3 Doulas

Still waiting...

By Jenny Gillespie

Mom is now 5 days past her estimated due date... She has been in early labor since the weekend. 

Yesterday, Monday she began experiencing mild contractions every five minutes or so beginning around 4 am.

All morning she was dozing on and off between contractions. She was staying hydrated, going to the bathroom and sitting on the birthing ball.

11:00 am: Mom went to the bathroom and noted a little bloody show

12:50 pm: Contractions picked up a little and became more challenging...

1:45 pm:  Mom called me and said she really needed some help with comfort measures.

2:30 pm:  I arrived at her house and her contractions were consistent, stronger and occurring every 4-5 minutes or so.  She was uncomfortable about the amount of bloody show, called her caregiver who suggested going to the hospital to get checked.

3:00 pm:  We were on our way to the hospital.

4:15 pm:  We arrived at the hospital's Labor and Delivery floor.

4:30 pm: We were taken to a triage room where mom was told to change into a gown, leave a urine sample and get into the bed.

4:45-6:00 pm:  Mom and baby were monitored.  Baby doing beautifully! and mom's contractions showing up like peaks on the strip.  An attending physician examined mom and told her she was 80% effaced, 2 cm dilated and baby was at -3 station.  We were reassured that the bloody show was normal, and told we should go back home.  

6:30-8:30 pm: Mom and I had a bite of dinner and a laugh...

10:00 pm:  I drove mom back home, where she took a shower and decided to try and get some sleep...

Let's see what today brings...

 

 

Still waiting....

I have posted a few times about women going past their due date (see Induction Question post, and Happy Birthday post).  According to a lot of sources, an average pregnancy lasts 40 weeks.  Average? what does that that mean?  Most first time moms deliver around 41 weeks. 

So my first question is what about those 7 or so days after mom's EED (estimated due date)?  What are women supposed to do for 7 days? 

Go on holiday? not a good idea, too far away.

Go back to work after they have begun their maternity leave? No co-workers want to see the baby not you.

Go on online and calculate that due date again? Chances are it will come up the same... earlier.

Ok so women at this point are literally in alert mode: every twitch, every Braxton Hicks, every fetal hiccup is a potential labor trigger.  How are women supposed to relax and enjoy those last few days of bliss and roundness before welcoming their baby?  Instead of being relaxed, most are anxious, nervous and worried.

 Most are constantly reminded by everyone around them from the greengrocer to the nosy neighbor:" Oh... hi... weren't you supposed to have your baby already?  I noticed you weren't home yesterday and for sure thought you were in the hospital..."  "No, silly, I was in the baby's room folding and refolding baby clothes" is the answer given by most moms.

As a doula, I tell all my "moms" that it is normal and OK to go past their due date. 

I encourage them to go to the movies, out to lunch with their best friend (whose first baby was also a little "late"), practice their breathing and relaxation.  A non-stress test is often recommended and performed by caregivers, and this answers a lot of important questions namely: is there enough fluid around baby? Is baby sounding and looking good? and is the placenta still functioning properly?  So if all looks good, the thing to do is wait.

I have a mom who was due yesterday.  She had that date circled in red and it came and went.  She is experiencing:

Backache

Vaginal pressure

A lot of Braxton Hicks contractions

The induction question came up last week.  She decided against it... We are waiting.  She has another OB/GYN visit next tuesday... Stay tuned, I will update you tomorrow 

How to Sleep When your Expecting

By: Aimee Oswald, CD (DONA), HCHI

www.sweetpeabirth.com

  

Sleep. We all know we won't get much of after the baby arrives but how come nobody talks about how difficult it is to obtain while you are expecting?   Now I know that there is that first trimester haze when you feel you still haven't gotten a full night even after 20 hours.  What I'm talking about is that middle place after the fatigue and nausea but before the "Oh my word where are my toes?"  The yummy space where all is right, you feel great, and you're little bump is leading the way yet sleep has become uncomfortable, a chore, fleeting.....Yeah that place.

I was a life long back sleeper.  Ever since I could remember I'd climb into bed pull the blankets up to my chin and laying flat on my back go to sleep.  This all changed even before I got the positive pregnancy test results. One night my back just felt wrong and for some crazy reason I rolled over and found peace on my stomach.  This was great I couldn't believe I had poo-poo'd tummy sleepers for so long! Then the two pink lines informed that this would not work for long. Could I go back to a supine position? Perhaps, but then that too was taken away, Gasp!! What was I to do? Stay awake for the next 6 months?

