If you haven’t already, please check out PART 1 of this post: Writing Your Birth Plan: Tips from an L&D Nurse. Also, at the end of this post check out a birth plan written and sent to me by one of my blog’s readers who is due any day now!
#1 DO keep your birth plan short, simple, and easy to understand (1-2 pages max).
“Keep [your birth plan] short. If you need to spell out a long list of points, you may not be with the right caregiver. If most of the things you want aren’t things your caregiver is used to doing (in which case you don’t need to put them in a birth plan!), you are unlikely to get them. For maximum effectiveness, keep your birth plan to a single page.”
Writing a Birth Plan by findadoula.com
#2 DO keep the language of your birth plan assertive and clear.
“Remember to keep your language assertive – polite but clearly stating what you want. Use phrases like “I am planning” and “I would like” rather than “if it is ok” or “I would prefer.
Be specific. Avoid words and phrases such as “not unless necessary” or “keep to a minimum.” What one person thinks is “necessary” is not what another does. What one person defines as the minimum is not what the next person does. Instead, use numbers or specific situations, for example: “I am happy to have 20 minutes of electronic monitoring and if all is well then intermittent monitoring every hour for five minutes after that” or “I am happy to have a vaginal examination on arrival in hospital and after that every four hours or on my request.”
Writing a Birth Plan by findadoula.com
“Be sure to be assertive, but not aggressive when discussing your options. Do not allow your caregiver to brush off your decisions or suggest that this is unimportant. At the same time, don’t assume your caregiver [or nurses] will be hostile or uninterested in hearing what you have to say.”
How to write a Birth Plan by birthingnaturally.net
#3 DO use your birth plan as an impetus for doing your own personal research about your preferences for childbirth.
One great place to start is at MothersAdvocate.com who, in partnership with Lamaze International and Lamaze’s Six Steps to A Healthy Birth, have created a website that offers FREE, evidenced-based, educational video clips and print materials to educate and inform childbearing families on how to have a safe and healthy birth for both you and your baby. These extremely well reserached and produced materials are a MUST READ for all expecting moms!!!
The introduction handout for these video clips and print-outs entitled Introduction: Birth–As Safe and Healthy As It Can Be reads:
“While no one can promise you what kind of birth experience you will have, common sense tells us and research confirms that there are two tried-and-true ways to make birth as safe and healthy as possible:
• First, make choices that support and assist your natural ability to give birth.
• Second, avoid practices that work against your body’s natural ability, unless there is a good medical reason for them.
Lamaze International, the leading childbirth education and advocacy organization, has used recommendations from the World Health Organization to develop the Six Lamaze Healthy Birth Practices that support and assist a woman’s ability to give birth. Years of research have proven that each of these practices increases safety for mothers and babies.
The Six Lamaze Healthy Birth Practices are:
1. Let labor begin on its own.
2. Walk, move around, and change positions throughout labor.
3. Bring a loved one, friend, or doula for continuous support.
4. Avoid interventions that are not medically necessary.
5. Avoid giving birth on your back, and follow your body’s urges to push.
6. Keep your baby with you—it’s best for you, your baby, and breastfeeding.”
The topics of the print materials include:
Choosing a Care Provider,
Changing Your Care Provider,
If You Have Been Induced,
Maintaining Freedom of Movement,
Positions for Labor,
Finding a Doula,
Creating a Support Team,
Tips for Labor Support People
and even a Birth Planning Worksheet!!
“We cannot know the day or week labor will begin, how long it will last, exactly how it will feel, how we will react, or the health and sizes of our babies. What we can do, however, is educate ourselves about the vast array of possibilities and learn which are more likely to occur. We can decide what is ideal and what we will strive for, what are the means to creating the most conducive environment for such a birth, and which people can best help us to attain those birth arrangements. Finally, we can prepare our own bodies and hearts for the process.”
Eyes-Open Childbirth: Writing a Meaningful Plan for a Gentle Birth
by Amy Scott
#4 DO include your fears, concerns, and helpful things for the nurse to know.
