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Showing posts with label bradley childbirth class. Show all posts
Showing posts with label bradley childbirth class. Show all posts

Tuesday, August 2, 2011

The Birth Story

Warning: This post contains details about labor and delivery. If you do not want specifics, do not read!! Do not say I did not warn you. Also- its very long!

Well here it is, the Birth Story....

I have put this off. Mainly because obviously the birth story is completely tied into the circumstances that unfolded afterwards with my son and thinking of all this just makes me an emotional wreck. But we will get to that. Lets start from the beginning, shall we?

Sunday the 17th, we got up and went to church just like every other Sunday. I felt the same I had for days. After church, we went to eat Mexican (I dont eat spicy food though, so dont go thinking it induced labor) like normal with some friends. Mr.Pate's Mom and Great Uncle came down too, so we then went back to Smiths Grove to unload some stuff they brought Dustin. After all the driving around, we went to Olive Garden. While we were there I started having these feelings in my lower abdomen, it kinda felt like Griffin was pushing out or something. But I noticed (from the outside) when it happened that my whole tummy was hard. Could this be a contraction I wondered?? This was 5 pm. After awhile I felt like they had been reoccurring, so I opened up my BabyBump app and started timing them at 6pm. We left Olive Garden and headed back to Smiths Grove one last time. These feelings were happening every 4 minutes or so I was pretty certain, but they werent super strong or painful. Mr.Pate's Mom was about to head back to Lousiville and I wondered if I should tell them, but since I wasnt sure I didnt.

I told Mr.Pate and we just decided to see what happened. We got home and he mowed the yard while I vacuumed. My contractions moved to every 2 minutes and were stronger. I had to stop moving during them. I was taken back bc they were so close together so soon. Weren't they supposed to take awhile?? At 7:30pm we called Dr.Gass to ask for advice. He wanted us to go in and get checked and have baby monitored since we were so far along, and then said  if we were still 3cm then we could come on home if we wanted. So we grab our bags and headed in. We got to the hospital at 8pm Sunday night.

When I got checked, I was still 3cm and 90% effaced. The same as I had been for several weeks now. The baby's heartbeat looked great and he seemed to be just fine. My contractions were still 2 minutes apart and consistent. The nurse (Aimee, she was awesome!) said my bag of waters was bulging and would prob break soon. We didnt know what to do- go home or stay? If we went home, what were we looking for to show us it was time to head in?? We had planned on gauging when to go in based on how far apart my contractions were. Normally when they are this close it means you are close to having a baby! So we just decided to stay. (I also had not enjoyed the car ride over with contractions, so I wasnt eager to do that again)

We gave our Birth Plan to Aimee and I was admitted. She was totally supportive of me wanting to go natural and was just a blessing. I got my hep-lock in and finally was allowed off the monitor for awhile. Dr.Gass told her just to make me get on it 20 min of the hour, which is much better than he had originally told me- score!  I was also allowed to drink gatorade or sprite all night bc I didnt have IV fluids, to keep me hydrated. Dr.Gass said he thought it would not be until the next night when I had the baby, so I need to try to rest. I just didnt know why it would take so long when I was having contractions so close together?? But ok.

We called our families and told them, but told them it would be awhile and they should probably wait. None of them listened and everyone headed to town. We sent my family to our house and Mr.Pate's family to Dustin's. No sense in coming to the hospital till we were pushing we thought.

So my contractions continued all night at 2 min apart. They were pretty intense and I had back labor too. We focused on breathing through them and relaxing all my other muscles to not make the pain worse (which works ps). I was surprised how the whole night I was in the zone. The TV was on and I never noticed it. I had no idea where my phone was and I didnt think about the internet once. Very unlike me. Ha! I constantly felt like i had to pee, and that was very uncomfortable. Most of the time I couldnt and just felt uncomfortable- this was bc of my bag of waters bulging down there. Contractions while I was in the bathroom were very hard for me. The toilet was tall and not very comfortable for me to sit on. Ugh.

At 1am I got checked again. No change. Are you kidding me?? What were these contractions doing?? One thing motivating me through this was that contractions serve a purpose- they dilate you so the baby can come out. If that wasnt happening then why was I going through this pain?? I was frustrated. Dr.Gass had suggested I take a sleeping pill to try to rest, so I did so. It didnt work and I couldnt rest. I couldnt lay down- super uncomfortable. I spent most of the night on my birth ball leaning onto the bed.

Our room did not have a chair that folded out into a bed for the guest, only rocking chairs. So poor Mr.Pate literally slept on the floor! The night was hard but manageable. The contractions were painful, but you knew they would come to an end and that helped you push through them. Once it was early morning I was losing some faith. I was telling Mr.Pate that if I hadnt made any progress next time we got checked then I wanted to think about pain meds. He just kept encouraging me and saying lets just see then.

Ours families ended up coming to the hospital at like 5 in the morning. Even though we told them not too. Because they didnt listen- they spent a long time in that waiting room! Ha!

At 7:30am Dr.Gass came and checked me. I was now 7 cm! I asked him if he thought I would get some relief from breaking my water, bc I was very uncomfortable down there. He said yes and we went ahead and did it. It did bring relief! Yay! I could pee! My water was meconium stained, so at this point we knew that we would need to watch Griffin closely at birth in case he swallowed some. (Side note: your water just keeps leaking after its broke. So bc mine was meconium stained, my bed had to be changed constantly. It was gross! But I barely noticed.) The NICU nurses would be on hand. Dr.Gass figured we would probably start pushing in about 3 hours. The baby's head wasnt in the greatest position and was not fully engaged. We kept on laboring. I was losing steam and did mention getting drugs a couple of times, but Mr.Pate would just say wait an hour and see where we are. So I would determine to make it another hour. It was effective.

