Ready for Labor Series: Test Your Knowledge about Common Labor Interventions as well as Labor Induction
I love me some good trivia games. I get a little over competitive and definitely over confident in wanting to crush my trivia opponents.
So, let's combine the fun of trivia and my love of labor education!! Doesn't this sound like the BEST date night during your pregnancy?! *wink, wink*
In my classes we discuss these options, and it can feel like an educational lecture. Not as interactive as I would love for it to be. So let's test your knowledge after our class together to see what you remember and where we can fill in gaps for education.
If you have yet to take a class with me, then let's connect and help feel more prepared for the labor process. Connect with me here.
First up, let's test your knowledge around Common Labor Interventions such as fetal monitoring, IV fluids, pelvic exams and eating & drinking in labor. Written in a jeopardy manner, play alongside your partner and see who will win the dessert in the back of your freezer. PLAY HERE.
After you have beaten that game, follow it up in testing your knowledge around Labor Inductions and Augmentation (using medications to start and/or speed up labor), such as pitocin, cervical ripening, sweep/stripping the membranes, & AROM (breaking your bag of waters for you). PLAY THIS GAME HERE.
Now comment below. How did you do? Who won the game?
Happy playing trivia friends!
Funny how the media portrays labor beginning: Water breaks everywhere, woman screams, hails a cab, shows up at the hospital and baby is born less than 5min. Woah! What drama! Seems like a woman in labor = everyone should freak out.
Let’s talk about how it really goes. You are within 39-41weeks (as evidence supports about 90% of women go into labor on their own within these two weeks), you go to bed, get your fort of pillows built up around you and finally find a comfortable position to fall asleep. In the middle of the night, you wake to the feeling of you peeing yourself. “Ah balls!” is your thought as you check to see if your partner is still asleep. So, you sprint (as quickly as a 39-41week woman can sprint) to the bathroom to clean up. You go back to bed and as your leg hugs your pregnancy pillow, you feel more pee come out again. “WTF? I’ve lost full control of my body”
Are you peeing yourself? Maybe. But maybe your water is leaking. Meaning, your water might have broken.
So, here’s the real deal…
About 8-10% of women start labor with their water breaking.
That’s all! Only about 8-10%. For the rest, it typically breaks the closer you are to pushing.
Okay, so what does water breaking have to do with tacos? Well, if your water breaks outside of your birthplace you’ll want to take note of TACO.
(T.A.C.O.) Time, Amount, Color, Odor
These are things that your prenatal healthcare provider will want to know.
TIME – There is an increased risk of infection as time passes once your water breaks, especially with more frequent vaginal exams. Your midwife or doctor may want to induce labor if contractions do not start on their own within 12-24hrs.
AMOUNT – No, you don’t need to squeegee the fluid into a measuring cup to see how many ounces you are leaking. Just note whether it is a trickle or a gush. If you are unsure if your water has broken, go to the bathroom, urinate, place a medium flow sanitary pad in your underwear, go lay down on your side for 10-15 minutes and then stand up. If water has pooled in your uterus and/or vagina and comes out when you stand up or if your pad fills up within half an hour, it would be a strong indication that your water broke.
COLOR – Should be clear. Yellow or greenish brown color would indicate that baby had a bowel movement in utero called meconium.
ODOR – A mild or odorless smell is normal but a strong odor may indicate infection.
After your water breaks, make sure to place a sanitary napkin in your underwear as you will continue to leak with many position changes and/or during a contraction as your placenta continues to produce amniotic fluid until it is birthed.
*If your water breaks and you are Group B Strep positive, your prenatal healthcare provider will want you to come to the birthplace right away so that they may administer antibiotics to you (as recommended by the CDC).
*If your water breaks, Group B Strep negative and are not having contractions, you may consider staying home to try to bring on contractions (evidence supports within 12hours 45% of birthers will begin to experience contractions). Walking and hula hoops on a birth ball can be helpful during this time.
*In labor, your prenatal healthcare provider will break your bags of water to ”help move your labor along” (aka augment labor). You always have a choice in this and have the right to discuss the benefits, risks and alternatives before following your intuition about this procedure (also called AROM, artificial rupture of membranes).
*As noted above, typically your water will break on its own at some point during labor. If this happens, let your healthcare team know so they can note TACO as well as provide you a pad for the continuous leaking.
Happy leaking from your vagina friends!
