It’s hard to overlook the articles circulating on social media right now. Miralax is under fire -for good reason- and parents are crying out for another answer to their child’s constipation issues. I feel the need to speak out on this because so many families don’t think to talk to a chiropractor about this problem.
I see many families who do come in with an infant begging, “Help her poop!” And the relief I hear in their voices later that day (when they call to excitedly thank me) is wonderful! When taking care of a new baby, you follow their bowel movements so closely, and you notice every tiny struggle. But something happens after the diapers come off, when the babies turn to children. Somehow parents miss the constipation until it turns in to chronic stomach aches, backaches, crying, and debilitating pain. By this point, parents are reaching for any over-the-counter option they can find – suppositories, laxatives, miralax, whatever looks promising… but there are better options.
While you can read more about natural options on the blog HERE and HERE, I have yet to break down solely why chiropractic care is a very important factor in aiding a child’s digestive system and can be key in getting them to have a bowel movement regularly.
Research shows that between 5-28% of children today suffer from chronic constipation. These children worsen the cycle by fearing to go when the feeling arises due to the pain. But regular chiropractic care can help.
A chiropractor finds the subluxations – think ‘energy blockers’ – within the body. These blockages prevent the nervous system from completing its job of firing neurons to their destination in a timely manner. As the nervous system controls everything within the body, this can be detrimental, and can surely effect the gastrointestinal track. Typically, patients suffering from constipation are found to have subluxations through the center and lower portions of the spine. These areas are linked to the colon and intestines, and a subluxation within this area causes inflammation, which can trigger constipation. A gentle chiropractic adjustment can be enough to allow for easy bowel movements again.
It’s important to note that chiropractic care is not a one-time-fix. Regular visits are needed to maintain proper alignment within the body. This, combined with a diet void of dairy, processed foods, and high in protein, fiber, and real whole foods may be enough to keep a child using the bathroom regularly.
By Dr. Skylar Kulbacki
MiraLAX is a commonly prescribed over the counter (OTC) medication that is becoming more popular among pediatricians for the treatment of constipation in their young patients. A laxative intended for adults, MiraLAX is now being prescribed to children and infants as young as a few weeks old.
The effectiveness and safety of MiraLAX and its active ingredient polyethylene glycol 3350 (PEG) has not been tested in children.
“Safety and effectiveness in pediatric patients has not been established.” 
Even though there have not been any studies to confirm the safety of the use of MiraLAX in the pediatric population, it does not stop many pediatricians from suggesting to parents to put their children on long term regimes using this potent drug. There have even been protocols created by The Seattle Children’s Hospital for long term use of MiraLAX, up to 12 months , even though it states directly on the label to not use the medication for longer than 7 days.
The cutout from the MraLAX product label .
What is this dosage doing to our children? Is it necessary?
How does MiraLAX work?
• PEG, the active ingredient in MiraLAX, is an osmotic laxative. This means that it acts by stimulating the intestines to pull in water from the body, softening the stool and allowing for an easier bowel movement. By pulling this water from the body and into the intestines, the risk for becoming severely dehydrated and experiencing electrolyte disturbances is greatly increased.
What does this mean for my child?
• By treating the symptom and not the source of constipation, a child may be at risk for developing long term complications due to chronic constipation and/or laxative use.
• The effects of prolonged and habitual use of MiraLAX is unknown, but due to its properties, this drug can at the very least cause dehydration, malnutrition, and Gastrointestinal dysfunction in a child.
• The body becomes accustomed to the stimulation provided by the medication, and constipation is likely to persist in the absence of laxative use. This creates a physical dependency upon laxatives to create a bowel movement at all.
How to help your child suffering with constipation:
• If your child is currently being treated for constipation using MiraLAX or another laxative, speak to your pediatrician about weaning your child off these medications safely.
• Try to figure out why your child may be suffering from constipation:
o Is your child drinking enough water throughout the day?
