Posts Tagged ‘birth’

Eating during labor

Wednesday, October 28th, 2015

Woman in laborYou may have heard a news report saying that it is okay for a pregnant woman to eat a light meal during labor. In fact, they even said it may be a good idea for some women, based on new research from Canada (not yet published). But, don’t rush out for a cheeseburger on your way to the hospital; you need to know all the details.

Current medical guidelines say that a woman should not eat solid food once she is in labor. The reason is to protect her from aspirating (breathing) food into her lungs. If a woman eats and then needs an emergency C-section, she could be at risk of aspirating during the surgery. Aspiration may lead to pneumonia, too. So, not eating any solid foods during labor is a guideline to protect the mother. (It is also the rule for scheduled C-sections and other surgeries.)

Labor is physically demanding, even grueling. A particularly long labor can leave a woman totally exhausted and lacking in energy, especially for when she needs to push. A little bit of food may go a long way in boosting her energy level. And, this study found that due to medical advances in anesthesia, eating a little bit of light food would probably not have a bad effect on a woman in labor.

The Canadian review looked at 385 prior studies and concluded that anesthesiologists and obstetrical doctors (OB/GYN) should work together to identify women for whom a light meal may be beneficial. They emphasized that doctors must identify women at low risk for aspiration – this is extremely important. And, each woman needs to be assessed individually.

But what does ACOG say?

As of the writing of this blog post, the American College of Obstetrics and Gynecologists (ACOG) has not changed their position on eating during labor. Their position remains that “solid foods should be avoided in laboring patients.”

How about liquids?

ACOG says “Although there is some disagreement, most experts agree that oral intake of clear liquids during labor does not increase maternal complications…modest amounts of clear liquids may be allowed for patients with uncomplicated labor.” So, if you can’t eat solid foods, clear liquids (such as broth) may help increase your energy level. But whether it is safe for you to drink anything at all is something you should discuss with your prenatal health care provider.

What’s the bottom line?

Remember, this study has not been published yet, and ACOG has not changed its guidelines.

As with all medical procedures, talk with your health care team to determine what is best for you.

 

What is a full-term pregnancy?

Thursday, October 24th, 2013

pregnant-belly2The American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine has issued a new opinion that defines the length of a full-term pregnancy. This includes the following definitions:

• Early Term: Between 37 weeks 0 days and 38 weeks 6 days
• Full Term: Between 39 weeks 0 days and 40 weeks 6 days
• Late Term: Between 41 weeks 0 days and 41 weeks 6 days
• Postterm: Between 42 weeks 0 days and beyond

We welcome this opinion. The following statement was issued today by March of Dimes Senior Vice President and Chief Medical Officer Dr. Edward R.B. McCabe:

“The American College of Obstetricians and Gynecologists’ and the Society for Maternal Fetal Medicine’s definition of a full-term pregnancy as 39 and 40 completed weeks of gestation is a welcome guideline that eliminates confusion about how long an uncomplicated, healthy pregnancy should last. This new definition acknowledges that the risk of adverse health consequences for babies changes at each stage of pregnancy. Babies born at 39 to 40 completed weeks of pregnancy have the best chance of a healthy start in life. The March of Dimes calls on all health care professionals and hospitals to embrace and apply the definition of full-term pregnancy and move as quickly as possible to implement it in practices and policies.”

What causes back labor?

Tuesday, April 30th, 2013

back painAsked about back labor, Dr. Siobhan Dolan answers the question in her new March of Dimes book, Healthy Mom, Healthy Baby.

“Babies are usually face-down (looking toward the mother’s spine) as they move into the pelvis. But sometimes a baby is face-up (looking toward the mother’s belly) instead. This can cause intense back pain during labor and is called back labor. If you’re having back labor, your provider may try to rotate your baby by having you change positions, although that doesn’t always work. Sometimes babies rotate (either in response to a mother’s changed position or on their own), and sometimes unrotated babies are delivered face-up.”

Dr. Dolan’s book includes a section on coping with pain through relaxation techniques and with pain medications. It’s good to know about both options. You can read more about the book at this link.

What is the breech position?

Friday, April 5th, 2013

Dr. Siobhan Dolan discusses the breech position in the new March of Dimes book, healthy mom, healthy baby.

“Babies typically move into a head-down position during the last month or so of pregnancy. But some don’t, meaning that when labor starts, they are positioned to be born feet-first or buttocks-first. This is called the breech position. Having a breech baby is most likely to happen when a woman goes into labor early, has had previous pregnancies, is pregnant with more than one baby, has a condition in which there is too little fluid in the amniotic sac, or has problems or abnormalities with the uterus or placenta. Sometimes it happens for no identifiable reason.

