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How To Work With The Design:

How To Work With The Design:
  • Learn about what you can do in labor – – take a class; read this article!
  • Labor is the work you do to deliver your baby!
  • Stay home as long as possible.
  • Keep moving and changing positions.
  • Have help and support.
A for Attitude.
  • Look at how you view labor. Labor is not something that happens TO you, nor is it a medical event. Rather, as the word implies, labor is the work your body does to deliver your baby!
  • Trust your body to do its work. The uterus is a very strong capable organ, very muscular and fit to do its work of carrying the baby, dilating the cervix and bringing baby out! Labor is a healthy normal process that works very well when we work with it.
  • See labor as a “ladder:” contractions are the rungs: each contraction is a step closer to your baby!
A for At home.
  • It is best to stay home as long as possible, as long as you and your baby are doing OK.
  • Most women wonder: how will I know if it’s labor? Irregular contractions are common in late pregnancy. Ignore contractions until they get your attention! Irregular contractions are your body’s way of working out the uterus to make it strong for its work of birth later on! Carry on with your usual activities of life. If it’s early enough in labor, try to sleep or at least get some rest! Avoid lying on your back; lying on your side is fine.
  • When contractions get stronger and longer and are getting closer together, start timing them.
  • If they are less than 5 minutes apart from the beginning of one to the beginning of the next,
  • and they’re a minute long, and getting stronger,
  • and this pattern persists for over an hour, then it may be labor!
  • It is normal to have spotting called “bloody show;” that happens when the cervix is starting to open.
  • If you think it’s time to come to the hospital, or have any concerns, call your midwife.
  • If your water is broken while at home, avoid getting in your tub, although getting in your shower is fine!
B for Birth.

Your uterus is doing the work of birth: first dilating the cervix, then when the cervix is open, your uterus will push the baby out! Your job is to cope and cooperate with this work of the uterus. How to do this:

B for Breathing.
  • Our natural reaction to pain is to hold our breath, tense up, and get away from it. That’s because pain usually signals something dangerous or damaging is happening! Labor is neither; rather it is the signal that the baby is coming! So we need to retrain and override these natural responses by breathing, relaxing, and workingwith the process.
  • There are many breathing techniques but here’s a simple one: just breathe in your nose and out your mouth, slowly, as when you are relaxing or falling asleep. Conscious breathing like this through contractions helps you focus on breathing, keeps you breathing rather than holding your breath, and your breathing is how your baby gets oxygen!
B for Ball.
  • The birthing ball is a great labor tool! It is a soft sitting surface, which means there is no pressure against your tailbone, so your pelvis stays wide open for your baby to drop down. Upright positions and staying out of bed also help in this way. You can slightly bounce or roll side to side on the ball.
  • Your helpers can massage your back while you sit or lean over the ball. You can put the ball on the floor, bed or chair to lean over.
B for Back.

Sometimes labor involves a backache. Positions that help the uterus drop away from the back can help:

  • Leaning forward over your partner’s shoulders, and swaying like “slow dancing.” Your partner can also rub your lower back during contractions in this position.
  • Leaning over the birthing ball or onto the bed. This allows your helpers to massage your back and put pressure on sore spots.
  • You can lean onto the wall of the shower or over the tub’s edge and have the hand shower spray your back. These positions also allow back massage.
  • Your midwife may suggest small water injections over tiny areas in your back. Called “papules,” these can decrease pain yet allow complete mobility and have no side effects.

B for Bathroom.

Keep your bladder empty. This helps your baby to drop.

Also, sitting on the toilet is a great position for labor! It allows your pelvis to open up, promotes dilation, and brings the baby down. Get a pillow behind you or lean into your partner for comfort, if needed.

You may sense rectal pressure at some point in your labor. It’s OK to try to have a bowel movement, but if you can’t, the pressure may just mean your baby’s head is coming down!

C for Class.

Take a childbirth class. You will learn stages of labor, breathing and relaxing techniques, and activities and positions that help you cope with labor and help it progress. Have your partner take it with you and practice together!

C for Coach.

Have a coach or support person to help you through labor. Sutter Davis has volunteer doulas. A doula is trained and experienced in helping women through labor. She’ll give you support and guidance. Having a helper in labor has been shown to shorten labor, decrease complications, help breastfeeding go better, and make for a happier birth! Your helper can coach your breathing, remind you to relax, recommend activities and position changes, and do massage!

C for Consume.

Continue to eat and drink as you like. Having a baby is a work out for your body so it needs fluids and calories! Keeping well hydrated helps your uterus function well, so continue to drink often even if your appetite decreases. Consider light foods that are easier on your stomach.

C for Counterpressure.