If appropriate, a birth plan can also include a few sentences regarding things you just want the nurse to know about and are important enough to make sure that every shift is aware of. For example, I once had a patient who wrote the following in her birth plan:
“My husband is a type I diabetic and at times suffers from episodes of hypoglycemia where he does not have any warning signs or symptoms. So if my husband starts to act inappropriate or seems ‘out of it’ or ‘drunk’ please offer him some juice!! I am afraid that if I am in the throws of labor that I will not notice and this is something that I am very concerned about!”
Although this information wasn’t necessarily birth related, as a nurse taking care of this family I found this information EXTREMELY helpful to have in the birth plan!! By putting it in her birth plan, this mother felt more at ease knowing that she did not have to waste any time worrying about forgetting to tell each new nurse that took care of her. Having this in her birth plan also served as a reminder for me to pass along this important information when I was giving report to the next shift.
#5 DO review your birth plan with your birth attendant and ask him/her to sign off that he/she read and understands it.
“Add a line at the bottom of your birth plan for your doctor or midwife, and other caregivers, to sign your plan under the statement ‘I have read this plan and understand it.’ When caregivers sign your plan, they are only acknowledging to you—on the record- that they have read and understood it. They do not have to sign and say: ‘I agree.’ No matter what you tell them, they are always responsible for offering you their best judgment and skills as different circumstances arise, and then together you and your caregivers can agree on your care. This benefits you. Your birth plan will help you take responsibility for your decisions and ask to be fully informed.”
Creating Your Birth Plan, page 219
By Marsden Wagner & Stephanie Gunning
#6 DO make your birth plan personal (don’t just copy paste) and DO make sure that you understand and can elaborate on everything in the birth plan if asked.
In my humble opinion (regarding birth plans), there is nothing more frustrating for a nurse (and nothing more detrimental to a nurse’s overall attitude and view of birth plans) than to have a patient just copy and paste a general, “all-purpose” birth plan off the internet, check the boxes that “sound good”, and pass it in to a nurse with her name typed in at the top. Why? Because when a nurse (like myself) sits down to review the birth plan with the mother and her labor companions in order to start a dialogue about how the nursing staff can assist in adhering to the birth plan, it will most certainly become obvious to the nurse that the patient has done little to no research on any of her choices making it almost impossible to help the patient follow her birth plan when the birth attendant comes in and wants to do things differently.
Let me give you a few examples:
Example 1: One time I had a patient who had the following statement on her birth plan: “Regarding an episiotomy, I am hoping to protect the perineum. I am practicing ahead of time by squatting, doing Kegel exercises, and perineal massage.” Now don’t get me wrong, this statement is great and it is one that I personally believe in and try to promote. So while reviewing the patient’s birth plan with her and her husband I enthusiastically said the following, “Oh, I see here you have been doing perineal massage and Kegel exercises and wish to avoid an episiotomy. That is great! How many weeks have you been doing perineal massage for?” The patient looked blankly at me and said, “What? Oh I don’t even know what that is! My sister just told me that I shouldn’t get an episiotomy so I checked that box.”
Ladies, it is really hard for a nurse to advocate for you if you don’t even understand what you are asking for!
Example 2: Almost all the birth plans I have seen make some statement about pain relief and pain medications. Again, I think that this is a great thing, especially if the mother was inspired to research all of her pain relief options (both pharmacological and non-pharmacological) and make an informed pain relief plan during the writing of her birth plan. One time I had a patient who had the following statement in her birth plan, “Regarding pain management, I have studied and understand the types of pain medications available. I will ask for them if I need them.” Again, I was very enthusiastic when I read this and said to the mother, “I see here that you have done some research on pain management. Wonderful! Have you taken any childbirth preparation classes or read any books?” The mother responded, “What do you mean?” I replied, “Well you know, like any classes or books by Lamaze, Bradley, Birthing From Within, Hypnobabies, etc.” The mother responded, “No.” I then said, “Oh, did you do any research on the internet or talk to anyone?” To which she replied, “No, not really. I mean, it’s my first time so I don’t know what to expect. My best friend just said she hated her epidural so I don’t really want one of those. Unless , of course, I really need it. We’re just going to wing it.”
