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Lamaze Care Practices: What They Are & How They Can Help

October 17, 2012 By Cara Terreri 2 Comments

Common sense tells us and research confirms that the Six Lamaze Healthy Birth Practices featured in these video clips and print materials are tried-and-true ways to make birth as safe and healthy as possible. But don’t take our word for it — click through to watch each of the short clips to learn more about safe & healthy birth and how best to achieve it, no matter where you give birth.

Introduction: Safe and Healthy Birth Practice - Download PDF

#1: Let Labor Begin on Its Own - Download PDF

#2: Walk, Move & Change Positions - Download PDF

#3: Have Continuous Support - Download PDF

#4: Avoid Unnecessary Interventions - Download PDF

#5: Get Upright & Follow Urges to Push - Download PDF

#6: Keep Your Baby With You - Download PDF

Download the complete booklet here.

Lamaze International partnered with InJoy Productions and their new Mother’s Advocate program to provide you with this free, evidence-based educational material.

Filed Under Birth, Coping with pain, Dads, Featured Story, Healthy Birth Practice, Hospital Birth, Labor, Parenting, Skin-to-Skin, Support Tagged With Healthy Birth Practices

Lamaze Breathing: What You Need To Know

September 24, 2012 By Cara Terreri 1 Comment

Once upon a time, the hallmark of Lamaze chidbirth education was “breathing” (hee, hoo, hee, hoo). Over the years, Lamaze has evolved into a comprehensive approach to childbirth, part of which are comfort measures for labor; breathing is one of the suggested comfort measures. So what does it mean to “breathe?” Here’s a little on what you should know (excerpted from The Official Lamaze Guide: Giving Birth with Confidence by Judith A. Lothian and Charlotte DeVries):

 

Breathing in Pregnancy:  A Daily Check-in
Finding the time, energy, and peace to face your fears—or do anything that requires mental focus—is a challenge in our culture. One pregnant woman shared that after years of working at her office, she’d tuned out the sounds of phones ringing and computers clicking. She didn’t even notice how noisy her office was until an older coworker looked at her across the bank of desks and said, “You’re bringing this child into a world of sounds my babies never heard.”

It’s true: In just a decade or two, technology has changed the world dramatically. From cell phones to ATMs, from microwave ovens to Facebook friends, from high-definition DVDs to iPods, technology fills our days with vivid images and messages. It’s a noisy, busy world that can crowd out the peace we need to connect with ourselves.

Connecting with yourself is an important task during your pregnancy.  It’s a big job to pay attention to all the physical, emotional, and spiritual changes you’re experiencing. It takes concentration to envision a future that includes a new role and a new person. Finding a place of stillness for a few moments each day can help you do this crucial work.

Even if your space and your schedule are crowded, you can find a place and time to keep a daily appointment with yourself. Perhaps you can retreat to the corner of your bedroom, the bathroom, a closet, or an empty room at your workplace. Perhaps you can sneak a moment before others wake up, after they’ve gone to bed, before you get in the shower, or during your lunch break. You might want to “check in” at the same time each day so you treat this appointment with yourself as the important time it is.

Your daily check-in may be a few moments of silence, meditation, or prayer. You can use this time to get in touch with not only your feelings, but also your body and the little one who is taking up more and more of it. Close your eyes for a moment and listen to your breathing, then take an inventory of yourself: Are there any tense areas in your body—neck, shoulders, throat, hands, back? Is anything nagging at your mind? Doing a full-body and -mind check will help you identify what needs to be released, relaxed, or dealt with.

 

Breathing Benefits from Yoga Practice
Yoga, an ancient form of exercise that includes breath control, meditation, and body postures, has become popular among pregnant women. It’s easy to understand why: Many yoga exercises include movements that open the pelvis. Yoga also teaches rhythmic breathing, concentration, stamina building, and relaxation. Some women who do yoga report improved physical coordination and more balanced emotions.

 

Lamaze Classes and Breathing
Lamaze classes prepare women for a safe, healthy birth by providing the most current, evidence-based information about birth, simplifying birth, and helping women navigate the maze of modern obstetrics. Be wary of “Lamaze” classes that spend a lot of time practicing relaxation and breathing and little or no time building your confidence or discussing how to keep things simple and how to have the safe, healthy birth you want in the birth setting you have chosen.


Breathing: Finding Comfort in Labor
When allowed and encouraged to, a woman will naturally move, moan, sway, change her breathing pattern, and rock to cope with contractions, eventually finding the right rhythm for her unique needs. Such active comfort-seeking helps her baby rotate and descend and helps prevent her labor from stalling. As her contractions get stronger, her body releases endorphins—nature’s narcotic—to ease her pain.

Conscious Breathing
Conscious breathing (especially slow breathing) reduces heart rate, anxiety, and pain perception. It works in part because when breathing becomes a focus, other sensations (such as labor pain) move to the edge of your awareness.

Conscious breathing is an especially useful labor tool because it not only keeps you and your baby well oxygenated, it’s also easy to learn and use. It’s naturally rhythmic and easy to incorporate into a ritual. And best of all, breathing is the one coping strategy that can’t be taken away from you—even if you’re stuck in bed attached to an electronic fetal monitor and intravenous fluids.

Conscious (or patterned) breathing used to be the hallmark of Lamaze childbirth education. For many women, it’s still an important way to stay relaxed and stay on top of their contractions. It’s true that conscious breathing can help you relax and feel less pain during contractions.  There’s no “right” way to breathe in labor, despite what others may tell you. Slow, deep breathing helps most women manage the pain of contractions. But the right way for you to breathe is whatever feels right to you. Issues like your number of breaths per minute, breathing through your nose or your mouth, or making sounds (like hee-hee) with your breaths are only important if they make a difference for you.

It may help you to have a visual focus to accompany your conscious breathing. You can recall an image with your eyes closed, focus on a picture or special object from home, keep your eyes on your partner, or simply stare at a spot on the wall. You may also find that as labor progresses, faster, shallower breathing—like a dog gently panting—feels better. You’ll figure out what works best for you. And what works best will probably change as you move through labor.

Many women “practice” breathing during pregnancy by using conscious breathing when everyday life presents stressful situations, like being caught in traffic, running late for an important meeting, or worrying about any number of things.

Find Your Rhythm
At some point in labor, you’ll “find your rhythm” or “get in a groove,” much like a marathon runner does. You’ll be living in the moment, doing without thinking.  To others you’ll appear to be in another world. Your movements will be rhythmic; you’ll relax between contractions; you’ll respond to contractions in the same way over and over again, perhaps shaking your arms, rolling your head, breathing slowly, chanting, or praying.