Kids Total Daily Beverage and Drinking Water Requirements:
4 to 8 year old Girls and Boys need 5 cups a day
9 to 13 year Girls need 7 cups a day
9 to 13 year old Boys need 8 cups a day
14 to 18 year old Girls need 8 cups a day
14 to 18 year old Boys need 11 cups a day
o Is your child eating a diet consisting of naturally binding foods?
o Does your child eat enough fiber each day?
o Does your child get enough physical activity throughout the day?
Daily physical activity and exercised helps to keep the bowels healthy and regular.
• If your child is still suffering from constipation after a change in diet, increased water consumption, and daily physical activity there are safe and effective options for promoting a healthy GI and regular bowel movements.
o A daily probiotic will help to feed the GI and creates an environment for regularity.
o Chiropractic care can remove any restrictions the body may have creating improper nervous system communication that directly regulate the bowel and GI tract.
o A gentle belly massage using lavender oil can help to stimulate a bowel movement. Working from the child’s right lower belly and massaging little circles with your hands in a clockwise motion in an upside-down U will help to ease discomfort and encourage a bowel movement.
Children should be having a bowel movement every day at the very least. For infants, it is more, at least 2-3 times each day. Feces are filled with toxins and it is vital to health that bowel movement are occurring daily.
1. Breckenridge Pharmaceutical Company. “Polyethylene Glycol,” Drugs.com, last revised Februaray 2016, [link].
2. Seattle Children’s Hospital Research Foundation. “Constipation Treatment Recommendations When Child is Over One Year of Age, for New Diagnosis or Recurrence of Symptoms. [link]
3. “Stop use and ask a doctor if you need to use a laxative for longer than 1 week,” MSD Consumer Care, Inc., “Directions,” “Warnings,” MiraLAX product label, [PDF file].
4. Academy of Nutrition and Dietetics. “Water: How Much Do Kids Need?”, eatright.org, last revised May 2015, [link].
Medication is not the first resort.
I have several clients who came to my practice with a medicine cabinet full of prescriptions to help them be ‘healthy.’ It’s funny isn’t it; how many drugs a person must take to counteract the problems occurring within the body? The truth is that these drugs typically act as a mask. They may lessen symptoms and appease doctors, but do they actually aid in solving the root of the problems?
Let’s talk about what blood pressure is.
“When your heart beats, it pumps blood round your body to give it the energy and oxygen it needs. As the blood moves, it pushes against the sides of the blood vessels. The strength of this pushing is your blood pressure. If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and this may lead to heart attacks and strokes.”
There are two readings you need to understand when having your blood pressure taken: Systolic (SBP: the higher number) and Distolic (DBP: the lower number). Your Pulse Pressure is the difference between these two numbers. While a systolic number above 140 (hypertension) places an individual at higher risk of problems, the greater the pulse pressure, the higher the risk factors become.
Hypertension exists in two stages:
Stage 1: SBP 140-159 or DBP 90-99
Stage 2: SBP > 160 or DBP > 100
Instead of reaching for the medication, let’s look at the main underlying causes to hypertension:
- Physical Inactivity
- Sleep Apnea
- Chronic Kidney Disease
- Primary Aldosteronism
- Thyroid Issues
There are many other reasons an individual may be experiencing hypertension, but altering the current lifestyle should help immensely.
More than 15% of deaths today are linked to high blood pressure. Remember that hypertension triggers strokes, heart attacks, aneurysms, cognitive decline, and kidney failure. According to the American Heart Association 28% of Americans have high blood pressure and don’t even know it.
Even if you are not actively hypertensive, it may be time to evaluate your lifestyle to see how you can prevent it from occurring in the future.
Things to consider when trying to lower your blood pressure:
NIH recommends the DASH diet rich in fruits, vegetables, fat-free or low-fat milk and milk products, whole grains, fish, poultry, beans, seeds, and nuts. Personally, I tend to recommend skipping anything labeled ‘low-fat’ or ‘fat-free’ and stick with real food, as opposed to altered, processed foods that contain food substitutes.