Overnight Bag (think 3night stay):
o Your own face masks (hospital will provide if you do not bring one)
o Toiletries for each parent (toothbrush, toothpaste, hair brush, deodorant, lotion, shampoo, etc.)
o Electronic chargers (phone, iPad, camera, etc.)
o Your own pillow, pajamas and clothes (you’ll still look about 6mo, so bring loose fitting and/or maternity)
o Partner pillow, pajamas, clothing, and a sweatshirt
o Nursing Bra and/or nursing tank tops
o White noise machine to encourage better rest
o Copy of insurance information and your ID
o 2-3 Baby outfits
o Blanket to wrap baby in
o Infant car seat – Bring with you into the hospital when you arrive in labor, or for your scheduled induction or cesarean
o Pediatrician or Family Practice doctor and doctor’s office information
o Your own brand of diapers* (This is optional; most Minneapolis/St.Paul hospitals have pampers for you to use during your stay)
o Your own brand of wipes* (This is optional; most Minneapolis/St.Paul hospitals have dry wipes for you to wet down with warm water from the bathroom for you to use during your stay)
o Your own brand of an infant formula* (This is optional; all Minneapolis/St.Paul hospitals have donor breastmilk and formula to use if supplementing is recommended. Also, if supplementing is recommended and your goal is to 100% breastfeed your baby your breastmilk, please contact a lactation professional.)
o Gallon ZipLoc Bags, to make ice packs
o Lacrosse Balls (for massage bottom and hips, plus great for counterpressure on lower back)
o Other massage tools8 (optional)
o Massage oil (coconut or almond oil are great, and if looking for odorless try cornstarch)
o Lip Balm
o Essential oils or other favorite scents (i.e. lavender, lemongrass, clary sage, peppermint, citrus, etc.)
o Phone or iPod/iPad with your labor music lists ranging from energetic to soothing
o Blue tooth speaker
o Small Tripod to set up smartphone or tablet to talk with your virtual doula or take photos
o A comfy wardrobe (i.e. knee-length skirt/dress, robe, slippers, soft bra easily removed, & warm socks)
o Swim top/Bralette to stay covered, if desired, while in tub for hydrotherapy
o Partner bring your swimsuit too if joining birther in the tub for better hands-on support.
o Electric tea light candles or simple string of lights to bring dim lighting
o Camera/video camera
o Copies of birth plan/birth wish list/preferences
o Copies of your labor/birth mantras and affirmations
o Copies of your labor/birth visual encouragements or inspiring photos
Food for your Labor and Stay (partner may not be able to leave to grab food, so plan to bring some extra meals that the hospital will not be providing. Nurses can help bring items to the microwave to heat up when needed. Most Postpartum Recovery rooms have refrigerators, but not all labor&delivery rooms.):
o Dates – Eating 6 dates/day in the last 4weeks of your pregnancy, evidence supports it can significantly
shorten your labor and be more efficient.
o Plain Water & Beverages with electrolytes (i.e. coconut water, gatorade, emergen-C, etc) – use a bottle with a straw (a water bottle for partner too)
o Light snacks for birthing mom (i.e. Applesauce, Oatmeal, Pancakes/Waffles, Homemade energy bites, Broth, Raw Honey Sticks (broth and honey sticks are great to sip on if you have an epidural))
o Bigger snacks/meals for birthing partner and postpartum recovery birther (i.e. Sandwiches, Salads/Stirfrys/Grain Bowls, Soups, Trail mix, Granola bars, Nuts, Crackers & Cheese, Fresh fruit/Veggies, Other snacky items)
o Breath Mints to be close to birther
This list may seem big, but many of these items are quite small. And you never regret bringing extra snacks anywhere in life!
For Cesarean Birth Moms, everything above plus:
Your healthcare provider may recommend the following medications. Please consult with your medical provider prior to taking any of the following medications.
Lastly, it is encouraged by The American College of Obstetricians and Gynecologists you are seen by your prenatal provider within 2-3 weeks post-delivery and again within 12 weeks post-delivery to ensure optimal physical recovery. So call your prenatal health provider and schedule your appointment! You deserve the best postpartum care EVER!!
Click on the button under the photo and view the rates for your hospital. Don't forget to ask your care provider directly about their group's cesarean rate, as it will differ from your hospital's average rate. (As I say in class, it's not your hospital deciding and performing the cesarean birth, it is the care provider and their colleagues you have been seeing/working with in your prenatal visits.) This will not only enhance your birth experience, but will also encourage you to be an informed-decision maker for yourself and your family's optimal health outcomes.
Let's dive into each piece and how to apply this in your support when you arrive to labor day.
The birthing mother needs privacy, respect, and continuous support to best cope with her labor and maintain the balance of hormones to progress labor. Maintaining this balance will keep her labor effective and her discomfort manageable. The environment surrounding you during labor influences these hormones, as well as your mind’s ability to enter into the deep relaxation.
So in reflecting on your ideal environment/birthing space:
The birthing mother is encouraged to stay well-hydrated for the duration of her labor as evidence supports those who took in more fluids had shorter labors by about 30 minutes, in comparison to those with mild dehydration could contribute to slightly longer labors. With so much fluid flowing through the the birthing mother means urinating every 45 minutes to an hour can help decrease the size of her bladder to make more room in the pelvis for the descending baby.
