Sunday, October 19, 2014

27 Things About Labor and delivery That Every Expecting Mom Should Know:

While pregnant, I found myself caught up in arguments with my husband about my how he envisioned my labor process. He saw it as a short and quick process wherein you go to the hospital when your water breaks, women fuss and sweat while guests are waiting outside, and the baby is out so quick that there's even a risk of the delivery happening in the car. One of the times he was ranting about how he's scared I will deliver in the car, I had to sit him down and go through what was in his head and realized that all of his ideas came from the television! Quite contrary to what was going on in my head. 

Ever since I found out how babies were born, the thought of me being in that position scared the living daylights out of me. However, while I was pregnant, I tried not to think about it for the majority of my pregnancy and focused on what was going on with my baby in the present. By the time I was closer I just so ready to be done. I had over time though formed an idea of what I wanted my labor to be like, who I wanted in the room, whether I wanted drugs or not, whether I wanted my husband to cut the cord and so forth. These are all individual decisions and I'm not going to tell you what's right or wrong, as there is no right or wrong! However, I will give you some tips on things you should know - no matter what your decisions are, or will be.

(Note:  this will not be helpful to anyone who has an elective c-section coming up, but if you plan to try the normal labor route, please go ahead and continue reading.) 



27 Things About Labor and Delivery that Every Expecting Mom Should Know: 

1. Ignore everything you have seen on TV (unless you make a habit of watching birthing videos). Seriously. 

2. Yes, the first baby tends to be late, and girls (because they are, on average, smaller, do too) but there is actually no way to tell if your going to be early, or late. It's very circumstantial and depends on your pregnancy.  All you do know is that there is only a 9 percent chance that your baby will be born on its due date.

3. Even dilation and effacement doesn't give you much of an indication as you can be dilating a 'couple' centimeters for weeks before going into labor. 

4. Nor does your mucus plug. It's a discharge that happens before you go into labor (thought it can also happen during labor). It can happen weeks before or minutes before. 

5. Effacement is how short your cervix is (in percentage, at 100 percent, your cervix is completely shortened), while dilation is how open your cervix is (in centimeters). 

6. You push when you're at 10 centimeters dilated and contractions cause dilation. 

7. There are three stages of labor - Early labor, active labor (defined as contractions every 5 minutes or more, and dilation of 4 cms or more), and pushing (when you are dialated and contractions are 2 centimeters apart.)

8. Be your own advocate or appoint one (probably easier if you're screaming more than speaking).  Make sure they know your wishes and needs.

Some of the many decisions you will have to make in the hospital..



9. Make sure you know your own wishes and needs first! Would you like music, do you want to see yourself crowning in a mirror, would you like to be able to move around...., the list is endless! Download a simple birth plan (from any website) and go through the questions. You don't have to write it all down, just know what you will be comfortable with.

Some more..

10. Then, decide how much of that you can let go, as it will never be as ideal as it is in your head. 

11. Keep in mind that you have to be flexible, and let your advocate know what you would like to be flexible about. I was admitted to hospital because I felt that my son wasn't moving as much and it turned out that his heart rate was fluctuating (he stabilized but the docs decided to watch me and if needed, get him out.) However, my plan of moving around during labor and not being stuck to a bed and monitors went totally out of the window. 

12.  When admitted, tell your nurse what you would like. Don't give her an endless list or overwhelm her, just pick three things that are important to you, and let her know what they are. (Mine were - cord blood banking, an epidural and wanting both my husband and mom in the room.. Keep in mind that I was two weeks early and my mom was on a flight from India to the U.S and I went into labor while she was unreachable!!)

13. Trust your nurse. She is your best resource and has done this more times than you can imagine, and seen more than you (or atleast I) would want to know about. 

14. Pain and stress slows down the labor process and increases the chance that you will need a c-section. Try and keep as calm as possible and take things with you that will help like music, maybe certain aromas/ fragrances. You can't use candles in a hospital (oxygen + flame = fire!!!), but you can take certain oils or scents. 

15. If you can, move around during labor. Lying on your back in a bed is not the most comfortable position. Holding onto a railing, bending over, squatting, even poop position or having your husband rub your back, may be more comfortable to you. 