At 9:30am they checked me and I was 9 cm!! Woo Hoo! We were so close! I just knew we would be meeting the boy soon! I had a second wind. His head was still not in a great spot, so I started doing knees to chest position to try to get him to move down and turn. This is when labor got really intense. All night it had hurt and been hard, but now the contractions were even more instense and the back labor was hardcore.  My nurse (who was now Jamie- also awesome) told me to tell her if I had the urge to push. A few times I really thought I had the urge and called her in to check. Every time I was still 9cm. Ugh! The pelvic pressure was intense and made me feel like I would split in two. Suddenly my contractions were right on top of each other. No rest. And because of the back labor and the intense pelvic pressure my body was spasming in pain. I could not move positions because I would try to wait for a break in contractions, but they never came (you cant move during contractions, it is torture!). This was the only part of labor that was just unbearable. I began to flip out. I was in sooo much pain.

Somewhere during this time I let my sister come in (until then only Mr.Pate had been back there). I let Mr.Pate go eat bc he really needed it! Both of them could see how bad I was losing it. I started snapping at Mr.Pate and I started constantly saying I couldnt do this. Even if I made it to 10cm, I could not push. I was so spent. It hurt sooo bad. I tried so hard to relax and breathe through it, but since the pain never ended I just felt like I was dying. I really did. It was horrible!!

Dr.Gass came in and he could tell I was struggling. He suggested me getting an epidural to try to relax and maybe that would help me progress, and I looked at Mr.Pate begging him to say yes. He did and I jumped on it! I think it surprised Dr.Gass how quickly I said ok. I knew I was at the end of my rope. I have never experienced pain like that- it wrapped all the way around my body and never ended. I was worried it would take forever to get the epidural, because usually you have to have a whole bag of fluids in you first. But they started the fluids, and I am pretty sure I only had like a third of the bag maybe before I got the epidural. It was 12pm when we decided to get the epidural and it was actually administered at 1pm. As I was waiting for it, I was most worried about sitting up and getting into the position to get it. I had been laying on my side and could not move because of the pain! But I knew I would have to, so finally I just told Mr.Pate to move me. It hurt!!

To get an epidural, they make you sit up on the side of the bed. They give you a pillow to hug, and you have to make a c shape with your back and be completely still. I was nervous about that bc of the pain. But I was able to stay still. The epidural didnt hurt, it just stung like any other shot does. The guy said it would take 10 minutes to take effect and 30 minutes for the full effect, but I didnt feel anything from then on! It was sooo weird. I went from being in horrid pain to not being able to feel anything. I could not feel the contractions at all. I could not feel my legs but I could move my feet, which I thought was strange. I asked my nurse if this is what labor is like for people who come in and immediately get an epidural and she said yes. That reality was so strange to me because of what I had just been feeling for the past 19ish hours. But it was a welcome feeling after the past 19ish hours too. My contractions spread out to 4 minutes apart after we started the epidural. That would figure right?! Ha!

So after I got the epidural I was ordered to sleep! So I gladly did. At 1:45pm they decided to start pitocin to try to get my contractions closer together again and finish dilation. The baby didnt seem to like this, probably because it was too many changes close together (the epidural lowers my blood pressure and then the pitocin too) so we stopped the pitocin at 2:20ish and gave me oxygen. Griffin did great after that. They also made me turn on my side to help him too, and I couldnt feel my legs enough to turn. Mr.Pate and the nurse turned me, but I kept going because I did not think I had turned. I almost feel off the bed! Ha! Once we did this the baby was fine. At this point we started letting family and friends who had been waiting outside forever come in to visit.

At 5:20pm I was still at 9cm with some cervical lip showing. Dr.Gass and my nurse decided I should push to try to move the lip out of the way. So Mr.Pate and my sister as well as the nurse were my cheerleaders and I started pushing. I could feel nothing, but pushing is hard work because of the breathing (or lack there of!)! Even though I could not feel, Dr.Gass said I was a great pusher. I pushed for about 20 or 30 minutes 3 different times with some breaks in between. The cervix would move, and then once we stopped it was right back. The nurse told me I get an award for strangest cervix ever. Yay.

After the last bout of pushing, I could tell Dr.Gass did not look optimistic. I just said, "Dr.Gass, is this going to happen? Am I going to be able to do this?" He looked at me real honestly and said he had his doubts and that he would feel better about me and the baby if we did a c-section at this point. I told him I was ready, that I just wanted my boy out and safe. And so we began prepping for a c-section. Mr.Pate was supportive and felt it was what we needed to do. Dr.Gass kept encouraging me that I had given it the best effort. I surprisingly wasnt sad or nervous, I felt calm and ready. I think my body knew it was just time.

We ended up going into surgery around 7 something. The room was sooooo cold! They put warm blankets all over me. The screen they put up (like in the movies) was like only 2 cm from my face, I was surprised it was so close. And it was hard to hear in there. I could barely stay awake and I felt very detached from what was happening. They finally let Mr.Pate in (they make them wait in some room until everything is prepped) and he was in a chair next to my head, but I didnt even know it at first. I couldnt feel anything. After what only felt like a few minutes, I heard a baby crying and knew my son was born. 8:21pm. He sounded like he was quaking!