The birthing mother is encouraged to move into 2-3 positions within an hour. Even changing how the birthing mother moves is included in the number of positions changes, because it causes their pelvis to be more dynamic to invite baby to descend. So, while they are on the birth ball hula-hoop the hips into a clockwise direction through 20-30 min of contractions, and then counter the hula-hoop movement for another 20-30min.
The big position changes and small movements all help the birthing mother find her rhythm and ritual to achieve effective relaxation to continue to work with her labor process.
Remind the birthing mother often how amazing she is, how powerful and strong she is. Partners, repeat your love for her. Tell her you are so proud of the hard work she is doing and thank her for taking this on for your family. Remind her she has everything she needs right there, right now and that she is safe and you will stay by her side.
Out of Bed/Open Pelvis:
Research suggests laboring and giving birth in an upright position can have several benefits: gravity can help bring baby down & out, less risk of compressing the mother's aorta so better oxygen supply to the baby, it will help the uterus contract more strongly and efficiently, AND helps the baby get in a better position to pass through the pelvis.
So even if continuous monitoring is needed for medical reasons, the birthing mother can still be upright by asking for wireless monitors or if needed to stay in one area she can consider sitting on the birth ball with more freedom to move.
If choosing or needing to spend time in bed, use a peanut ball to place between the birther’s knees to keep the pelvis open to encourage baby’s descent.
Rest between/Relax during contractions:
In between contractions, the birthing mother and her partner should rest to reserve energy. Evidence supports in a 12-hour labor, only 2 of those hours are actually spent contracting, while the remaining time is the body resting. If the body is resting, the birthing mother along with her partner should rest too. Think pillows, soft places to lie into, blankets, quiet room, cushioned knees, leaning over a birth ball, leaning into partner, etc.
Relaxing during the contractions by taking a deep cleansing breath and soften the jaw, mouth and then your pelvic floor to communicate directly to the cervix and vagina to open, allowing a more effective descent for baby. This is the basics of the Spincter Law.
Touch & Massage:
Using the power of touch and massage to reduce stress and anxiety during labor helps heighten the production of oxytocin and thus more endorphins to aid the birthing mother in a more comfortable labor experience.
Touch during and in between contractions in early labor promotes rest as the body learns how to labor during this phase. As the birther progresses in her labor journey, she tends to prefer massage as a form of full relaxation in between contractions. She may ask for counterpressure and/or massage on her lower back, bottom, hips, and/or thighs during contractions. Follow her lead and if she says no to touch, respect her boundaries and let her know you are willing to touch/massage again if her needs change. Using heat along with your touch can also be comforting.
But now it’s been 5 days after baby’s birth, and dread is starting to settle in.
‘I haven’t pooped yet.’
You start to wonder if you ever will be able to push anything else out of your body again. ‘I mean, I’ve pushed a small ham out of my body, how hard can it be to push out a BM?!’ Pretty hard…pun intended.
Doesn’t matter if you’ve been a good patient taking your stool softeners like tictacs or not, the first postpartum poo can be a scary thing and nobody talks about it!
So let’s talk about it.
First and foremost, we need to discuss the fear factor. You’re probably worried about splitting your stitches (don’t worry, you won’t), hemorrhoids, experiencing intense pain (again…so soon…do I get a prize again, like sleep this time around?) or simply being embarrassed. But the sooner you get the deed done, at least once, all the fears will begin to dissipate.
So save yourself and follow these 6 tips for handling the first postpartum poo:
1. Get medicated: As you count your precious baby’s finger and toes, flag down your nurse for some ex-lax, tucks pads/witch hazel pads, cooling creams, stool softners, and mild laxatives. Then flag your partner for some wine…lots of it.
2. Move around: Go on short, easy walks around the block. DO NOT push yourself to walk the routine 1, 2, 3, etc miles you use to walk or run prior to birth. Your lochia (postpartum bleeding) will tell you if you’re pushing yourself too much. So an easy walk around the block once or twice can do wonders in getting things to move around and out. Even some gentle yoga can help.
3. Find a pooping buddy: So I’m not talking about someone sitting with you in the bathroom (unless you want that, then go for it!), but I’m talking about someone to care for the baby so you can concentrate on the deed and not have to worry about being interrupted because baby started to fuss. (postpartum doulas are great pooping buddies!)
4. Put down the French fries: Avoid fatty foods and low-fiber foods. Fibrous foods will be your friend during this time, such as beans, whole grains, bran cereals, fresh fruits and veggies are helpful in adding fiber to your diet. And wine….pretty sure wine has fiber….