You’ll be totally focused, but you won’t necessarily look comfortable. You’ll look like you’re working very, very hard—which you are. When this happens, you’ll know endorphins are working their magic—dulling your pain and helping you ride your contractions intuitively. You’ll be doing exactly what you need to do. You won’t need to be rescued; in fact, the worst thing that could happen to you at this point is to be disturbed or interrupted. A healthy dose of encouragement, support, and respect are all you’ll need from your support team.

Do you have experience with conscious/patterned breathing during labor? How did it affect your birth experience?

Filed Under Birth, Breathing, Coping with pain, Featured Story, Health and well-being, Labor, Pregnancy Tagged With Lamaze breathing

22 Ways to Make Your Birth Easier

February 3, 2012 By admin 2 Comments

By Lyn Dee Rankin, LCCE, CLS

21 ways to make your birth easier? It is all in the birthing bag that every pregnant woman should assemble in her last trimester. This is the bag that goes with you for birth — different from the suitcase you pack for the hospital stay after the baby is born. Wherever you choose to birth, you and your labor support people can be well prepared for the potential use of many items to make labor easier. The image of the Mary Poppins bag comes to mind. Different items serve specific purposes, but may simply serve as a distraction or a much needed change to support relaxation, focus, confidence and resolve so as to move through intensifying uterine waves (contractions). Consider the following:

  1. Written birth plan/preferences: It is helpful for all involved to have a reminder handy of what your preferences are. A mother-led birth helps result in a satisfying birth.
  2. Clothing to maximize freedom of movement in labor in and out of a birthing room (light shirt, sweater or robe and slippers or warm socks); anything to replace or cover a typical hospital gown.
  3. Focal Point: Many women practice relaxation using both internal and external focal points. Use one you can take with you.
  4. Favorite music or relaxation narrative on a portable device: Several compilations from smooth, relaxation, to motivating, movement music may be chosen during different times in labor for calming “zoning out” or rocking and dancing to encourage baby’s descent.
  5. Lollipop: Especially sour candy on a stick promotes salivation to keep mouth moist and deliver sugar for energy. The stick allows taking out to breathe.
  6. Breath spray or mouthwash: If support partners are breathing closely with birthing mom….
  7. Juice: A small can of sweet juice or energy drink to add to ice chips.
  8. Washcloth for cooling moisture. Colored so it can be distinguished from facility’s white ones.
  9. Lotion/oil for massage.
  10. Lip balm: It just feels good.
  11. Distractions: Cards, portable game for prolonged labor and distraction
  12. Back massage devises: Commercially designed rollers or just tennis balls in a can. (The balls alone are useful for easing back labor and the entire can rolled in a towel works well too.)
  13. Aromatherapy
  14. Mood lighting if birthing room has limited light control.
  15. Birth ball if not provided at facility.
  16. Hair accessories to pull hair from face.
  17. Labor log to record timing of uterine waves and other sign posts of labor (don’t forget a pencil/pen).
  18. Timing Device to track progress through length of uterine waves — stop watch, watch with a second hand, etc.  Reminding a laboring woman of her progress through each uterine wave builds confidence and resolve, one wave at a time.
  19. Labor positions on a list or a set of cards of each position to post around the labor room. It is essential that labor support partners promote movement and changes in positioning throughout labor.
  20. Support partners’ notes for reference. Childbirth educators usually provide summaries of labor signs and suggested appropriate coping techniques. Written narratives for relaxation and mediation will ease labor. No one is expected to remember it all!
  21. Support partners’ snacks: A well-nourished, comfortable support partner will be your best advocate.
  22. Support partners’ trunks or bathing suit for joining you in the shower or tub.

AND DON’T FORGET…

Key phone numbers: Birthing facility, doctor, support persons and family.

Last minute additions:  Wallet and insurance documents, glasses and contacts and respective cases, camera and phone.

Lyn Dee Rankin is an experienced educator, having taught children and adults since 1976 in multiple areas of Health Education and served on educational boards. As an independent, non-hospital Lamaze Certified Childbirth Educator, she has prepared hundreds of couples for safe and healthy births, and has had both a vaginal and cesarean birth, and breastfed both of her children. 

 

Filed Under Birth, Birth plans, Coping with pain, Featured Story Tagged With birth bag, Hospital Bag, pain relief strategies

What Does a Contraction Feel Like?

September 12, 2011 By Cara Terreri 12 Comments

This is probably the most oft-asked question by first-time expectant moms, preceded only by “How will I know I’m in labor?” The textbook answer is something along the lines of, “The way a contraction feels differs from woman to woman, but in general, you will feel a all-over tightening of your uterus and pain or cramping that may begin in your lower back and radiate to the front of your uterus.” Of course, if you do a Google search or spend any time on an expectant moms’ web board, you’ll come across responses that range from “intense menstrual cramps” to “pressure and back pain.” Some women experience what they describe as very intense pain while others describe contractions as nothing more than dull, crampy aches. And, your experience with labor can also vary greatly from one child to another.

Having just [very] recently experienced labor and birth again for the third time (this time without any medical pain relief), I would describe a contraction in active labor as an all-encompassing kind of pain. There was the tell-tale uterine tightening, but then the sensation is something that is hard to describe — I felt it mainly in my abdomen, but it was so intense, my whole body reacted to the feeling. Since labor with my first child, I’ve always said that with a contraction, it’s as if there’s no way to escape it when it’s happening — you just have to succumb — but yet when each contraction is over, the pain relief is immediate and complete. I would describe the experience as intense and painful, but manageable. It was nothing my body couldn’t handle as long as I was free to move and do what helped me cope with the pain. Now, the minute I had to be confined to a certain area or position, it was awful! For example, the car ride to the hospital was NOT fun!

Here is how nine other women describe their contractions:

Throughout my pregnancy, the Braxton Hicks contractions felt like little charlie horses over the top of my belly. When I was in labor for my first child, I remember finally deciding to get the epidural and when the medicine started to work, it only worked for half of my body. One side was bearable while the other side felt like it was being squeezed and twisted as far as it would go. I couldn’t believe the difference. I would have preferred to have all or nothing! Also, having had three kids now, I will say that the difference between contractions with and without Pitocin is night and day.

–Vanessa

I think contractions feel like a combination of nasty period cramps and horrible bowel movement cramps at the same time. I know they say they start in your back, but I felt like mine started everywhere at the same time.

–Maddy

My contractions with my second pregnancy were completely different from my first. With my first, they were the textbook example of a contraction. The pain started at my sides and worked it’s way to the middle of my stomach. They started out like pretty mild menstrual cramps and then became completely unbearable. With my second labor, I suffered from pubic symphysis dysfunction and all of my contractions started in my lower back and moved to the front of my lower abdomen and into my pubic bone. They were really severe very quickly after my water broke. And with every single one I felt the urge to push. Of course, the doctors and nurses told me not to since I was only 4 cm dilated! I labored for 36 hours! I now wonder if I should have listened to my body and pushed a little it would have went faster. Who knows. Labor is a funny thing. I just learned that every labor and pregnancy will be different!