Dr.Gass brought him over to me to see, but I didnt have my glasses on so I could barely see him! Then they took him over and were suctioning out his lungs. Mr.Pate took some pictures and then they let him take him to the nursery. I of course was still there getting sewn up. Afterwards, they took me to recovery. They had told us before that I would be there for an hour. But when I got there and asked the nurse, she said more like an hour and a half. Turns out I was there for 2 hours. I drifted in and out of sleep and begged for water. I was sooo thirsty! She wouldnt let me have any yet. Anyhow, my numbing wore off and she pressed on my stomach every ten minutes to prevent hemorrhaging.

While I was in recovery, my nurse got a call from the NICU. She then came over and told me that Griffin was admitted to the NICU for breathing problems. Strangely, I didnt freak out. I knew lots of babies were admitted to the NICU for short periods bc of this, and I figured this would be the same. Not quite. When it was finally time for me to get out of recovery, they wheeled me down. My family was in the hallway waiting on me. I stopped and got my glasses, then Mr.Pate made them wheel me into the NICU in my hospital bed! Griffin was on a bed thats called a giraffe, so it was tall. I could barely see him. He had the CPAP on him and wires everywhere. I reached out and held his little hand and just couldnt believe this was my baby. He was beautiful. And apparently sick. I felt confused and out of it and really didnt know what to think.

After that I got taken to my room. To be honest, the next few days are somewhat blurry. I was still on meds and sleep deprived and it all runs together. I started pumping every three hours that night. By mid-day the next day I got to get up and go down to the NICU to see Griffin. I got to hold him either that day or the next day. And the rest I think has been blogged.

This is Griffins birth story. It was nothing like I could have imagined. I am still processing through all of the emotions that come along with it, so that will have to be another blog for another day. For now, this is what I have. I praise the Lord that He kept me and Griffin safe. It may have been hard and different than I wanted it, but I am sitting here today with a healthy boy who is about ready to eat. How can I complain??


Monday, July 4, 2011

Bradley Birth: Second Stage Labor

Let's talk about the second stage of labor, shall we?

Here are just some random things I learned in class about Second Stage Labor. Those that have experienced this, please feel free to add your wisdom. It is so important to remember that no two labors are alike, so take all of this with a grain of salt. This is just info to help you become familiar with the birth process and maybe make you less intimidated by it all.


Some Definitions:
  • Afterbirth: The birth of the placenta and membranes after the birth
  • Episiotomy: Surgical incision made in the perineum (the skin and tissues between the vagina and anus) to "prevent tearing"
  • Cord Clamping: Clamping down on the Umbilical cord to stop the flow of blood and oxygen from the mom to baby so you can cut the cord. The baby then starts breathing on its own for the first time. 
  • Ferguson Reflex: When baby presses onto the Ferguson Plexus of nerves, creating Ferguson's reflex, the urge to push
The Second Stage of Labor is when you are ready to push. At this point you are fully dilated (10cm) and fully effaced (100%), which means the cervix is completely thinned and open and ready to let baby out. Baby has descended down the birth canal and is ready to emerge. Some women will feel what is called an urge to push. This is generally caused by the baby pressed onto the Ferguson Plexus of nerves, creating Ferguson's reflex, the urge to push. It is important to note that some women may have a break between becoming completely dilated and feeling the urge to push (this urge feels the same as when you have to "go"). Baby may be getting into a better position. So use this time to rest and get ready for the next stage. 

Upright positioning is usually favorable for the second stage, allowing gravity to assist the mother. There are numerous positions available in modern birth beds, including the squat bar, and foot pedals.

Out of bed positions are wonderful and becoming more popular, particularly for women having trouble pushing in the bed. Including:

Squatting (Opens the pelvic outlet an additional 10%)
Birth Stools
Birth Balls
Water Pools
Birth Chair
Dangling
Toilet
Side lying positions are used to slow down a very rapid labor and are great for protecting the perineum during a rapid birth.

Semi-reclined, or laying on your back with stirrups are still very common in many hospitals, particularly if you have regional anesthesia, or will be having a forceps or vacuum delivery. This position does not use gravity and increases the length of the pushing stage and increases the use of episiotomy, vacuum extraction, and forceps. You can request a different position.

I would recommend googling "pushing positions for labor" or "positions for second stage labor" to get other ideas. Because all we ever see in movies and mostly in real life is women laying on their backs in the bed, it is hard to figure out what else you could do. 

When you are asked to hold your breath to a count of ten, numerous times during one contractions, we call this purple pushing. Purple pushing came into play as the epidural rates increased and women never got an urge to bear down. We now extend it to nearly everyone having a baby.

The options are:

Laboring Down: Allowing your body to push the baby out on its own. Not really assisting the pushing efforts of the uterus, unless you have an overwhelming urge to push. This is particularly useful for women with epidurals because then they are not pushing against a baby who is still in a malpresentation.

Spontaneous Bearing Down (Positive Pushing): Allowing your body to tell you when to push. When this technique is used we never find mom holding her breath more than about 6 seconds, allowing more oxygen for the baby.

Bradley definitely recommends positive pushing so you are working with your body and contractions to be more effective. 

