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Having a baby is truly a remarkable event. It is a once in a lifetime experience, or one you may experience more than once. If more than once, you can be sure that each birth will be completely different than the one before!
Pregnancy and birth is a magical mystery. Your health care provider can’t even predict with absolutes when the happy event will occur.
There are only guidelines to follow and signs of impending labor to watch and prepare for. I like to call these signs “labor behavior” because it’s all physical. As already discussed, when, where, and how is totally individual and up to your body and baby when it’s ready.
Forget all the bad stories you have heard, focus on your own pregnancy experience, and read some good stories about birth instead!
Because pregnancy and birth is a mystery it comes with uncertainties and unknowns of how your labor will progress. This certainly is a cause for potential apprehension and fear – understandable.
However, if your pregnancy has been going well – meaning no major problems, you’re in good health, you feel baby moving, you are seeing your healthcare provider routinely, etc., there is no reason to believe that you would have an unhealthy baby, or problems giving birth.
But, expectations of what you want or don’t want during your birth experience can cause additional stress, just like watching the clock can as well! So don’t do either!
Birth teaches us patience. Birth happens in it’s own time.
So, “go with the flow”, toss the clock, and just let your labor unfold in its own way.
Now, life is filled with unknowns. Life is FULL of unknowns and they happen everyday when you walk out of your home in the morning! But we don’t dwell on what we don’t know, do we? Everyday is a new day filled with unknowns, but we don’t lock ourselves up in a closet everyday. No. We live our lives. We travel, commute to work, meet people, move to other cities, and so on. Eventually returning home safely without mishap or accidents.
We live life regardless of the unexpected and manage to live with the outcomes of the unexpected.
What’s different here is you KNOW ahead of time you are having a baby and the process of birth will challenge you on some level physically and emotionally. This is awesome because you know the experience is coming and now you can prepare for and manage it!
Once I had a new mother in labor and she was so worried about what was going to happen, she was very tense. All she could think about were the horrible stories she heard about labor. She kept waiting for everything she heard about to happen to her and it didn’t! As her labor intensified, progressing steadily towards near delivery of her baby, she used the breathing techniques (no epidural) learned in her childbirth class. after one hour of pushing, she delivered a healthy baby boy. Sometime later she pulled me aside and said ” Ya know… that wasn’t so bad after all.”
The point is you can “psyche” yourself into having an imagined horrible birth experience! What you expect may never happen, and sometimes events may happen that you didn’t expect. But, you’ll know what they are.
What are some unexpected events?
- Miscarriage: This can happen at anytime in the first trimester. It certainly is upsetting when it happens. However, it’s your body’s way to rid a fetus that either has not implanted well, or for other most likely unknown reasons. This does not mean you can’t get pregnant again, or have to wait a period time, etc. Many women miscarry, get pregnant again and have healthy babies.
- Preterm Labor: Some women experience preterm labor which can be controlled by medications. 36 weeks and earlier of gestational age is considered preterm. This has to do with the lung maturity of the baby. 36 weeks and earlier, baby’s lungs are immature and may need medical assistance for it to breathe in room air. 37 weeks or later if baby were born, it would do well without medical intervention. If your are experiencing contractions, about 4 or more times in an hour, and they come and go throughout the day, are earlier than 36 weeks in gestation, you may be in preterm labor. Call your healthcare provider, even if you are not sure what you are experiencing. The medication they use to stop the contractions is Brethine, which causes the uterus to relax. Side effects for you may be increased heart rate, restlessness, tremor, drowsiness, weakness, and headache. They may also give you another drug, a steroid, to help the lungs of the baby mature. The decision to use these treatments would depend on the results of your examination performed by your physician or Midwife.
Stress has been recognized as a potential cause for preterm labor. Learning relaxation skills and using them daily throughout your pregnancy may significantly reduce the risk of preterm labor.
- drink lots of water to stay hydrated. Dehydration can cause contractions
- change your position. If standing, go lie down
- If contractions continue, call your doctor or midwife
- Fast labors: Sometimes, women experience fast labors! This is often the case if you have had more than one child. But, there are times when a first time mother has a fast labor in the hospital lasting less than three hours, and accompanied with strong contractions. If you think that your labor is happening rapidly, call your health care provider, and go to the hospital. If no one is with you to take you to the hospital, call 911, they are emergency professionals.