–Bri

I agree with Vanessa, contractions with Pitocin versus without it are so so different….black and white. And with my first, it was back labor so it was also totally different. They were throbbing and long and it felt like my back was going to split open. With my home birth, the contractions felt like a deep, deep ache. Deep down inside my body, almost as if the sensation of my cervix spreading combined with my son descending were like my bottom was going to fall out…but in a good way. A productive way. Thinking back, they weren’t painful as much as a feeling that snapped me into the present.

–Pamela

With my second, I felt only a long, long awful pain across my entire abdomen. From the outside, you could feel that my whole abdomen was rock hard and it felt like a charlie horse, only a million times worse. The pain didn’t change or come and go, just remained for hours. On the monitors, it was showing that I was contracting every two minutes when I got to the hospital, but again to me the pain and hardness never stopped and started, just constant. With my first son, the pain was fairly textbook as menstrual pains that got worse, deeper, and closer in time as labor progressed.

–Alicia

With each of my four births, my contractions have been different. For number one, I was induced with Pitocin. I had been planning an unmedicated birth, but was told in my childbirth education classes that it was impossible to have Pitocin without an epidural, so each contraction was a fight for the birth I wanted. Ultimately, I had an epidural that didn’t work, and I dilated completely unmedicated. The second time I was also induced with Pitocin, but was absolutely certain that I would have an unmedicated birth, so each contraction was a validation that I was strong, and could do it. With my third (I had become a doula and childbirth educator), I had absolute trust in my body, and each contraction literally felt orgasmic. They were intense, but after the peak of each one, I felt the same rush that I do after an orgasm. It was amazing! With the fourth, I was in complete denial for most of my very rapid labor, so each contraction was almost a surprise. I had intense back labor, but if I vocalized throughout the contraction it was bearable.

–Liz

With my first, I felt no Braxton Hicks or at least I didn’t know what I was feeling. My labor started with what I could only describe as a “funny feeling” in my belly…I didn’t feel cramp-like sensations or hardening until later on. As I progressed, I definitely felt the tightening, hardening feeling with intense cramps but all in my abdomen area…nothing in my back. With this one, I have been having BH contractions for quite some time. They began early on for me and the sensation felt like the baby was doing a twirling or twisting motion. Eventually, I realized that they were BH contractions and felt the classic hardening, tightening in my abdomen.

–Becky

With my first birth, they started out similar to menstrual cramps and gradually became more intense like extreme bowel movement cramps. It was that menstrual cramp feeling in the beginning, though, that distinguished them from the Braxton Hicks cramps I’d had through the pregnancy and let me know it was “real” labor. Once I was about halfway dilated it felt like one big constant contraction, with no rest in between, even though the monitors showed a brief break between them.

The contractions felt different with my second birth, though, and I wasn’t sure I was really in labor. They didn’t feel the same way they did the first time around, and my BH contractions had been so intense and uncomfortable (painful, not just the tightening feeling) the last month or two of my pregnancy, that I constantly felt like I was in early labor. My baby was “sunny side up” that time too, so more of the pain was in my back. My mother and mother-in-law had told me they never knew when they were having contractions, just felt the pressure of pushing at the end. That astonished me. My mom literally never knew when she was having contractions, just knew that she “felt funny.”

–Brittany

I am an old woman, and my kids are 14 1/2 and almost 11, so it is hard to remember the details of the sensation of contractions. I had a c-section after pushing non medicated for 5 hours with my fat, 9lb 37 week direct OP baby (occiput posterior — baby who is facing up instead of back), and a non-medicated VBAC with my second, so feel like I really got a sense of what things felt like. They started as menstrual cramps, and an ache in my lower back, moving around and increasing in intensity deep in my pelvis. I did not have back labor with either, even the OP babe. I have to say that I did not think they were that bad, I mean, intense, yes, requiring deep focus and coping, yes, but the worst pain I ever felt? No! It was very freeing to surrender to the contractions, doing whatever felt good, no matter how crazy or silly it seemed. From my two datapoints, I seem to take forever to labor/dilate to 3 cm, and then go from 3-10 really fast! Labors last about 36 hours each, in both labors, I immersed myself in the tub, completely, except for my nose, when I had the intense contractions, removing all the sensory stimulation, ears underwater, eyes closed, remaining really loose. Alternately, I did a lot of deep vocalization. As I said, hard, yes, intense, yes, all encompassing, yes, body wracking, yes, but incredibly painful — no. If I could, I would labor and birth once a year! No pregnancy, no baby to keep, just a big ole labor and birth! It was the hardest, most intense, but doable work I have ever done!

–Sharon

 

 

Filed Under All Recent Articles, Birth, Birth stories, Coping with pain Tagged With Braxton Hicks, contractions, Coping with pain, Pitocin

Pros and Cons of 11 Common Labor Positions

March 28, 2011 By admin 5 Comments

By Paulina G. Perez, RN, BSN, CD, LCCE, FACCE

Movement and positioning in labor work magic. Movement enhances comfort by stimulating the receptors in the brain that decrease pain perception. The result is that you are able to tolerate increasingly strong contractions. When contractions become very strong, endorphins are released and pain perception decreases even more. Ultimately, your movement in response to your contractions decreases pain and facilitates labor – a win-win. Movement also helps the baby move through the pelvis, and some positions enlarge pelvic diameters.

The positions shown here facilitate the normal, natural process of labor. What position should you use? Follow your body. Move freely in response to what you feel. Your body will let you know just what position is best at every point in your labor.
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Standing Supported SquatSTANDING SUPPORTED SQUAT

Pros
  Realigns your pelvis to increase the opening by up to 15 percent
 Allows you to be supported by your standing or sitting partner, the wall or a squat bar
 Takes advantage of gravity
 Makes contractions feel less painful and more productive
 Lengthens your trunk and helps your baby line up with the angle of your pelvis
 Movement causes changes in your pelvic joints, helping your baby through the birth canal
 May increase your urge to push in the second stage of labor  

Cons
  Requires a strong partner
  May be tiring for both of you  
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SITTING ON TOILET

Pros
 Helps relax perineum
 You get used to an open-leg position and pelvic pressure
 Uses gravity  

Cons
 Pressure from toilet seat may be uncomfortable 
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SittingSittingSITTING
 
Pros
 Good for resting
 Uses gravity
 Can be used with continuous electronic fetal monitoring  

Cons
 May not be possible if you have high blood pressure   
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SQUATTINGSquatting
Pros
 Encourages rapid descent
 Uses gravity
 May increase rotation of baby
 Allows freedom to shift your weight for comfort
 Allows excellent perineal access
 Excellent for fetal circulation
 May increase pelvis diameter by as much as 2 centimeters
 Requires less bearing-down effort
 Descent is encouraged by the position
 Your thighs keep baby well aligned  

