Pregnancy, Parenthood & Playtime

During my journey to becoming a Lamaze childbirth educator, there are so many things I would like to document and share through the information and learning processes on my blog. I hope that others enjoy the information as I work through it and share what I feel so be some of the most important pieces of key information.

Today I am going to touch on the different Stages of Labor. Many who are active in the childbirth community may already be familiar with these, but what I have noticed through my work with pregnant women, and what is being shown in studies, run of the mill pregnant women are not familiar with most of the information provided in childbirth education courses. Stages of labor happen to be one of these.

Prodomal Labor

What is going on?

• The cervix is beginning to thin out, and soften, and move forward. During this process it also may start to open.
• The baby will settle into the pelvis.
• You may start to notice some contractions, but will remain irregular, slightly noticeable, and will not form a pattern.
• The contractions may be noticeable or identified as a pain in the lower stomach, or back.
• Normally this phase can last anywhere from a couple hours, to days.

This is your bodies way to gear up for the marathon of labor it will be running shortly.

What Helps?

• Don’t worry or over think what you are going through. You will not miss labor, and you will certainly know when you are in labor!
• Be patient!  Having confidence that your body truly knows what to do is key.
• Take care of yourself. Sleep, eat, stay active, and overall be healthy (but you should be doing that through your entire pregnancy to begin with)
• Be sure to only surround yourself with supportive and positive people. You only want those around who will make you feel not only safe, but comfortable.

Early Labor (Latent Phase)

Whats going on?

• Your cervix will start to dilating to about 3-4 centimeters, and the cervix continues to thin.
• Labor can tend to be slow, but most prefer to call it gradual. On average, the latent phase of labor makes up two-thirds of the total labor time in most mothers.
• Over time contractions will become longer, stronger, and more intense.
• Contractions will become more regular, and start to form a pattern.
• Contractions can be described as 5 minutes apart, and 25 to 45 seconds in length.
• You may have pinkish discharge that can be normally called a show that will increase as labor progresses.

What Helps?

• Be calm, relax, and don’t get too excited or worked up that labor has finally started.
• Alternate staying active with relaxation. A great example is chores, or taking walk, followed by taking a shower, and including snacks, and lots of fluids.
• Keep your environment pleasant and positive. Visitors or people who will not carry out this kind of environment should be asked to leave, or change their tune.
• Work on positive activities, you can do some light work in the new babies room, listen to music or even watch a favorite tv show.
• Stay at home as long as you can. Most women find that home is the most comfortable option for laboring in a positive environment.
• When contractions start to become more intense, or unbearable, be sure to have your support team helping you, and supporting you in the activities around the house.
• Use relaxation, as well as breathing to work through your contractions.

Active Labor

Whats going on?

• Contractions will become longer as well as stronger, and become about 3 minutes apart, and last about a minute at a time.
• Women in active labor will start to become very focused on their labor.
• During this phase which lasts between 2 to 6 hours on average, the cervix will completely efface, and dilate to 8 centimeters.

What Helps?

• Listen to your body!  It is meant to give birth to babies and now has you really rockin’ and rollin’ towards birth.
• Do something to stay active during contractions, walk, talk, breathe, or just move around, and take the time in between contractions to rest.
• Create a peaceful, and relaxed environment as your surroundings will impact your labor, and harsh feelings, comments, or actions can halt your labor.
• Personalize your surroundings. Use your own music, clothes, and comforts of home (especially in a hospital setting)
• Changing positions will help you stay more active and comfortable, and will also help you to progress.

Transition

Whats going on?

• The cervix will finish effacing and dilating.
• Contractions are powerful, efficient, and close together.
• Phase usually lasts about less than an hour.
• Some women will feel very sick to their stomach, or actually vomit during transition.
• Women may feel wreckless or increasingly emotional and irritable.

What Helps?

• Focus on your contractions, one at a time to help from getting overwhelmed with your experience. There is a lot going on, focus on the most important part, your contractions.
• Continue to focus on your breathing as well as visualization techniques.
• Those who are providing labor support should be giving you their undivided attention to help you through your contractions. Massage, talking you through, encouragement and praise.
• Continue to use your time between contractions for rest and to relax. The time spacing may be much smaller, but it is still very important.

Second Stage (Pushing)

Whats going on?

• Your body will now shift from dilating and effacing to pushing.
• The baby will make its way down through the pelvis and birth canal.
• This phase can last anywhere from 15 minutes to several hours.
• Some women may not feel the urge right away after full dilation, many will feel the urge to start to “bear down”. This urge will continue to get stronger as the baby descends.
• Many women will feel as though their head has been “cleared” and they have a renewed energy for pushing.
• Just before your baby will be born, many women will feel a burning , stinging, stretching at the open of the vagina. Many call this the famous “ring of fire” but not all experience it.
• The babies head will emerge, and it will turn to one side to allow the shoulders to pass through, and the rest of the baby will slip right out.