Foods to avoid: alcohol, processed foods, sugar, trans-fats, caffeine, excess sodium.
According to the Mayo Clinic, “Regular physical activity — at least 30 minutes most days of the week — can lower your blood pressure by 4 to 9 millimeters of mercury (mm Hg). It’s important to be consistent because if you stop exercising, your blood pressure can rise again. Exercise can (also) help you avoid developing full-blown hypertension. If you already have hypertension, regular physical activity can bring your blood pressure down to safer levels.The best types of exercise for lowering blood pressure include walking, jogging, cycling, swimming or dancing. Strength training also can help reduce blood pressure. Talk to your doctor about developing an exercise program.”
SUPPLEMENTS (Always talk to your doctor about adding supplements into your routine)
The following are all linked to lowering blood pressure:
- Fish Oil
- Coenzyme Q10
- Cat’s Claw
- French Lavender
- Celery Seed
- Deep Breathing
- Quit Smoking
- Lessen Chronic Stress
- Get More Sleep
Several studies lead to the same conclusion: Chiropractic care, in combination with a healthy diet and lifestyle, can aid in lowering blood pressure. More research needs preformed, but from personal experience, I believe that these three categories (along with adding homeopathics, acupuncture, and supplements) will keep the medications far from your body.
Giving birth is an intense experience in which the body pushes itself, causing stress and pains to the mother that can last well after the baby arrives. Even if no immediate pain is felt, there is still need for chiropractic care during the postpartum period.
I often explain to my clients that after having a baby, the body needs time and help to reach its full potential again. So many women complain about things never being the same, or that back, hip, pelvic, or wrist pain intensifies instead of dissipating. Considering all the body has been through during pregnancy: the hips widening, additional weight being carried, a postural shift, hormonal changes, and other ailments, it is easy to understand that the body may be out of alignment. When you then add hours of contractions, pushing, and birth into the equation, it’s clear that one of the first trips out of the house after having your baby should be to the chiropractor.
Did you know?
A woman’s pelvic biomechanics can be altered during birth. As the baby descends, especially if he is posterior (sunny-side-up), the bones of the pelvis can shift and become misaligned.
Chiropractic care can manipulate the pelvic bones, restoring balance and comfort.
Throughout the last few weeks of pregnancy that lead to labor, the following occurs:
• Hormones work to soften the ligaments between the bones in your pelvis which allows for the pelvis to shift, granting additional room for the birth. This can cause soreness in some women. These hormones are not only released to the pelvic region, but the entire body is affected. This means that all ligaments have the opportunity to become looser, weaker, or less effective. This puts you at an increased risk of injury, inflammation, and pain at all joints of the body. These hormones commonly cause instability and abnormal motion of the sacroiliac joint, pubic-symphysis, and other joints that can cause lasting pain.
• Baby drops lower into the pelvis, engaging for birth. This shift or drop can cause further stress on the body, as the mother alters her posture to accommodate this extra weight and different position from baby.
• Braxton Hicks contractions. These are the body’s way of preparing birth, and they can be both positive and negative. If brought on by dehydration, stress, over-working, or exhaustion, the body will not be working as a whole. Maintaining a healthy diet, proper sleep, and daily exercise should help keep Braxton hicks contractions to a beneficial amount.
If birth was difficult or traumatic, the spine and pelvic joints large challenges to overcome.
Once the baby has arrived, a mother’s center of gravity is altered drastically, causing her to even walk differently. Her hormones rollercoaster, and her body works toward nourishing the baby. Holding this new baby can shift the posture and strain the wrist, neck, or back. Failure to restore normal biomechanics may result in permanent health problems in need of medical intervention.
The jury is still out on exactly how long the hormone relaxin can affect the body postpartum. If it is still present, the ligaments of the body will not completely tighten. Research shows that the ligaments begin to re-tighten nearly 8 weeks after giving birth, but the process’ length can be different for each woman, taking up to a year or more. It is critical to work with a qualified chiropractor before ligaments begin to pull back, as it can cause long-term problems if the joints are not properly aligned.