So how are you supposed to sleep while pregnant?  The most commonly recommended position is on your left side with one leg crossed over the other and a pillow between them. Why on your left side?  Because our hearts are on the left side.This allows for the maximum flow of blood and nutrients to the placenta but still enhances kidney function which means a better elimination of waste and fluids and less swelling of hands and feet.  The right side is also good for this. You may also find it comfortable to place a small pillow or wedge under your tummy in the later months to prop up your abdomen and support the uterus.  Now I've spoken with quite a few women who have sworn to me that they slept on their bellies until the day the baby was born, I still don't know how they did but....

What about the back?  Why is this position such a no no?  Here are the facts; There is a large abdominal vein (the inferior vena cava) located between the spine and the uterus.  This large vein carries blood from your legs to your heart but with the weight of the baby, your uterus and everything else in there this vein gets pinched off causing a drop your blood pressure.  The drop in your blood pressure may cause you to feel dizzy, short of breath and experience light headedness but this drop also cuts off oxygen to your baby. If you must lay on your back here are a few tips to make it more comfortable for you and baby:

• Tilt to one side, the left side if you can
• place pillows or a rolled up towel under one shoulder, hip and leg
• bend your knees so that they are "side laying" but your torso is almost flat

What if you try all these positions and keep waking up on your back?  Simply move to one of the above positions. Don't worry- as a rule our bodies take really good care of us and they wont let us sleep too long in an unfavorable position.

As for me I've turned into a side sleeper!  Fully on my side with a pillow under my head and one in my arms...I've found this a the optimal spot for leaping out of bed at the sound of crying or vomiting, something a mother deals with long after the pregnancy is over!

The last great secret-Finding out if it's Pink or Blue

 
 

By Aimee Oswald, CD (DONA), HCHI

www.sweetpeabirth.com

I was 16 when my mom's youngest sister got pregnant.  She had always been my favorite aunt, she was young. Listened to Rock music, took me to the zoo and bought me my very first burrito from Tito's-the best local taco joint in our neighborhood.  She was the first pregnant lady I ever saw close up.  I really got to look at her tummy, feel the baby kick and listen in awe to her stories of the hospitals new "ABC Room" where she was going to have a natural childbirth.  She had taken Lamaze and my uncle was going to coach her.  She had a plan and knew what she was going to do.  The only two things she didn't know were what day this birth would occur and what sex the baby would be.  At her baby shower the women had her lay down on the floor and take off her wedding ring. The ring was put on a chain and this was hung over her belly- if the ring swung side to side the baby would be a girl and if it moved in a circle then the baby would be a boy.  I can't remember what the "test" showed but boy do I remember all the laughter in the room.  Some of the older women wanted to see how she was carrying, out in front=boy while all over meant a girl.

When I got pregnant years later and was asked if I wanted to find out the sex of the baby by the doctor I thought, "wow is he really going to do the ring thing?" of course not. He would have the ultrasound technician look for me.  I immediately said I didn't want to know.  This I found out annoyed many, many people.  But my thought was and still is- "How many TRUE surprises do we get in life?"

The way the world is now we can find out news the second it happens. We rarely get anything "good" in the mail and you can instantly reach anyone anyplace by text.  So whats left?  Babies' birth dates and their gender.

With many women scheduling the birth of their babies (that's a whole other argument that I'll save for another day) truly their baby's sex is the last great mystery.  I know I'm old fashioned and some would say I have no curiosity.  But I am curious I just loved loving my baby without putting a name or gender on them. This was just our baby.  Our nameless, faceless bundle of joy.  I loved picking out names for boys and girls and trying to design a gender neutral bedroom.  I know I may be the cheese standing alone in this world of instant information so here is some information if the suspense is just too much for you to bear.

The most common method to find out the sex of your baby is ultrasound or sonogram. This method is most accurate between 18-22 weeks. Earlier than that it is hard to tell and sometimes later there is simply too much crowding in there to get a good peek. There are still many factors in this method that prove it to be not 100% accurate; they include the mothers weight, The gestational age of the baby, The training of the technician and the equipment being used and of course the baby's position.

Other methods of sex prediction are more accurate but carry more risk to the pregnancy. The most commonly used methods are amniocentesis and chorionic villus sampling (CVS). These tests can be used earlier in pregnancy. They are also much more accurate than ultrasound, with results very close to 100%. 

