A birth plan can help you feel prepared for labor, but birth does not always go according to plan. In this solo episode, Dr. Sasha Hakman shares her perspective as both a board-certified OB-GYN and a mom preparing for her third delivery after IVF. She breaks down birth plans, hospital vs. home birth, induction at 39 weeks, VBAC and TOLAC, epidurals, doulas, delayed cord clamping, cord blood banking, and the interventions that may come up during labor. Most importantly, she explains why informed decision-making, flexibility, and finding a care team you trust matter more than creating the "perfect" birth experience.
In this episode, we cover:
→ How to create a realistic birth plan, why Dr. Sasha prefers a one-page list of preferences, and why shared decision-making and informed consent should be at the center of your delivery experience
→ The different approaches to birth, including low-intervention and unmedicated labor, epidural-focused plans, planned induction, scheduled C-section, and TOLAC (trial of labor after cesarean) with the goal of a VBAC
→ Home birth vs. hospital birth, the risks Dr. Sasha considers when choosing where to deliver, who should not consider a home birth, and why she personally prioritizes delivering at a hospital with a high-level NICU
→ Dr. Sasha's first two birth stories, including her scheduled C-section for a breech baby, her unexpectedly fast TOLAC and vaginal delivery, and what those experiences have changed about her birth plan for baby number three
→ 39-week induction vs. waiting for spontaneous labor, what the ARRIVE trial found about elective induction, and why Dr. Sasha personally hopes to deliver by 39 weeks
→ How an induction of labor actually works, including cervical ripening, Foley balloons, Pitocin (oxytocin), medication options, membrane sweeps, dates, nipple stimulation, and why some induction medications are not appropriate after a previous C-section
→ Low-intervention labor, when to go to the hospital, why active labor is now generally considered around 6 centimeters, intermittent vs. continuous fetal monitoring, eating and drinking during labor, and choosing the position that feels best for you
→ Why Dr. Sasha has changed her perspective on doulas, how the right doula can provide continuous support and advocacy, and why your partner may need support during labor too
→ Epidurals and pain management, including the benefits and risks of epidural anesthesia, whether epidurals increase C-section risk, IV pain medication, spinal headaches, blood pressure changes, and why Dr. Sasha plans to request an epidural early this time
→ What happens during pushing and delivery, including tearing vs. episiotomy, vacuum and forceps-assisted delivery, and when interventions may help avoid an emergency C-section
→ What happens immediately after birth, including skin-to-skin, delayed cord clamping for 30 to 60 seconds, placenta delivery, postpartum Pitocin, breastfeeding, and monitoring for postpartum hemorrhage
→ Cord blood banking vs. donation, why Dr. Sasha does not personally plan to use private cord blood banking, and why she prefers donating cord blood to a public bank when possible
→ Dr. Sasha's birth plan for baby number three: spontaneous labor if possible, delivery by 39 weeks, early pain control, continuous fetal monitoring, openness to intervention when medically necessary, and ultimately one priority, a healthy mom and healthy baby
Follow Dr. Sasha! TikTok: @sashahakmanmd Instagram: @sashahakmanmd @tryingpod YouTube: @sashahakmanmd
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