Cons
 Often tiringSquatting
 Sometimes hard for health-care provider to hear fetal heart tones
 May be hard for you to assist in birth if you wish to do so
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SIDE-LYING

Pros
 Helps get oxygen to the baby
 Good resting position
 Helpful if you have elevated blood pressure
 Fine with epidural
 Can make contractions more effective
 Easier for you to relax between contractions during the second stageSide Lying
 Can slow a birth that’s moving too fast
 Your partner can assist in the birth by supporting your legs
 Lowers chances of tearing or the need for episiotomy
 Good access to perineum  

Cons
 May be hard for health-care provider to access fetal heart tones
 No help from gravity
 If no one can hold your legs, you must support them on your own
 You may feel too passive in this position

WALKING

Pros
 Uses gravity
 Contractions are often less painful
 Baby is well aligned in your pelvis
 May speed labor
 Reduces backache
 Encourages descent  

Cons
 Not recommended if you have high blood pressure
 Cannot be used with continuous electronic fetal monitoring

STANDING

Pros
 Uses gravity
 Helps get oxygen to the baby
 Contractions are more effective and less painful
 May speed labor
 Helps create a pushing urge  

Cons
 Poor control at birth
 Hard for health-care provider to see the baby

LEANING OR KNEELING FORWARD WITH SUPPORT

Pros
 Can help shift the baby if needed
 Uses gravity
 Birth ball can be used
 Contractions are often less painful and more productive
 Baby is well aligned in your pelvis
 Relieves backache
  Easier for your partner to help relieve your back pain
  May be more restful than standing
  Good for pelvic rocking
 Less strain on your wrists and arms  

Cons
  Hard for health-care provider to help with birth

KNEE-CHEST

Pros
 Good for back labor
 Assists with rotation of baby, if needed
 Takes pressure off hemorrhoids
 Good position to avoid tearing or episiotomy
 Good delivery position for large baby
 Helpful if fetal heart tones are low  

Cons
 Hard for your support team to maintain eye contact with you
 Hard for you to see what’s going on

SEMI-SITTING

Pros
 Comfortable
 Good use of gravity
 Good resting position
 Works well in hospital beds
 Good visibility at birth for your support team
 Easy access to fetal heart tones for your health-care provider  

Cons
 Access to your perineum can be poor
 Mobility of your coccyx is impaired
 Puts some stress on your perineum but less than when lying on your back

ON BACK WITH LEGS RAISED

Cons
 Works against gravity
 Compresses all major vessels
 Tearing or need for an episiotomy is more likely
 No use of gravity to aid in birth 

LEANING OR KNEELING FORWARD WITH SUPPORT

Pros
 Can help shift the baby if needed
 Uses gravity
 Birth ball can be used
 Contractions are often less painful and more productive
 Baby is well aligned in your pelvis
 Relieves backache
  Easier for your partner to help relieve your back pain
  May be more restful than standing
  Good for pelvic rocking
 Less strain on your wrists and arms  

Cons
  Hard for health-care provider to help with birth

KNEE-CHEST

Pros
 Good for back labor
 Assists with rotation of baby, if needed
 Takes pressure off hemorrhoids
 Good position to avoid tearing or episiotomy
 Good delivery position for large baby
 Helpful if fetal heart tones are low  

Cons
 Hard for your support team to maintain eye contact with you
 Hard for you to see what’s going on

SEMI-SITTING

Pros
 Comfortable
 Good use of gravity
 Good resting position
 Works well in hospital beds
 Good visibility at birth for your support team
 Easy access to fetal heart tones for your health-care provider  

Cons
 Access to your perineum can be poor
 Mobility of your coccyx is impaired
 Puts some stress on your perineum but less than when lying on your back

ON BACK WITH LEGS RAISED

Cons
 Works against gravity
 Compresses all major vessels
 Tearing or need for an episiotomy is more likely
 No use of gravity to aid in birth

Filed Under All Recent Articles, Birth, Coping with pain Tagged With Birth Positions

Epidurals: Food for Thought

March 21, 2011 By Cara Terreri 2 Comments

In a series of posts on our sister blog Science & Sensibility, Dr. Michael Klein, family practice physician, pediatrician, neonatologist and Senior Scientist for the Centre for Developmental Neuroscience and Child Health and the Family Research Institute, shares the research, history and implications — positive and negative — for epidural use. Over the next few weeks at Giving Birth with Confidence, we’ll be sharing snippets of Dr. Klein’s posts on epidurals for your review.

Prior to the availability of epidural analgesia, the childbirth education movement utilized a variety of techniques that were physiologically and psychologically helpful to reduce pain, such as breathing and imagery. These methods began to take hold in the culture in the 1950s and 1960s but today are less prominent in many childbirth education classes. Some classes are more focused on teaching women compliance with particular hospital technological methods and approaches, routines and policies, rather than on teaching women coping skills.

In the late 1970s and early 1980s, the first studies appeared, showing the value of continuous emotional and physical support by a caring, trained and knowledgeable woman, whose responsibility was to focus solely on the labouring woman rather than on the institution or equipment – the doula. Backed by randomized studies,(2-4) it has become apparent that this emotional and physical continuous supportfrom a doula gives a woman more confidence and ability to work with her labour. All studies to date have demonstrated that hospital-based nurses cannot function as doulas,(5, 6) even if those nurses are midwifery-trained. It is not the fact of being either a midwife or a nurse that matters, but the fact that when these care providers are employed by the hospital, their primary allegiance is to the institution, and they are professionally responsible for the conduct of the labour and the safety of both mother and fetus. A doula who is employed by the woman is responsible only to her. Autonomous midwives in the Canadian context are strongly supportive of doulas, with whom they frequently work in collaboration.

Pain moderation by transcutaneous nerve stimulation (TNS) or intradermal water injections can be very helpful, especially in the earlier stages of labour. Other non-pharmacological methods like water baths or showers or movement, including the use of birth balls, are also helpful for many women who find that partial pain relief is sufficient to help them through contractions. Doula care provides a complementary approach which can reduce the need for an epidural or delay epidural usage until the active phase of labour, when some of the negative effects of epidural analgesia are reduced. In particular, during her labour, doula care and non-pharmacological approaches allow the mother more opportunity to produce her own oxytocin. Natural oxytocin has some important effects: it is the anti-stress hormone, and helps contractions to be more productive; it is also the ‘love hormone’ that later goes on to enhance the bonding process following the baby’s birth—an effect suppressed by synthetic oxytocin, little of which enters the brain of either mother or fetus.