Ummmm, huh?!?! Now again, don’t get me wrong. I feel that I am very supportive of mothers that are preparing for a natural, or physiological, childbirth and I often write about the risks and benefits of common obstetrical interventions, including pain medication and epidurals. But ladies, your nurse can’t be the only one who is advocating for your natural childbirth. YOU have to be on board too and YOU have to understand your reasons for not wanting pain medication or epidural. Because if you don’t even know why you don’t want an epidural then the next person who walks into that room who feels differently, be it a nurse or your birth attendant, guess what’s going to happen?! You’re probably going to agree to anything said nurse/birth attendant tells you you should get, because you don’t know any alternatives.
I am not trying to say that taking a certain childbirth preparation class or reading certain books is required for a positive and empowering birth experience. But some type of research and preparation on the part of the mother and her labor companions/partner is EXTREMEMLY IMPORTANT!!
Now here’s one more example to give you the full perspective.
Example 3: One time I was taking care of a patient who had the following statement in her birth plan: “My husband and I have been preparing for and planning a natural childbirth. I am very interested in using the Jacuzzi tub for pain relief in labor and have been reading about other drug-free ways to cope with pain. I am not interested in pain medication or an epidural as I had both with my last baby and had a poor experience with both. I respectfully request that they not be offered to me. I have done research and feel that the risks outweigh the benefits.” When I asked her about it we embarked on a really informative discussion about her last delivery, in which she had persistent numbness in her right leg for 2 months after the epidural as well as a debilitating spinal headache that took required two blood patches and made it difficult for her to nurse or care for her baby during her hospital stay. She also told me that she did not like the way the IV narcotics made her feel, as she was “seeing things” and generally “very out of it.” After our conversation I felt confident in advocating for her with her doctor (who often insisted his patients get epidurals) because I knew that if I said anything to the doctor that she would, in a sense, back me up and likewise I would back her up!!
It is so hard when a patient has something in her birth plan like “I don’t want an epidural”, and hence I argue with the doctor about how the patient does not want an epidural, but then when he goes into the room to ask the patient himself, the patient says “Oh well, whatever you think is best doctor!” It really just makes the nurse look like she is trying to “push her own agenda” when in reality the nurse was just trying to follow the patient’s birth plan!!
One more thing…I don’t want anyone to feel like I am implying that a woman has to “prove” anything to me when I ask questions about her birth plan. That is NOT the case. I just know from personal experience how important it is for a woman to understand and agree with everything she herself puts in her birth plan! Remember, mothers, labor companions, and nurses work best when they are all on the same page and work as a team to facilitate a positive and empowering birth experience!!
#7 DO look at examples of great birth plans online to get some ideas.
The following is a list of some good places to start. Remember, while these websites provide a wealth of ideas, they should not be simply copied and pasted! The best and most effective birth plans are personal, NOT just a list of things with check marks next to them!!
a) BirthingNaturally.net
b) Sample Birth Plans from BirthingNaturally.net
c) ChoicesinChildbirth.com
d) American Pregnancy Association
e) BabyCenter.com
f) MothersAdvocate.com
#8 DO run through scenarios in your mind about how labor could unfold and actually talk these scenarios out with your labor companions and doula (or perhaps even your childbirth educator or birth attendant too!)
Think about all the different ways labor could unfold and how you might react if labor was faster or slower than expected; harder or easier than expected. What would you need for comfort, support and information in each of these variations? Thinking about “worst case scenario” doesn’t mean it’s going to happen. But if it does, or if any variation does, it will make you more at ease to know that your team has already talked about it and knows your wishes.
“If you knew that something would go wrong or would pose a difficult challenge during a portion of the labor and birth, what would your ideal strategy and scenario for handling that problem be? How would you want your midwife or doctor to speak with you? How would you like your spouse or another support system to help? What alternatives would you like to try, and in what order? Again, in your mind’s eye permit yourself to have the best. What would help you relax and be able to continue labor under difficult conditions?”
Creating Your Birth Plan, page 219
By Marsden Wagner & Stephanie Gunning
#9 DO try to treat researching and birth plan writing as a fun and exciting experience, not a chore!