When baby's head crowns, some people experience the "ring of fire", which is a burning sensation. After baby's head is through the rest of pushing is generally much easier. 

Once the baby is born, the doctors will probably suction out their mouth and cut the cord. You have the option to cut immediately or wait for the cord to stop pulsing. (If baby is having any issues, they will cut immediately so they can move baby to the NICU station and tend to the issues.) Reasons to wait for the pulsing to stop would be that baby is getting the last bit of blood that was intended for them, they are still get oxygen from mom for a moment, and studies have shown the stem cells in the cord (ie why we cord bank now) can protect against lots of crazy sickness. You can ask that baby is immediately laid on mom to do skin to skin at this point (bonding of mom and baby skin to skin, which helps baby regulate their blood temp). 


After this comes the birthing of the placenta. Some call this the third stage. It is when the placenta separates from the wall of the uterus, and is delivered through the vaginal canal. You will still be having contractions at this time, but they are much less intense than before. For some women, they’re still strong enough that it helps to use labor breathing techniques to cope with the discomfort of these contractions.  Some women are so enraptured with the baby that they barely notice the cramping. Your caregiver may ask you to push a few times to deliver the placenta. Again, this pushing is less intense than the delivery of the baby. Third stage usually lasts ten to thirty minutes. If it lasts longer than this, you may be given Pitocin to increase contractions to encourage the delivery of the placenta, and help the uterus to begin involution (shrinking back down to the non-pregnant size.) During third stage is also the time when your caregiver will clean your genital area, examine your perineum, and will stitch up your perineum if you’ve torn or had an episiotomy. A local anesthetic is used if you haven’t had an epidural. In this period after birth, most of the parents’ attention centers on the baby, and not so much on the final stage of labor. In the first hour after birth, you will want to begin breastfeeding.


Ok moms that have been through this- what else can you share with us who haven't??

Bradley Birth: First Stage Labor

Let's talk about the first stage of labor, shall we?

Here are just some random things I learned in class about First Stage Labor. Those that have experienced this, please feel free to add your wisdom. It is so important to remember that no two labors are alike, so take all of this with a grain of salt. This is just info to help you become familiar with the birth process and maybe make you less intimidated by it all.

Some definitions:

- Anterior Presentation: this is when baby is facing the back of mom, and it's the most common and easiest to deliver (its what you want)
- Cervix: this is the neck of the uterus and at the lower end of it
- Dilation: the opening of the cervix, which they measure in cm
- Effacement: the thinning of the cervix, which they tell you in percentages

So first stage labor is when labor starts until you are ready to start pushing baby out. To prepare for labor, your body may have Braxton-Hicks contractions (practice contractions), softening of the cervix, loss of the mucous plug, etc. If you are unsure if this is real labor or pre-labor, then when you get contractions do these five things: eat, drink, walk, shower and nap. If the contractions continue on after these things then this is the real deal baby.

Once early labor begins, your uterus starts contracting. This could happen before or after your water breaks (for some women, their water never breaks on its own). When the uterus contracts, it tips forward. This is why laboring by laying on your back is supposed to be so painful, because gravity is pulling the uterus back down and causing a great deal of pain.

Today, we tend to focus on the vaginal exams to see how we are progressing during first stage. But watching the outward signs can be very helpful as well. A woman will go from being able to talk during contractions and being a very busy body, to a very inward focus where she doesn't seem to notice all that is going on around her. This is a sign that labor is progressing well. Also, the further labor gets the more modesty a woman loses. Another good outward indicator that things are moving along. Most women are hungry during the early labor and then not hungry later on.

Just before pushing, most women go through transition (but not all). Transition can suddenly change how the woman is feeling drastically. Suddenly she is defeated and saying she cant do this, talking irrationally and possibly very irritable. This is a good sign that pushing is very close! Transition is generally the hardest part of First Stage, but it usually does not last long. This is where she will need a coach who believes in her and can encourage her the most.

Things Bradley Classes commend you do to cope with First Stage:

  • Change positions often! Try to get in positions that help gravity, so try not to lay on your back! Sit on a birth ball, sit leaning forward in the bed, get on hands and knees, squat, walk, lean over a chair, etc. 
  • Urinate often! This will alleviate discomfort and wont hinder baby from coming down the birth canal. 
  • Eat and Drink as needed. Not some big fatty meal, but small things that can give you some much needed energy. 
  • Dim the lights so you can concentrate. 
  • Abdominal breathing- not chest breathing. Deep breaths will calm you and short breaths will make you feel anxious. 
  • Shower. This helps with the pain. 
  • Try not to tense up! When a contraction comes on, try hard to relax all other muscles in your body. Tensing up makes the pain worse throughout. Having a coach that can look for tense muscles and gently remind you to relax will help.
  • Do not get caught up on numbers. So much of birth is a mental thing. Dilation does not happen in a regularly scheduled pattern ( a 1cm an hour or something). Your body can go from 2 cm to 10 cm in 5 minutes if it wants to. So focus on these other things and believe your body knows what its doing. 
  • Have a birth plan. This will help you remain focused during this time. To see ours, click here. (If you have any questions about ours, just let me know). Your birth plan can be very simple or complex. But having it will enable you to focus on the task at hand and not have to make decisions on the fly. Just google birth plan and you will get all kinds of info on this. 
So, current moms- what else should be know about First Stage Labor? 

