By Antonio V. Sison, M.D. Princeton HealthCare System
Pregnancy and childbirth are personal experiences, unique to every couple, and from preconception to delivery, the questions and decisions are many.
When do you start taking prenatal vitamins?
How will you get through the pain?
What if you need a C-section?
The Maternal-Child Health Program at University Medical Center at Princeton is committed to helping couples like you feel confident and comfortable through pregnancy and labor and delivery, as well as prepare to take care of your baby when you go home.
At UMCP, physicians and maternal and family health experts are there with you, every step of the way.
Preconception Planning. If you’re thinking of having a baby, get a healthy head start by scheduling a preconception visit with an obstetrician- gynecologist.
During a preconception visit, your doctor will give you a complete physical exam and ask you about your diet, exercise habits and lifestyle. He or she will discuss with you any changes you should make, including to medications you may be on, and will recommend steps to take to boost your chances of a healthy pregnancy.
Once you start planning for a baby, it is important to begin taking a multivitamin with 400 micrograms of folic acid a day. Folic acid is a naturally occurring B-vitamin that helps prevent birth defects of the brain and spinal cord. To be effective, it must be taken prior to conception and during early conception when the neural tube is developing.
In addition, now is the time to get in shape. Beginning an exercise routine and establishing healthy eating habits before pregnancy, will go a long way in helping you handle the physical demands of pregnancy and labor.
You’re Pregnant. Now What?
One of the first things you should do upon learning that you’re pregnant is to make an appointment to see your ob/ gyn. On your initial visit, the doctor will perform a thorough review of your medical and gynecological history. He or she will talk with you about any risk factors — such as age — that could complicate the birth and will lay out a plan for care during your pregnancy.
The doctor will continue to follow you throughout your pregnancy, monitoring your health and the health of the baby. As your due date gets closer, the doctor will talk with you about your options for delivery, including whether you want medicine to control pain, and prepare you for what takes place during labor.
When the big day arrives, the doctor will oversee the delivery, ensuring you and the baby stay safe and healthy throughout the process.
To Medicate or Not to Medicate.
Each woman experiences labor differently and has a different threshold for pain during delivery. Fortunately, there is a range of options for managing pain, from traditional pain-relieving medication to alternative methods such as self-hypnosis.
Common medications include:
• Narcotics, which are delivered intravenously to help reduce pain during the first stage of labor. They are typically not used during the second stage of labor when the mother is pushing because they can make the baby sluggish and delay delivery.
• Epidural analgesia, which is administered in a space just outside the spinal cord and decreases feeling in the abdomen, making contractions less painful, but still enabling the mother to push.
For mothers who hope to deliver without medication, there are a variety of effective techniques to help cope with labor pain. Some examples are:
1. Jacuzzi bath. Many women report that being in water during labor and the massaging power of Jacuzzi jets help ease the pain of contractions.
2. Breathing exercises. Focusing on the breath can help direct attention away from labor pain and help mothers relax during delivery. The Lamaze approach to childbirth is one of several methods that teach different breathing patterns to assist in childbirth.
3. Birthing balls. Essentially a giant exercise ball, a birthing ball can help make delivery more comfortable by decreasing the strain on muscles. The expectant mother sits on the ball and can move her hips and pelvis freely to promote the baby’s descent.
4. Massage. Massage is always a good relaxation technique, but it can be incredibly helpful during labor, especially for lower back pain.
5. Self-hypnosis or hypno-birthing. Using learned visualization and breathing techniques, expectant mothers achieve a relaxed state that allows them to work through discomfort to deliver the baby calmly and peacefully.
Caesarean Sections.
A C-section is a surgical procedure used to deliver the baby through the mother’s abdomen. While the surgery may be considered elective, most C-sections are performed when complications arise during a vaginal birth or when a pregnancy is considered high risk, such as when the baby is breech or when the mother is carrying multiple pregnancies (twins).
The American College of Obstetricians and Gynecologists finds that complications from C-sections are no greater than complications from vaginal births. However, doctors still encourage vaginal births whenever possible.
With so many questions and so many decisions to make, start talking with your doctor even before you get pregnant about what approach to childbirth is best for you — and most of all what is best for your baby.
Princeton HealthCare System’s Community Education & Outreach Program offers a complete range of childbirth preparation programs, including classes such as Birthing Basics, Prenatal & Post partum yoga, and HypnoBirthing.
University Medical Center at Princeton is a national leader in maternity care, ranking in the top 5 percent of hospitals in the United States for maternity services by HealthGrades, the nation’s leading healthcare quality company, for four years in a row.
For more information about the Maternal-Child Health Program, Community Education classes or to find an ob/gyn on staff with Princeton HealthCare System, call 888-742-7496 or visit princetonhcs.org.
Antonio V. Sison, M.D., F.A.C.O.G., is board-certified in Obstetrics and Gynecology and is a Fellow of the American College of Obstetricians and Gynecologists. He is a member of the medical staff at University Medical Center at Princeton.