Is epidural analgesia the best form of pain relief?
Epidural analgesia is a very effective form of pain relief, meaning that compared to a variety of other pharmacological and non-pharmacological methods, it provides generally consistent pain reduction. If there were no problems associated with epidural analgesia, almost everybody would want it. Unfortunately, though, associated with its use there are various undesireable effects, including:

  • longer first stage labours
  • longer second stage labours
  • increased incidence of maternal fever directly caused by the epidural, which often leads to the use of antibiotics in both the labouring woman and her newborn
  • increased rates of operative vaginal delivery (forceps and vacuum)
  • increased perineal trauma with and without instrumental births – including severe tears into the rectum (3rd and 4th degree tears).
  • a variety of complications such as a placement of an epidural too high on the spine (leading to breathing problems).
  • failure of the epidural to provide any pain relief, or insufficient pain relief—requiring the continued use of other methods of pain relief
  • increased need for a bladder catheter
  • maternal hypotension leading to worrying fetal heart rate changes
  • an increase in the likelihood of the need for a cesarean section – this last complication being the subject of great debate, which will be discussed further

Of course, some of these problems may occur whether the epidural was or was not truly needed. And when an epidural is truly needed for pain relief or to solve a specific problem, it can dramatically change a situation for the better and can improve outcome. It is only when epidurals are used routinely, and especially very early in labour that these complications are more likely to occur.

Photo from Wikimedia.

Filed Under All Recent Articles, Birth, Coping with pain Tagged With epidural

How One Mom Moved & Grooved Throughout Her Labor

March 9, 2011 By admin 8 Comments

The following is a post republished with permission from blogger, doula and mother of two, Kristen Oganowski of Birthing Beautiful Ideas. This post also appeared on our sister blog, Science & Sensibility, as part of their Healthy Birth Practices blog carnival.

According to the Lamaze Healthy Birth Practice paper on [moving during labor], research shows that:

…when compared with policies restricting movement, policies that encourage women to walk, move around, or change position in labor may result in the following outcomes:

  • less severe pain,
  • less need for pain medications such as epidurals and narcotics,
  • shorter labors,
  • less continuous monitoring, and
  • fewer cesarean surgeries (Lawrence et al., 2009; Simkin & Bolding, 2004; Simkin & O’Hara, 2002).

In fact, no woman who participated in any of the research studies said that she was more comfortable on her back than in other positions (Simkin & Bolding, 2004). No study has ever shown that walking in labor is harmful in healthy women with normal labors (Storton, 2007).

So it is easy to see why walking, moving, and changing positions is a healthy birth practice!

For this post, I’d like to document and describe the ways that I walked, moved, and changed positions throughout my labor.  And this is because I think that it is important for women to have access to images of real women who are really laboring and who are really able to walk and move and change positions throughout their child’s birth.

Worth noting is that for most of my labor, I just followed my body’s signals and natural instincts when changing positions.  Sometimes, I also changed positions based on what my doula suggested. 

And for the entire time, I found my labor to be an intensely powerful, empowering, and healthy experience.

A few “stats” about my labor before I begin:

  • Even though this was my second child, I was a “first-time laborer” since my first child was born via a pre-labor cesarean section.
  • My labor began with my membranes rupturing.
  • My contractions began approximately 1 1/2 hours after my membranes ruptured.
  • My entire labor lasted a little over 14 hours (or 15 hours if one were to count the irregular, painless contractions I was having in the hour before my water broke).
  • I labored at home for approximately 8 1/2 hours before leaving for the hospital.
  • My cervix was 1-2 cm dilated and nearly 100% effaced by the time I was checked at the hospital.
  • Three hours later, my cervix was dilated 4 cm.
  • Just over one hour later, I was fully dilated.
  • I actively pushed for about 35 minutes before delivering my healthy 8 lb. 3 oz. baby.
  • And I moved and grooved all throughout my labor.

This is what it looked like.

kneeling

Here I am in early labor, kneeling over the armrest of the couch.  Obviously, the contractions weren’t terribly intense at this point since I could still talk on the phone.  (I do believe, however, that I ended up throwing the phone onto the end table about ten seconds into my next contraction!)  Nonetheless, even though the contractions weren’t very intense, I still found that this position helped to relieve the discomfort that they caused.

What else does kneeling help to do?

It can help to relieve backache, it can encourage the rotation of the baby, it can help a mom to move and/or rock through her contractions, and it also provides a mom’s labor support team with access to her lower back for counter pressure.  One can also kneel over a birth ball or over the back of a raised hospital bed.

side-lying

Here I am laboring on my side.  I was still in the early phase of my labor, so I wanted to relax as much as possible before the really hard work began.  I used one of my hypnobirthing deepening exercises to help me do just that.

How does side-lying help a mom during labor?

It helps to promote rest and relaxation in early labor, it can help to improve fetal oxygenation (especially when a mom is on her left side), it can help to slow down a precipitous second stage, and it can help to encourage fetal rotation.  It is also a good “alternative position” (instead of lying flat on one’s back) for a mom using epidural analgesia.

standing

Here I am standing to stop for a contraction after walking around the house for a while.

Standing and/or walking throughout labor gives a woman the advantage of gravity to help the baby descend, it encourages the rotation and descent of the baby, it can help to bring on more productive contractions, and it also helps the baby to be well-aligned with the mother’s pelvis.  What’s more, it is yet another position that gives a mom’s labor support team access to her back for counter pressure and/or other touch-based comfort measures, if she desires them.

One of the other great standing movements is to slow dance with one’s partner, doula, or other labor support person.  (I slow-danced with my husband, Tim, right after this picture was taken!)  Besides providing emotional closeness(especially if one is dancing with one’s partner), dancing can offer a mother all of the benefits of walking or standing while allowing her to take some of her weight off of her feet.

hands and knees

Remember how I mentioned the “really hard work” that was on my horizon?

It had definitely begun by the time this picture was taken.

And laboring on my hands and knees felt like the most comfortable and most natural position for me to be in at this point.

Being on one’s hands and knees during labor can help to relieve backache (which I was definitely experiencing here), can encourage the rotation of the baby, and can also allow access for back massage and/or counterpressure.  Doing pelvic rocking while on one’s hands and knees is also an especially good exercise for encouraging the rotation of a baby in the occiput posterior position.

standing and leaning

Here I am standing and leaning against the stairs.

As with most upright positions, this position gives moms the advantage of gravity, it can encourage more productive contractions, it can help with fetal rotation, and it can be more restful than standing alone (and putting all of one’s weight on one’s feet).

Since the stairs are pictured here, I should mention that I also made quite a few trips up these stairs during my labor.  Climbing stairs can also enhance rotation of the baby and pelvic mobility, and it may help to “speed” up one’s labor even more than walking does.

Worth noting is that most of those trips up the stairs were taking me to our bathroom, where I spent a good deal of time laboring on the toilet.  (For obvious reasons, I have no photos of this!)  Laboring on the toilet gives a mom the assistance of gravity while still allowing her to “rest,” and it may help her to relax her perineum.  (It is usually not recommended for moms who have trouble with hemorrhoids, however.)

birth ball

Here I am sitting and swaying on my birth ball.  This proved to be tremendously helpful during the time that I labored at home.