Ill be back soon to discuss Second Stage Labor, which includes pushing baby out and delivering the placenta (yes you have to do this too and no one tells you about it!). 



- Mrs.Pate via my iPhone

Thursday, June 30, 2011

Bradley Birth: A few labor tips

Warning: This post contains some "gross" topics or facts concerning labor. If you dont want to hear about specific bodily details, then dont read! Now dont say I didnt warn you...


One article we got during my Bradley class was focused on teaching you to notice outward signs of how far dilated you are without doing a vaginal exam. Allowing too many vaginal exams can really discourage a laboring mom (what I am not past 4 yet??!!) and invite bacteria in each time. 

So here are some tips it gives on how to assess the progress you are making during labor:

1. Sound: During early labor, you can still talk normally and chat in between contractions. Once active labor starts, you probably wont talk during contractions and seem in your own world in between as well. Once you get to transition, you will completely be in your own world and oblivious to those around you. This means you are about to start pushing. 

2. Smell: There is a smell that comes around the end of dilation. It is a mix between mown hay, semen, and dampness. 

3. Irrationality: This is a sign of hitting transition. You will begin saying things that make no sense or are the exact opposite of what you were saying. Its a good sign that you will be pushing soon. 

4. Feel: When your uterus starts thinning and dilating, the muscles of the uterus bunch up at the top of it. During a contraction, at the beginning of labor, check how many fingers you can fit between the fundus (top of the bump) and the bra line- you will prob be able to fit 5 fingers. When you can fit 3 fingers head to the hospital, you are prob 5 cm dilated. And at 1 finger you are fully dilated. 

5. Look: There is a shadow that extends from the anus up towards the back along the crease of the buttocks, which is called the 'bottom line'. It begins at 1 cm and lengthens to 10cm, and its length coordinates with cervical dilation. 

6. Gooey Stuff: The bloody show. (This is different than the mucus plug.) Usually this happens around 2-3 cm dilated and then a 2nd time around 8 cm dilated. It is up to a couple tablespoons in quantity, and can be clear but is usually streaked with pink, brown, or bright blood. The 2nd show means labor is very near. 

7. Opening of the Back: This is the spot above the tailbone and it will bulge out just before pushing. 

So there are some ways you can try to assess how your labor is going. Do not get caught up on numbers but instead look for other signs that your body is doing what it needs to do to get that baby safely out! 


Monday, June 6, 2011

Bradley Birth: Other Info

I had really hoped to share much more about what we learned in our Bradley classes, and maybe some of that will still happen. But as for now, it is not looking likely. These posts take lots of focus and writing, and I am afraid I have hit the exhausting end of pregnancy and just cant put fort the effort. Right now everything is taking ten times longer to complete, which is kinda annoying! Ha! And the to-do list before Griffin gets here is getting long and requires my attention.

But I wanted to go ahead and share lots of links that cover some different topics we did talk about in class. My teacher Lindsey has a page on Facebook called An Everyday Miracle, and if you are interested in Natural Childbirth then you should like the page. She is constantly sharing great links. So without further ado here are a bunch of random articles on random things pertaining to natural childbirth (let me note that I do not always agree with each article or chose what they say, but it is good to be informed regardless):




I am sure there are tons of other topics I wanted to discuss, but I am tired! Soon I do hope to either write a post on labor positions and dealing with pain in labor, or share an article. Lets hope that happens because I am sure I need a review anyhow! Goodnight all...

Friday, May 20, 2011

Bradley Birth: Interventions Part 2


It is finally time to finish sharing what all I learned in my Bradley Classes! You can find all the other Bradley Birth posts I have done here.

Last time I started sharing about different Interventions we learned about in class:
Bradley Classes are all about helping you to avoid "interventions". Intervention is when doctors have to intervene with your labor with some type of medical procedure. The thought process on avoiding them is that "intervention begets intervention", or one intervention often leads to more interventions. This is where I think Bradley classes get kinda controversial for some people, because as a society, American Birth is filled with interventions. Usually we really like our interventions too. 

So what are some common interventions or procedures/policies and why would they maybe not be the best route for us? I am going to go over some we have talked about in our class in a series of posts. I am not fully sure where we stand on several of these, and please remember I am not sharing this info to tell anyone their way of laboring is wrong etc. I just want to share new things I am learning and processing through.
So on to the next few:

Electronic Fetal Monitoring (EFM): 

  • This is when the doctors or nurses monitor your baby's vitals electronically. They like to keep an eye on the Baby's heartbeat throughout labor. 
  • This can be done Externally or Internally. 
  • External is done by strapping a monitor onto the Mom's stomach. 
  • Internal is done by sticking a monitor on to the babies head by going through the vagina. 
This is a very common practice today. In majority of movies you see them coming in to check how the baby is doing through the monitor. So this is just normal to us. Most doctors want to do EFM at least 15 minutes of every hour of labor. The external method is more common. 

The reason this is considered an Intervention is because quite often the info they get from EFM leads to other interventions like a c-section. It is very neat that we can now check on Baby and see how he or she is doing, but sometimes we over read the situation.  Often changing positions can calm baby's heartbeat down, or eating a little can make it come back up it drops a little low. But instead of trying these things, EFM is a direct reason many doctors choose to rush a woman into a c-section. So limiting EFM can prevent this misdiagnosis. 