- The use of instruments: Such as forceps and vacuum extraction to deliver baby. These are usually used in difficult deliveries and at times when mother has been medicated, not pushing effectively, and/or overly exhausted. Reasons vary and this is a great conversation to have with your care provider BEFORE you go into labor. 🙂
- Episiotomy: This is an incision done on the perineum (the area between the vagina ad the rectum) to create a small amount of space, or room, for baby to birth vaginally. Medication is given locally, such as Lidocaine to numb the area prior to the incision, or if you had an Epidural you shouldn’t feel it because of the numbness already created through the epidural. This is a spontaneous decision made by your doctor or midwife and should be discussed beforehand at one of your prenatal visits. They are done less today making them less “routine” as it once was, but still occur. CARE: Sitze bath soaks daily. Start them usually 24 hours after birth and continue until you don’t need to do them anymore. Print out this handout for more information:
- Induction: The truth is, labor starts on it’s own. But many pregnancies are induced and not always with great outcomes – premature development of babies, increased rates of Cesarean births, not to mention the emotional toll on mothers. The current recommendation for when an induction should happen is 39 – 40 weeks of gestation, and there should be a MEDICAL reason for it.
- Cesarean/Surgical Birth: Now, here is a hot topic in the USA! It is estimated that about one in four women will have a Cesarean birth – although startling that number is increasing! Why? One reason is the increase in labor inductions, your physician’s philosophy of care, circumstance, and how informed you are about managing your labor and choices available to you. So, it’s a good and FAIR question to ask your physician what percentage of his/her deliveries are Cesarean, and what his/her philosophy of delivering babies is in general. Remember when Doulas were mentioned earlier, (need a review) and it was stated that research has shown that the use of a Doula with a laboring woman, decreased the rate of Cesarean births (good book-Mothering the mother, all about Doula care and research studies)? Why? Because Doulas provides continuous emotional and physical support, which helps the laboring woman to RELAX and cope emotionally during her labor. Many times this is ALL a woman needs! Visit Doulas of North America www.dona.org
There are many factors involved in the decision to have a Cesarean birth.
- well-being of you and your baby.
- labor progression
- your anatomy
- baby’s anatomy
- the size of your pelvis
- baby’s position
- the size of the baby
- your stress level and coping abilities
- fetal distress
- your health during your pregnancy and labor
- your age
- history of sexual abuse
Often these factors do not present themselves until you are in the throws of labor and your physician makes a judgement call to perform a Cesarean birth. Many times a Cesarean birth is the only way to give birth for medical reasons in which case it will be planned by you and your physician, and performed before labor starts.
- placenta previa
- multiple births
- pre-ecalmpsia (toxemia)
- breech, or transverse position of baby
- active herpes
- Gestational diabetes
For these reasons it’s best to view Cesarean birth as a medical option if needed – depending on your personal situation.
There are emergencies when a Cesarean birth is necessary:
- Cord Prolapse: Baby’s umbilical cord is outside the opening of the cervix, and pressure from the baby’s head is compressing the cord compromising oxygenation to the baby.
- Placenta Abruption: Premature separation of the placenta from the uterine wall, causing pain, bleeding, and a rigid abdomen.
- Cephalopelvic disproportion: An incompatibility of the mother’s pelvis and the size of the baby’s head.
- Uterine Rupture
- Fetal Distress: Consistent drops in fetal heart rate
Can you avoid a Cesarean Birth? You can certainly do your best by:
Throughout your pregnancy, and early labor, eat healthy and drink plenty of fluids ( No dehydration aloud! ). Keep your prenatal appointments. Take your prenatal vitamins. Learn all you can about medications, and remember how they effect your body’s chemistry and muscle function. Ask your physician about his/her Cesarean rate (FAIR question!).
- Take a childbirth education class to learn about medical interventions, fetal monitors, inductions, augmenting labor…etc. Learn about and know your options, and how to manage your labor with or without medication.
- Throughout labor stay active by moving and changing positions, walk, take warm baths, use your breathing techniques with massage and visualization, and RELAX..
- Avoid taking medications in early labor if you can. If you have an epidural, have the anesthesiologist decrease the amount of medication so that you may feel the contractions and work with them when it is time to “push”.
- Avoid being induced. There is a high correlation between induction and increased rates of Cesarean births.
One last thought: It’s important to know if you have a Cesarean birth – you did not fail in giving birth.
You carried that baby for nine months, you worried, and felt amazed at the life inside you, you gave life and delivered that baby into this world and into your arms. You will love that baby no differently than a woman who gave birth vaginally. You may feel disappointed, sad, feel a loss that a fundamental attribute of being a woman was taken from you, yet you are no less because of it. You are more in spite of it. Allow yourself to feel so, it’s alright.
Afterthought. Things are slowly changing in the operating room for Cesarean births in the USA. Watch this video. Then ask your doctor of midwife if you can do the same in the OR:
- can I do skin-to-skin in the OR
- can I start breastfeeding in the OR
- Can I keep baby snuggled on your chest/breast while being moved into the recovery room
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