During the postpartum period, chiropractic adjustments speed recovery time, aid the body in normalizing pelvic and spinal positions, and help correct the posture. Seeking chiropractic care within the first two weeks after giving birth may help to prevent headaches, shoulder problems, neck discomfort, muscle tension, lower back pain, sciatica, upper back pain, wrist and elbow pain, and more.
When pregnant mothers frequent my office, we often discuss their birth plan along with their pregnancy experience. Typically, women committed to chiropractic care are of the more natural mindset and plan for unmedicated births whenever possible. One of the biggest pieces of advice that I offer is to hire a doula. Not just any doula, but a doula who you feel connected with.
You will read about how a doula will support a birthing mother and help educate couples about birth; some are even known as postpartum doulas and help after the baby is born. But what you will not read is about the emotional support, the true in-the-moment help that a doula provides. There is an unselfish act of giving herself – her entire being – to ensure that a mother brings her child into the world safely, and as peacefully as possible. A doula does not push her believes or choices on families, but instead, she accepts and fights for what a mother wants. She will spend hours, even days, foregoing her own needs to support the birthing mother. These are the events that the research cannot tell you.These are the stories you must hear from mothers who have given birth with a doula present.
There is also a science behind childbirth and doulas. Actually, there is quite a bit of science. Researchers have studied how doulas impact birth, and the results are nothing less than I would expect. Labors involving doulas are significantly shorter with greater progress (dilation) made before entering a hospital or place of birth – and far more progress before the accepting of medical interventions (epidural). Research also shows the having a doula lowers the risk of an unplanned cesarean section and increases APGAR scores at both 1 and 5-minutes post-birth.
to a 2013 study published in the Journal of Perinatal Education, “Doula-assisted mothers (are) four times less likely to have a low birth weight (LBW) baby, two times less likely to experience a birth complication involving themselves or their baby, and significantly more likely to initiate breastfeeding. Communication with and encouragement from a doula throughout the pregnancy may increase the mother’s self-efficacy regarding her ability to impact her own pregnancy outcomes.”
It is more than just emotional, physical, and educational support that a doula gives to a birthing woman. She is her advocate. Her voice helps account for the reduced need for interventions during birth, less complications, and an overall happier experience during and after birth.
Research shows that doulas create a:
- 12% increased chance of spontaneous vaginal birth
- 28% decreased chance of c-section
- 31% decreased chance of accepting an epidural
- 34% decreased chance of being unhappy with the birthing experience as a whole
It is important to note that doulas can be utilized for any birth situation. A planned c-section still needs support and advocating – just as much as an unmedicated vaginal birth.
I feel as though many couples are afraid of having “another body” in the room with them, but to these couples, I encourage you to reach out and interview doulas in your area. The right doula will never feel like a body taking up space, but as a partner in your birthing team. Hospital nurses have been reduced and their time is spread thin. The days when a nurse was by a woman’s bedside throughout her labor as a supportive figure are gone. This paired with our society’s need to intervene with the birthing process, leaves many couples feeling defeated. A feeling that belongs nowhere near pregnancy, labor, or birth.
One of the largest take aways from the research is this: There is absolutely zero harm that has been proven in having a doula present for birth.
Not every birth is traumatic, but many are. What is a traumatic birth, you ask? The term is subjective to each woman (and baby) who experiences the birth. While one mother may consider a 48 hour natural labor traumatic, another may not. The key is to understand that a traumatic experience depends on how a woman feels about her birth. Were forceps or a vacuum unexpectedly utilized? Was an episiotomy given without consent? Was baby ‘stuck’ at an odd angle for a prolonged period of time? Not one mother will share the same story, but thousands can share their version of traumatic birth.