In addition to offering a mom the advantage of gravity, swaying on a birth ball can help to enhance pelvic mobility.  It is also much more comfortable than merely sitting on a chair!

As you can see here, using this particular position with the birth ball also allowed me to gain the advantages of leaning, to receive some emotional support from Tim, and to get the back-relieving benefits of counterpressure from my amazing doula, Chris.  So this was really the “mother” of all laboring positions!  (Sometimes I can’t help myself when it comes to silly birth-puns…)

hospital bed

Here I am at the hospital, lying on my side just as I did at home during early labor.

I was strapped to the wires and transducers needed for the electronic fetal monitor (and didn’t have access to the telemetry unit yet), so my range of mobility was significantly limited.  And even though I needed to rest and “re-group” after a night of laboring and after discovering that I was “only” 1-2 centimeters dilated, the very fact that my range of motion was limited seemed to make coping with my contractions more difficult.

In fact, the time that I spent in the hospital bed, strapped to the monitors, was the only time that I ever considered asking for pain medication during my entire 14-hour labor.

water

But then I got in the water.

Oh, the water!  Take a moment to review the look on my face in the above picture and then the look on my face as in the picture to the right.  These pictures were taken within about three hours of each other.  And in the one to the right, I am a little less than two hours away from holding my baby in my arms.

Hydrotherapy during labor (which also includes laboring in the shower) can be very relaxing and can help to reduce the intensity of the pain of contractions.  Notably, women are generally advised to avoid getting into a tub or jacuzzi until they are at least 4 cm dilated since getting in the tub “too early” can contribute to irregular and/or less frequent contractions.

In addition, although these items are not visible in the above photograph, moms laboring in the water should also have access to a cold drink (my choice was Gatorade) and cool washcloths so as to help regulate their body temperature.

(Although a bigger tub–or an actual birthing tub–would have been preferable to the hospital’s small bathtub, I was still able to float in between contractions and to move my body during contractions.  In other words, I was still able to move and change positions while in the tub!)

side pushingI began pushing while lying on my side.  Although I did not find this to be the most comfortable and advantageous pushing position for me, pushing on one’s side does have some specific benefits.  In particular, this position encourages good fetal oxygenation, it is helpful for moms with elevated blood pressure or who are using epidural analgesia, and it allows the mother to rest in between contractions.

I eventually moved to my hands and knees while pushing and then rested in a sitting position in between contractions.

As one of the many optimal birthing positions, pushing on hands and knees can help to improve fetal heart tones, it can assist with fetal rotation (especially for a baby in the occiput posterior position), it is an excellent position for a woman expecting a large baby, and it can help a mom to avoid a laceration or an episiotomy.

alec's here!And it was certainly a position that helped this first-time-pusher to deliver her 8 lb. 3 oz. baby after only 35 minutes of active pushing!

Filed Under All Recent Articles, Birth, Birth stories, Coping with pain, Healthy Birth Practice Tagged With Healthy Birth Practices

Why Choosing “Free Range” Labor May Make Birth Easier

February 14, 2011 By Cara Terreri 1 Comment

[A Lamaze news release]

Close your eyes and imagine a woman in labor.  If you picture the scene as it occurs regularly in movies, on television and in hospitals everywhere, you probably see her lying in a hospital bed, hooked up to an IV and wearing belts around her belly to continuously monitor the baby’s heartbeat and the contractions.  Her “range” is limited to a few square feet. 

What’s wrong with this picture?  A lot, according to research. 

“The best way to keep your baby moving down and out is to keep your own body in motion.”  said Marilyn Curl, CNM, MSN, LCCE, FACCE and president of Lamaze International.  “Being confined to bed, tethered to monitors and IVs, interferes with the body’s ability to move the baby through the pelvic bones and down the birth canal.” 

Many hospitals have routine protocols like continuous fetal monitoring that limit movement and the use of epidurals commonly requires confinement in bed. 

Researchers have examined published studies that compared policies that encouraged movement during labor with policies that restricted movement. The conclusions show that the policies which encourage women to walk, move around, or change positions during labor may help women experience:

  • less severe pain
  • less need for pain medications, such as epidurals and narcotics
  • shorter labors
  • less continuous monitoring
  • fewer cesarean surgeries
  • lower likelihood for an episiotomy and use of vacuum extraction or forceps

Why does movement during labor have these effects?  Staying upright during labor means that gravity can aid the body’s natural efforts, which let the pelvic bones open as much as possible.  Women who are laying on their backs confined in bed lose this advantage, which increases the likelihood that the baby will be unable to navigate through the pelvic bones.
 
“It’s frustrating to see women routinely put on their backs and confined to bed and then be told that they ‘failed to progress’ or that the baby ‘didn’t fit’ through their pelvis when a simple move into an upright position could easily resolve both situations,” said Marylou Carrico Tietz, LCCE, FACCE, a Lamaze childbirth educator from Bethesda, Md. and president of the Washington, D.C. chapter of Lamaze International.  “Women need to be encouraged to listen to their bodies in labor and question routine hospital policies that may slow their progress.”  

Lamaze educators find that many women also report that movement during labor is an effective pain management tool, reducing pressure on the lower back, increasing space within the pelvis and allowing for an easier descent.  Tietz continued, “The mother’s movement throughout labor can help ease the baby through tight spots in their journey to being born.  The easier it is on the baby, the easier it tends to be for the mother as well.”

The best ways to avoid unnecessary confinement to bed include:

  • Choose a care provider who supports “mobile moms” – If they express support, put their answer to the test and ask what percentage of their patients end up staying up and mobile during labor.
  • Know the facts on fetal monitoring – In low-risk mothers, research shows that occasional checks of the baby’s heart rate are just as safe as constant monitoring.
  • Know the facts about epidurals – The benefits are well known, but also consider the possible drawbacks.  Switching positions can help get babies “un-stuck” but an epidural will render you mostly immobile.
  • Choose the right support – A doula or labor support person who will help you stay moving and can “negotiate” with your care provider or nurses, as needed.  They can also help you manage each and every contraction.
  • Use a birthing ball when you need a rest – Remember that you may need to bring your own, since many hospitals still don’t support women laboring in upright positions.
  • Stay upright during the pushing phase too – Many care providers will “let” mothers walk or sit up during the dilation phase, but will put them on their back or bottoms during the pushing phase.  These positions shrink the pelvis and make it harder to push the baby out.
  • Don’t be afraid to insist – It is difficult to go against hospital routine, but remember that many hospital routines are in place for the comfort and convenience of staff, not the health and safety of you and your baby.  The easier the birth is for you and your baby, the better the chances of a safe and healthy outcome for both of you.

