Preparing for Childbirth: 11 Things to Do Before Your Baby ComesMarch 12, 2020 - Dr. Elizabeth Mosier
Pregnancy is full of surprises and every baby is different. Finding out your baby's gender, discovering your little one's passion for 3 a.m. rib kicks and trying to determine when you will finally get to meet him or her is fun but — sometimes stressful.
I always tell my patients that, despite our best efforts, a lot of the time…baby is in charge. Pregnancy is both awe-inspiring and humbling, and babies have a knack for teaching moms (and me) to "go with the flow."
However, preparing for childbirth and staying organized can provide a sense of calm and control during the whirlwind that is pregnancy.
As you approach your third trimester, there are a lot of things to set up before your baby's arrival. While you don't need to get everything done right at 28 weeks, I do recommend getting started a little at a time to keep it from becoming overwhelming — and to avoid stress if your baby decides to come earlier than expected.
Register at your hospital
No one wants to show up with contractions and realize there's a pile of paperwork waiting. You'll want to register at your hospital well in advance. The best time to preregister is ideally before your third trimester (between 20 and 26 weeks) to avoid any hiccups. In fact, at your first OB visit, you may want to ask for your registration pack — that way you can complete it when you have time.
Take a hospital tour
Touring the labor and delivery unit at your hospital helps you get an idea of what to expect, where to go and will likely help you think of questions you didn't even realize you had. The nursing staff will show you the triage, labor and delivery, and the postpartum unit. They'll talk to you about when to call your doctor and when to go to the hospital. They also can talk to you about what equipment and staff is available on-site to support you while you are in labor, such as wireless monitoring, aromatherapy, birthing balls, squat bars, and mirrors to keep you motivated while pushing. The tour also helps you get to know the nursing staff. You might even see a friendly face from your tour during your delivery.
Attend child birth classes
I encourage all of my patients to attend child birth classes in the third trimester. Being a new mom can be rough, and classes can help you prepare for labor, caring for a newborn and breastfeeding. It's also always a good idea to take an infant CPR class. You never know when you could save the life of your (or another mom's) baby.
Choose a pediatrician
While your OB doctor will love to "ooh" and "ahh" over those cute little fingers and toes, you will want an excellent pediatrician to provide your newborn's care once your baby is delivered. Your OB doctor can provide you with a list of offices that he or she has worked with in the past. I recommend you speak to your family and friends to see who might fit you best.
You'll want to contact the pediatrician's office to inquire about its new patient process and make sure the practice is in-network with your insurance. Many pediatric offices also offer a "meet and greet" visit to see if you like the provider. Generally, this visit is a quick one, but it can help you get a sense of the pediatrician's personality and clinical approach and you can ask a few questions.
Your pediatrician does not necessarily need to have privileges at the hospital where you are planning to deliver. Many hospitals have pediatricians on staff for deliveries and newborn care in the hospital. If your pediatrician does have privileges at your hospital, he or she can see your baby in the hospital. If not, the hospital pediatrician will care for your newborn until discharge, and your pediatrician will see your baby once you leave the hospital.
See a lactation consultant
Breastfeeding is amazing. It provides your baby with essential nutrients, boosts his or her immune system, promotes mother-baby bonding, and, to top it all off, it's free. That being said, breastfeeding is not always easy and can be a serious source of stress. I encourage all my new moms, and any mom who has struggled with breastfeeding in the past, to see a lactation consultant while in the hospital (your doctor can arrange this) and after discharge home.
Do your breast pump research
A breast pump can be a lifesaver for many moms. From engorgement and plugged ducts to inverted or flat nipples, a breast pump can help you build or maintain your supply of breast milk. If you need to return to work, travel or be separated from your baby, a breast pump can be essential.
You can choose to buy or rent a breast pump. Most insurance covers the cost to buy an electric breast pump. The USDA's WIC Program can also help pay for a breast pump and supplies. Your doctor can provide a prescription for a breast pump in the third trimester. Please communicate with your insurance provider, as it may limit which brands are available. Your insurance may not deliver your breast pump until the last few weeks of pregnancy.
There are many excellent brands of breast pumps, and we recommend checking reviews and speaking to your family and friends to decide which breast pump best suits you. Choosing a breast pump is very personal and there is no perfect choice. Breast pumps are medical devices and generally cannot be returned once opened, so make sure to research your choice.
If you decide to rent or borrow a breast pump, you will want to make sure to get one meant for multiple users or a "hospital grade" pump. These types of pumps will require a new set of tubing and breast shields for each new mom to decrease the risk of infection. You can rent a breast pump from some baby supply stores, medical supply stores, lactation consultants or hospitals.
