I want to talk a bit about the expectations after delivery because I remember being confused about my birth plan versus the reality. After I completed my plan I submitted it to my doctor and hospital and was confident that I now knew what to expect. In reality I didn’t.
You see while plans like these are helpful for things within a pregnant woman’s control before labour; after labour it’s just a piece of paper.
Reality After Labour
The reality, in a typical hospital setting, is that after labour everything moves really quickly. The baby is out and then there is a rush to clear the baby’s airway to get that first cry, then to quickly examine, cut the umbilical cord and then to warm the baby, check vitals and record everything: time of birth, APGAR (Appearance, Pulse, Grimace, Activity and Respiration) score etc.
Simultaneously, the new mom is being checked for successful delivery of the placenta, any vaginal/perineal tears and blood loss (this is huge).
What is Postpartum Hemmorrhage?
Normal blood loss during a vaginal delivery is 500 ml and during a caesarean is 1000 ml; anything more is in the territory of Postpartum Hemorrhage (PPH).
I remember my first time delivering and after delivering looking around frantically at where they were taking my baby and wondering why the baby wasn’t with me for skin to skin like I stated on my birth plan. Instead, I had nurses around me frantically massaging my belly and trying to get a needle that had gotten dislodged during labour, back into my vein . I thought to myself, I delivered the baby already. The baby is crying and doing well; why are they still trying to get this needle back into my hand when I am done with it? Not to mention the pushing down on my belly when the baby and the placenta was already out.
Three labours later, I finally learned why...
Severe bleeding after giving birth, also known as Postpartum Hemorrhage (PPH), is still one of the leading causes of maternal morbidity to date but with skilled and timely care it is preventable. The precautions taken to ensure a safe post delivery experience for the new mom may include:
- Administration of a drug through the IV drip (such as Oxytocin) to help the uterus to contract and stop blood loss. This, in my case, is why nurses were so frantic to get the needle back into my vein.
- Controlled Cord Traction (allowing the placenta to deliver naturally via your own pulsations before clamping)
- Uterine massages and or compressions to help the uterus contract and to deliver any placenta pieces that may have been detached and left behind in the uterus.
- Monitoring the new mom’s blood loss from 4 to 24 hours after delivering.
That’s why even though you may have one or two nurses attending to you while experiencing contractions; by the time you are about to deliver, a swarm of nurses enter the delivery room alongside the Doctor. Ideally, they are all there to ensure that mom and baby get past that first step of survival.
Takeaway
That’s also why you should ideally hold your birth plan loosely because your healthcare team has their own plan and goal and that is: a safe birthing experience for mother and child. However, it’s also important as an expecting mom or support person, to know what to expect in those few hours after giving birth so that you can advocate for your personal healthcare in the event that you are not receiving proper post partum care.
Wishing you all the very best in your labour and delivery mama! 💜💪
Disclaimer: This blog article is not a substitute for medical advice. I’m sharing my personal experience and research in addition to giving my own advice. Please always consult with your doctor or medical professional about your healthcare.
