9 Things You Need To Know Before Giving Birth - Dr. Nicole C. Rankins

9 Things You Need To Know Before Giving Birth

Congratulations on your upcoming birth! I’m Nicole, an ob/gyn physician and certified integrative health coach. I’ve been in practice for over 10 years, and have had the privilege of helping hundreds of moms deliver their baby. From both research and my experience I've learned a great deal about what makes for a great birth experience. Here are 9 things I want to share with you to help you be well prepared for giving birth. 


1. there's no right way to give birth.

This one’s first because it’s really important. People have strong opinions about how women should give birth. Some say it should be without any medication. Some think it’s crazy not to have an epidural. The truth is only you can decide what will work best for you. If you don’t want to use medications to manage pain - cool! If you want an epidural as soon as possible - that’s ok! If you want to read lots of books and take courses - awesome! If you want to skip the books and just rely on your doctor or midwife for information - that works too! There are different approaches to birth and there’s nothing wrong with that. So as long as you and your baby are healthy, do you! (And be sure not to judge other women who do something different than you).

2. your doctor is important but so is your labor nurse.

Let me tell you….there’s nothing like a good labor nurse. Labor nurses are a critical part of helping you have a safe and fulfilling experience giving birth. Labor usually lasts several hours, and your doctor can’t be with you the entire time. A labor nurse’s job however, is to be with you during your labor. A labor nurse will usually have only one and no more than two patients at a time. She’ll keep a close eye on you and your baby to make sure everything is progressing smoothly, and alert your doctor to any concerns. She’ll help you with pain management techniques and coach you through pushing if needed. She gets you through the not so sexy parts (like cleaning up poop, blood, and vomit). And she’ll get you started with breastfeeding. So yes, while you’re doctor is an important part of your baby’s birth, your nurse is too.

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If you want an unmedicated birth, ask for a nurse who has experience caring for women who don't get epidurals.

3. your doctor should wait to clamp the cord.

Delayed cord clamping is the practice of waiting to cut the umbilical cord for at least 30 to 60 seconds. It can be done at the time of vaginal birth and c-section. As long as your baby is vigorous at birth, your doctor should delay clamping the cord, even if your baby is preterm. The practice of delayed cord clamping is recommended by the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and the American College of Nurse-Midwives.

There are many benefits to delayed cord clamping. In full term babies, delayed cord clamping increases hemoglobin, the part of blood that carries oxygen. It also improves iron stores in the first several months of life. In preterm babies delayed cord clamping decreases the need for blood transfusion, decreases the risk of bleeding in the brain, and lowers the incidence of necrotizing enterocolitis, a potentially devastating intestinal problem that occurs in preterm babies. There is a slightly increased risk of jaundice with delayed cord clamping, but it tends to be minor and resolves quickly.

Your Doctor Should Wait At Least 30-60 Seconds To Clamp The Umbilical Cord 

4. there should be skin to skin contact as soon as possible between you and your baby.

Skin-to-skin contact is when your baby is placed directly on your chest, belly down, with nothing (no bra or gown) between you and the baby. Skin to skin contact should happen as soon as possible after birth. Your baby can be dried on your chest, covered with a warm blanket, and a hat placed on his/her head. Skin-to skin can also be done by your partner.

If you have a c-section or if the baby needs to be assessed by doctors first, then skin-to skin contact may be delayed a bit. Just start as soon as you can within the first hour after birth. Some hospitals offer immediate skin-to-skin contact even at the time of a c-section. This is done by using a specially designed drape for the operating room table.

There are many research proven benefits to skin to skin contact including:

Benefits of skin-to-skin contact:

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    an easier transition to newborn life
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    more stable breathing
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    more stable temperature
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    helps with breastfeeding
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    you’ll have increased confidence in caring for your baby
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    it promotes bonding between you and your baby

5. labor is intense.