Enjoy this time! Don’t be afraid to be creative and fanaticize! There are so many amazing thing that you can discover and learn about while doing research for your upcoming birth. It is never too early to start so don’t put it off till the last minute!
And finally…
#10 DO remember to bring your birth plan to the hospital!!
It won’t do much help to the nursing staff if you forget it at home on your coffee table! I encounter this very often at work and I always feel so badly because I know that there is usually a lot of work put into writing a birth plan. It might be best to make sure that you place a copy of your birth plan in the bag you have packed to take with you to the hospital. I have even had a few mothers put an extra copy in their car’s glove box so that they wouldn’t forget it!
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SAMPLE BIRTH PLAN
This birth plan was sent to me by a reader of NursingBirth who goes by the name “ContortingMom”. Contortingmom’s guess date is 7/17/09 and she is still “cooking” with her first baby 
I really like her birth plan for a variety of reasons. #1 She was inspired to add some stuff to her birth plan after reading a couple posts of mine (which I think is pretty cool and #2 I think it is a perfect example of a personalized birth plan!! No check boxes here! Thanks again to ContortingMom for allowing me to post her birth preferences for other moms to read and learn from!!
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Birth Preferences:
I understand that labor and birth are unpredictable and ultimately want the health and safety of both the baby and I to take precedence. In all non-emergency situations, all proposed procedures are to be discussed (benefits and risks) so I can direct the decision making with informed consent.
Your help with these preferences is very much appreciated.
Labor:
• I intend to have as natural a labor as possible – including freedom of movement, intermittent monitoring, a saline lock instead of an on-going IV, and clear liquids as tolerated.
• Due to my GBS+ status, I request only very limited vaginal exams and do not want an amniotomy.
• Please accept my request that pain medication not be offered to me. For many reasons – personal and medical, I’m striving for an unmedicated labor and delivery. If I eventually want drugs or an epidural, I’ll be the first to ask for it and understand that options change as labor progresses.
• If augmentation is necessary, I would like to try non-pharmacological methods before resorting to meds. However, if my OB and I agree that pitocin is required, I request that the it be administered following the low dose protocol and increased in intervals no closer than every 30 minutes, allowing my body an appropriate amount of time to adjust and react to each dose increase.
Birth:
• Please do not direct my pushing with counting or yelling. I will ask for help if needed.
• I strongly prefer a tear to an episiotomy and do not want a local anesthetic administered to the perineum.
• I plan to be as active during pushing & delivery as possible, including choosing productive positions. They will be probably anything except supine, lithotomy or “sitting squats” that put pressure on my tailbone. It’s been broken several times & currently inflamed. I also have restrictive pain from spinal injury & surgery, so please allow a position suited to my medical needs. I’ll make sure the OB has comfortable access.
• I would like to have the baby brought to my chest immediately for skin-to-skin contact & initial procedures – and to try nursing to see if it works to contract my uterus, delaying pitocin until we know.
If Cesarean Is Required:
• Please use double-layer sutures when repairing my uterus. If I have a second child, I hope to attempt a VBAC and understand this is a requirement for many doctors.
• As health permits, I would like to skin-to-skin contact with the baby, to stay together during repair and recovery, and to breastfeed during the initial recovery period.
• If my husband has to leave the operating room with the baby, I would like my doula to take his place.
Baby Care:
• We would like to spend as much time as possible with our baby after birth before being taken off for procedures and will be breastfeeding, so please refrain from giving bottles/pacifiers.
We Appreciate Your Support. Thank You!
Please check out Rixa’s post over at Stand and Deliver about 
The Good, The Bad, and The Icky on Vomiting in Labor October 19, 2009
Tags: bowel movement, gag, labor, labor and delivery, labour, poop, pooping during labor, pooping during labour, throwing up, throwing up during labor, throwing up during labour, vomit, vomiting, vomiting during labor, vomiting during labour
Submitted on 2009/10/18 at 9:43pm
Comment left at: Top Ten Things Women Say/Do During Labor (And trust me… they are totally normal!)