What Helps?

• Follow your instinct. Women normally feel the strongest urge to push at the peak of a contraction, follow what your body feels like it needs to do, or wants to do through the contractions.
• It may help some women to be vocal, but loud high pitched sounds will only use up all of your energy and breathe. Low, deep noises and moans are most helpful.
• Those supporting you in your labor should remain as quiet as possible, or provide low or quiet support and encouragement.
• Let go of any tension you may feel in your perineum. Applying a warm compress may help.
• If progress is slow, changing positions can be very helpful. The most efficient positions to push in tend to be squatting, laying on your side, or hands and knees. (The lithotomy position, or flat on your back with your legs in the air decreases the opening of your pelvis.)
• Rest in between contractions.

Third Stage (Recovery)

Whats going on?

• Your baby should be placed on your abdomen, and quickly dried.
• You will probably experience a boat load of feelings, excitement, joy, happiness, awe, and relief that it is finally over!
• The cord will be cut and the placenta will be delivered normally within 30 minutes.
• Many women get after pains of “the shakes” after birth.
• Cold compresses are often applied to the perineum to ease your discomfort as well as help with the swelling.

What Helps?

• Touch, caress, and cuddle your new little baby without time restrictions. (If there is no medical needs for mother and baby separation).
• Skin-to-skin contact with your baby is your best option.
• All routine infant procedures can be done without removing your baby from your side. Request that all measuring, weighing, and other procedures be delayed for the first few hours.
• Offering your baby the breast during this time will increase the likelihood of a successful breastfeeding relationship, and will also help to decrease the bleeding, and tightening of the uterus.

Lots of information, in a long post.
I hope you all enjoy and find it as educational and helpful as I do!

Yesterday, April 28th, 2010 at 1:00pm a local Milford family was featured on the TLC show A Baby Story, documenting the home birth of their second child. Filled with midnight strolls on the private beach area, and a beautiful water birth.

After an intervention filled hospital birth with her first child, Glorvina had no desire to repeat the experience, or step foot into the hospital to birth her second child, which is something we are increasingly seeing across the United States.

The episode is described on the TLC website as :

“Glorvina and her husband, Jason, were ready to try something different. They did some research and found a midwife they trust, and are ready to have a water birth at home. When delivery day finally ensues, Glorvina realizes fast that she’s not in control.”

Fortunately for the family, their delivery was not as dramatic as the show producers made it sound.

Baby girl Bernadette was born peacefully in the water at the conclusion of the episode.

Husband Jason explained at the conclusion of the episode that if they had known everything they know now going into the birth of their first child, they would have never stepped foot into the hospital to give birth to their first son.

This episode featured local Certified Nurse Midwives, Vicki Marnin and Amy Romano of the practice Birth & Beyond out of Madison. Unfortunately for the women of Connecticut, since this birth which took place last June, they are unable to take on births at this time.

Also included in this episode is the late Doula & Childbirth Educator Karen Kilson who suddenly lost her life in October of 2009.

After the success of our Post Cesarean Feelings Survey, The Healthy Baby Network, and myself are working on a second survey project focused on All About Doulas.

If you know what a doula is, or have thought about using one with the birth of your children, please take a couple minutes to fill out the quick survey!

Would you take the time to go into a public bathroom, unpack your lunch and then proceed to eat it in there?  Sounds a little on the disgusting side right?  I mean, certainly it is not something I would do because those places have to be some of the most germ infested, disgusting, illness breeding grounds.

So why do so many people, women included, suggest that breastfeeding mothers take their baby, sometimes brand spanking new, into this germ infested public toilet area to eat?  Seems a little backwards.

Whether it is pumping breastmilk, or breastfeeding, no one should be thrown into a public bathroom to do it. Even if the facility itself appears to be clean. According to experts, Public bathrooms may contain several kinds of harmful bacteria, including E. coli, salmonella, coliform, rotavirus, cold virus and the potentially deadly form of staph known as MRSA.  All things we would never in a million years want to expose our new babies to, I certainly know I wouldn’t want any of my children exposed to any of it.

In fact, the majority of these bacterias are not even on the toilet seat itself, but on the floor, walls, sinks and other areas of public bathrooms, which would be thought to be the safer places to sit or touch when using a public bathroom.

