News Moms Need

Asked 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.

Fetal scalp blood sampling is a quick test your health care provider can use to check if your baby is getting enough oxygen during labor.

Sometimes fetal heart monitoring doesn’t provide enough information about how the baby is doing with the stress of labor. In these cases, testing the scalp pH can help the health care provider decide whether the baby is getting enough oxygen during labor. This helps the provider decide if the baby is healthy enough to continue labor on its own, or if a faster delivery with forceps or a cesarean section might be a better route to take.

During labor, a woman’s cervix, the opening of the uterus, thins and opens to let her baby pass through the vagina. In order to have fetal scalp blood sampling, the cervix must be dilated enough that the provider can reach the baby’s head.

The test may remind you of a pelvic exam. It takes about 5 minutes. The woman lies on her back with her feet in stirrups. The provider places a plastic cone in the vagina that fits up against the baby’s head. The provider pricks the baby’s scalp and takes a small amount of blood. The blood is tested, and results are ready in just a few minutes.

If mom has an infection, like HIV or hepatitis C, her provider may not recommend fetal blood sampling. This is because she can pass these infections to her baby through the spot where his scalp is pricked.

If you’ve been to the gym, you’ve probably seen those giant exercise balls you roll yourself up and down a wall with or balance on while doing crunches. Or if you’ve had the misfortune of injuring yourself and have needed physical therapy, you’ve seen balls people balance on to help strengthen injured muscles. Well, that’s what a birthing ball looks like. They may seem weird, but I know a lot of women who swear by them!

Birthing balls can be used in several different ways. Sitting on the ball offers a soft cushion while gently forcing you to balance and maintain good posture. Kneeling in front of the ball and draping your arms over it can do wonders to help you stretch and relieve back pain. Leaning against the ball helps you shift weight, reduce stress and take the pressure off. And squatting on a birthing ball can enlarge your pelvis more than lying flat while it maintains the alignment of your baby in the pelvis.

A birthing ball offers support and flexibility and it won’t interrupt fetal monitoring.

If you are thinking of borrowing or buying a birthing ball, keep these things in mind.
• Buy a strong, sports-grade ball that comes with a pump (take the pump with you to the hospital in case you need to change the pressure at some point)
• The average woman uses a 65 cm ball.
• You should be able to sit comfortably in an upright position with your feet flat on the floor about 18 inches apart
• When getting started, have someone be your spotter for a while until you have a good sense of balance (it may be trickier to balance than you think!)
• Have fun with it and practice several positions before labor so that you can run through your repertoire and experiment with all of them when labor finally arrives.

Don’t forget, that the birthing ball can be enormously helpful with getting back into shape once your little one has arrived.

Today’s post is written by Sarah Ingersoll, Text4baby Campaign Director, National Healthy Mothers, Healthy Babies Coalition

September marks National Infant Mortality Awareness Month and while millions of families prepare their children for a new school year, this is also a time to reflect on the thousands of families who have lost a child far too soon. The infant mortality rate (6 in 1,000 live births) in the U.S. is one of the highest among developed nations and rates are much higher within the African-American community, regardless of income, educational level, or location. More than twice as many African-American babies die compared to their White counterparts during the first year of life, statistics that reflect a true health crisis in our country.

We know that providing mothers with the best possible information and access to care can help. This is where text4baby comes in. Text4baby is the nation’s first free text messaging service for pregnant women and mothers of infants under age one. Moms receive three text messages every week, timed to their due date or baby’s birth date, throughout pregnancy and up to baby’s first birthday. Moms get information on labor signs and symptoms, developmental milestones, breastfeeding, car seat and sleep safety, and many other topics. To sign up, textBABYto511411.

In honoring Infant Mortality Awareness Month and striving to empower more moms with text4baby, those who sign up between September 1 and September 30 will be entered to win a year’s supply of baby products courtesy of the program’s Founding Sponsor, Johnson & Johnson. Sign up now and be sure to share with your friends and loved ones!

Learn more at http://text4baby.org/. Follow up on Facebook and twitter (@mytext4baby)!

Some 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.

Pitocin 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.

Is 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.

When it comes to managing labor pain, some expecting moms prefer to deal with the pain of childbirth naturally, using breathing, massage, meditation and relaxation techniques. Others decide to use pain medication to help manage labor pain. One option for pain medication during labor is an epidural block (or epidural). It’s among the most effective methods of pain relief during labor.

An epidural is an injection into the lower back, which numbs the lower body. While Mom is still awake and alert, the medication blocks the pain of the contractions. It can be given during active labor or just before a cesarean section.  As with every procedure, however, there are risks and benefits to having an epidural. If it is something you are considering, read more about it, including pros and cons, at this link.

Labor pain affects each woman differently. Some women have mild discomfort. Others experience intense pain. If you try natural childbirth and you have a long and difficult labor, you may think about using medication for pain after you have been at it for hours. It’s okay to change your mind. Don’t feel like you gave up or let your baby down. Only you know how strong the pain feels. It’s okay to talk with your provider about medication and to do what you think is best.

BTW, if you’re a lover of body art, most health care providers will give an epidural to a woman with a tattoo on her lower back. But they may not if the tattoo is recent and still fresh. Read our earlier post on tattoos and pregnancy.

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.

The American College of Nurse Midwives has great information about midwifery on their web site. You will see that they are primary health care providers to women throughout the lifespan. They perform physical exams, prescribe meds including contraception, order lab tests, provide prenatal care, gynecological care, labor and birth care, as well as health education and counseling to women of all ages.

If you are interested in talking to a midwife, the Find a Midwife practice locator is a web-based service that allows you to find midwifery practices in your area. It also supplies you with basic contact information like practice name, address, phone number, e-mail address, web site and a map of the area. Check it out.

It used to be that once you had a c-section, you’d always have a c-section. Now, health experts are rethinking this idea and believe that many women may be able to safely have a vaginal birth after a c-section (called VBAC).

The American College of Obstetricians and Gynecologists today released guidelines to make it easier for more women to have VBACs by encouraging health providers to consider VBACs as an option for healthy pregnant women. In fact, about 6 to 8 out of 10 women who try a VBAC are successful in having a vaginal birth. Even women who are carrying twins and had more than one c-section in the past may be able to have a VBAC safely.

While there may be some risks in doing a VBAC (as with childbirth in general), it can be safe for many healthy women and their babies. The benefits of having a VBAC include a lower chance of infection, blood loss or other health complications associated with c-sections as well as a shorter recovery time after giving birth. You’re more likely to have a successful VBAC if:
• Your c-section cut was made in the lower part of the uterus
• Your health and baby’s health are well during pregnancy.
• Your labor starts on its own and continues naturally at 37 to 40 weeks of pregnancy.

If you had a c-section and are pregnant again, talk to your health provider to see if a VBAC is the right choice for you.