Avoiding unnecessary medical intervention is part of Lamaze’s Six Healthy Birth Practices.  Based on recommendations by the World Health Organization and backed by extensive research that supports a woman’s natural ability to give birth, these practices are:

  • Let labor begin on its own
  • Walk, move around and change positions throughout labor
  • Bring a loved one, friend or doula for continuous support
  • Avoid interventions that are not medically necessary
  • Avoid giving birth on your back and follow your body’s urges to push
  • Keep mother and baby together; it’s best for mother, baby and breastfeeding

To learn more about the Lamaze Six Healthy Birth Practices, please enroll in a Lamaze childbirth education class and visit www.lamaze.org/healthybirthpractices.

Filed Under All Recent Articles, Birth, Birth plans, Coping with pain, Healthy Birth Practice, Labor

Preparing for Birth Before Going Into Labor

February 2, 2011 By FitPregnancy 4 Comments

By Gayle Sato

The words “easy labor” may seem like an oxymoron, but there are steps you can take, both throughout pregnancy and during labor, to make your experience less stressful and more comfortable, less clinical and more joyful. And although the following tips won’t guarantee you’ll have a sweat-free, pang-free birth, they can help make your labor and delivery more manageable.

1. Start preparing now. When you’re in the grip of labor, it’s too late to crack open that self-hypnosis book or locate a birthing ball. Preparation counts. Case in point: Squatting increases the size of the pelvic opening by about 28 percent. But if you wait until you’re in labor to try it for the first time, your squatting stamina won’t add up to … well, squat.

2. Seek higher education. Take a childbirth class, and enroll as early as possible: Not only do classes fill up fast, but some run 12 weeks, which means you need to start them in your second trimester. Learn about the different stages of labor so you know what to expect. Ask tough questions—and “stupid” ones, too. Find out your doctor’s philosophy on epidurals vs. nondrug ways of managing pain, as well as on Cesarean sections. “The better prepared you are, the more choices you have during labor,” says nurse practitioner Lynette Miya, M.N., R.N.P., co-owner of Bright Beginnings & Beyond, a childbirth and family resource
center in Redondo Beach, Calif. “You don’t want to arrive at the hospital without any idea of what’s going to happen.” Once labor starts, no surprise is a good surprise.

3. Take a prenatal yoga class. “The most important thing women learn through yoga is how to focus,” says Carmela Cattuti, L.P.N., founder of Yoga for Pregnancy & Fitness in Boston. “Yoga also strengthens the entire body, increases flexibility and gives you stamina. But maybe more importantly, it helps your mind relax.” This, in turn, leaves your body free to go about the business of birthing.

4. Hire a certified doula. Doulas are nonmedical professionals trained to provide emotional and physical support as well as information to women during pregnancy and labor. Studies have found that with a trained doula’s continuous support, epidural use decreased by 60 percent; C-sections, 50 percent; oxytocin use for induction, 40 percent; forceps use, 40 percent; and average length of labor, 25 percent. To locate a certified doula in your area, visit dona.org.

5. Give yourself options. During my first labor, breathing exercises gave me a massive sinus attack. Worse, I was out of tricks—no alternative pain-coping techniques, no weapon handy to beat my husband for getting me pregnant. Don’t let this happen to you. Learn several techniques to manage pain, such as self-hypnosis, position changes, heat packs and different breathing methods; bring music to play for relaxation. “If you don’t know what your options are, you don’t have any,” says Tracy Hartley, a certified doula and owner of BEST Doula Service in Southern California.

6. See no evil, hear no evil. Some childbirth educators believe graphic images, catastrophic tales and words of discouragement (“You’ll never be able to get that monster out without a C-section!”) can affect your subconscious and
create a mental block during labor. At best, negative thoughts make labor stressful; at worst, they’ll actually intensify pain. Change the channel, cover your eyes, tune out or walk away when the subject matter makes you uncomfortable. Bonus: Being able to do this will help you ignore all the unwanted advice you’ll get after the baby is born.

7. Set the mood. For most women, a dark, quiet environment is ideal during labor, so ask your nurse or partner to dim the lights and minimize noise. Little touches make a difference: a favorite pillow, pair of socks or soothing scent. “Aromatherapy, especially the scent of lavender, is very calming in labor,” says nurse practitioner Miya.

8. Don’t take labor lying down. Upright positions, such as standing, walking, kneeling, slow dancing, sitting and squatting, allow gravity to help move the baby down and out. “Sometimes, getting the baby into the pelvis is like fitting a key into a lock,” Hartley says. “You need to do a little jiggling. Rocking back and forth on your hands and knees may get the baby into position.”

9. Get wet. Early in labor, a warm bath is a blessing. Later, the sustained warmth and weightlessness that water provides can feel more like a miracle. If you have access to a warm tub during labor, run—OK, roll, if you have to—and take the plunge. (Be sure to get your doctor or midwife’s green light before doing so; there’s a risk of infection if your water has broken.) If a soak isn’t possible, take a shower.

10. Stand your ground. Labor transforms you, but it won’t make you suddenly love lime Jell-O, New Age music or the sight of your in-laws as you breathe through a contraction. People may press all kinds of suggestions on you during labor; listen but don’t feel you have to go along with them. It’s your body, your baby and your labor, so stick to your guns. Consider it practice for when your baby is a teenager.

Filed Under All Recent Articles, Birth, Birth plans, Childbirth education, Choosing a care provider, Coping with pain, Exercise, Labor, Pregnancy, Working with a doula

Birth Blog Carnival Round-Up: Positive Experiences with Healthy Birth Practices

January 28, 2011 By Cara Terreri 2 Comments

The language we use to describe birth is a tricky and often touchy issue. I had originally referred to the posts for this birth blog carnival as “birthing success stories,” but as one reader pointed out, using the word “success” implies that birth can also be described in terms of “failure.” Women, listen up: you cannot fail at birth. For this birth blog carnival, Giving Birth with Confidence will share stories from women who describe a positive birth experience in which they were successful at implementing one or more of the Six Lamaze Healthy Birth Practices.

What is a ”Healthy Birth Practice” anyway?
The Six Lamaze Healthy Birth Practices are tried-and-true ways, based in research and best medical evidence, to keep birth as safe and healthy as possible. Understanding these practices can help you alleviate common birthing fears, know how to manage pain with minimal or no medication, and provide the foundation for informed discussions between you and your care provider.

After collecting the stories for this carnival, I noticed several recurring themes. Just like you can’t make a cake without flour, it appears that a positive birth experience requires certain elements.

Nearly every contributer mentioned the importance of their care provider.

