Special delivery: Baby on board

by Jeana Coleman
Stripes Guam

Having a baby is an amazing, exhilarating, frightening experience all rolled into one little cooing (or crying) bundle of love. Although wonderful, it can also be stressful, especially for first-time parents. It’s not uncommon to be immediately bombarded by hundreds of questions as soon as that blue line appears on the little stick. Add to this an additional stress — expecting a baby while stationed in a foreign country where locals speak a different language, with your spouse prone to TDYs or deployment. Worse yet, you have no network of family or friends surrounding you during this life-changing event. This article will help answer questions about the childbirth choices that are right for you and your growing family. Also, don’t be afraid to ask other military or civilian moms stationed near you about their childbirth experiences, providers and facilities. There are great support groups available to you.

U.S. Military hospitals vs. facilities on the economy

Sometimes the military medical treatment facility (MTF) that services your military community may not have the personnel or facilities to accommodate you when you need to deliver, and will refer you to a civilian provider. You may also decide to utilize a civilian provider without a referral after you disenroll from TRICARE Prime and enroll in TRICARE Standard. Before you decide, ensure the switch is right for you. For a fact sheet about TRICARE maternity care, enrollment policies and other related issues, visit www.tricare.mil. You’ll find free downloads about pregnancy issues under their “Life Events” tab on their home page. Just click on “Having a Baby or Adopting” for options.

DOD civilians do not have the option of utilizing MTFs and must use civilian providers. However, whether you are military or civilian, you will find that many birthing centers and medical facilities across the world are state of the art. The best thing to do is educate yourself on the options available to you in your area and then choose the best childbirth method and facility right for you and your baby.

Help and support beyond your spouse

Expecting mothers should consider the services of certified doulas and midwives in their labor and delivery. Both highly skilled and trained professionals provide specific services that focus primarily on the mother and secondarily on the spouse, aiding in a more comfortable and personal birthing experience. Mothers with deployed spouses will also benefit from the additional physical and emotional support while the partner is away. Ashley Chenard, spouse of an active duty airman at Ramstein, chose to deliver her baby at St. Johannis in Landstuhl. Although her husband was present, she wanted a natural birth with less clinical intervention. Highly pleased with her experiences with the hospital and services of both a doula and midwife, Chenard is training to be a certified doula. “Around 35 weeks I knew I wanted a doula, and another mom told me about the KMC Doulas page on Facebook,” said Chenard. “My midwife, who delivered my daughter, and the doula worked to keep me focused on the delivery. I was able to have a water birth — something not available at the military hospital — which helped ease my contractions. The whole experience was so different from my son’s delivery in the States, and definitely inspired me to become a doula,” she adds.

Doulas – provide labor support and companionship during the labor process. Relationships are established a few months prior to delivery, and although they are extremely knowledgeable in the childbirth process, they do not administer medical care. Seeking a doula in your area? Contact your Women’s Clinic on base/post, or your civilian physician’s clinic. You should also ask other women through a local support network. TRICARE does not currently cover the cost of doula services, which may be anywhere from $300 to $1,000.

Midwives – these nurses and nurse practitioners receive rigorous training and clinical internships to become midwives. Skilled in labor and delivery, they provide hands-on, continuous support before, during and after labor, and monitor a mothers’ physical, psychological and social well-being. Their goal is to deliver the baby, minimize clinical/technological interventions while also identifying and referring patients who need specialized obstetric care. They also provide individualized prenatal and postnatal education and counseling. Check with the Women’s Clinic on base/post or at your civilian clinic for access to midwifery staff.

Method and location options

Some facilities offer both traditional and non-traditional labor and delivery methods and locations; customize your childbirth options in numerous ways. Before choosing non-traditional methods or locations, you should consider any pre-existing conditions, or age, whether this is your first pregnancy or if you’ve had any prior complications.

Birth methods

Vaginal Birth – Traditionally the most common method, women’s bodies can recover quickly and allow for easier breastfeeding. Hospital stays are also shorter. Mothers can choose either a natural delivery or a pain management plan with medications such as an epidural or spinal block.

Water Birth – Although not available for women with pre-existing complications or for multiple births, this method is available at some birthing centers and healthcare facilities. Mothers in labor are placed in the 90-100 degree water near time of delivery to provide an additional level of comfort to both mother and baby. Babies can be either delivered in or out of the water. Once the baby enters the water, he/she is immediately removed to allow for clearing of airways and for breathing to begin. Inquire with facilities in your area if they provide this method. Hospitals have a limited number of birthing tubs, so inform your midwife or nurse as soon as you arrive to the facility that you’d like to use their tub. For more information, visit www.americanpregnancy.org/labornbirth/waterbirth.html.

Hypnobirth – For more than 20 years, the hypnobirth method has been available as a natural birth technique to help women through labor pain without the use of pain medications. Mothers are taught self-hypnosis, controlled breathing and focus techniques to better deal with contractions and the process of delivery. For more information and to locate a hypnobirth professional near you, visit www.hypnobirthing.co.uk and www.hypnobirthing.com.

Caesarean or C-Section – This is a surgical procedure in which the doctor removes the baby through an incision made in the abdomen and uterus. Recovery times are longer after delivery and may pose infection risk. This method is usually suggested for women with breech birth or complications, multiples or who have health conditions that pose problems during labor. Some facilities may use a C-section as a faster delivery method, so inquire whether you medically need a C-section before giving consent.

Birth locations

Hospitals – Those expecting complicated births (breech, multiples), planned C-sections, have pre-existing health conditions or seek more traditional methods of pain management will need to use a medical facility. Many hospitals are now adopting a more natural approach within birthing suites, providing the services of midwives for delivery with physicians standing by. They also provide specialized birthing beds, chairs, balls and water birth options, encouraging laboring moms to deliver in new, non-traditional positions that offer the most comfort. Be familiarized with their clinical staff, facility, parking, entrances, level of care (such as a neonatal intensive care unit) and policies before the special day comes. Depending on your outcome or procedure, you may have a longer stay.

Birth centers, birth homes and midwives clinics – These facilities are run by certified nurse midwives with an emphasis on natural childbirth with little to no clinical intervention. These facilities prescreen and accept expectant mothers with low risk pregnancies who seek a personalized level of care. Some facilities are stand-alone and some are connected to medical facilities for easy access to emergency care if complications occur.

Home birth – This option has become more popular and provides privacy, comfort and no clinical intervention. Water births are sometimes utilized, and certified midwives perform the delivery. The best candidates for home delivery are younger expectant moms with low risk pregnancies. Planning ahead is crucial; talk to a midwife or physician about your plan and inquire about the supplies you will need in your home. Have an emergency plan in place in case complications arise.

A birth plan

Once you have decided on the type of birth, facility and labor support you need, consider creating a birth plan. It’s great to know what you want ahead of time, but once labor starts, you may not be able to fully communicate your needs or desires. By writing down how you would like to give birth, you are creating a birth plan that will help you and your spouse communicate and manage your needs with your medical or midwifery staff once labor has begun.

Plan now for after the delivery

Want to take a quick trip to the States to show off your new addition? You’ll need your baby’s passport to do this. So, between taking care of the baby and seeking sleep, it’s important to immediately start the process of applying for a social security card and passport. Contact your base/post passport office now. They may have a packet available for download or to pick up in person before you deliver. Don’t wait to think about it; it could take you a while to locate or organize your information needed to correctly complete the passport packet.

Still hoping to get a little traveling done before the baby arrives? It’s an excellent time!

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