Posts Tagged ‘childbirth’

Medications for pain relief

Monday, December 2nd, 2013

iv-bagWhen it comes to managing labor pain, some expecting moms prefer to deal with the pain of childbirth naturally, using breathing and relaxation techniques. Others decide from the start to use pain medication to help manage labor pain. One option for pain meds during labor is to use narcotics (also called analgesics or opioids).

Narcotics affect the whole nervous system, instead of just one area. They are given through an intravenous (IV) catheter (a small tube that is inserted into a vein) or by injecting the medicine into the butt or thigh muscle. The medication lowers pain and makes it easier to rest.

Narcotics can be given anytime during labor, but work best during early labor when the cervix isn’t fully dilated. Sometimes, you may be able to control your own pain relief by pushing a button that releases a fixed amount of medicine through the IV tube and into your body. Pain relief begins within minutes. You remain conscious throughout labor and into delivery. Pain relief can last between 2 and 6 hours, depending on how it’s given.

As with most things, there are pros and cons to using narcotics.
Pros –
• Narcotics lessen your pain and take effect quickly.
• They help you rest without causing muscle weakness or lowering your ability to push.
• In some cases, you can control how much medication you use during labor.
• Narcotics can be used with other pain medications like an epidural or spinal block.

Cons –
• Narcotics may leave you feeling sleepy.
• They may cause nausea.
• If too much medication is used, it can temporarily slow down breathing for both mom and baby.
• The medication cannot be given right before delivery because it may slow the baby’s breathing and heart rate at birth.

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.”

Midwifery – What does a midwife do?

Tuesday, October 8th, 2013

midwifeThis is National Midwifery Week, created by the American College of Nurse Midwives to celebrate and recognize midwives and midwife-led care.

A certified nurse-midwife is a registered nurse with advanced, specialized training and experience in taking care of pregnant women and delivering babies. Certified nurse-midwives are licensed to provide care before, during and after delivery.

There are several different types of midwives, each holding different certifications based on their education and/or experience. Certified nurse-midwives (CNMs) and certified midwives (CMs) attend approximately 93% of all midwife-attended births in the United States, and as of 2010 they are required to have a master’s degree in order to practice midwifery.

Midwifery care fits well with the services provided by obstetrician/gynecologists (OB/GYNs), who are experts in high risk, medical complications and surgery. By working with OB/GYNs, midwives can ensure that a specialist is available if a high-risk condition should arise during pregnancy or labor and delivery.

Once your baby is here, a midwife can assist with questions about breastfeeding (it’s not as easy as you think.) Midwives can provide you with health care in the postpartum period and between pregnancies at well woman visits. They can provide pain medications, birth control, screenings and vaccinations. They treat women from the teen years through menopause.

Here is a link to more information about midwives from the American College of Nurse Midwives.

Dads, are you up for the delivery room?

Tuesday, August 21st, 2012

delivery dadSome guys seriously can’t handle the delivery room (the sight of blood makes them pass out cold – not so helpful) and that’s OK… but if you’re not too keen on being bedside when your little one arrives, consider the following. Don’t say no without making an informed decision. Sure, this whole birthing thing is scary, but you can be a lot more supportive than you may think.

Attend prenatal care appointments with your partner. Talk with her provider and nurses to understand a typical birthing routine within their practice. Ask who will be present, what will happen and who will be in charge of your partner and the baby after delivery.

Take childbirth classes and learn more about the process and how you can be supportive during labor. Make a list of questions and ask them all. You’ll learn a lot and meet other soon-to-be dads.

Take a tour of the hospital maternity ward so that you’ll be somewhat familiar with the layout once you arrive and, again, ask questions.

Ask yourself what you want out of the birth experience. Do you want to “catch” the baby? Cut the cord? Or just do your best to stay upright?

Talk with your partner about how she would like the delivery to go, what she sees as your role in it and what she needs and wants you to do.  Make a birth plan together, one that works for both of you. Be sure to discuss different scenarios in case things don’t go as planned.