5. Apply counter pressure: By applying counter pressure on your perineum with a cool tucks pad or frozen pad can make it so much easier to go without worrying about anything ripping. (Additional tip: Soak a sanitary napkin in water and then place in freezer. Take out when you’re ready to go poo.)
6. Seek out your healthcare provider if it doesn’t get better: After your first time pooing, you may encounter more issues with being able to go or find any regularity. That will get uncomfortable quickly (inside and as it makes its way out!). So put on your big girl pants and talk to your provider about what’s going on, especially if it hurts to go for more than a week or so. You may need a prescription to poo in a peaceful manner. No shame! Many mamas have been there….they just don’t talk about it with their friends or strangers (surprising, I know!).
Now that you have these tips in your back pocket to pull out after baby is out, I should probably also mention that no matter what it will still be uncomfortable. The whole situation in general is comfortable. So be kind to yourself, be gentle, be safe and avoid anything that is going to put stress on your body (like excessive visitors).
All these tips above should help things go smoother with less uncomfortableness overall. And if you want to feel better about yourself pooing, just pick up the great children’s book “Everyone Poops”.
Remind yourself that early labor contractions are your body working very hard, building up to stronger, longer contractions. So this is very little reason to feel disappointed!
So here are my top 5 tips to cope with early labor:
Tip #1: Avoid Telling Family and Friends! -- You are probably already sick of people asking you if the baby has arrived yet (uh, yeah, we would've told you!), so you can imagine how frustrating things could get if you tell them you are in early labor. Because it’s going to take some time before the baby is actually ready to be born, telling others that you are in labor only serves to heighten the anticipation and pressure.
Tip #2: Rest, Rest, Rest! -- This is the number one tip I mention over and over in all my classes, REST. Labor takes a lot of energy and you need to reserve it for when labor intensifies. Rest does not mean sleep; if you can sleep that is great, but some moms feel anxious and cannot fall asleep so instead lay down and watch a favorite movie/show or read a book/magazine. Your partners biggest, and hardest, job will be to tell you to go rest. Depleting what energy you have now can lead you to feeling exhausted too early. Wait on a bath until active or transitional labor; the weightlessness works against gravity and can result in slower or stalled labor. If you do want to use water for pain relief, soak under the shower instead.
Tip #3: Keep Yourself Distracted - Start a Simple Project or Finish Packing Your Labor Bag -- Plan some things now with your partner to keep you distracted, especially in the form of some simple projects you have been meaning to do. Bake a treat for your nurses or yourself when you return home, gets your nails done, go get a massage, write in your journal, scrapbooking, knitting, file away photos or recipes, rearrange things you have been meaning to in a while. This way time will pass a little faster and you will have achieved something at a time when you might feel like you are not achieving much at all (even though your body is doing a lot of work)! Plus this one is silly to mention, but double check your labor bag for any last minute items and throw it in the car. Just another thing to keep you distracted.
Tip #4: Eat and Drink Lightly -- Keep up your water levels to avoid dehydration, while visiting the bathroom often to make room for baby to come down. Food wise, you want to eat foods that are going to give you lasting energy, so carbs are a great option (I'm a fan of Oatmeal). Some women might say that they don’t like to eat prior to labor, out of concern they will only throw up, but it’s very important for your energy levels and for baby to eat in early labor. Some women will throw up regardless due to hormones – I’m sure most of us would rather throw up food than bile! Yuck!
Tip #5: Don’t Feel Disappointed! -- If your labor is taking longer to establish than you hoped, don’t feel disappointed! Your body is working very hard – and if it’s any consolation, some women find that when they have longer early labors, they have a shorter active labor. The early part of your labor is not in any way a sign of what is to come. The time it takes to get to active labor does not mean that it will take that long to get to the next phase. Remember, feeling anxiety or stress can slow or stall your labor – and that’s the last thing you want to do! Enjoy this special time before your baby arrives – you have got a great big job ahead of you and you can totally rock it!
Happy Birthing, Alexia
Many movies and TV shows portray birth with lots of screams that all started with a gush from the mothers water breaking in the middle of a mall. Or if you google birth stories all you find are the horror stories.
What happen to the positive birth stories? Where mom and dad meet their baby in joy?
Well, let's fill you up with positive images/videos of birth!
Here are 10 birth videos where moms and dads meet their babies in complete, euphoric joy!
If videos are not your cup of tea, how about stories that you can read to boost your confidence and reassure your mind that your body knows exactly how to labor and birth that baby to meet the world.
Here and Here are two websites FILLED with positive birth stories. And one of my favorite hospital birth stories to read.
Positive thinking is expecting, talking, believing, and visualizing what you want to achieve. Make your achievement to be 'Meeting your baby in JOY' no matter what your birth story will entail.
Alexia the Doula
Birth Doula, Childbirth Educator & Postpartum Doula serving Minneapolis, St Paul and the greater Twin Cities area.