Archive | July 2016

Are these contractions really labor?

First, second, third and beyond time moms almost always get to that point in their pregnancy where they have some contractions. A tightening  and something just uncomfortable happening. So they wonder ‘Oh, is this IT?! Is it time NOW!?’ and get excited, nervous, worried and overjoyed all at the same time. Things keep going for a bit so you start to time them. Eight minutes apart, yes this must be it! Seven minutes apart, they are getting closer! Then…..nothing. It piddled out. Again. How frustrating.

Let’s talk about the differences in type of contractions. There are Braxton Hicks contractions, also referred to as BH in pregnancy groups online. BH are usually irregular, sometimes they seem to be in a pattern, (7 to 9 minutes for example) but then you’ll have some that space back out before coming back closer together again. BH also do not get more intense. They do not get more painful, which most women do not describe them as painful anyways. They may be uncomfortable and bothersome, but they usually do not get any worse.  BH can usually be made to go away, or at least slowed down tremendously. Drinking a big glass of water, taking a bath/shower, laying down or getting up. Just changing what you are doing activity wise can cause BH to stop.

Real labor can be confusing at first. Early labor contractions can seem as though they are Braxton Hicks contractions. People always tell you “When it’s really time, you will know” and chances are you want them to shut up because that’s crazy, how will I ‘just know’? I’m not a turkey with the little red thing that pops out when it’s done!! The majority of the time, this is true, you will know. Or at the very least, you will be thinking that it is time or almost time. Real labor contractions can start off irregular and inconsistent. This is the time to play the ‘I’m not in labor game’, to ignore the contractions the best you can. Eat a meal, take a nap, whatever. Gather your strength, you will need it! Labor contractions will get stronger, they will become more intense. For some women it takes a lot longer for that happen than others. So this where the gathering your strength and resting is very important. If you think your contractions are BH and you do all the little things that can make them go away but they do not, then you probably are looking at real labor contractions. When they are the real deal, nothing will make them stop.

I don’t like to use the term ‘false labor’ because there is nothing false about what you may be feeling! It is very real, it is preparing your baby and your body for the work out that is labor. If you are unsure about what you are feeling or are concerned in any way never hesitate to call your care provider. No one will think you are silly, I promise!

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My baby is breech, now what?

So you go to your 37 week prenatal appointment and the doctor feels your abdomen like usual, only is taking a lot longer this time. Then the words are said “I think baby is breech now”. So you have an ultrasound and it confirms that baby is now head up and butt down.

Now what? Your mind is likely racing with questions with the biggest one being ‘I have to have a c-section now, don’t I?’ The answer to that question can be a bit complicated. The biggest factors will be your care providers and your preferences. Is your doctor skilled in breech vaginal births? Do you want to have a breech vaginal birth? Is your doctor only giving you one option, having a cesarean birth? Would you prefer a cesarean birth?

In 2001 the choice of vaginal vs cesarean birth for breech babies went away. Many doctors since then have not been trained how to handle breech vaginal births in medical school. Most care providers that do still attend breech vaginal births are older and are starting to retire out of the baby catching business. So finding one who will give you the options you desire can be difficult.

Like all things in life it is a matter of weighing risks vs benefits. Depending on who you ask will determine the type of answer you get about which method is safer or better for mom/baby.

ACOG states that the preferred method of delivery is cesarean birth. But they go on to say that women should be counseled on their options and be able to make informed choices. You can read about their full opinion here.

There are a few studies that have been done more recently and they seem to have differing opinions on which is the best method of delivery for a breech baby.  Some like to point out the risks of attempting a vaginal breech birth, while others point out the risk factors with cesarean births. Both are valid arguments.

Let’s talk about those for a minute. The risks are usually small, but they are still there and a chance these things could happen. Risks of a cesarean birth:

  • Infection
  • Excess blood loss
  • Blood clots
  • Nausea, vomiting and severe headache due to spinal anesthesia(also known as a spinal headache)
  • Bowel problems
  • Injury to other organs(bladder, bowels,etc)
  • Maternal death
  • Injury to baby during surgery
  • Need for baby to go to NICU
  • Respiratory distress and other breathing complications, immature lungs
  • Premature delivery (since due dates are often wrong)

Risks of a breech vaginal birth: again, small risks but still chance of happening

  • Head entrapment (this is where a skilled provider is key)
  • Cord prolapse (which can happen in head down babies too)
  • Insufficient head molding
  • Internal organ injury (seems to happen with inexperienced providers)
  • Shoulder dystocia and nuchal arms
  • Nuchal cord (common, happens in 1 out of 3 births regardless of presentation)
  • Fetal death

I want to take a minute and talk about the risk of head entrapment. In our Southern Illinois area there is one provider that I have had a conversation with regarding breech vaginal births. I specifically asked about a baby’s head getting stuck after the body has emerged. He explained to me that in full term sized infants that the buttocks and hips are the same size (or almost) as the head and if those came out, usually the head does as well with little to no issue. After some research, I found that to be true. Not that I ever doubted him or his skills. If you are interested in learning more about this care provider please message us.

Here is a link that goes in-depth about the risks of a vaginal breech birth.

Now let’s talk about after birth. If you have a vaginal birth, you will likely have an easier recovery and shorter healing period versus a cesarean birth. If you are planning more children, then having a cesarean can cause complications in future pregnancies. Depending on your care provider having a vaginal birth after a cesarean can be difficult to achieve. You can read Sarah’s personal VBAC stories here. Making a decision that is often time sensitive can be stressful. Take a breath, do research, talk to a professional(or two or three), talk to your partner, express concerns and talk it out. Be prepared to hear opinions or advice from well-meaning friends and family members and to take it with a grain of salt.

Make your decision based out of confidence and not fear, not a decision that was made for you from a lack of options. Your body, your baby, your birth.

No matter what you decide, Trinity Doula Services supports you.