first-timer on this life-changing voyage, there’s likely to be a lot you don’t know. But the good news is most of the folks around you—from your prenatal care provider to the labor and delivery nurses—have done this time and again. They’re pros, and they’ll fill you in on what’s important. That said, if you have any questions, just ask.

Flight crew
When you’re expecting, one of the first decisions you’ll have to make is who is going to be flying this pregnancy plane. You’ll be seeing a lot of each other over the next nine months, and the person you pick to manage your prenatal care may very well be the one who assists you in bringing your babe into the world (depending on how their practice works). So, it is imperative that you choose someone you trust and are comfortable with.

When it comes to a prenatal care provider, moms-to-be typically see an obstetrician (OB) or a midwife, though in some cases you could go to a maternal-fetal medicine specialist if you have a high-risk pregnancy. But by and large, most women pick an OB or midwife to guide the way, with the majority opting for the former.

An obstetrician is like the pilot—this is whom most people tend to think of as operating the aircraft. In fact, more than 90 percent of all U.S. births are attended by OBs. However, they’re not the only ones who are trained and equipped to fly the plane. Midwife-attended births are on the rise and accounted for up to 8.3 percent of all U.S. births in 2014, according to the American College of Nurse-Midwives. A midwife can be thought of as a co-pilot, someone who is equally qualified to oversee your care and delivery.

It’s up to you and your partner as to which type of provider you prefer. Both are highly trained health care professionals. Both are licensed and regulated in all 50 states. And, generally, your health insurance will cover either if you’re delivering at a hospital. (Many insurance plans also cover a portion of birth center deliveries, but home births are often not covered.)

So, here’s where their key differences lie. Midwives are experts when it comes to normal, low-risk pregnancies. They tend to use more natural and holistic methods of care, aiming for as few interventions as possible. Obstetricians, on the other hand, are more likely to view pregnancythrough a medical lens. Therefore, they will suggest medical interventions as they see fit. But that’s partly because they can; OBs are trained with a different set of skills in order to manage normal as well as high-risk pregnancies—and perform C-sections (something a midwife cannot do). So, if there are complications, a mom-to-be may need to be transferred from a midwife’s care to a doctor’s. Whichever you choose, know that both are committed to keeping you and your baby healthy. They might have different philosophies and approaches to birth (so find one whose perspective and goals coincide with your own), but you and your little one will be in good hands either way.

Baggage check
You know you need a labor bag, but what exactly should be inside varies from mom to mom. Think about the birth experience you aim to have, and pack accordingly. If you’re hoping for dim lighting and calming music, don’t forget a portable Bluetooth speaker and battery- powered candles (a nice alternative to the real deal because most facilities won’t allow an open flame). If you’d prefer to streamline the whole affair, stick to the basics. (See sidebar for a handy packing list.)

Those interested in bringing along a few more creature comforts—think your own towel because the provided ones are usually worse for the wear—might want to consider bringing two bags instead of one. No, the other isn’t for your partner. Instead, divvy up your necessities based on when you’ll be reaching for them. Your labor bag, which you can think of as your carry-on item, won’t need to hold nearly as much stuff. Fill it with everything you’ll want before your baby is born and immediately after. That includes a ponytail holder to get your hair up and out of the way, lip balm to give your dry mouth relief, and lots of copies of your birth plan.

The second, more substantial bag is the equivalent of checked luggage. You can leave this suitcase in the car until you’ve transferred to recovery. Dad will appreciate having one less thing to haul around while trying to check in and support you through contractions. Once you’re in your postpartum room, have your partner make a quick trip to the parking garage to fetch it, so you’ll have access to toiletries and changes of clothes for the duration of your stay. Plus, he can even swap your labor bag for your postpartum one, so you have a lighter load for your eventual departure from the hospital. (Fewer bags to keep track of tends to mean fewer forgotten items.)

One person you won’t have to worry about packing for is baby. The hospital or birth center will have diapers, wipes and blankets galore. Go ahead and rely on their stash while you can.

In-flight entertainment 
Once you’re cruising through the clouds, mere hours away from your grand destination of motherhood, you’ll be looking for a way to pass the contraction-filled hours.

In the earliest stage, you can continue about your day without too much interference. Most providers will encourage you to stay home for this phase, as contractions will be coming regularly but should be more uncomfortable than painful.

The best thing you can do during this period is listen to your body. If you could use a catnap, squeeze in a few more hours of shuteye. If you’re too energized about the prospect of meeting your babe soon, take a stroll to keep your mind off things. (It can even help move labor along!) Now is the time to wrap up any last-minute tasks, but take care not to wear yourself out before the main event. Find time to put your feet up, even if only for a few minutes. Labor is hard work, and you’ll be thankful you rested.

Those in need of some relief from the pressure in their midsection can try hopping in a warm shower or tub. Just don’t let your body get overheated. (Tip: If you’re sweating, the water is too hot.)

As contractions become longer, stronger and closer together, you’ll want to push that call button and clue your care provider in on your progress. She’ll let you know whether to sit tight or hit the road.

When you reach active labor, which comes when you’re about 4 to 6 centimeters dilated, there will be a noticeable shift as contractions amp up in intensity. Now is not the time for chores but more likely the time to head to the hospital. These contractions will require extra focus and effort.

At this point, you’ll want to rely on whatever pain management options you’re comfortable with. If you practiced breathing exercises or meditation, turn down the lights and set the tone in your room. If you are ready for that epidural to be placed stat, let the nurses know, so the anesthesiologist can head your way. There are numerous ways to lessen the ache, including …

• Movement, changing positions, walking
• Rocking on a birthing ball
• Hot/cool compress
• Warm shower/bath
• Aromatherapy
• Acupressure
• Breathing exercises
• Meditation,visualization
• Affirmations,mantras
• Massage, counter pressure
• Narcotics (Demerol,Stadol)
• Epidural

Employ whichever methods work for you, and don’t be afraid to mix it up. What seemed useless hours ago might be just what you need to power through transition (what many consider the most trying part of labor). This occurs when your cervix opens from approximately 8 to 10 centimeters, just before it’s time to start pushing. Expect contractions to be powerful and come in quick succession. This is the real deal. Thankfully, transition doesn’t last very long, and it means you’re close to meeting your mini.

Prepare for landing
Maybe you forgot about the pilot up there in the cockpit. (If you have an OB, you likely won’t see her until you’re fully dilated and ready to push.) But she’ll let your delivery crew know when it’s time to prepare the cabin—or your delivery room. Things will start to happen quickly. Lights will turn on. The nurses will clear the aisle (aka the area around your bed). And you’ll get in position for baby’s final descent.

You’ll work with each contraction in an attempt to move your wee one down the birth canal. Your caregiver might have you push for a count of 10. (This is a technique to guide mamas who received an epidural.) Or you could be encouraged to push only when you feel the urge. After hours of waiting, many moms are grateful for the opportunity to do something that feels productive, albeit exhausting.

Before you can hold your newbie in your arms, there’s one final bump as you’re rushing toward the runway: crowning. When your babe’s head appears, it will put an incredible amount of pressure on your perineum, which is why this is often dubbed the “ring of fire.” If you can pause pushing to allow the skin to stretch, there’s a chance you could minimize tearing, but it can be hard to hold back when your body is bearing down. Once baby’s head emerges, her body will soon follow. In a matter of seconds, you’ll hear your doctor or midwife say that your child has arrived … and so have you, in the wonderful world of motherhood.