Knowing all of this, why would anyone in their right mind suggest anyone eat in there?
One of those things that make you say hmmmm?

Continuing the What Do I need for a Baby Series inspired by the Babies R Us New Parents Checklist, today is onto part 6!
If you missed parts 1-5 you can click on the links below to check out what you missed.

What Do I Really Need Part 1
What Do I Really Need Part 2
What Do I Really Need Part 3
What Do I Really Need Part 4
What Do I Really Need Part 5

When we left off, we were discussing baby furniture!  Cribs, Gliders, and Blanket Chests. Today we will pick up with crib mattresses and move on from there!

Crib Mattress – Obviously if you are planning on using a crib at some point in time, you need a mattress for it. There are so many different types of mattresses for cribs, but I stuck with the traditional spring mattress. I suggest researching other options if they are something you may want to use.
Crib Mattress Pads – Yes! Another must have. Babies are messy little creatures, spit up, diaper explosions, little boys peeing the second you get them out of the bath… If you don’t want your mattress ruined, I highly suggest one, or three. LOL
Portable Crib, Bassinet, Cradle Mat - Another positive, especially if you are the kind of person who doesn’t like to stay at home. Taking this along for diaper changes in various places is very helpful!
Crib Bedding Set – Again important if you are going to be using a crib. If you are trying to save money, skip on the crib bumper. For the first months, at least until your baby can roll over, it is not recommended to be used due to the risk of SIDS.
Fitted Crib Sheets – You obviously need fitted sheets if you are planning on using a crib, but having 3-6 of them is highly recommended. Between spit up, diaper mishaps, and everything else that comes out of babies, being able to change sheets nearly ever other day without having to run and do laundry immediately is helpful.
Blankets – Having at least 4-6 thicker, fleece or warm blankets I highly recommend, no matter what time of the year your baby is born. You will find plenty of need for them, even once your baby is nearing a year old.
Receiving Blankets – You can never have enough of these. We averaged at least 6 of them at all times clean and folded and ready to be used. While you don’t need that many, they are very helpful for swaddling, and day to day use, and even for catching spit up. I also recommend cloth diapers made by Gerber for burpie cloths.
Changing Table Covers – If you are anything like us, your changing table will become a storage unit for diapers and wipes and never actually be used to change your baby. But if you do, having a cover for the changing table pad may be helpful. The changing table as a whole for us was just a piece of furniture we could have gone without.
Sleep Positioner – If you are planning on using the crib, and not co-sleeping in the same room I suggest using a sleep positioner.  We never really had a use for ours, but there is a great use for some.
Wall Hangings – If you are going all out and decorating a nursery, the use of wall hangings and other decorations may be something you would like, but certainly not a must have for your new baby.
Switch Plate Cover – The same goes for the switch plate cover as the wall hangings. It is not something you need for your baby, but it may be something you would like to use for your nursery.
Crib Mobile – They are cute, as well as useful if you are planning to have your little one sleeping in the crib. But certainly not something that you or your baby would not be able to live without.
Lamp – This is hit or miss. If you are planning on using a nursery for midnight feedings, your best bet would be to use a small lamp as opposed to an over head light that producing a good amount of light. Trying not to stimulate your baby too much at night may be your best bet for getting more sleep.
Wall Border – A cute decoration, but a HUGE pain in the butt! We had to use one with our nursery and it ended up being a nightmare. From putting it up, to having enough to go around the entire room, to trying to match the pattern up where the other roll ended.
Window Treatments – Good for decoration, not something you can’t live without.
Diaper Stacker – I loved my diaper stacker! It was useful for storing diapers, and quick access to them when it came time for changing diapers. They are also much more appealing to the eye than stacking diapers everywhere.
Rug – If you have a room that already has carpet it isn’t something you really need.  And it is certainly something you can live without. It depends on what you want to spend and how you want to decorate. Small nursery rugs can run you a good amount.
Hamper – A must have with the amount of laundry you are going to be going through with a new baby! I always thought to myself, how dirty can a baby get?  VERY!
Waste Basket – We never used one in our nursery, we just always used the normal house garbage can. Depending on the set up of your house you may want to use one, but we never really found a use for one.

Looks like from here on out, there may be 1-2 more posts!
Make sure to tune back in!

If you are someone who has been reading here since I started writing this blog last August, you will know that my family carries a yearly pass to the Beardsley Zoo in Bridgeport. It is a great activity for our children, and it makes a fun family day, whether on the weekend, or just going for an hour or two during the week.

Around Halloween time I posted a list of awesome events for the kids to go and get involved in, and for the upcoming month of May they have some more great events, activities, and days planned. I wanted to share them with my readers who are local!