Most women experience labor as painful. Your attitude towards the pain plays a big part in helping you work with your body to deal with the pain instead of fearing it. Labor pain is a different type of pain. It comes and goes at pretty predictable intervals. The cause of the pain is a joyous occasion. And there’s a definite ending to it. Thinking about labor pain this way can make it easier to manage.

How to deal with labor pain is often what concerns women the most about giving birth. The good news is that you have many options available for pain management. There are effective medication free options, you can use some medication but not an epidural, or you can get an epidural. What you choose is a personal decision, and whatever choice you make is the right decision. There’s no prize for how you manage pain in labor.

If you want to know more about the options for pain management in labor, sign up below and I’ll send you a free guide. It will help you make the best decision for how you manage pain in labor. It covers medication free techniques (like hydrotherapy, hypnosis, massage), medications (intravenous medications, nitrous oxide), and epidurals.

6. your doctor may not be there for the delivery.

It’s increasingly common that the doctor who delivers your baby is not the doctor you were seeing for prenatal care. More often it’s the on call doctor or it’s someone like me - an OB Hospitalist. As a Hospitalist I only work in the hospital and 95% of what I do is deliver babies.

There are many reasons for this shift in care. A big one is safety. Doctors can’t work day after day and be up night after night and provide safe care. It also helps doctors have some predictability to their schedules and improves work/life balance. Most women still have a fantastic experience even if it’s not their regular doctor at the delivery. If you’re concerned about this, ask if there’s an opportunity before your delivery to meet the doctors who could be at your delivery.

7. giving birth is normal, but also unpredictable.

The vast majority of births are normal, healthy, and uncomplicated. But, we can’t plan exactly how things go. Birth is unpredictable, and your baby won’t consult any plans you or your doctor make. Now this doesn’t mean you shouldn’t have wishes for your how you want your birth experience to go. This is an incredibly special event so of course you have wishes about how you’d like things to go! Take some time to educate yourself so your wishes are well informed and based on good, reliable sources. Also be sure to remain flexible during the process of giving birth. Again, the most likely outcome is that you and your baby are healthy and well. But the journey to the happy ending isn’t always what you expect. Flexibility will leave you feeling comfortable and at peace however things unfold.

8. get a doula.

Doulas provide physical and emotional support during labor and the postpartum period. Most don’t have any medical training. Doulas are especially helpful if you’d like an unmedicated birth. But they’re also helpful if you have an epidural or planned c-section. Research studies show that having a doula can shorten labor, decrease the need for pain medicine, and increase your chances for having a vaginal delivery.

Choose a doula who's had formal training, doesn’t push her own agenda, and doesn’t try to replace your partner. To find a doula get recommendations from family or friends or try https://doulamatch.net/. Your care provider or hospital may also have recommendations.

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Labor support from a doula can shorten labor, decrease the need for pain medicine, and increase your chances for a vaginal delivery.

9. consider taking a look at the placenta.

The placenta is your baby's lifeline. It provides all the nutrients your baby needs and filters waste. About a year or so ago I started routinely offering to show the placenta to anyone who wants to see it. I’ve been surprised at how most people take me up on that offer! Women and family members have been amazed (ok and occasionally grossed out) at seeing the sac the baby lived in, how long the umbilical cord is, and the fleshy part that does all the work. Lots of people take pictures. 

You may have heard about some women ingesting the placenta after birth (a somewhat controversial practice). Here’s a good summary of the available evidence on the most common way women ingest the placenta -placental encapsulation. This is the practice of ingesting the placenta after it has been steamed, dehydrated, ground, and placed into pills.


I hope you found this helpful.  I'd love to hear from you in the comments which tip you found most useful.

And if you're looking for more information on managing pain in labor, download my free guide below. It's a great guide to help you understand the details, pros and cons of medication free options (e.g. hydrotherapy, hypnosis, massage), medications (intravenous (IV) opioids and nitrous oxide), and epidurals. 

I wish you a healthy and fulfilling experience giving birth!

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