Susan Delauter hauled a few creature comforts with her to the hospital when it came time to deliver her first baby.

A birthing ball.

A CD of instrumental music.

Her mom.

“My husband is very squeamish, so my doctor knew he didn’t want to see any blood,” said Delauter, who delivered her daughter, Ava, nearly 11 months ago in Traverse City, Mich.

“He didn’t want to cut the umbilical cord and wanted to stay as close to my head as possible, so he wouldn’t see any blood. I had a backup person in case he couldn’t make it through the whole thing.”

Delauter is not alone in alerting physicians and hospital staff how she wanted her newborn welcomed into the world.

Today, birth plans help chart preferences, covering everything from the intensity of delivery room lights to when the umbilical cord should be cut – and the plans are as varied as newborns’ birth weights. One big change is the increased number of friends and family allowed to share in the birth experience, said Gloria Dykstra, supervisor of labor and delivery for Spectrum Health Butterworth Campus in Grand Rapids, Mich. Some women want as many as 10 people in the room, while others prefer a subdued tone.

“We see greater family involvement at time of delivery,” Dykstra said.

“Now, whoever the mother feels is family is whoever they want to be there. That gradually has been changing the past 10 to 15 years. It’s becoming less rigid and a more relaxed experience.”

For pain treatment, mothers can control their threshold of discomfort through a self-administered epidural (after the initial dose into the spine). Studies show when medication is self-administered, mothers require less of it.

“There’s a lockout and dosing limit,” said Nyla Auperus, obstetrics clinical coordinator for Metropolitan Hospital in Grand Rapids.

“Patients feel they have some control over their pain level. They find that, through the patient pump, they get less medicine because they have that control as needed.”

Birth positions no longer are one size fits all, either. Some women lay on their sides, others squat or walk around. It’s the mother’s choice.

Auperus doesn’t recommend women lie on their backs.

“Laying on the back closes the pelvis up,” she said.

Hospitals also have relaxed a policy that required visitors to don hospital gowns and wash hands before holding the baby.

“Retroactive studies show that babies have an immune system and are not as high risk to get infections,” said Theresa Smith, manager of the childbirth center for Metropolitan Hospital.

Medical treatment models used to be based more on physician convenience than on mothers’ preferences, said Cindy Reistroffer, director of women’s and infant’s services for Spectrum-Butterworth.

“Our whole intent is … to help them feel comfortable by aesthetically providing an environment that pleases the patient and re-creates the home experience,” she said.

Hospitals have developed a listening ear to keep pace with patient demands, said Carol Veldkamp, nurse manager for the birth center at Holland Hospital in Michigan.

“So much of what we offer is directly related to the feedback we’ve received from our patients,” Veldkamp said.

“We watch for new services and ideas for our moms and babies, but we rely more on the comments and suggestions we receive from our patients to help us decide what’s offered.”

A “birthing plan” is a list of preferences mothers-to-be discuss with their physicians and hospital staff.

It generally includes what moms expect during a normal labor and delivery, how they want their babies to be treated after they’re born and what they want to happen in case of unanticipated events, Smith said.

Delauter’s birthing plan took a detour when her physician discovered Ava was not breathing after she was born.

She was revived but required a five-day stay in intensive care, delaying Delauter’s plans to breast-feed her daughter. She also planned to leave the hospital with Ava the day she was released, but that didn’t happen.

“My birthing plan was I didn’t want to leave the hospital without my daughter. That got changed,” she said.

Hospital amenities doesn’t necessarily stop after babies are born. Hospitals may offer post-delivery exercise classes, infant massage instruction, lactation consulting and parent-support programs.

Some institutions even enable friends and family who live too far away to visit to ooh and ahh. Babies’ photos can be viewed online at some hospitals’ Web sites, or e-mailed after parents saunter to a kiosk where a camera shoots digital pictures of the new family.


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