Kristine of Lamazing suggested in a post at Mother’s Advocate to do your research when choosing a care provider:

“…take the extra time, make the extra office visit, to find a great fit for you. Birth is a big deal — spiritually, emotionally, physically, you name it. You want someone with you who is on the same page: who reads your birth plan, who takes extra time when needed, and who is responsive and listens well. Don’t be afraid to change providers, either: better a change in the midst of your pregnancy than a rough birth experience with someone you didn’t trust to begin with!”

Tricia at The Planet Pink interviewed her midwife prior to the birth of her third child:

“The hubs and I made an appointment and met with a midwife who we quickly agreed would be the perfect person to partner with. She was laid back and relaxed and not at all concerned about making my pregnancy or labor fit into a certain box.”

Laboring at home for as long as possible is a big deal.
For first-time families, it’s easy to get caught up in the excitement and want to rush to the hospital or birthing center at the first sign of labor. I know because I did it too. Laboring at home until your contractions are regular and “longer-stronger-closer together,” however, can have a big impact on your overall birth experience.

Tricia at The Planet Pink talks about how she spent an entire day (not completely convinced she was in labor) walking the mall, enjoying lunch with her husband, walking her neighborhood, watching movies, bouncing on a birth ball and spending time in the tub before finally experiencing consistent and strong enough contractions to leave for the hospital at 3:00 am. When she arrived, she was 8cm dilated!

Now, on to those Healthy Birth Practices.

Letting labor begin on its own.
All of our contributors went into labor at home, on their own, and were supported in the hospital/birth center to labor without artificial induction or augmentation by Pitocin.

After beginning to dilate at an early 32 weeks and being put on modified bedrest, Jenny of Conscientious Confusion knew she was really in labor when she felt a small gush of water at 2:00 am, three days after her due date. Her son was born later that morning.

Sheridan of Enjoy Birth provided for our birth blog carnival an excellent resource for moms on induction (complete with videos!), including risks and rewards and how to know when an induction is medically necessary. Sheridan says, “It amazes me to hear that moms often get induced without even knowing why. … I would love it if moms would inform themselves on this choice early in their pregnancy.”

Walking, moving around and changing positions throughout labor.
All of our birth story writers shared wonderful details about moving around in labor, from walking to squatting to soaking in a tub.

With the guidance of her doula, Sheryl of Little Snowflakes found an effective laboring position:

“My doula suggested raising the hospital bed so that I would have something to lean against during the contractions. That turned out to be my favorite position to manage the contractions! When a contraction would come, I would stand up, bend over, bury my face in a pillow on top of the bed, and hold [my husband's] hands.”

In contrast, Sheryl commented, “It felt HORRIBLE to experience a contraction lying down. I could barely handle it!”

Kate Hodges of Two Bee Birth Services shares a story from one of her clients who experienced a vaginal birth after cesarean (VBAC). Mom, Marianne, describes:

“I tried a few different positions, however I did not feel like walking around or standing up like I had anticipated. I spent a good bit of time in the jetted bathtub, which really helped with the pain.”

Bringing a loved one, friend or doula for continuous support.
The old adage of “it takes a village to raise a child” also holds true for birth. Genuine and loving support can have a huge influence on the duration, pain management and enjoyment of birth.

Jenny of Conscientious Confusion looked to her husband for support:

“He was always encouraging me and reminding me to breathe calmly and relax. Every time I did that, it helped so much. … When I was pushing, he was right behind me, pushing right along with me. It was so helpful to see him concentrating just as hard as I was, and he was always there with a cool washcloth.”

Marianne at Two Bee Birth Services said of her third birth:

“…this has definitely been the quickest, easiest recovery. Although it was a very hard delivery, with the help of my husband and [my doulas] Kate and Claire, I had a successful, unmedicated VBAC.”

Avoiding interventions that are not medically necessary.
Did you know that many of the routine hospital procedures during birth aren’t always medically necessary? Get to know these procedures and learn when they are and are not needed.

Armed with intervention research, Marianne at Two Bee Birth Services commented:

“The hospital staff was wonderful and they honored my request to have no IV and limited monitoring.”

Tricia of The Planet Pink spent her labor with a hep lock, a device (usually inserted on the back of your hand) that provides access  to hook up an IV line if it is needed. This allows you to labor without being tethered to an IV.

Avoiding giving birth on your back and following your body’s urges to push.
The standard image of birth in a U.S. hospital is of a woman giving birth on her back, legs pulled back and someone coaching, “Now, bear down and push! 1, 2, 3, 4….” Not surprisingly, the purple-faced, flat-back pushing is not effective.

Patty Reis, a mother who e-mailed her birth story for the carnival, writes about pushing:

“[The nurse] announced that I was complete and could push whenever I felt like it. Well, all I understood at that point — and you have to remember, there’s no blood circulation to the educated brain at this point; it’s all in the uterus, where it should be – was that something was wrong with me because I didn’t have any feeling to push. So I announced it.  The nurse quieted me and told me the baby would come out whether I pushed or not. Well, I was sure relieved about that!”

Keeping mother and baby together after birth.
There are so many documented benefits to keeping mother and baby together, skin-to-skin, immediately after birth, and yet, so many hospitals separate the pair shortly after birth. As long as mother and baby are healthy, exams, weight and measurement, and bathing can be put off until later.

Jenny of Conscientious Confusion, who was at a birthing center, had a similar experience:

“After the birth, they did not remove Little Sir from my chest for a hour or more — all the checks and tests were done there on my chest and I was able to breastfeed as soon as Little Sir was able to figure it out, with [my husband] right there the whole time.”

Sheryl of Little Snowflakes describes her post-birth scenario:

“Benjamin stayed on my chest for the first hour of his life. He latched on like a pro within minutes and I fed him on and off for that first hour. It was so incredible that he just knew what to do. My midwives knew that it was really important to me to have that first hour of skin-to-skin and waited to do the newborn exams.”

And for some parting advice? Kristine writes at Mother’s Advocate:

“Bring goodwill with you. Believe that everyone helping you in the hospital, from the front desk to the checkout desk, is there because they genuinely, honestly want to help people — you included. The labor and delivery wing of a hospital is almost always the happiest part of the whole place, and for a good reason! Know that even if the technician who straps on your name band is grumpy at the moment, he or she entered the profession to help you. And be flexible! No one can predict the course of their labor before it happens. No one. If you find your labor going down a path you didn’t anticipate, breathe and discuss everything you want to with your provider.”

__________________________________________________________________________________

Thank you to all who participated in our first birth blog carnival of 2011! Your healthy birth stories will help inspire, inform and demonstrate to women that positive, safe and healthy birth experiences are possible.

Be sure to visit Science & Sensibility for other posts in this birth blog carnival!

Filed Under All Recent Articles, Birth, Birth Center, Birth plans, Birth stories, Blog Carnival, Childbirth education, Choosing a care provider, Coping with pain, Healthy Birth Practice, Induction, Labor, Pregnancy, Working with a doula, Working with a midwife
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