Dear NursingBirth,
Hello, I know this is an old post, but I’ve been searching information on vomiting during labour for a few hours (lol!) and can’t quite find what I’m looking for. So with the housework waiting I thought I should just come out with it and ask! Your post is very informative and you seem lovely so I hope you are able to help me! (Or others who have been through it!)
I have emetophobia (fear of vomiting), and find I am able to calm myself about the potential of vomiting (because I have had to face that fact that I can’t just escape it!), if I
#1: Know that “everything will be ok” if I do vomit. (i.e. Mainly that people won’t be disgusted, or freaked out and that someone will be able to deal with, well, the result, if I’m not able to. Even though I’ve never vomited anywhere except in a toilet, it’s just the potential that terrifies me! My husband is a wonder, and it’s only actually since being with him that I’ve begun to get over the phobia because he’s not scared about it, and not fazed by it).
And
#2: Remember that I can handle vomiting much better if it isn’t preceded by hours and hours of painful nausea.
SO, I find myself trying to prepare mentally for the possibility of throwing up during labour, and I have some questions stemming from this for you (I know it is an irrational fear, and these questions seem trivial but they are things that really stress me out – I actually lose sleep over them – so I appreciate your answers):
#1 Will the midwives be ok if I throw up all over the place? Will the staff get disgusted or freaked out?
#2 Will the staff clean it up or will I or my husband have to?
#3 What happens if it gets in my hair?
#4 Will I choke because I might be lying down?
#5 Will everything be okay if I do vomit?
And, finally
#6 Is it a different kind of vomiting – one that just kind of happens, rather than following hours of terrible nausea?
Anyway, I don’t mean to waste your time, and many thanks in anticipation of any answers – I’m just trying to mentally calm myself so I can focus more on the really important things about labour – like my baby!!
Sincerely,
NervousMumToBe
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Dear NervousMumToBe,
First of all I am sending you one MAJOR cyber *HUG* right now complete with back patting and me saying “You can do this!!”
Second, you are NOT wasting my time so don’t mention it!! I have written before about worrying, that is that “WORRY is the WORK of pregnancy!” In her book Birthing From Within, certified nurse midwife Pam England tells the story about a patient of hers (Hannah) that worried a lot about having a natural birth experience after having had a highly medicalized birth with her first baby. She writes that Hannah longed to hear her say things like “Don’t worry” and “Everything will be alright” but instead England encouraged her to face her fears. She instructed Hannah to write down all of her worries and explore each of them with questions like “What, if anything, can you do to prepare for what you are worrying about?” and “If there is nothing you can do to prevent it, how would you like to handle the situation?”
England lists the “Ten Common Worries” of Labor as:
1) Not being able to stand the pain
2) Not being able to relax
3) Feeling rushed, or fear of taking too long
4) My pelvis not big enough
5) My cervix won’t open
6) Lack of privacy
7) Being judged for making noise
8.) Being separated from the baby
9) Having to fight for my wishes to be respected
10) Having intervention and not knowing if it is necessary or what else to do
I would like to add #11:
11) Fear of pooping in labor/Fear of embarrassment regarding bodily functions
As you know I am a labor and delivery nurse and have estimated that I have been present at over 300 births during my career and still, I would have to say that when it is my time to give birth, #1 through #6 are top on my list of worries!! And I witness the amazing power of women everyday!! So NervousMumToBe, don’t *worry* about “worrying” about vomiting! I am so happy that you are FACING YOUR FEARS!! If vomiting is something that you are really concerned about, no matter how trivial it might seem to others, it is important to you and that is all that matters! So I applaud you!
Okay now that the most important thing is out of the way (i.e. the hug) lets get down and dirty about the #2 thing on every pregnant woman’s mind…VOMITING IN LABOR!! (If you are wondering what the #1 thing on every pregnant woman’s mind is it is POOP. Don’t believe me? Check it out here.) I want to preface the following post with a few things in the interest of full disclosure:
Now to some answers!! I will take your questions one at a time:
#1 Will the midwives be ok if I throw up all over the place? Will the staff get disgusted or freaked out?
