Where to Start
Pregnancy can be a whirlwind. Your body is changing, your emotions are in flux, and you need to start planning for baby’s arrival. But where on earth do you start? I’m happy to walk you through the steps you will take as you prepare to welcome your baby into this world.
The majority of providers fall into two categories: expectant care or active care. A doctor with an active care style generally has a typical course of action. He is likely to encourage induction at a certain time before or after the due date, use drugs to speed things along if not progressing to his expectation, and actively manage the birth process in general. He often has a higher episiotomy rate and prefers women to deliver in a semi-reclining or reclining position on the hospital bed. If you prefer for the doctor to make you feel safe and make the decisions for you, you may feel very comfortable with an active management caregiver.
A doctor with an expectant care style is basically the opposite. He is generally more comfortable with allowing you to labor at home before coming to the hospital and more likely to use interventions only if there is a medical indication for it, as opposed to as a matter of routine. You are more likely to be able to deliver in a non-reclining position or off the hospital bed. You will generally be able to labor at your own pace. With this style, you are more in control.
If you are not sure yet which style you will prefer, that is fine. You can always find a new doctor if you change your mind about your preferred delivery style. The most important thing is to find a doctor who has your best interests in mind and is willing to listen to what you want. You can use the following questions to try to flesh out the preferred style of your prospective caregiver.
Questions to Ask a Prospective Caregiver:
-How long will I have past my due date before an induction is recommended?
-When is it necessary to have a cesarean section?
Ginny works closely with Dr. Lai Fon-Min at A Company For Women at Camden Medical Center. Dr. Lai believes in empowering women to make informed decisions about their care. He takes his time with his patients, listening to their concerns and helping them through the various choices they must make. He does not have a set agenda for how he would like you to deliver—it is up to you based on your particular situation, and he will do his best to help you achieve the sort of birth you would like. He is very experienced in high-risk pregnancies and traditionally difficult births such as vaginal breech, VBAC and VBA2C. He is currently the only doctor in Singapore willing to attend a homebirth as well.
Dr. Lai keeps a detailed audit of his own practice so that he knows his cesarean section rates and VBAC rates. He does not believe in using fear to pressure women into a course of action. He has seen many anxious mothers who have been told the following:
- “It is safer and better to have a repeat Cesarean section as you had one before.”
- “The amniotic fluid is decreased or the baby is not growing and we need to deliver the baby by inducing/cesarean section.”
- “There are placental calcifications/your placenta is failing and we need to induce labor.”
- “Your baby is too big to deliver and your baby could end up with shoulder dystocia and die during delivery so it is best we induce/do a cesarean section.”
- “You have bleeding in pregnancy/threatened miscarriage and so you need to be hospitalized for bed rest.”
- “You are at risk of preterm delivery/have a short cervix and need to have a cervical cerclage.”
- “We need to induce labor as you are past your due date.”
- “The safest way to deliver a breech baby is by cesarean section.”
While there are certainly times a cesarean section is required, it is also more convenient for the doctor and is often a preferred course of action. If you need a second opinion, feel free to schedule a consultation with Dr. Lai or Ginny Phang at A Company For Women.
Doctors often work with only one or two hospitals, so your caregiver decision will go hand in hand with your choice of hospital. The following table will give you a general guide to the hospitals in Singapore. Some hospitals, like Thomson, require an interview in order to be permitted to do a water birth, so please go on the hospital’s tour to be informed of such special procedures. A tour will also help you to become familiar with the hospital layout, parking, and nurses so that you feel more comfortable when your big day arrives.
- Waterbirthing and Laboring in Water. Laboring in water uses the comfort and relaxation of a bath to help you manage the stress of labor. It is generally used after a majority of cervical dilation occurs. Many women enjoy the relaxing effect water has on their bodies during labor. A waterbirth is when the baby is actually delivered in the water. The baby is still receiving oxygen through the umbilical cord and will start breathing air once brought out of the water and onto mommy’s chest. This is only available at the hospitals indicated above; please confirm this availability through your doula or hospital tour. Some hospitals have bathtubs in the delivery rooms while others use inflatable tubs that are sterilized.
- VBAC, VBA2C. Vaginal Birth After Cesarean and Vaginal Birth After Two Cesareans are performed by all caregivers. If you are interested in delivering vaginally but have had one or more cesareans, please talk to your doctor about his or her willingness to support this.