“If your baby is breech, your provider may recommend a procedure called an external cephalic version. In this procedure, a provider places his or her hands on your belly and tries to move the baby into a head-down position from the outside of your body. This can be uncomfortable, and it may not work. Sometimes a “version,” as it is often called, is attempted more than once. Delivering a breech baby vaginally is risky, especially for mothers having their first delivery, so if your baby can’t be moved out of the breech position, your provider will likely recommend a c-section.”

Learn more about healthy mom, healthy baby, read excerpts from the book, even order a copy at this link.

Why a birth plan is important

Friday, July 27th, 2012

pregnant-bellyYou don’t have to have a birth plan. But having one is a great idea! It helps things run much more smoothly when delivery day finally arrives. A birth plan is a set of instructions you make about your baby’s birth. It tells your health care provider how you feel about things like who you want with you during labor, what you want to do during labor, if you want an epidural, spinal block or narcotics for labor pain, and if there are special religious or cultural practices you want to have happen once your baby is born.

If you’re pregnant or planning a pregnancy, fill out a birth plan with your partner. Here’s a handy list of questions to consider and answer together. Start discussing a plan with your provider at your first visit. If you disagree on important issues (vaginal birth after a c-section (VBAC) or not, natural methods or drug relief for childbirth pains…) you will have plenty of time to choose another provider, if necessary. And share your birth plan with the nurses at the hospital or birthing center where you plan to have your baby. Share it with your family and other support people, too. It’s best for everyone to know ahead of time how you want labor and birth to be.

Questions about induction

Thursday, December 15th, 2011

Dr. Siobhan Dolan talks with a new mom about her experience with induction. Dr. Dolan also suggests questions a pregnant woman can ask her health care provider when planning for an induction or c-section.

3 stages of labor

Friday, October 28th, 2011

itstimeIs it time? Recognizing the signs of labor can help you know when it’s time to call your health provider and head to the hospital.  Learning about the stages of labor can help you know what to expect during labor and delivery.

Labor occurs in three stages. When regular contractions begin, the baby moves down into the pelvis as the cervix both effaces (thins) and dilates (opens). How long labor lasts and how it progresses is different for every woman. But each stage features some milestones that are true for every woman.

Stage 1: Early labor and active labor – The first stage of labor takes place in two phases: early labor (which can last a few hours or days, especially for first time moms) is usually at home; and active labor where you’ll want to be at the hospital or wherever you have planned to deliver.

Stage 2: Baby is born – During the second stage of labor, your cervix is fully dilated and ready for childbirth. Your health provider will want you to begin pushing to allow your baby to be born. Your baby finally is here!

Stage 3: Delivery of placenta – During the third stage of labor, the placenta, which gave your baby food and oxygen through the umbilical cord, is delivered. While you are bonding with your new baby during the first minutes of her life, your provider will get you ready for this final stage.

Read more, learn what you can do to help you through each stage and watch our video at this link.

Cesarean – it’s major surgery

Monday, April 11th, 2011

I went to a conference recently that focused on how to reduce the number of cesarean deliveries in the U.S.  Nurses, docs and other health professionals attended and it was very interesting.  It became apparent that many women ask their provider to schedule a cesarean delivery for convenience or to avoid the pains of childbirth. Our focus was about how to convince women that cesarean has risks and, unless there is a problem, it’s better for mom and baby to stay the course and deliver vaginally.

Concern about pain is usually not a good reason to request c-section. Safe and effective pain management methods are available to help women cope with vaginal delivery. Some of these methods use drugs; others are drug-free.

Having your baby early, even if it’s just by a week or two, can make a difference in your baby’s health. For example, the brain and lungs are still growing. And there are some risks to a baby associated with mom receiving anesthesia.  A c-section may affect the health of your future pregnancies, too. That’s because there’s a greater risk of pregnancy complications,  such as placenta previa, with every c-section you have.

It takes 4 to 6 weeks or longer to fully recover from a c-section. Recovery from a vaginal birth is shorter. Also, the hospital stay for a vaginal birth is 2 days. But with a c-section, you’ll probably stay 3 to 4 days in the hospital.  This may prove more expensive, especially if your health plan does not cover cesarean for non-medical reasons.

If you’ve already had a c-section and are pregnant again, talk to your provider about having a vaginal birth after c-section (VBAC). There are several medical reasons for repeat cesarean delivery,  but for many women, a VBAC can be a healthy, safe choice for birth.

Pregnancy affirmations for the holidays

Tuesday, November 23rd, 2010

Our guest post today is from a doula who participated in Bloggers Unite Fight for Preemies.  We thank her for joining us then and are delighted to share her holiday post with you now.

