What to Include in Your Birth Preferences – Part II

Welcome to part II of my post discussing birth preferences and how to create yours. If you haven’t already, check out part I where I go over what birth preferences are, the importance of using the term “preferences” instead of “plan,” and how to compile your list.

Adding Two Addendums

Since we can’t plan our births (do I need to even say this anymore?), I think it’s a good idea to also create two addendums in the case of 1) an epidural birth – whether planned or unplanned and 2) an unplanned, non-emergent cesarean birth – the tips I’ll outline in this one can also be applied to a planned cesarean birth. Please note, if you haven’t already, I highly highly HIGHLY recommend going over these addendums in advance of your labor/birth with your care provider. It’s good to have these discussions well before labor has even begun so you’re both clear on expectations and what’s feasible. It will also be helpful to come prepared with evidence based data in certain cases. For all things evidence based, I love this website: https://evidencebasedbirth.com/

All About Epidurals

Let’s dive into today’s post all about epidurals. First of all, epidurals are wonderful tools to have in your toolbox. Whether you go into birth knowing you want one, or maybe it’s something you’re actively trying to avoid, it’s good to include in your birth preferences list what you’d like in the event that you have one.

Quick dive into what epidurals are. An epidural, or epidural block, is a regional anesthesia where “medication is given through a tube placed in the lower back. For labor and vaginal delivery, a combination of analgesics and anesthetics may be used. You will have some loss of feeling in the lower areas of your body, but you remain awake and alert. You should be able to bear down and push your baby through the birth canal. For a cesarean delivery, the dose of anesthetic may be increased. This causes loss of sensation in the lower half of your body.” (Source: ACOG)

What to Include Under Epidural Addendum

If you are aiming for an unmedicated labor you might want to put it at the very bottom of your list and say something like “in the event of an epidural.” If you’re planning on one from the get-go, you can simply have an “Epidural” section. Answering the below questions will help craft your preferences:

Epidural/In the Event of an Epidural

– Would you like access to a peanut ball (a small, peanut sized rubber ball that goes in between your legs to help keep your pelvis open when lying down)
– Would you like to rest for a few hours, and then have help with flipping from side to side every 45 minutes-1 hour to allow baby to descend
– Would you prefer for your epidural to be turned down or off as you approach 10 centimeters/pushing so you can feel pressure and the sensations to push
– Would you like to explore positions (like supported hands and knees/squatting with help from a squat bar/throne position in bed where the lower half of your bed is lowered down and the back of your bed is straight up) besides laying on your back/side during your labor/while pushing
– Once complete, or 10 centimeters, if baby is still high, would you prefer an hour or so of “passive descent” to allow the baby to come down in the pelvis more
– When it comes to pushing, would you like a nurse or doctor to place their fingers inside of you during contractions to help you identify where to push

I hope this helps you as you complete your preferences list! Stay tuned for part III where I’ll go into cesarean birth preferences.


About Katelyn Gonzalez

Hi, I’m Katelyn - a seasoned birth and postpartum doula, childbirth educator, placenta specialist, Ayurvedic postpartum care practitioner, and certified women’s health coach. My #1 priority is to empower women to see what they can do when they believe in themselves and their beautiful bodies. I live in the East Bay with my husband, daughter, and fur babies.

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