Labor and Delivery With CF

Entering into parenthood with CF can be an exciting and anxious time for many couples. However, first you need to give birth to welcome your precious baby. Labor and delivery with cystic fibrosis doesn’t have to be a scary or challenging experience but there are some unique considerations to keep in mind when planning for your birth such as your lung health, how much physical activity you can handle, and CF care in the hospital postpartum.

Thinking of a birth plan

In the last trimester of pregnancy is a good time to speak to your OBGYN and CF team and discuss a birth plan that works for you and your health. You want to plan for the healthiest and safest birth possible while keeping in mind and physical abilities and risks.

Some things to consider and discuss while forming your birth plan include:

• What type of birth are you hoping for? Vaginal, C-section, VBAC, etc.
• What type of pain management will you use? Epidural, nitrous oxide gas, IV medications, no medication, massage, other therapies, etc.
• Will respiratory therapy be on-call if needed? Will you do airway clearance during labor?
• Any other complimentary birth practices? Essential oils, birth tub, doula, delayed cord clamping, etc.

Pain management considerations

During birth, there’s many pain management considerations to think about with CF. Many physicians (and mamas) advocate to get an epidural during contractions to save up energy and rest before it’s time to push in the final stage of delivery.

That being said, you don’t have to have an epidural with CF if that’s not something you’re interested in. Many moms with various lung functions have gone on to have unmedicated and healthy births.

CF care on L&D

One of the most uniquely challenging aspects of giving birth with cystic fibrosis is the postpartum care in the hospital after birth. Most labor and delivery (L&D) floors have very little experience caring for women with CF and their specific medical needs, because becoming a mom with CF is a relatively new phenomenon. Therefore, access to many specialized CF drugs, quality and quick airway clearance, and adherence to infection control guidelines may be a barrier to proper CF care on L&D.

Some tips to making postpartum CF care work for you include:

• Request your CF care team contacts the L&D floor to review a care plan
• Ask prior to delivery what specialized medications you may need to bring
• Make sure L&D is aware of CF infection control precautions

Moreover, the new role of parenthood may bring some challenges of its own but it’s vital to advocate for yourself and your CF care after birth as well.

Airway clearance after birth

In my experience completing airway clearance in the hospital postpartum was a bit of a mess. My labor and delivery floor had very few patients with CF give birth (even though the hospital is connected to the CF Center) in the past. Respiratory therapy was always late and at one point I wasn’t able to do my morning meds until 2pm. That just doesn’t work for a new mom who is trying to heal and needs airway clearance to breathe.

Some tips to make sure airway clearance is a priority postpartum include:

• Bring your own airway clearance vest
• Ask respiratory therapy to do airway clearance at specific times
• Ask if they can drop off your medications earlier than you plan to do them
• Don’t be afraid to advocate the importance of airway clearance to the entire team

Have you given birth with cystic fibrosis? What was your experience? Share with us below!