Medication Yes No Yes No Breastfeeding Formula Chooses to stay with current OB/GYN Chooses hospital Schedules an induction Elects to have amniocentesis Elects to have an epidural Enters labor intending on vaginal birth Refuses a c-section Starts breastfeeding Prenatal Testing Provider(s) Place Scheduled Induction Pain Management “I’ve always been comfortable with my doctor—switching never crossed my mind.” “I hate surprises, plus my mom wanted to come to town for the birth. Modern medicine can do some great things.” “I heard of people scheduling c-sections, but I felt in control enough planning an induction and figured recovery would be quicker.” “I’d already ruled out a c-section and wasn’t ready to give up so easily. But I wish I’d known how powerless the epidural would make me feel.” “Formula seemed like an unnecessary expense at first, so I looked into the nutritional facts. Mom talked me into breastfeeding though.” “I thought about other options, but knew I’d give into the pain so just went with the epidural.” “There are a quite a few hospitals in the city—I toured the ones close to work and home, and picked the one with the nicest staff and rooms.” “I was back and forth, but did it to be on the safe side. Was really scared when I thought I was having a miscarriage, but it turned out to be alright.” Planned Method of Birth Failure to Progress Feeding Vaginal C-Section VBAC Try Alternative Positions Wait Emergency C-Section Hospital Birth Center Home Stay with current Switch Add Another Labor & Delivery Postpartum Pregnancy Pre-pregnancy Option eliminated because of epidural DEMOGRAPHICS 39, Getting Married, 1st Pregnancy Northeastern Big City, Master’s Degree Systems Analyst, $80k+, Private Insurance GOALS Have a safe pregnancy Get through it without too much discomfort Balance maternity and her career NEEDS & OPPORTUNITIES Provide Harriet with authoritative information about prenatal testing, induction and concerns for older mothers Support Harriet’s conversations with her doctor about exercise and labor options Remind Harriet to consider whether circumcision and other post-birth procedures are right for her child OB/GYN recommends testing Visits local hospitals for maternity tours Comes across information about natural methods, brie y considers Lamaze, but doesn’t have time to take a class Has heard of epidurals and starts looking online for details Starts researching formula after seeing an advertisment Discovers prenatal testing while researching “advanced maternal age” - online forums send mixed messages Wonders if she can schedule the birth, discovers induction Mom sends info from La Leche League OB/GYN suggests c-section Reads forum posts about scheduling c-sections Statistics about prenatal testing [1] EM Reads about risks but decides to induce anyway [3] EM Reads about pain management options [2] EM Learns about long recovery for c-sections [4] EM #XJOURNEYS @UXJAM 11
doctor promised. As he finishes s2tching and cleaning her up, Yen cranes her neck to try to see her baby on a warmer in the corner of the room. She is itching to try to breasCeed, but the nurses tell her she needs to rest. Her boyfriend paces back and forth between the baby and Yen’s side, and finally the nurses wrap up their procedures and permit him to hold the liFle girl. He brings her over and Yen tries to feed, but the newborn is 2red and more interested in napping than latching. Yen is disappointed and finally gives up. Yen is open to geGng an epidural for the pain, but tries using a tub to manage pain and try different posi2ons to keep labor progressing. Her boyfriend comforts her throughout, while her doula guides her based on their strategy, periodically reassuring and reminding her why they made certain decisions. The birth is quicker than Yen expected, and soon she is holding her baby girl. Yen is stunned at how alert the newborn is and overjoyed when she latches on and begins to breasCeed. #XJOURNEYS @UXJAM 15