Our doctor requires 15 minutes of the hour. I tried to get him to agree to 10 minutes but it was a no go. Mr.Pate and I decided this is not one we really want to fight, because we feel prepared to not freak out and jump to conclusions or get rushed into something we dont think is best. 

Vaginal Exams:
  • This is when the nurse or doctor exam your vagina. They are looking to see how far dilated a woman is, how far effaced her cervix is, if they can see the baby, etc. 
  • Some doctors or nurses try to do these every hour of labor, and others do it every 3 or 4 hours. 
This one can really put the pressure on. The more you check the more you could get hung up on a number. It is important to remember that the body prepares at different rates. There is not a set 1 cm an hour process here. So even if a woman is "stuck" at 4 cm for several hours, she could suddenly dilate to 10 in 5 minutes. Bradley Classes push you to not rely on vaginal exams and instead to look at the external signs of labor to see how you are progressing (more on this later, but basically what is mom's demeanor etc). The birth process has a lot to do with your mental state, so you dont want to feel defeated. Also, the more vaginal exams you do the more opportunity to introduce bacteria into the vagina or birth canal. 

Our doctor believes in really spreading these out to every several hours and not getting hung up on it. 

Episiotomy: 
  • This is when they cut the area between the vagina and the anus to prevent tearing when the baby comes out. 
  • Some doctors do this automatically and others only do this when they see the need during the pushing phase. 
Episiotomies take longer to recover from and can really hurt. But if you have to have one of these and you are going natural, there is a time when the doctor can cut and you wont even feel it (your perineum will be blanch white from the pressure of pushing and this makes it numb) so be sure to talk to them about this. 

It is important to realize that ripping is not an absolute given. If you have done lots of squatting beforehand, your perineum (the area they would cut) will be more stretched and flexible. This is why you need to be doing those exercises I discussed here


So thats a few more interventions we have discussed. More to come! Any thoughts or questions on these??



Saturday, April 2, 2011

Bradley Birth: Interventions



Bradley Classes are all about helping you to avoid "interventions". Intervention is when doctors have to intervene with your labor with some type of medical procedure. The thought process on avoiding them is that "intervention begets intervention", or one intervention often leads to more interventions. This is where I think Bradley classes get kinda controversial for some people, because as a society, American Birth is filled with interventions. Usually we really like our interventions too. 

So what are some common interventions or procedures/policies and why would they maybe not be the best route for us? I am going to go over some we have talked about in our class in a series of posts. I am not fully sure where we stand on several of these, and please remember I am not sharing this info to tell anyone their way of laboring is wrong etc. I just want to share new things I am learning and processing through. Here we go with the first two:  


  • IVs: 
It is very routine for a laboring mother to be hooked up to an IV as soon as she arrives at the hospital to give birth. The thought process here is that we need to keep her hydrated and this helps us introduce pain medicine when it is needed or wanted. The disadvantages to the IV are that it limits the mothers mobility during birth (more on this in a later post, but laying in a bed stalls labor while walking around encourages it), and it can increase the swelling a mother experiences. Often today the IV fluids have dextrose in them, because we are not allowing the mother to eat or drink anything (more on that next), so she needs something! But this gives her a sugar high and then causes exhaustion. Thought you were exhausted from the labor? Chances are that was multiplied by this raising and lowering of your blood sugar.

What would an alternative to an IV be? Well if you labor at home (which I am not doing) then you are able to hydrate yourself with real fluids and light food as needed. If you are in the hospital then an alternative could be a Hep-Lock, which is basically a "port" stuck in your arm that an IV can be plugged into at a moments notice if needed. This allows moms to move about freely without having to bring along the IV tower, and helps her avoid the dextrose.

  • NPO (Nothing by Mouth):
Today you are often not allowed to eat or drink during labor at a hospital. The history of this starts back in the 40s when we first starting using local anesthesia during c-sections or when using forceps during labor. The fear was women would throw up and choke on it during the procedure. This was mainly because they used a face mask and it was poor quality. This type of anesthesia is rarely used in birth today, very rarely. And yet, the policy of NPO still stands. They basically decided back then to cut off all fluids and food by mouth, and started administering the IV instead. Today 1 in every 200,000 will aspirate during labor, and even when it happens it rarely causes death anymore because of better technology and treatment.

Why would limiting food and drink during labor matter? It can cause dehydration and ketosis (where the body starts breaking down muscle as food). Studies have shown that women who are able to eat and drink during labor have shorter labor, less of them need augmentation with Pitocin, they require fewer pain meds, and the babies had higher Apgar scores.

This is one of the standard polices that bother me the most I think. It just is dumb. So many women end up having to take pitocin or having a c-section because their bodies wont progress in labor, but the main problem is they are exhausted and no one has fueled the body! You would not have someone run a marathon with no fuel, why would you expect them to labor that way?? I know many women who have said my body just wouldnt progress, it just is like that. And while there may be some people that this condition is true for, majority of our bodies are readily able to birth. We are just expecting it to do it quickly with no fuel and thats dumb. So if you are wondering... I will be trying to labor at home as long as possible (good thing I am only 2 minutes from the hospital) and sneaking food in when I do go in. I refuse to be told my body cant handle labor just because I am starving it. Now if its something else that my body is having issues with ok, but I wont have a c-section just for starvation. No thank you. : )

I will add that in 1999 the World Health Organization began suggesting that women be served light meals during labor, and yet 12 years later we still dont implement it. It shows how Health care today is so slow and does things more out of ritual and tradition than medical necessity. (Pardon the soap box... Ill step down now)


Any opinions on the first two??