- Vaginal Breech Births. Though women are often made to fear this occurrence, it is truly not that exceptional a situation. With a doctor who has experience doing this, a vaginal breech delivery is not an issue. If your baby is in breech position and you would like to try to turn him, please schedule a private consulation with Ginny Phang to learn what you can do. Information regarding baby positioning and what you can do proactively to encourage optimal positioning is provided in the Four Trimesters Antenatal Group Classes.
- Cesarean Births.
- Home Births/Family Births. Some women choose to give birth at home or have their children in attendance at a sibling’s birth. They choose this because home is where they are most comfortable, and they want to be in a place that makes them easily feel relaxed.
The next step is to take an antenatal class. Knowledge is often the difference between feeling in control versus helpless during labor and delivery. Your body is innately able to give birth comfortably and easily. The Four Trimesters Antenatal Group class will give you knowledge and deepen your understanding, so you can prepare your mind for the birth experience. Our thorough class will also prepare you to care for your baby after birth through breastfeeding, creating a safe environment for your baby, and understanding baby’s zones and cycles during a 24-hour period. This knowledge will leave you feeling empowered and calm—able to confidently make choices for your baby and your family.
In class, you will learn about the various ways to manage labor, from affirmations to exercises, and you will learn ways to move labor along if it stalls. You will become familiar with what is normal and what is exceptional, and you will have the information at hand if you encounter problems. The wealth of information presented in the Four Trimesters Antenatal Class is like no other, and the bonds you form with other parents in the class will last a lifetime. These people will be your allies and your partners as you experience the highs and lows of the parenthood adventure.
A class at Four Trimesters is so much more than a class — it is knowledge, support, and camaraderie all rolled up into one. You will be walked through everything you need to know, one step at a time. You and your partner will be fully prepared to make informed decisions for the health and wellness of your baby.
Delivering your baby is really a moment like no other in your life, and it is important to secure support for this experience. Many women choose to rely on their partners for this support, often realizing during labor that their partner may not be well suited to the task. Even when a partner is perfect for the job, a break is often needed and welcome, or an errand must be run, but your partner can’t just desert you in your moment of need.
A doula is an incredible support during this time. A doula is a trained Professional Labor Assistant who understands the emotional and physical needs of a woman in labor and provides continuous support and care for the parents. A doula believes in “mothering the mother,” thus enabling a woman to have a much more satisfying, positive and empowered time before, during and after birth, and thus allowing her baby to have a better start in life.
*Women supported by a doula during labor have been shown to have:
- 50% reduction of cesarean rate
- 25% shorter labor
- 60% reduction in epidural requests
- 30% reduction in analgesia use
- 40% reduction in forceps delivery
*From Mothering the Mother: How a doula can help you have a shorter, easier and healthier birth by Marshall H. Klaus (Perseus Press, 1993)
There is something special about being supported during labor by a woman who understands what you are going through and has the strategies at hand for managing the process. A doula knows the ropes in the hospital and will help you navigate the areas in which you are unsure. A doula won’t be offended by what you say during labor; she understands what you are going through. She is a clear head in the delivery room that intimately knows your wishes and desires and can help you advocate for them.
For centuries, women have supported other women as they made their transition into motherhood, encouraging them, helping them, celebrating with them. Engaging a doula for the birth of your child will help to ensure a positive experience, no matter the outcome. Click here to learn more about our warm, caring, and professional doula team that is ready to support you every step of the way or click here to attend our Doula Taster.
The transition to parenthood is life altering. Most couples find it to be a singularly stressful time in their lives. It is important to take care of yourself and your relationship with your partner during this time, as well as to connect with other parents who are going through the same struggles.
Every Friday, Four Trimesters hosts a Parents Circle Support Group. This is a wonderful chance to talk with others, share your successes and vent your frustrations as well. There are Four Trimesters doulas present to answer your questions and a guest speakers is invited to speak (the topic varies from week to week). Plus yummy treats to boot—bring something to share! Parents today can often find themselves quite isolated at this time; please make the effort to get out together or on your own to do things you enjoy and reconnect with the things that make you happy in life.
To proactively protect your relationship with your partner, you can take our Bringing Baby Home class. The Dr. Gottman research-based workshops prepare couples for life with baby and help them become the best parenting team possible. In a relaxed and supportive environment, you will learn to strengthen your relationship. This will help you to foster your baby’s development during this challenging time. The sessions build on what Dr. Gottman and colleagues found to be the best predictor of marital adjustment after baby arrives: the quality of friendship in the marriage.
If you are struggling with specific issues with your little one, from breastfeeding to sleep issues, feel free to book a private consultation with Ginny. Four Trimesters is here to support you no matter the issue. If we cannot provide the help you need, we will connect you with the right professionals who can.