May 8th 2010 from noon till 3pm is the spring fling : The Spring Fling includes a lot of hands on activities in the Barn Yard area of the zoo. Animal encounters, a blacksmith demonstration, and lots of crafts and activities for your kids!

May 8th 2010 from noon till 3pm is Pet Adoption Day : The zoo, and Petco is sponsoring an Animal adoption day. There will also be demonstrations and lessons for our children showing how important adoption is, as well as how to take care of our pets, and why rescue organizations are important!

May 9th 2010 from 9am till 4pm is a Mothers Day Celebration : All mothers are admitted to the zoo free of cost in celebration of Mothers Day to show appreciation for all that Moms do!

Zoo Tots Day : A program designed for children 18 months to 3 years including story time, games, and zoo related activities.
The program runs on 5/11 from 10:15-11:15 & 1:00pm – 1:45pm
And 5/12 from 10:15-11:15 & 1:00pm – 1:45pm

Lots of great things coming up!

For more events, or information you can visit this website.

Going into the hospital to give birth can sometimes be a scary experience for some women, especially with the maternity care system as we know it today. Knowing your legal rights as a patient is very important.

Here is a sample of the Patient Bill of Rights (I highlighted the rights that stand out in maternity care)

• To safe, considerate and respectful care, provided in a manner consistent with your beliefs;
• To expect that all communications and records pertaining to your care will be treated as confidential to the extent permitted by law;
• To know the physician responsible for coordinating your care at the Clinical Center;
• To receive complete information about diagnosis, treatment, and prognosis from the physician, in terms that are easily understood. If it is medically inadvisable to give such information to you, it will be given to a legally authorized representative;
• To receive information necessary for you to give informed consent prior to any procedure or treatment, including a description of the procedure or treatment, any potential risks or benefits, the probable duration of any incapacitation, and any alternatives. Exceptions will be made in the case of an emergency;
• To receive routine services when hospitalized at the Clinical Center in connection with your protocol. Complicating chronic conditions will be noted, reported to you, and treated as necessary without the assumption of long-term responsibility for their management;
• To know in advance what appointment times and physicians are available and where to go for continuity of care provided by the Clinical Center;
• To receive appropriate assessment of ,and treatment for, pain;
• To refuse to participate in research, to refuse treatment to the extent permitted by law, and to be informed of the medical consequences of these actions, including possible dismissal from the study and discharge from the Clinical Center. If discharge would jeopardize your health, you have the right to remain under Clinical Center care until discharge or transfer is medically advisable;
• To be transferred to another facility when your participation in the Clinical Center study is terminated;
• To expect that a medical summary from the Clinical Center will be sent to your referring physician;
• To designate additional physicians or organizations at any time to receive medical updates.

When it comes down to it, if you say no, or do not wish to undergo a certain procedure, you legally cannot be forced into it, which we are seeing in an increasing number today.
You have rights!

A new study that has come out recently shows that despite all the medical advances, and advances in infant formula, there are 911 babies in the United States alone annually that will die as a result of not being breast fed. Scary as a mother of a child who had to be formula fed for medical reasons after breastfeeding for the first 6 weeks of his life!

According to this new study, over 13 billion dollars annually could be saved by more mothers breastfeeding their children. These are costs of medical care, private insurance, medicaid, and government agencies, including WIC which is the largest supplier of infant formula in The United States to low income families, the same families more likely to experiences these 911 infant deaths.

Various medical organizations including The World Health Organization and The American Academy of Pediatrics recommend a minimum of breastfeeding for 6 months. Unfortunately for American women, the CDC reports that only 74% of women attempt to breastfeed, only 33% are still exclusively breastfeeding at 3 months, and only 14% are still breastfeeding at 6 months, most not meeting the minimum recommendation.  It is estimated that less than 5% of mothers truly cannot breastfeed for a medical reason.

Many are quick to point the finger at many different reasons that breastfeeding may have not worked for them, but according to this study, as well as many other publications regarding the topics, the biggest factors impacting the ability to breastfeed for the minimum of one year are :

• Lack of education on breastfeeding
• Lack of skilled IBCLC’s in The United States
• Conflicting and confusing information provided to mothers
• The economy
• Women have to return to work shortly after birth because most do not have any form of paid maternity leave.

There are many other factors that impact these choices, especially the way birth is handled in the hospital. The window of the first hours after birth, often when babies are being taken away from the mother for bathing, tests, weight and height measurements, and all that goes along with modern American maternity care strongly impacts the change of a successful breastfeeding relationship.

To read more on this study, you can visit this site.