A birth that doesn’t go as planned can cause post-traumatic stress disorder, postpartum depression, impact the breastfeeding relationship or milk production, effect relationships -including the bond between mother and baby, have physical implications for mother and/or baby, and have lifelong effects that can impact both mother and child.
It is assumed, through little research, that at least 1-2% of all mothers develop post-traumatic stress disorder after a difficult birth. With the lack of ample research done in the field of traumatic birth experiences and their overall impact on mothers and infants, I choose to believe in the word of the mothers and the physical differences I see in these families after their traumatic births. I have witnessed many infants in need of immediate chiropractic care after their challenging entrance to the world, and I have also seen many who have managed to only need a slight adjustment. The thing to remember is that it is important to be seen by a good family chiropractor.
According to a 2004 study, an undefined prolonged second stage (pushing) of labor results in the use forceps. (This is a topic for another post, as there should be several natural things done prior to grabbing forceps.) The use of forceps is linked to facial injuries, cranial distortions, injuries to the brainstem and spinal cord, and subluxation to the infant. They are also linked to meningeal tears and injuries to blood vessels, muscles and ligaments, and the nerves and bone structures. The same study included the possible side effects of utilizing a vacuum for extracting a baby during birth. This is linked to cephalohematomas, lacerations, and subluxation.
Keeping in mind how subluxations tend to run hand-in-hand with sensory processing disorder, adhd, sleep issues, and so many other common chronic problems children are faced with today, it is not a far stretch to consider that a child’s birth may be the origin of these problems.
Erb’s Palsy, “a form of obstetric brachial plexus disorder (A plexus is a network of nerves that supplies a specific area of the body), is an injury that occurs when the nerves in a baby’s upper arm are damaged. It typically affects one or two of every 1,000 babies. The injury usually occurs as a result of a lesion at Erb’s point, the area near the baby’s neck where the fifth and sixth cranial nerves merge to create the upper point of the brachial plexus.” This is caused by one or more of the following, with birth trauma being the most common:
The use of forceps and/or vacuum extraction tools during delivery
Large infant size
Small maternal size
Excessive maternal weight gain
Second stage of labor lasting over an hour
Infants with high birth weight
Infants in the breech position
While chiropractic care may not cure severe cases of birth traumas, it is a tool that may provide help in lessening symptoms, improving the quality of life, and allowing the body to be in its best alignment possible.
Birth trauma is often overlooked by doctors as the cause of chronic problems, and over time, as the child grows, it becomes a thought less considered. But the truth is that birth trauma is real, and the impact it can have on a mother or child needs to be addressed. Psychological therapy, physical therapy, chiropractic care, acupuncture, and other healing techniques should all be considered following an extremely difficult birth.
The rate of surgical births (c-sections) has declined from 32.2% to now 32.0% (as of 2015); a statistic that means close to 1 in 3 pregnant women will still be in the operating room to bring their baby into the world. While there are numerous ways to help prevent this from happening to you, the top of the list includes being educated. Understanding pregnancy, labor, birth, and the natural abilities of the body can lower the risk of delivering via c-section. However, the odds are against so many mothers, and unfortunately many of the mothers and infants in my practice began seeking my care after experiencing a surgical birth.
One of the first questions that I am asked by these mothers is, “Can I see a chiropractor after having a c-section?” The answer is an overwhelming, “Yes.”
There are several reasons for a c-section to take place, but even when completely necessary, the mother and newborn may have negative side effects. Chiropractic care can be life-changing for these families suffering from daily pain and problems with their baby.
During a C-Section:
· An epidural is given. This can cause issues within itself for both mother and baby in relation to chronic pain after delivery.
· The baby is pulled from the womb through a small incision, which means that the neck and head are forced into an unnatural angle, the plates of the skull do not experience the pressure they need for proper placement and development, and the lungs are not compressed through contractions as the baby passes through the birth canal. All of these issues are linked to weakening the immune system, as well as evoking stress hormones to be released.