Miscarriage is the primary risk related to amniocentesis. The risk of miscarriage ranges from 1 in 400 to 1 in 200. In facilities where amniocentesis is performed regularly, the rates are closer to 1 in 400. Miscarriages can occur because of infection in the uterus, the water breaks or labor is induced prematurely. Although extremely rare, it is possible for the needle to come in contact with the baby. Great precautions are taken by using a sonogram to guide the needle away from the baby. The mother may experience some pain or discomfort as the needle pierces the skin and following the procedure she may undergo cramping, leakage of fluid and minor irritation at the injection site.

Of course you can forgo all these modern methods, take off your wedding ring and tie it to some string or just go to any grocery store and people will freely offer their opinion on how you are carrying and what that means. It may be hard to wait all those months to find out if you'll be buying pink or blue curtains but the moment that baby is in your arms you will find you knew all along exactly which sex your baby was, you knew it in your heart.  ( Oh! And just a side note I did keep myself busy waiting on my bundle by sewing baskets of curtains....all yellow. My daughter just loved them!)

Best Laid Plans of Mom's and Dad's-What to include in your birth plan

By Aimee Oswald, CD (DONA), HCHI                                

www.sweetpeabirth.com

I am sure you've heard the saying; "If you want to make God laugh tell him your plans", Sometimes I think this also goes for Caregivers, Family members and well meaning friends when you bring up the topic of a birth plan.  Those previously mentioned will often look at the expectant women and try to nod in a supportive all the while trying to hide a look that says; "Poor thing. She thinks she can plan this".  Can she plan this?

Having a baby is a life changing, momentous event.  I often tell my clients that unlike planning your wedding, dream vacation or extravagant party with this event you have no idea what time it will start, what day it will be and sometimes you don't even know the sex of the guest of honor! Despite what you may assume it is actually very productive to prepare a birth plan for your labor and delivery. The tricky part is knowing what to include and what to leave out. Here is what I advise the couples I work with to cover in their birth wish list;

You should begin your birth plan with a short introduction of you and your partner, just a few sentences stating who you are and how excited you are about meeting your little bundle. Next include any very specific issues or concerns you may have, this would be a fine place to inform the staff of a back or any other prior injury. The final sentence of your introduction should include the members of your support or birth team, just their names and what their function is on your team. For example; Mary is Sue's mom she will be in the labor room until delivery, Nancy is our doula and will remain with us throughout labor, delivery and for about an hour into our postpartum time.

The second thing to do is to break your birth down into stages and state your desires for each stage.

First Stage of Labor: declare your wishes for the environment; things such as lighting, your mobility, if you would like to eat or drink, how much fetal monitoring you are comfortable with, what you would like to wear during this time, would you like to be offered pain medications or alternative options, if you need any augmentation with your labor would like it to be medical or would you rather try things like nipple stimulation first, do you want to have a routine IV, in the event of a C-section who would you like to accompany you, who will then cut the cord.  Cover all possible scenarios of this first stage of labor.

Second Stage-Pushing: What position would you like to push in, would you like the nurse to direct this pushing by counting to 10 or would you rather try spontaneous bearing down, who would you like to help you hold your legs or would you prefer stirrups, What type of care would you like to your perineum, would you prefer to tear or have an episiotomy?

Third Stage- Delivery of the Placenta: Would you like to exam your placenta, would you like to keep it or take it home (please note that if you are interested in taking it home you must make arrangements to have it removed from the hospital premises very shortly after your birth), Do you wish to deliver the placenta spontaneously, would you like your baby placed directly on your chest for skin to skin contact.

Finally you will want to include a section on newborn care, this can also be a separate "newborn plan" In this section you will address things like who will cut the cord, are you banking cord blood, do you want delayed cord clamping, are you inclined to delay the routine newborn procedures such as the vitamin k shot, antibiotics drops to the baby's eyes, any other injections and weight, head measurements and length of the baby. This section is also the place to state weather or not you'd like the baby to have a bottle, pacifier, be separated from you or have a bath.

Once you have made all these choices and done your research on any you are not familiar with you are going to type them all up on a single sheet of brightly colored paper.  Give a copy to your doctor or midwife, a copy to your doula and keep about half a dozen in your hospital bag.  This will become your birth plan. Embrace your plan, visualize it, speak it out loud, draw a picture of it and then be prepared to change it at a moments notice.  Birth is a completely unpredictable event and for you to enjoy your Birth Day you will need to wrap your arms and heart around flexibility. Being flexible is the most important component of every birth plan.

Make your plan, let them laugh because you know the truth...Plans, like rules are made to be broken.

Lets talk about S.E.X!