You do not have to bring your breast pump to the hospital — one will be provided to you while in the hospital if needed. However, if you would like help learning the set-up and use of your breast pump, you can bring it and a lactation consultant can assist you.
Choose and install a car seat
You will need have your car seat ready and installed prior to leaving the hospital, so make sure to get this process started in advance. Car seats should be installed in the back seat and facing the rear of the car. You will want to try locking and unlocking the buckle and changing the length of the straps in the store. Check the seat's height and weight limits to see when you will need to change it as your newborn grows. If you are buying or borrowing a used car seat, check the expiration date and make sure it has not been in an accident.
Make sure to register your car seat with the manufacturer or online to get updates and recall information. Once you have installed your car seat, you can take it to an inspection station to ensure everything is ready for your first ride home from the hospital.
More information on how to pick a car seat can be found on the National Highway Traffic Safety website.
Pack your baby bag
You don't want to scramble to pack after your water breaks. There are never-ending lists and videos online for what to pack in your hospital bag. Here's a common favorite: www.whattoexpect.com/pregnancy/checklist/hospital-packing.aspx.
You'll want to bring your important documents like ID, insurance cards and birthing plan, as well as your phone or camera. You can bring your own hospital gown if you choose, but be aware that labor can be messy. I recommend bringing something to keep you occupied during long labors. Most hospitals have TV and DVD players, but a laptop, book or set of cards can go a long way.
Loose-fitting maternity clothes are important. Your abdomen will not shrink immediately after delivery (usually it returns to about the size that you were at six months of pregnancy), and you'll want to be comfortable. Don't forget your nursing bra and nursing pillow.
If you have any special prescriptions or inhalers, you will want to bring them to the hospital. While hospitals can provide most prescriptions, sometimes a substitution will be made.
Your baby will need a change of clothes for leaving the hospital, mittens/socks and a baby book if desired. The hospital will provide you with sanitary pads, lanolin cream, diapers, wipes, blankets and bottles/pacifiers/formula if needed. Leave valuables like jewelry at home.
Create your birth plan
Because childbirth can be unpredictable, the best birth plan is a flexible one. Emergencies can happen and your safety and your baby's safety always come first. That being said, a birth plan is a valuable tool for you to prepare for your delivery. It opens discussion and communication among yourself, your partner, your OB doctor and your nursing staff about your values and preferences.
Your hospital, your OB doctor and your risk factors may limit what options are available, so I encourage patients to discuss their preferences with their doctor. Your birth plan generally is an ongoing discussion both before and during labor, and it's okay if your decisions change.
Generally, interventions like episiotomies, vacuum or forcep deliveries, and cesarean sections are limited to when they are medically necessary. Your doctor should discuss these interventions with you if they become necessary.
Otherwise, there are a number of things to consider, including:
- Do you want to wait for natural labor, or do you want to have an elective induction, or do you have medical problems that require earlier delivery?
- Do you want to go "all natural" or have pain medications?
- What visitors do you want in the room?
- Who do you want to cut the cord?
- Do you want to do cord blood banking?
- Do you want to hold your baby immediately after delivery, or would you prefer that he or she be cleaned and weighed first?
- What are your plans for breastfeeding?
- If your baby is a boy, do you want to circumcise or not?
Thinking about these questions in advance can really be helpful for determining what is (and what is not) important to you.
Think about pain management
All labors are unique, and pain levels can vary. Some patients may prefer to go "all natural." There are several pain management techniques, including Lamaze and the Bradley method, which use movement, positioning, breathing and massage. If you're planning to go all natural, I do recommend going to classes to prepare.
Anesthesia is also available in several forms. Your choice of anesthesia may depend on how far your labor has progressed and any medical complications.
An epidural is placed by an anesthesiologist to numb the pain of contractions and delivery. An epidural does not affect the baby, and evidence shows that epidurals do not slow down the progression of labor, either. An epidural can have occasional side effects, including low blood pressure or headaches. These are frequently treatable with IV fluids, but sometimes may require other interventions.
IV pain medications are also available to help with the pain of contractions. However, because IV pain medications go through the bloodstream, they can affect the baby. IV pain medications are typically not given close to delivery as they may affect your baby's ability to breathe and cry after delivery. IV pain medications can make you feel drowsy, dizzy or nauseous.
Local anesthesia, or a pudendal block, is an injection of pain medications into the nerves to help numb the pain of delivery. It does not help with contraction pain and is used just before delivery.
Consider cord blood banking
Cord blood is the blood from the baby that is left in the umbilical cord and placenta after birth. It contains stem cells that can be used to treat some types of diseases. There are many different private companies that offer cord blood banking to families. If you choose to bank, please let your doctor know and bring your kit to your delivery. You may also consider donating cord blood, if you are interested.