Bradley Birth: Nutrition



Another thing Bradley Classes emphasize is good nutrition. They really push Dr.Tom Brewer's pregnancy diet, which promotes a well-balanced, high-quality diet that includes 80 to 100 grams of protein a day, adequate salt (to taste), and water (to thirst), as well as calories from all of the food groups. "During pregnancy a woman's blood volume increases as much as 40 to 60 percent, and in order to reach this necessary level and maintain it, a woman's body needs adequate protein, alit, calcium, potassium and water from her diet" (Amy Haas, "Nutrition during Pregnancy"). 

A quick google search will provide you with the food plan that Bradley Classes suggest, so I wont waste time typing it all. Instead I will focus on the few things that they really emphasize and why. (Each week we are given a pink sheet to record all of our food on one side and our exercises on the other... guess I didnt get too far from WW huh?)

Protein:
Recommendation- 2 servings per day
Provides amino acids which are the building blocks of the body. Important for healthy bones, teeth, muscles, brain, everything. Inadequate protein intake can lead to fatigue, swelling, and lack of appetite. 

Salt: 
Recommendation- salt your food to taste
Cutting back on salt can cause a decrease in the amount of blood circulating through your body and placenta (hypovolemia), thus reducing the supply of nutrients passing to your baby. Too little salt in the diet leads to leg cramps and fatigue. It can also cause swelling and preeclampsia. 
** I was really surprised to be encouraged to eat salt during pregnancy. I thought that was a no no. But it makes sense, your body has to make a lot more blood- and it uses protein, salt and water to do this. So don't skimp out on the salt people!

Milk Products:
Recommendation- 4 servings per day
Provide protein, calcium, and other essential vitamins and minerals. Important for bones, muscle growth, muscle contraction and nerve transmission. Essential for healthy blood, eases insomnia, and helps regulate the heartbeat. 

Eggs:
Recommendation- 2 a day
Provide protein, vitamins and minerals, including vitamin A, the anti-infection vitamin. 
**They really push having 2 eggs a day. Its a cheap protein and has tons of good benefits for you. 

Greens:
Recommendation- 2 servings per day
Rich in vitamins and minerals, particularly A and B complex, which are necessary to help your body use the protein in other foods. These are also high in folic acid, which you need for good growth. And they play a roll in the formation of red blood cells. Best if raw and dark green. 

Citrus (and other High Vit C foods):
Recommendation- 1-2 servings per day
Vitamin C is important for the body's manufacture of collagen, the substance that holds tissue together. Without adequate vitamin C, your uterus is not as strong and may not perform well in labor. Vitamin C is crucial in the body's defense system against infection and in improving iron absorption. 
** It helps me absorb iron, and helps my uterus work well in labor? Sign me up!

They also recommend grains, fats and oils, yellow and orange colored fruits and vegetables, and water. 

That was a lot of info I know. The main point is that we need to be very aware of what we are feeding our bodies during pregnancy (all the time really). Eating healthy during pregnancy really helps you have a more comfortable pregnancy and more efficient labor. Any questions??? 

--All info from these two sources:
The Bradley Method Student Workbook, written by Marjie, Jay & James Hathaway (2010 AAHCC)
Nutrition During Pregnancy, by Amy V. Haas (2002 Midwifery Today)


Saturday, March 26, 2011

Bradley Birth: Exercises



Bradley Classes are all about preparing you for labor. Just like you would not show up to run a marathon having not trained and prepared yourself, you should not show up to labor without utilizing the time before to prepare. One big thing they emphasis is regular exercise and pregnancy exercises. Here are the exercises and recommendations:

- Regular Exercise:
They recommend continuing regular physical exercise during pregnancy (as long as your doctor has not limited your activity because of issues). Ultimately 30 minutes a day.

- Pregnancy Exercises:
These exercises are designed to specifically prepare the areas of the body used during labor. They also help minimize most of the common pregnancy discomforts.

1. Tailor Sitting: It encourages the uterus to move forward instead of bearing down on the pelvis. Basically this is sitting on the floor with your legs crossed or feet touching soul to soul. Remember good posture and to change your position often. In pregnancy you should not stay in the same position for long periods of time. You can lean back on something or lean forward on your legs. This exercise is recommended "often" instead of a set period of time a day.

2. Squatting: Squatting naturally puts the body in the right position to put pressure on the uterus, it prevents arching the back which is bad for pushing, shortens the birth canal and increases the pelvic opening. It stretches the perineum (helping to prevent episiotomies- which is when they cut a woman to 'prevent' tearing) and shortens second stage labor (with is the pushing stage). Sign me up! haha!

Basically start in a standing position with legs apart. Then bend the knees and tucks your hips under. Stay down in the position for a few moments, trying to have the feet flat on the floor. You made need to practice this one for awhile before your feel will go flat. And you may want to hang on to something for balance. They recommend doing this "often" also. You should stop bending over at the hip, and instead squat to get things or get down.

3. Pelvic Rocking: This one is supposed to give you more benefits than any of them. It tones the ab muscles and the lower back. It is supposed to relieve pressure on the lower back, uterus and bladder, increases circulation, relieve general tension and improve digestion. It helps the baby come forward and relieve pressure.