When back discomfort is associated with contractions, a technique called counterpressure often helps: have a helper press in on the area of discomfort during contractions. Staff can also make a moist heat pack for sore areas. Sometimes the “hip squeeze” is comforting: have a helper apply pressure inwards on both hips during contractions.

C for Calm.

Having a calm environment can really help with relaxation: dim lighting; calming musicin the background; familiar objects and your own pillows and clothing are welcome.

C for Closeness and Comfort.

These words are lumped together because they mean one thing to your newborn baby: YOU! Baby will be placed immediately upon your chest at birth, skin to skin. This is the best “recovery room” for your baby! You will both enjoy this continual contact throughout your stay. This contact comforts the baby and also helps baby stabilize vital signs, blood sugar, temperature and oxygen levels! Being skin to skin also stimulates milk making hormones. This closeness especially helps the baby breastfeed: the baby can crawl to the breast unaided and begin nursing through built-in reflexes.

C for Colostrum!
  • You’ve got milk! Colostrum is produced in the breasts from the 5th month of pregnancy. This early milk is in just the right amount to match baby’s stomach size! As the baby’s stomach size grows, so does your milk supply! In fact, the baby’s sucking determines the milk supply. Being close to mom means more than just getting milk to a baby; it is comfort. Most babies are a bit overwhelmed with their new world at first. You may notice this by extra fussiness after baby’s second day or night. Babies need continual contact and very frequent nursing these early days; this is a normal process that helps them adjust and increases milk supply! Their stomach size grows to accommodate the increased milk volumes that typically happen after the third of life.
Drugs and Anesthesia in labor:
  • Options: Narcotics and epidurals.
    Side effects: may affect labor, birth, baby, and breastfeeding.
    Narcotics:

  • Do not take away all the pain.
  • May cause side effects of nausea, sleepiness, dizziness, confusion, or hallucinations. Some even cause the baby to have hallucinations.
Narcotics:
  • Do not take away all the pain.
  • May cause side effects of nausea, sleepiness, dizziness, confusion, or hallucinations. Some even cause the baby to have hallucinations.
Risks:
  • Because they go into the mother’s bloodstream, the baby gets them too. This means the medication will affect the baby:
  • May affect baby’s breathing;
  • May affect babies’ ability to breastfeed: baby may have a delayed, weak, or uncoordinated suck.
  • May affect baby’s alertness and ability to show feeding cues and sustain latch and sucking.
  • May slow labor progress.
Epidurals:
  • The mother is unable to move or get out of bed for the rest of her labor. This means she is unable to use gravity and position changes to help the baby come down through the pelvis.
  • She is not allowed to have food other than clear liquids, which may mean she has less energy for labor and pushing.
  • The epidural affects the nerves that control normal urination, so she must have aurinary catheter to empty her bladder. Sometimes bladder function is affected after delivery.
  • She will have to have an IV.
  • She will have to remain on the fetal monitor continuously.
  • Labor may take longer because the contractions may slow down or stop. Pitocin,a medicine used to make stronger and more regular contractions, may then be needed.
  • Without an epidural, women will feel a strong urge to push when it is time. The epidural may numb this feeling and make the pushing phase take longer.
  • There are common side effects such as itching, shivering or fever.
  • Women with fevers will be treated as though they have an infection, even though it may just be a side effect of the epidural. This could mean unnecessary antibioticsfor the woman, and the baby may need extra blood tests or treatments, too.
  • There may be a backache or headache later on following an epidural.
Risks
  • It may not work. Women sometimes have pain even after getting the epidural, or they may only get partial relief.
  • The woman’s blood pressure may be lowered so much that she cannot get enough blood to her placenta and her baby. This can lead to the baby not getting enough oxygen and going into distress (the baby’s heart rate goes down to a dangerous level). Usual measures to solve this distress are: increasing IV hydration to the mother, giving her oxygen, and giving a medication to raise her blood pressure if this is the problem. If these things do not resolve the baby’s distress, a C-section may be necessary.
  • There is an increased risk of needing to use a vacuum or forceps to help the baby out. These procedures can cause more extensive tearing of the skin below the vagina for the woman.
  • Permanent damage to the nerves is very rare, but possible.
  • Some women experience a severe headache in the days after having an epidural.
  • It may cause breastfeeding problems such as delayed milk onset and lower initial milk volumes.
Does an epidural increase the chance of having a Cesarean Section?
  • It has not been proven by research that an epidural directly increases the risk of C-Section. However, many of the other problems associated with epidurals (prolonged labor, continuous fetal monitoring, longer pushing stage, babies not rotated to the right position, use of Pitocin, fever, fetal distress) do increase the likelihood of having a C-Section.
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