How to Plan for Common Labor Complications

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1Creating a Useful Birth Plan

2Preparing For the Unexpected

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If you're expecting a baby, you're probably learning about how to prepare for labor and delivery. While many women experience labors or births that go as planned, common complications can come up. This is why it's helpful to think about how you'd like labor to progress. Write a birth plan that informs your health care providers of your preferences and talk with them about how common complications are handled. Remaining flexible and positive about your labor will also help you feel more confident and prepared.

Steps

Method 1

Method 1 of 2:

Creating a Useful Birth Plan

1. 
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   Determine where you'd like to give birth. Women have many options for where they'd like to deliver. For example, you could choose a hospital, birth center, or home birth. If your doctor or midwife feels that your pregnancy and labor are at risk for complications, you may be urged to labor at a hospital that is near a children’s hospital. If your pregnancy is low-risk, choose a location where you'll feel the most comfortable.

   • If you're concerned you'll have complications during labor or would like pain management, you'll probably want to deliver at a hospital.
2. 
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   Choose your support person. Choose someone that you feel comfortable with to be there for you during labor. This could be a spouse, partner, relative, or close friend. You could also hire a doula or someone trained in labor support to be there with you. Your support person should know your preferences for labor and delivery. If complications arise, they should be useful in communicating your desires to medical staff.

   • If you choose a relative or friend, keep in mind that they will have to be able to attend your labor with short notice.
   • A doula can be a great source of support for you, even if you don’t have complications during labor.
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3. 
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   List your planned style of delivery. Even the most basic birth plan should include how you'd prefer to deliver your baby. While you can list your first choice, it's also a good idea to mention scenarios in which you'd be alright with other delivery methods. For example, if a C-section is recommended because of a labor complication, you could say you would like:

   • A second opinion
   • To remain conscious
   • To ensure that there are no other delivery options
4. 
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   Create a strategy for pain relief. Decide what pain relief you'd like during labor, so you can inform your medical staff or support person. For example, if you'd like an epidural, your health care provider can talk with you about the benefits and drawbacks of a walking or standard epidural. Or, you may choose to utilize other pain-relieving techniques. If you'd like to avoid medication or if your labor progresses too quickly for an epidural, you could try:

   • Breathing techniques
   • Hot shower therapy
   • Hypnosis
   • Meditation
   • Massage
   • Walking
   • Music
5. 
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   Discuss strategies to avoid episiotomy. An episiotomy is a surgical cut made to enlarge the vaginal opening during delivery. You should only get one if it is medically necessary, so speak to your healthcare provider about avoiding one if possible. You can decrease the risk of needing an episiotomy by choosing an upright position while giving birth, having a water birth, doing perineal massage, and being patient while pushing.

   • In some cases, an episiotomy is medically necessary, such as if you or your baby are in distress.
6. 
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   Be realistic about your birth plan. Understand that your birth plan lists your preferences about how labor should go. Your birth plan is not a contract guaranteeing specific services, so try to avoid using language that's demanding. If complications come up, your healthcare provider may need to intervene or give medical assistance that's not listed on your birth plan.

   • Remember that your healthcare provider should make an effort to respect your preferences. But if your health or the health of your baby is compromised, the healthcare provider may need to give a different treatment.
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Method 2

Method 2 of 2:

Preparing For the Unexpected

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   Ensure you have access to medical care. If you're planning on delivering at a hospital, you'll be surrounded by a trained support staff. If you're planning on a home birth or birth center birth, talk with your doula or midwife about what urgent medical services are available if a complication comes up.

   • For example, many birth centers are located next to a hospital. This makes transportation to the hospital for urgent treatment very easy.
   • You should also make sure there is a children’s hospital located near the place you plan to give birth in case any complications arise with the baby.
2. 
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   Discuss common complications. Before your due date, talk with your healthcare provider and support person about possible complications that could come up during labor. Ask about the likelihood of complications, how they're usually handled, and talk about how you'd like them managed.

   • Common labor complications include labor that does not progress, your water breaking early, perineal tears, excessive bleeding, perinatal asphyxia, and an abnormal heart rate for the baby. Address each possibility with your healthcare provider and have a plan for each complication.
   • Ask your healthcare provider if they have a birth plan they'd like you to fill out. You can discuss your responses to ensure that you're agreed about the treatment you'll get.
3. 
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   Remain positive about labor. It's easy to read about complications and become fearful about labor. Remind yourself that you're prepared to give birth and you've surrounded yourself with people who know your wishes. Keep a positive mindset and realize that you and your baby will be cared for whether or not you develop complications during labor.

   • For example, instead of saying, "I will not get a C-section under any circumstances," you might say, "I hope to avoid a C-section, but would accept one if the health of my baby is compromised."
4. 
   4
   Be flexible about your expectations. It's difficult to know how your labor will actually progress. This is why it's important to be open to suggestions from your health care providers. If a complication comes up, you may be urged to try a different labor strategy.

   • For example, if you plan on laboring on a birthing ball, but the baby is turned differently (malpositioned), you may be told to labor on your knees in an attempt to help the baby turn.
5. 
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   Make plans for your support partner. If complications arise, your support partner may feel like they don't know how to help you. Make it clear in your birth plan how your support partner can be there for you and your baby. For example, you might have your support partner:

   • Stay with you during a C-section
   • Hold the baby if doctors are caring for you
   • Contact family members to discuss the labor
6. 
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   Create a support network. Before you go into labor, talk with friends or family members about how they can help out. You'll probably have people offer to bring you meals or help out once the baby arrives. If complications arise during labor and you'd like additional support, have your support person call these people and explain what's going on.

   • For example, your support network could show up and provide emotional support after a difficult labor. Or you could ask them to look after your other kids if your labor is prolonged or you end up needing a C-section.
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