You can imagine the impact this has on the infant’s alignment.
Babies born via c-section are at an increased risk of experiencing:
· Chronic Pain. Stress hormones are released and can cause mental and physical discomfort.
· Chronic Illness: Obesity, allergies, asthma, and diabetes top the list.
· Subluxations (neurostructural dysfunction) due to delivery method and position in the womb.
· Improper Microbiome Balance due to not passing through the birth canal and avoiding the absorbing of the mother’s bacteria meant to create the foundation of proper gut health in the baby.
Studies show that infants are affected for at least the first two year of life after being born by c-section. The research points to these problems continuing throughout childhood and into adulthood as well, but more time is needed to continue the studies.
Chiropractic care can eliminate the subluxations that cause the above-mentioned problems. Most women who choose chiropractic care do so because it is not invasive, there are no medications needed, and it is a safe and effective option for healing both mother and her baby. A highly-qualified family chiropractor can work wonders.
Sleep is a vital component to health, and it is not uncommon for women to have trouble sleeping during pregnancy. Physical, emotional, and hormonal changes during this time create stress on the body and nervous system, which consequently may make it more difficult for women to fall asleep and sleep soundly at night.
A sufficient amount of quality sleep for women is crucial throughout their pregnancy. Studies have found links between women with poor sleeping habits during pregnancy are at higher risk for birth complications such as low birth weight and pre-term births (University of Pittsburgh School of Health Sciences, 2013).
An added difficulty is that many conventional sleeping aids are not able to be utilized while pregnant. Luckily, there are several natural and safe remedies that women can utilize during this time in which sleep is crucial for both mom and baby.
Vital for promoting and maintaining bone health, vitamin D also plays an important role in neuromuscular functions, immunity, and reduction of inflammation. It is estimated that up to 50% of the general population is deficient in Vitamin D (Lee et al., 2008). Research indicates that insufficient levels of Vitamin D may negatively influence a person’s sleeping habits. A positive correlation was found between those with sufficient levels of Vitamin D in their system and an increase in their sleep quality and quantity (Blumberg et al., 2014).
Vitamin D is found naturally in very few food sources; the food sources with the highest amount of Vitamin D are fatty fish such as tuna, mackerel, and salmon. One of the best sources of Vitamin D is through sunlight. Our bodies are able to use the ultraviolet rays from the sunlight to synthesize its own Vitamin D, however, the average person does not receive enough daily sun light exposure to maintain adequate levels. Supplementing Vitamin D daily is often the most effective way of maintaining proper levels.
Epsom Salt Baths
Epsom salts are a naturally occurring mineral, magnesium sulfate, and has several beneficial uses. Magnesium is a natural muscle relaxant and when there is a sufficient amount in the body, it helps to promote production of serotonin, a calming neurotransmitter. When the body is under stress, it is depleted of magnesium, resulting in a decrease in serotonin levels as well. When added to a bath, Epsom salts are absorbed through the porous openings in our skin, soothing our muscles and decreasing stress levels (D.O., 2014).
Creating a nightly routine with Epsom salt baths can aid in better and more rested sleep. It is important to use natural Epsom salts without any added perfumes or artificial coloring, as these can be irritants to sensitive skin. If you do not have a bathtub, that’s okay, a foot bath with Epsom salts will do just as much good when it comes to absorbing the magnesium and soothing your nervous system.
Aromatherapy has been shown to have many beneficial physical, mental, and emotional effects to those who utilize it. Difficulty in falling asleep and sleeping soundly can often be linked to a nervous system under stress. If the nervous system is not able to relax, then the body and mind will not be able to relax either.
Studies have shown that the scent of lavender oil before bedtime, calms the body’s nervous system and puts it in a parasympathetic state (Sayorwan et al., 2012). The parasympathetic nervous system is commonly referred to the “rest and digest” nervous system. When in this state the body’s heart rate slows, blood pressure decreases, and an environment of relaxation is created for the body.