Yes and No!! YES! The midwives and the labor and delivery nurses will be okay if you throw up all over the place and actually, they probably will not even bat an eye if you throw up! And NO! The staff will not get disgusted or freaked out if you throw up! If bodily functions bothered us, we wouldn’t be working in healthcare! I have been thrown up on before…more times than the average person for sure! I have been splashed with blood, amniotic fluid, pee, spit, and mucus. I have also cleaned up my fair share of explosive diarrhea. And if I do get splashed with something I just kept on doing what I was doing until I have a break where I can go change. (Remember L&D nurses usually have to wear hospital scrubs just in case they end up in the operating room. The other bonus to this set up is that if you get splashed with something gross then you just go in the locker room and change into a new pair of hospital scrubs!) I am sure over the course of time there has been some burnt out nurse that has said something really nasty or insensitive to a mother if she has thrown up but in reality, it’s all part of the job and the vast majority of nurses and midwives don’t get bothered by vomit!
#2 Will the staff clean it up or will I or my husband have to?
This question is assuming two thing: #1 That you are going to vomit (remember not all women vomit in labor) and #2 That if you do vomit that you will make a mess (remember not all women who vomit miss the bucket or don’t have a chance to throw up in a bucket). That being said…
I know I can’t speak for every single nurse out there but I would NEVER EVER expect a husband (or any coach for that matter, including the mother herself) to clean up something like that. After all it is the husband’s (or partner, coach) role to support the mother and if the mother did throw up, say, on the floor, I would ask the husband (partner, coach) to stay with the mother while I went to grab some towels to clean it up. And then I would clean it up quickly. And then it would be a non issue! Done!
One time I had a mother who was taken off guard by her need to vomit and accidentally threw up all over her bed. She was very apologetic but apologies were not necessary. I knew that she didn’t mean it! With the help of her husband I walked her into the bathroom and had her sit down on the toilet to pee. Her husband stayed in the bathroom with her. Within 5 minutes I had the completely remade the bed with clean sheets. Then I helped her into a fresh, new, warm gown and then back to bed. It was like it never happened! We all moved on and no one mentioned it again. After all, who was thinking about a little vomit when there was a BABY about to be born!
I learned from that experience and ever since then I always make sure that I give every mom a bath bucket when she is admitted and I put it right on her bedside table so that if she needs to throw up, it is right there for her. Because I do this, I have rarely ever had a mother throw up in labor and not use the bucket. Since you have a concern about vomiting, I would recommend that you ask your nurse for a bucket when you get to the hospital, just in case. And when I say bucket I mean bath bucket (or wash basin), not those ridiculous kidney shaped “emesis basins” that wouldn’t even be helpful to catch ladybug vomit!
Remember, although it is not rare for a mother to throw up in labor, it is rare that she throws up all over the place, or has no idea that it is coming. In my experience the vast majority of moms who vomit in labor do indeed make it into the bucket and therefore, there is nothing to clean up! Also remember that labor vomit is different that “stomach flu” vomit. That is, there is no risk to me as the nurse of getting sick from a laboring woman’s vomit because it is not caused by illness. I’d rather clean up your labor vomit over my own stomach flu vomit any day!
#3 What happens if it gets in my hair?
If you were my patient and you started to vomit I would hold your hair back. And I am sure that your husband would do the same for you too. That way you wouldn’t get any vomit in your hair at all. Have you considered putting your hair into a pony tail or clip while you are in labor? If your hair was up it would be very unlikely that it would get any vomit in it. Perhaps you can pack a few extra clips or elastics into your hospital bag just in case you need them. If you don’t usually wear your hair back you may want to consider wearing a few hair elastics around your wrist so that they are readily available if you need them to tie your hair back if you feel nauseous. I also have been known to cut the opening off a rubber glove and use it as a make-shift hair tie for just this type of circumstance!
However if a little bit of throw up did get in your hair and if I was your nurse I would probably wet a warm washcloth and clean it out. And then I would put your hair into a pony tail or clip for you to get it out of your face. If it was really bad (I have never seen this but I suppose that technically it could happen) and if your midwife allowed, I would help you into the shower. After all, many women find laboring in the shower to be extremely soothing and helpful!