By: Aimee Oswald

www.sweetpeabirth.com

We're all friends here, correct? I mean I can talk openly.  As you may have already guessed I am shy about few things, well....actually I'm not really shy at all.  I can say vagina with a straight face.  I don't grimace at all when I say things like rectum or perineum and breast is a no brainer for me, But I'll admit there was something I rarely spoke about when pregnant.....SEX. Now don't get me wrong I am big fan of sex I just didn't love it like some pregnant women I've met.  I'd heard these gals speak of this crazy sexual desire they felt when pregnant and I kept waiting for this craving of sex to hit me and well.....it just never hit.

But as you know I'm here to serve and as a doula, the topic of sex during pregnancy is something I hear about all the time; so lets go for it...Let's talk about SEX!

First and foremost sex during pregnancy is perfectly safe and enjoyable. The only time when intercourse may be prohibited is in the case of preterm labor,any time your membranes have ruptured, or if you are in your third trimester and have been diagnosed with Placenta Previa. Also women who have a history of miscarriage or premature birth should consult their doctor prior to any sexual stimulation. For the rest of pregnant women,  sex is still very much an option -in fact it may even facilitate you going into labor if you are near your due date. 

How does sex help labor start? Human semen contains the most concentrated source of prostaglandins which soften and the the cervix in preparation for labor. (Induction drugs like Cervidil try to mimic prostaglandins.)  In Ina May Gaskin's book- Ina May's Guide to Childbirth she says that in her observation, women who regularly engage  in sex during pregnancy were  more likely to go into labor at around forty weeks. But don't worry- if you have a normal, healthy pregnancy, sex will not cause you to go into labor before your baby is ready.

Let's talk about positions; There are not any positions that are off limits.  As long as you can get into it go for it.  Some positions may be more comfortable than others, Woman on top or spooning are great options and usually very comfortable for both of you.  Generally , Sex doesn't hurt the baby. The cervix is toward the rear (posterior) and even the deepest penetration will not cause harm. Some doctors may ask you to stop having intercourse at thirty-six weeks if this is the case ask the doctor why they are recommending you stop, since as I mentioned above Sex can aid in the start of labor.

Why have Sex?  Well, why not?  let's face it feels great! Besides all that it's a wonderful way to get close to your partner.  If this is your first baby the birth marks the beginning of your life as a family but it also signals the end of your life as a childless couple, so take this time to really connect and cherish your couple time.

So stop reading, go find your lover and get busy!!

 

Rosie O'Donnells Girlfriend A Doula!

I was just enjoying my afternoon cup of tea and indulging in a little Oprah viewing....I admit it I had to see what Rosie O'Donnell has been up to all these long months.  It was a very lovely interview with lots of interesting tid-bits and I was just about to doze off for a moment when i heard some news that made me sit up and take note Rosie has a new girlfriend who besides being an adopted mom to 9 children from foster care is also a doula!! I have to tell you it makes my heart sing anytime I hear of doulas in the media!! 

Just in case you've never heard of a doula here is a small sample of what we do; a Doula's job is profound and yet very simple.   We are there to provide physical, emotional and educational support.  We work with you to gain an understanding of what is important to you and what your desires are for you birth.  Our level of expertise allows the non birthing partner to relax and focus on supporting the mother.  Find out more about doulas and the things we do by reading our blog; 3doulas.com, Checking out organizations such as DONA, CAPPA or Doulas Association of Southern Californina (DASC) and pass this information on to any and all pregnant women you know.  After all doulas are in the Media!

By Aimee Oswald

www.sweetpeabirth.com

When Right Side Up Is Upside Down: Breech Babies

By Aimee Oswald

You've done all the "right" things.  You've had the baby shower. You've taken your Childbirth Education course. Then your doctor tells you that your little bundle has decided that he/she likes the view from the top-in other words your baby is breech.  Does this mean an automatic C-Section?  Well maybe not, there are tips and tricks you can use to get that babe back on it's head. 

There are things you can do that are completely non invasive. Below is a list of these techniques:

Morning Sickeness? Try This!

By Aimee Oswald

YAY!! You’re ecstatic you just found out that you’re pregnant!!!  All is going along wonderfully until the day it hits you….morning sickness.

Some women seem to breeze though it with barely a nod to the porcelain commode, while for others, it can lead them to their doctor's door begging for help!  Then there are the rest of us, who feel a constant nagging nausea. The ones who make several trips to the bathroom in one day.  The ones who cannot figure out why in the world they call it morning sickness when it lasts all day!  That was me.