Paging Dr. Grunebaum: Birth Plan Do’s & Don’t’s

So, so many pregnant women come to me with very strong ideas about how they want the labor and delivery process to go, with birth plans running pages and pages long.  While it’s perfectly lovely to put together your ideal labor plan, the actual reality often differs, either due to hospital policy or because things go slightly differently than planned.  In order to prepare everyone for what to expect, we’ve put together all the nitty gritty questions we could think of about birth plans and posed them to Dr. Grunebaum  of BabyMed.com, Director of Obstetrics and Chief of Labor & Delivery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

(1) Lots of mothers want to set the mood for the room, but are there certain things that you wouldn’t allow? For example, can women bring candles into the room? Can they play any music they want, even if the doctor finds it annoying or offensive?

Dr. G: Setting a certain mood for your delivery is important to make you feel better. One thing I usually tell my patients is to bring in their own music, which is incredibly easy now that smart phones have the great ability to store hundreds of songs and you can mix your own music ahead of time. Just make sure to bring a charger so hat you don’t run out of batteries. In addition, there are great wireless loudspeakers which improve the sound. With regard to candles, many hospitals need to follow certain guidelines set by regulatory agencies for hospital safety, so because of fire safety, lit candles are usually not a good idea, though if you look online you could find great electric substitutes. Other “mood-enhancers” could include frangrance oils, or even posters to help you focus. 

(2) In terms of beauty and appearance, we hear more and more women trying to look their best while in labor. Can women wear makeup and nail polish?  What about jewelry? Have you ever had to ask someone to remove something because it was interfering with labor?

Dr. G: I truly understand that women want to look their best when they deliver their baby. Having your hair done is just one way to make you feel better. Many women also want to keep up with trimming “down there” or shaving regularly. Jewelry is generally not a great idea as it can get lost easily. Make-up is generally safe as long as it’s not too heavy or runny, while nail polish should be fine as long as it can be easily removed if necessary for medical reasons.

(3) For personal grooming, is there a preferable way to go into labor? Does a Brazilian bikini wax make it easier to deliver or, if necessary, have a c-section?

Dr. G: Personal grooming is really a very personal decision and most doctors don’t care much about what, if any, kind of grooming you have “down there”. But before you groom, make sure it’s done safely because if not done safely it could increase your risk of injury and infections.

(4) How many people can join mom and dad in the labor room? What’s the most you’ve ever seen? What about young children?

Dr. G: Most labor and delivery units allow two people in the room, though some units allow more. You should ask your doctor or midwife about the policy at your hospital. In my experience, small children are not allowed for the delivery in most units.

(5) Can a woman eat her placenta? What steps need to be taken to make that happen?

Dr. G: Yuck! Why a woman wants to eat her placenta is beyond my understanding. There is no major culture in the world that includes women eating the placenta. There is no scientific study showing it’s safe or that there is a reason to do so. People who claim that there are some health benefits to eating the placenta either raw, cooked, or in capsule form have no scientific evidence to their claims.

(6) Is there any reason why you wouldn’t be allowed to breastfeed right away?

 Dr. G: We usually strongly recommend breastfeeding as early as you can. But this is not a must and you need to be up to it. In rare circumstances it might not be possible to do this like after certain cesarean sections, if there are medical complications, if you are HIV positive, or shortly after general anesthesia.

(7) What is the deal with letting the umbilical cord hang out (“lotus birth”)? Would you let someone do this?

Dr. G: We now know that delayed cord clamping of up to one minute after delivery improves the baby’s outcome, as long as the baby is stable and healthy and does not need resuscitation. Anything beyond a minute has not been proven to add any benefit to the baby.

(8) What’s the craziest thing you’ve ever been asked to do or allow during labor?  

Dr. G: Recently, I had a patient who touched herself and stimulated her clitoris in labor and said that it makes her feel better and improved her discomfort. That was a first to me. She eventually had a quick delivery with a healthy baby.