#4 Will I choke because I might be lying down?
NO! You will not choke, even if you are lying down. Only people that are unconscious, have an impaired gag reflex, or are debilitated in some other way have a risk of choking on their own vomit. I have never seen a conscious laboring mother choke on her own vomit…NEVER. Why? Because every single healthy, able-bodied, conscious person sits up or leans over automatically when they start to vomit. I have never even seen a mother who was positioned flat on her back and numb from the breasts down for a cesarean choke on her own vomit. Why? Because every single healthy, able-bodied, conscious mother in that situation automatically turns their head to the side to vomit.
If necessary every hospital room and operating room has (or at least should have) a suction canister in it with a yankauer suction set just in case a mother does lose consciousness and her mouth needs to be suctioned. You might not have seen it when you toured your hospital because most birthing suites keep that kind of equipment behind pictures or in cabinets so that the room doesn’t look too “hospital like.” But they are there. I personally have only had to use the yankauer suction set ONE TIME as a labor and delivery nurse and I used it because my patient had an eclamptic seizure (a rare complication of preeclampsia) and when she came too she was really out of it (“post-ictal”) and her mouth needed to be suctioned because it was full of secretions. That’s it, one time only.
#5 Will everything be okay if I do vomit?
YES! In fact, labor and delivery nurses get excited when they see a patient vomit because vomiting is usually a sign of transition which is the last stage of active labor (usually 7-10 centimeters) right before a women begins the pushing phase. Remember whether or not she has been eating throughout early labor, a woman may still vomit when she enters transition so it is not necessary to starve yourself on purpose because you are afraid to vomit later on. In fact, some women vomit because they have done just that! (I know I personally get very nauseous as well as get a headache if I haven’t eaten anything all day). I always think of it as a way the body is “making more room” for the baby!
Also since vomiting, like holding your breath or making a bowel movement, is a vagal response, it inadvertently helps your cervix dilate and hence, is a great sign to a labor & delivery nurse! The body does awesome things to help the process along! So really it is not just okay if you vomit, it is GREAT if you vomit because it may help you cervix dilate! I also want you to know that you will not hurt anything if you vomit, including the baby or your cervix.
#6 Is it a different kind of vomiting – one that just kind of happens, rather than following hours of terrible nausea?
In my experience as a labor and delivery nurse most women who have a natural, unmedicated, spontaneous labor do NOT have hours and hours of nausea before they vomit. Instead, once there labor really starts to ramp up for the last few centimeters they get a feeling of nausea that gives everyone enough warning to grab the bucket and then they throw up. After throwing up, the vast majority of women have told me that they feel better. It is very rare that I have taken care of a woman who continues to throw up once they are 10 centimeters dilated and begin to push or is nauseous for hours and hours before they vomit. That being said…
Nausea and vomiting are very common side effects of narcotic pain medications (e.g. stadol, nubain, demerol, morphine etc.) as well as ALL forms of anesthesia (including labor epidurals as well as spinal blocks often performed for cesarean sections). Because of this, some physicians and midwives prescribe an anti-emetic (aka anti-nausea medication) like Phenergan, Zofran, or Reglan to be administered with the narcotic, epidural, or spinal to counter act this side-effect. Sometimes it helps, sometimes it doesn’t. Because you have such a fear of vomiting I want you to be aware of this fact.
So there you have it: the skinny on vomiting in labor! I hope this has helped calm your fears and worries however if you have any more questions about this topic please feel free to leave a comment!!
Thank you for writing in to me. You are certainly not alone in your fears!!! I know that your question will help other women out there who experience the same fears as you! GOOD LUCK with your upcoming birth and CONGRATULATIONS to you!!! And remember, although birth might be one of the messiest experiences of your life, no amount of fluids, cursing, farting, pooping, striping naked, howling, crying, peeing, bleeding, or vomiting will take away from how honestly empowering, mind blowing, and touching this experience can be for you and your family!!
Sincerely,
NursingBirth