Lee, J. H., MD, O’Keefe, J. H., MD, Bell, D., MD, Hensrud, D. D., MD, & Holick, M. F., MD, PhD. (2008 December 9). Vitamin D Deficiency : An Important, Common, and Easily Treatable Cardiovascular Risk Factor? Retrieved January 4, 2017, from http://www.sciencedirect.com/science/article/pii/S0735109708031756.
Blumberg, M. S., PhD, Karlsson, K. E., PhD, & Seelke, A. M., MS. (2007). SLEEP – Vitamin D and Actigraphic Sleep Outcomes in Older Community-Dwelling Men: The MrOS Sleep Study. Retrieved January 04, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC428860
O. (2014, October 14). How Epsom Salt may help you (and your kids) sleep better. Retrieved January 04, 2017, from https://sleepsense.net/epsom-salt-may-help-kids-sleep-better
Sayorwan, W., MPham, Siripornpanich, V., MD, Piriyapanyaporn, T., BSc, Kotchabhakdi, N., PhD, Hongratanaworakit, T., & Ruangrungsi, N., PhD. (2012). The Effects of Lavender Oil Inhalation on Emotional States, Autonomic Nervous System, and Brian Electrical Activity. Retrieved January 04, 2017, from https://www.researchgate.net/profile/Tapanee_Hongratanworakit/publication/ 225051306_The_Effects_of_Lavender_Oil_Inhalation_on_Emotional_States_Autonomic_Nervous _System_and_Brain_Electrical_Activity/links/0fcfd51257861db827000000.pdf.
University of Pittsburgh Schools of the Health Sciences. (2013, July 17). Poor sleep in pregnancy can disrupt the immune system and cause birth-related complications. ScienceDaily. Retrieved January 04, 2017, from www.sciencedaily.com/release/2013/07/130717164725.htm
It can be so intimidating that most women forego writing one altogether.
Don’t let that be you. Skipping your birth plan means that you are skipping the educational aspect of giving birth. You are walking in blind – uniformed – and unprepared for the possibilities that lie ahead.
You may have the birth of your dreams without a birth plan in hand, but if just one domino falls, your birth has the chance of not being what you were hoping for. How does a birth plan change any of that, you ask?
Like most things in life, it isn’t so much about the end result, but the journey to get there. Your birth plan is a culmination of your research; a brief proposal of what you would like, how things should be handled, and how you deserve to be treated.
Before writing your birth plan, tour your birthing facility and schedule a time to talk with your doctor (or practice of doctors), or midwife. You cannot begin this until all of your questions are answered. You need to know what the standard of care is from the moment you enter the facility until the second you are wheeled out. (Are you allowed to walk out? -simple questions like that need to be asked too!)
Once you have a basic timeline of events, you can dig into the research and figure out your priorities. I have yet to ever see two identical birth plans.
Make sure to bring your birth team a copy of your plan after it is written. Pack a few copies in your birth bag and have your partner pull them out upon arrival when you are in labor. Everyone can receive a copy – the doctor, all nurses, anyone who enters the room can be asked to take 2 minutes to ‘Please review my partner’s birth wishes. We would really like to be team through this, and I want her priorities to be known. Thank you!’
Now it’s time to write.
The easier the plan is to read, the higher the chances are that it will be read. There are three basic formats to choose from:
Bullet Points: Simple, brief statements listed under different headings (example: Early Labor, Active Labor, 2nd Stage, 3rd Stage, After Delivery for Mom and Baby)
Chart: Each procedure listed with the mother’s thoughts or wishes next to it, in charted form.
Paragraphs: Harder and longer to read, paragraph format is typically done under headings like bullet points, but contains longer thoughts.
*Remember not to include WHY you are choosing these things, that does not matter. Keep is SIMPLE and include everything important to you.
A birth plan is not written in stone. No matter what though, YOU SHOULD NEVER BE PUSHED OR TALKED INTO ANYTHING. If situations arise, take the time to talk about your options, risks, and make informed decisions.