Get down on hands and knees and relax your lower back. Tuck your pelvis and hips under then release them back to the starting position. Most of the movement should be in the hips and lower back, not arching your back up and down. They say start these slowly and work your way up to 4 sets of 40 a day plus 80 just before bed. Sound like a lot? It is : ) Lets hope they are worth it!

4. Butterfly: This one tones your abductor muscles (outer muscles on your thighs) and helps you pull your legs back easier during pushing. It also reduces the shaky legs after labor.

Sit on the floor leaned back against something with your knees up and together with feet flat on the floor. Have the "coach" place their hands on the the outside of the knees and apply some pressure. The woman should open her legs and push knees to the floor, keeping the feet touching (soul to soul), while the coach gives her some resistance to push through. Then return to starting point and do again.

5. Kegel: Doing your kegels helps you improve the pelvic floor muscle tone. This helps you avoid wetting your pants when coughing or sneezing (common in pregnancy and after), discomfort, lack of sensation during sex, unusual pain during labor, and a long pushing stage of labor.

Best way to describe this one is to imagine you are peeing and you make yourself stop. The muscle you pull in to hold your pee in- thats your kegel. To work it out, pull it in then release. At first just work on pulling the muscle in 100 times a day. Then work on pulling it in and letting it go intentionally (before it will let itself go until you build it up some) 100 times a day. After that work on doing this 200 times and day and holding it in longer.

These exercises take time, but I think they are more than worth it. A lot of the prolonged labor and pain in labor we see today is because the areas of the body we are using are not used to it at all. That makes total sense to me. Have any of you every done any of these exercises or do you know other ones that help during pregnancy?

Ill keep you posted on how these help me out as I go. I have not been very uncomfortable in pregnancy yet and have had little to no back pain, but I have a ways to go so we shall see...


Bradley Birth: An Intro


Before I jump into telling you what I have been learning in my Bradley Classes, I figured I should share a brief intro of what Bradley classes are. So I found this summary on the web and thought I would just use it (borrowed from Babycenter.com):

This method embraces the idea that childbirth is a natural process and that, with the right preparation, most women can avoid pain medication and routine interventions during labor and birth. It's named after American obstetrician Robert Bradley, who developed the method in the late 1940s.

The program lasts 12 weeks and is more intensive than other childbirth education classes. Proponents claim that over 86 percent of Bradley-trained couples have had spontaneous, unmedicated vaginal births.

The Bradley philosophy says that it takes months to prepare for childbirth and parenting — mentally, physically, and emotionally — and prides itself on addressing all aspects of natural childbirth, as well as many pregnancy and postpartum issues. The course also emphasizes educating partners to be effective coaches.
What will my partner and I learn in a Bradley course?:

To make sure the classes are thorough and personal, classes are limited to eight couples and are often even smaller. The course will address: 
  • Nutrition and how it affects a growing fetus 
  • The importance of exercise (when appropriate) during pregnancy 
  • Common pregnancy symptoms and complaints, and how to cope with them 
  • Techniques for relaxation during labor and birth, with an emphasis on breathing methods to help you "tune-in" and manage your pain rather than distract you from it 
  • Methods to help your partner be an active participant and a skilled coach on labor day 
  • The stages of labor and how to cope with the changes your body experiences during each one 
  • Medical interventions and how to avoid unnecessary ones 
  • How to reduce your risk of having a c-section and what to do if it becomes medically necessary 
  • Making a birth plan and how to communicate effectively with your medical team 
  • Breastfeeding

Upcoming Post Warning


I am about to start posting all the stuff I am learning about in my Bradley Birth Classes. I just wanted to warn those who are not interested. All of the posts will start with "Bradley Birth", so feel free to skip those if not interested.

Tuesday, March 22, 2011

Bradley Birth Class: Pros and Cons

Before I dive into sharing the info I am learning in my Bradley Birth Class, I want to just do an overall post on what I think the Pros and Cons are of the class so far.

Pros:

  • I feel way more informed about pregnancy, labor, birth and the beginning of parenting. 
  • They emphasis the role of the "Coach" during this process. Usually this role is the husband, but if you dont have one then it can be someone else you trust and lean on. This was important to me because Mr. Pate understands me and helps me through things better than anyone on this earth. He is and will be my rock through this. 
  • It focuses on healthy nutrition and exercising during pregnancy. I love this. 
  • It makes me feel empowered and reminds me my body was created to do this. Sometimes I feel like we treat labor like something really odd that we have to get through, but women have done this since the beginning of humanity. 
  • They teach us coping strategies/ relaxation techniques to prepare us for actual labor. 
Cons:
  • There is really an "us" vs "them" mentality against modern medicine and doctors. It comes across pretty strong in the material, the teaching, and even in the comments from the others in the class. You could really come out totally against your doctor if you weren't careful. I love our doctor so far, and I think he loves what he does and has our best interest in mind. I get that a lot of what they are teaching us is against how most doctors handle labor today, but we dont have to paint them in such a bad light. 
  • If you are planning to labor in a traditional hospital with a traditional OB, you kinda feel like an oddball. This is funny to me because Dr.Bradley, the guy who started this shindig, was a regular OB who delivered babies in a hospital. 
  • We have to drive to TN... this is getting old and we get super tired! 
Thats my thoughts so far. We are only 5 weeks in I think, so we have a ways to go. That means I have a ton more to learn! Ha!