Things to talk about

Talking with your care team about your values and preferences is an important part of shared decision making. This list may help you talk with them about how you would like your labor and delivery to go, and what you would prefer if something unexpected happens.

Method of Delivery

Vaginal Delivery

This is the recommended method of delivery for uncomplicated births since it has fewer risks and faster recovery than Cesarean delivery.

Cesarean Delivery

A Cesarean delivery, also known as a C-section, is surgical delivery of a baby through an incision in the mother’s uterus and abdomen. Approximately 30% of babies are delivered this way. It is only recommended if it is safer for mother and baby than a vaginal birth.

Trial of Delivery After Cesarean (TOLAC)

If you have had a previous C-section, you may choose to have another C-section or you might consider a Trial of Labor After Cesarean (TOLAC) to have a vaginal delivery. This is a safe option for many women and 60-80% who attempt a TOLAC have a successful vaginal delivery. Your care team will talk with you about the risks and benefits of this option for your particular situation.

Pain Management

Medication

Many types of medication can ease pain during labor and delivery. Some of the more common choices are epidural and spinal blocks. Other options include local anesthetics, opioids, a pudendal block, and nitrous oxide. Each of these options has pros and cons and potential side effects.  It is important to talk with your care team about what is right for you.

Non-Medication Methods

If you would prefer not to have pain medication, you have other options. These include breathing techniques, massage, meditation, and others. Discuss with your care team what methods are available at the hospital where you plan to give birth.

Episiotomy

An episiotomy is a surgical cut in the perineum, the area between the vagina and anus, as the baby’s head is delivering. Most women do not need an episiotomy but there are some situations where it is necessary. You care team will discuss this with you if they think it is needed.

Fetal Monitoring

Fetal monitoring is the process of checking the baby’s heart rate to make sure everything is okay during labor.  Your care team may check the baby’s heart rate periodically or they may want to monitor the heart rate continuously. Your care team may discuss this with you in advance if they think it will be necessary or may talk with you about it if it becomes necessary during labor.

Labor Induction

If your care team is concerned for your safety or your baby’s safety, in certain circumstances they may recommend inducing labor. There are several methods of inducing labor and some serious risks associated with it. It is not an option for every woman but if it is an option for you, your care team will talk with you about whether or not it is best for you and your baby.

Assisted Vaginal Delivery

Two types of assistance—vacuum suction and forceps—are sometimes done during a vaginal delivery if labor is not progressing or if the baby’s health depends on immediate delivery. Both types of assistance use an instrument to help guide—not pull—the baby through the birth canal. Assisted delivery can help some women avoid a C-section. If this is an option for you, your care team will discuss the potential risks and benefits with you.

Feeding Plan

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of a baby’s life. Most women (94%) need help with breastfeeding so it is important to talk with your care team and learn as much as you can about it before your baby is born. If you decide not to breastfeed, talk with your care team about which formula is best for your baby.

For Baby Boys: Circumcision
Circumcision is the surgical removal of skin from the tip of the penis. It is usually done in the hospital a few days after birth. There are some health benefits associated with circumcision and some risks involved. If you have any questions about the procedure, talk with your care team.