This is a sample birth plan. Yours will be your own, but feel free to start here and add/delete and alter as you see fit. It is based on a plan for a natural hospital birth without medical intervention. Remember, you may not agree with my plan, but that’s the beauty of it – you get to make your own!
SAMPLE BIRTH PLAN
I would like to have an unmedicated, peaceful birth with the help and support of you as my birth team. My partner and I are educated and understand that unexpected situations may arise. If anything occurs, please help us to continue on the most natural path as possible, granting us time to make decisions and supporting us through the process.
In case of emergency, save both mother and baby in any way possible.
*There will be a photographer with us, and she is allowed to stay with us in all situations.
- I would like to let labor begin naturally, even past my due date, and do not want any interventions to begin labor.
- If water breaks before labor begins, I would like 48-72 hours before any interventions are suggested. I agree to have my fluid levels monitored.
- If I arrive before active labor has begun, I would like to leave and come back further into labor – even if my water has broken.
- I deny antibiotics for GBS and will watch for fever and signs of illness after birth.
- I would prefer no heparin lock be put in place, but will compromise if an IV will not be attached.
- DO NOT OFFER PAIN MANAGEMENT MEDICATIONS.
- My partner will remain with me and be included in all discussions.
- I would like a peaceful, calm, and intimate environment with minimal interruption.
- I would like to move freely and labor in any position comfortable.
- I will eat and drink throughout labor.
- I would like access to the birthing tub (if available).
- No cervical checks unless requested.
- No artificial rupturing of membranes (water breaks naturally or baby is born in the caul).
- I would like baby’s heartbeat to be monitored intermittently through Doppler or stethoscope. No electronic fetal monitoring, internal monitoring, or wireless monitoring. If continuous monitoring is needed, wireless monitoring will be permitted so I can still walk freely.
- As long as my baby and I are fine, I would like to be free of time limits and not have my labor augmented.
2nd Stage Labor:
- No episiotomy unless I am naturally tearing toward my clitoris.
- No vacuum or forceps. Instead a change of position.
- I will wait until my body naturally begins pushing before I push.
- Please do not instruct my pushing, I will listen and aid my body, taking breaks when needed.
- I do not want to be laying on my back to push.
- I would like access to the squatting bar and birth stool.
- I would like to ‘catch’ my baby, or have my partner catch the baby.
- My partner will announce the baby’s gender.
- Baby will immediately be placed skin to skin on my chest.
- We will let the umbilical cord pulse to completion before clamping.
3rd Stage Labor:
- No medical interventions to birth the placenta.
- I wish to see the placenta.
- Placenta will be kept in the provided cooler to be encapsulated.
- A c-section will only be performed once all options have been exhausted and it is a medical emergency.
- My partner will remain with me throughout the procedure.
- I would like to have feeling and the ability to move my arms. (Avoiding general anesthetic.)
- I would like a family-centered c-section with a clear curtain, mirror, and inclusion in the birth conversation.
- Baby will be placed directly on my chest with the umbilical cord and placenta still attached to the baby.
- Take extreme care with incision and sutures to support a future VBAC and more pregnancies.
- My partner or child will cut the cord after it has finished pulsing.
- No separation from baby. Hold off on any newborn checks. Anything needed can be done with baby on my chest.
- In an emergency, my partner will accompany the baby everywhere needed.
- Breastfeeding will be attempted before any weighing or measuring takes place.
- All procedures will be held off until initial bonding has been established.
- Vernix will be rubbed into the baby’s skin, please do not wash it off.
- I decline the Vitamin K injection and antibiotic eye ointment.
- NO VACCINES: I decline the hepB vaccine and any other vaccines or injections offered.
- DO NOT CIRCUMSIZE if baby is a boy (or a girl).
- Do not bathe baby.
- No formula.
- No Bottles.
- No pacifiers.
- I would like a lactation consultant to be available as soon after delivery as possible.