16. Stay at home as long as possible. Given the time of day estimate how far you are from the hospital and try not to go in until you are closer to delivering. The rule of thumb is when your Contractions are 5  minutes apart, lasting for one full minute and have been in this state for an hour. 

17. Only in 10 percent of deliveries, does your water break before your contractions start. It's usually the other way around. If your water breaks, go to the hospital. They will not be able to do too many medical exams (internal) but will need to keep an eye on how quickly your labor is processing as your child is now susceptible to infections. 

18. You actually can have a glass of wine while Laboring at home. (As per medical professionals, not just me. This was all in my plan that went out the window.) 

19. I know there's all this buzz about natural labor, but don't feel forced, pressured or stressed to do anything you are not comfortable with. There's no shame in wanting an epidural, or even other drugs during induction or while your labor is starting. You have grown a baby, you are already a hero. (Again, the more you stress or are in pain, the longer your labor and more likely you are to need an induction or c section due to the effect of stress hormones on the labor process.) 

20. I don't believe in making your decisions for you but I can't resist adding this - Home delivery, to me, is for pizza, not for babies. Get to a hospital, your child's life is in question, as is your own, why would you not want to have licensed medical professionals around? 

The talented Namita Azad struggled to get one of these with Coco in them too.

21. Epidurals are given in the spine. I was more terrified about this than the entire process because I knew I was going to get one. But honestly, it's given when you need it, and at that point the prick in your spine is really not as painful as the contractions. (My epidural was given by a resident because I was desperate, it was given 6 times because and I didn't care much about the pain from the injection because I was so excited to finally be getting some relief about 18 hours of labor). No you will not be groggy it does not put you to sleep but it does help you get some rest while your body prepares for labor. And no, it will not make your baby sleepy, all newborns are sleepy at birth (more on this next week). 
This was the best we got!

22. Group B strep is a type of bacteria that lives in your birth canal. Most women do not have it but some do, just like yeast. You will be tested a few weeks before delivery, and if you are positive you will be given iv-penicillin (or another antibiotic if you are penicillin allergic) every 4 hours during labor, to protect your child. Take the meds for your baby but don't stress about a positive diagnosis, and don't google the crazy list of signs either. You will just get scared and you don't need that right now. 

23. Do you believe in insurance? Cord blood banking is just that, it's an insurance policy for your baby and actually, your entire family, against any potential issues your child or relative or sibling can have in the future. If you can afford it do it, all you have to do is send the umbilical cord and placenta (the nurses will do it for you entirely), which would otherwise be medical waste anyway. (Note, in some hospitals you can donate it if you are not banking it.) 

24. Delayed cord clamping is all the rage nowadays. But while it does increase the iron your baby has in their blood at birth it also increases your baby's odds of getting jaundice as all that iron is hard on the baby's liver. You can always do a minute clamp and not wait for the umbilical cord to be completely dead, as that is a healthy medium (and will leave your cord bankable.) 

25. Even if you do end up with a c-section, insist on skin to skin as soon as you are able. It calms down your baby immediately, it helps you bond, it helps you nurse, it's been shown to be better for your baby's health in the short and long term, and it helps them recognize you! 

26. I was terrified about the recovery and had a lot of stitches, I didn't have an episiotomy (when the doctor has to cut, as that is no longer common practice  in the US but is practiced in most places), but I did tear. I must say, the doctors and nurses gave me great tips and meds (baby safe), and it was not as bad as I expected.

27. Breathe, breathe, breathe... Or don't! I practiced breathing while holding cubes of ice for a minute at a time.. And yet, when the time comes it's the last thing you want to do (unless you have superhero concentration) or be told to do.
I don't think any mom looks good in this post delivery shot!
But until you get there... Breathe!!!! It will be there, and will be over before you know it. You will be left cuddling your bundle of happiness (and desperate to sleep). 

I haven't gone in depth on many subjects, but if you have questions or want to know more, feel free to reach out.

I will be back with more on what to expect from your newborn baby.

More to come! 
-TKV








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