Capital Region Doula
This is a great talk by Rebecca Decker with lots of good info about how fetal position can affect your labor!
picture from: http://www.earthboundtherapeutics.com/blog/fetal-positioning-aka-belly-mapping
Labor is quite unpredictable! Whether this is your first or sixth baby, there will be a lot of variation within the range of “normal” that is considered healthy and safe for each mother & baby; every mother is unique, every baby is unique, so every labor is different! In fact, there is no “normal” birth! Everyone will have their own unique and personal birth story.
That said, your body will usually give hints that labor is near. Hopefully the following will help you and your partner realize when you are truly in labor . . . and when you are not (thus preventing a disappointing trip to the hospital).
*Backache that makes you restless/irritated
*Menstrual-like cramps
*Several soft-bowel movements (however, by itself, this could simply be indigestion)
*Nesting urge!
*Braxton-Hicks contractions (light and variable non-progressing contractions that can be mild to moderate, regular for a time, then irregular for a period of time)
*“Bloody show” (a.k.a. loss of mucous plug that was blocking the opening of the cervix). It is a blood-tinged mucous discharge.
*Your water breaks (trickle)
*Progressing contractions (these contractions get stronger, longer, and closer together as time passes). Changing positions does not make them go away; the mother can no longer be distracted from them (they “take your breath away”).
*Your water breaks (gush) with progressing contractions soon thereafter
A labor could last anywhere from 2 to 24 hours, on top of hours/days/weeks of prelabor (before the cervix starts dilating beyond 1-2 cm). One of the big wild cards in labor is prelabor. For some women, prelabor may take a lot longer than anticipated—days or even weeks. Contractions, sometimes strong and regular for hours, will start and then stop again. For others (a small percentage), prelabor is seemingly nonexistent and she jumps right into progressing contractions that dilate the cervix. Then there are those who are somewhere in the middle of these two extremes.
It’s important to focus on what is normal and healthy for you, and not “most people.”
It’s impossible to predict what labor will be like for any woman, and it’s best to just relax, go with the flow, and trust your body to birth the baby in its own way and in its own time.
Simkin, Penny. The Birth Partner, Boston: The Harvard Common Press, 2013, pp. 43, 44-47, 61-62, 67-68.
#1 Less chance of developing a fever
One of the possible side effects of epidural anesthesia is developing a fever. The longer the epidural is in, the more chance of the mother’s temperature rising too high during labor.
Mother developing a fever in labor means that Baby gets a fever, and there is more chance that they will be separated at birth. She will also need antibiotics (since there is no way to tell if the fever is from the epidural side effect or an actual infection).
See if you can delay the epidural (wait until you are in active labor or 5-6 cm dilated)! The doula will help you by assisting with comfort measures at home and/or when you arrive at the hospital. Therefore you can go a bit longer than you planned without the epidural, reduce the overall time the epidural is in, and reduce your chance of getting a fever.
#2 Emotional support
Even after a mother has received an epidural, she still needs constant emotional support. She may not be prepared for the sense of detachment that accompanies the much needed pain relief! She will need conversation, reassurance that everything is going well, and simply someone to be there. If it’s been a long labor, and the partner needs to step out for a meal or take a nap, hiring a doula will insure that the mother is never left alone. The nurse and doctor/midwife will check on the mother intermittently, but a doula offers continuous support to keep the mother from feeling a sense of abandonment.
#3 The mother still needs physical support too.
Even though she can no longer feel the contractions, a woman who has received an epidural still has some work to do. She should continue to change positions every 20-30 minutes in order for her labor progress not to slow down. Changing positions can also prevent the baby from getting “stuck” and lower the chances of a cesarean. If Mom is moving, then Baby will be able to make any needed shifts/position changes to navigate the birth canal more easily.
Of course Mom may need a nap, but after some rest she will need help to change her position. The doula has the expertise and training needed to help with this. She also can help with any other uncomfortable side effects of the epidural, such as itchiness, trembling, or chills.
This article was written by Abi Schoonover, Birth Doula
References
Segal, S., et al. (2010). “Labor epidural analgesia and maternal fever.” Anesth Analg 111: 6.
Simkin, Penny. The Birth Partner, Boston: The Harvard Common Press, 2013, pp. 281-287.
Featured image from the article “Epidural pain relief for labor“
I’m excited to share this brand new article with you by Rebecca Decker (Evidence Based Birth). I hope it helps you make good choices for your own birth. Enjoy!
In this video, Penny Simkin gives some excellent advice for moms planning for an epidural. What about postponing it? The longer it’s in, the denser it becomes, so Mom will have less ability to move her legs as time goes on. Also, the chance of Mom acquiring a fever increases the longer the epidural is in. She recommends planning to use self-help comfort measures (you will need it at home anyway) such as breathing, relaxation techniques, massage, and changing positions to delay the epidural.
Here is a short & sweet educational video about labor and delivery. It’s not a live birth, so for those with queasy stomachs, it’s a good one to check out:
You may see little bits of yourself or your partner in your baby: Maybe he has your eyes, or his dad’s nose. But did you know that your little babe is also a part of you?
Scientists have found fetal cells in mothers’ bodies post-birth, including fetal cells in a mother’s brain, heart and kidneys. While this has been confirmed in humans, studies that began in female mice showed that the fetal cells that ended up in mothers’ hearts developed into cardiac tissue—and became actual beating heart cells.
by K. Michelle Doyle, CNM, NYS LM, BCST
This is a great piece that gives balance to the standard advice given to pregnant women to take lots of folic acid.
Here is a great article by Debra Goodman, MSPT about helping women heal from a cesarean section. Since ~one-third of all births in the US are c-sections, it would be good to have this info out to more women. Of course, check with your doctor first about doing the recommended exercises!
She explains the surgery, how to mobilize the scar, and how to strengthen the abdominals after this major surgery.