Don’t get your feathers ruffled or take it personally if she gets a little snippy on the day of… it isn’t you.

If you’d love to support her but really don’t think you can take a ringside seat, talk with her about getting a doula or coach involved for that part. We’re all different and we can only do what we can do and, truly, that’s OK. But let her know that one way or another you’ll do all you can to see to it that she has what she needs when the time comes.

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.

What is Pitocin?

Monday, June 25th, 2012

iv-bagPitocin is a medicine that acts like oxytocin, a hormone your body makes to help start labor contractions.  When used, it is administered in the hospital by an IV drip and the dosage is regulated, gradually increasing until labor progresses well.

Contractions, which signal the beginning of childbirth, are when the muscles of your uterus get tight and then relax. They help push your baby out of your uterus (womb). If you’ve ever had a baby, you know and never will forget what contractions are like. But if you’re a first time mom, you might not be too sure in early labor if what you’re experiencing is the real deal.  You can read about contractions and the different stages of labor on our web site.

Sometimes labor begins but doesn’t move along as well as doctors like.  A woman’s water may have broken, but contractions have not started.  Labor may have slowed down or the contractions just may not be strong enough to move labor forward. In these cases, health care providers may use Pitocin to strengthen the contractions.  Other times it may be medically necessary, for the health of the baby or the mother, to induce labor that has not yet begun. This is often the case with women who have reached 42 weeks gestation. Giving the mother Pitocin can induce labor.

If you’re pregnant and your doctor wants to give you something to help your labor progress, you should start having labor contractions shortly after you begin Pitocin. Depending on the dosage you receive, it can make your contractions very strong and may lower your baby’s heart rate.  So, your provider will carefully monitor your baby’s heart rate for changes and adjust the amount of Pitocin you get, if needed.

Tearing during childbirth

Tuesday, May 29th, 2012

The perineum is the area between your vagina and rectum. It stretches during labor and vaginal birth, but sometimes it can’t stretch enough and it may tear. Tearing is common in childbirth, especially if you are delivering a baby over 8 ½ pounds or if forceps are used to help deliver him. If your baby is being delivered face up, there is more of a chance of tearing. You may be more likely to tear if this is your first labor and birth, or if you had tearing or an episiotomy (a cut made at the opening of the vagina to help widen the passage) in a previous birth.

Tearing may affect only the tissue around the vagina which should heal on its own, or the muscles between the vagina and anus may be torn which would require stitches by your provider post delivery. In more rare and severe cases, rectal tissue may be torn requiring the surgical skill of a specialist.

The perineum often is pretty sore after giving birth and it can take a couple of weeks before you’re comfortable enough to sit on a hard chair again. This is especially true if you have stitches from a tear or an episiotomy.  While healing, it is important to keep the area clean. Rinse with warm water after every time you use the toilet and always wipe from front to back to help prevent infection.

Here are some things you can do to help you feel more comfortable and heal sooner:
• Kegel exercises – These strengthen the muscles in the pelvic area, which helps the perineum heal. They’re easy to do – just squeeze the muscles you use to stop yourself from peeing. Hold the muscles tight for ten seconds, then release. You can do this anytime, anywhere (in the car, at the grocery store, in an elevator…) so do them whenever you think about it.
• Put a cold pack on your perineum – just be sure to wrap it in a towel so you don’t freeze any skin!
• Sit on a pillow. Some gals highly recommend a donut shaped pillow.
• Soak in a warm bath.
• Use stool softeners to keep from getting constipated.

If you try all this and you’re still really uncomfortable, ask your health care provider about pain medication for a few days. You can read more and watch a video about postpartum discomforts at this link.

Inducing labor – medical reasons

Wednesday, January 11th, 2012

Dr. Siobhan Dolan talks with a new mom about her experience with induction. Dr. Dolan also reviews situations when inducing labor can help keep mom and baby healthy.

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.