As a birth doula I work with women as a pregnancy and labor support person. The families who hire me are hoping to have an uncomplicated full term birth. We meet to discuss their needs and concerns, then I go with them to their birth to provide physical, emotional and informational support.  Many women hire a doula primarily because of the doula’s role at the birth itself. However, some of the most important work I do with my clients is during the final weeks of their pregnancies.

By the time you are 37 weeks pregnant, everyone you know is waiting for you to birth. People call, email, pester you on Facebook. Strangers look at you knowingly. The risks of pre-term birth are not something it is easy to talk about with people at the grocery store.  It is hard to make people believe you are doing the best thing for your baby.

At holiday time it is especially difficult for pregnant women to receive support in staying pregnant until labor begins on its own. As a doula, I’m not waiting for you; I’m waiting with you. Moms don’t want inductions. Most have heard that research supports allowing labor to begin on its own is healthiest for moms and babies and reduces the risk of prematurity.

When my clients ask their doctors about giving birth at the holidays, they are not requesting an induction. They are looking for information about the type of care they might receive.  What they want to hear is “The hospital is always open. Our staff are always prepared to help our patients.” Here are a few things some have heard:

Well, hopefully that won’t happen!
I’m sure you’d rather be home holding your baby by then.
Your baby is getting pretty big. We don’t want to wait too long….
It’s nuts here on Thanksgiving and I’m not sure who is covering yet.

If you are pregnant at this wonderful but stressful time of year, try using the pregnancy affirmations I give to my clients:

I’m thankful my baby can stay safely inside me until labor begins on its own. I’m thankful we are both in good health.
A baby at the holidays is a tremendous gift to my family – both in and outside of my body.
A baby under the tree is nice, but a healthy start is the best gift I can give myself and my baby.
A few more days or weeks inside me is not harmful to my baby.
Allowing labor to begin on its own will be a great start for a great New Year.
I can always eat the leftovers.
At least my mom is already in town.

You can write your own pregnancy affirmations for the holidays too.  Tape them up on your mirror. Put them on a note on your planner. Find a doula, a friend or a mother who will support you staying pregnant until your baby and your body decide it is time for labor to begin. Wishing happy and healthy holidays to you and your babies!
————–

Karen E. Bayne is a mother, birth doula and childbirth educator. She has been supporting birthing families since 2003.

Meconium aspiration

Tuesday, September 21st, 2010

Meconium is the stuff that first poops are made of. It’s greenish-black, sticky and tar-like, but may be treated as gold because it shows that the baby’s intestines are working.

Sometimes the passing of the first stool happens while the baby is still in Mom’s uterus or during delivery.  Meconium aspiration happens when a newborn inhales (or aspirates) a mixture of meconium and amniotic fluid.  The inhaled meconium can partially or completely block the baby’s airways, making it difficult to breathe and causing meconium aspiration syndrome, or MAS.

If that happens, the doctor will order a number of tests to see how affected a baby might be.  The primary focus is to clear the airway as much as possible to decrease the amount of meconium that is aspirated. This is done by inserting a plastic tube into the baby’s windpipe through the mouth or nose and applying suction as the tube is slowly removed. This allows for suction of both the upper and lower airways. The doctor will continue trying to clear the airway until there’s no meconium in the suctioned fluids.

MAS can affect the baby’s breathing in a number of ways including irritation to the lung tissue, airway obstruction by a meconium plug, infection, and the destruction of surfactant by the meconium (read our previous post on surfactant.)  The severity of MAS depends on the amount of meconium the baby inhales and, generally, the more meconium a baby inhales, the more serious the condition.

Babies with MAS may be sent to a special care nursery or a NICU to be carefully monitored for the next few days. Most babies with MAS improve within a few days or weeks and usually there is not severe permanent lung damage.  These babies, however, may be at a higher risk of having reactive airway disease (lungs that are more sensitive and can possibly lead to an asthmatic condition).  Severe cases may necessitate the baby be given mechanical ventilation, which can increase the risk for bronchopulmonary dysplasia, a lung condition that can be treated with medication or oxygen.  Rarely, MAS can lead to a collapsed lung or pneumonia.

If not at the hospital when her water breaks, it’s important for a pregnant woman to tell her doctor immediately if meconium is present in the amniotic fluid, or if the fluid has dark green stains or streaks. Doctors may use a fetal monitor during labor to monitor the baby’s heart rate for any signs of fetal distress. In some cases they may recommend amnioinfusion, adding saline to the amniotic fluid to wash meconium out of the amniotic sac before the baby has a chance to inhale it at birth.

Although MAS is a frightening complication for parents to face during the birth of their child, the majority of cases are not severe.  Did any of you face this problem?