Tonight was the first session with our doula, beyond the initial interview. Lots of good information, but also lots of overwhelming feelings right now! This post is just to help organize my thoughts.
Pregnancy and childbirth books
I gathered all my books together, both read and unread, to give her an idea of where we are at in preparing and thinking through the type of birth we want. So far I’ve read The Thinking Women’s Guide to a Better Birth and The Official Lamaze Guide. Both of these were not so much about birthing methods, but all the choices you face for medical interventions and the impact of each. Obviously they are going to be biased, but I found them helpful. In the unread stack, we have Birthing from Within, Husband Coached Childbirth, Natural Childbirth the Bradley Way, plus I have Ina May’s book and Pushed on hold at the library. She thought these were all great choices and pointed out illustrations in the Natural Childbirth the Bradley Way for baby position and what is happening to mother and baby. She also said the relaxation technique in there is something hubby and I should be practicing at least once a week.
Medications during birth
She did an overview of various medications that can be used in the various stages of birth. Some was familiar from my reading, but it was helpful to hear that and to have hubby hear it. Notes I made were:
Pitocin–I didn’t take notes about using it during childbirth, since it isn’t something I want to do and she said the docs at my clinic are extremely reluctant to use to induce labor. It was interesting to hear that they do give a shot after delivering the placenta to help the uterus contract. We have the option to wait to see if uterus will contract on its own.
Unisom, benadryl, Rx sleep aids–these may be taken during early labor to help rest during contractions.
Nubane or epidural are choices for pain of contractions.
Nubane–this is used during active labor and can be difficult on baby if it is administered close to the time when delivery occurs. They may have to administer more drugs to baby to counteract the effects of the meds. Women have reported that it goes straight to their head in a drunk feeling, but in a way that makes you feel like you’ve gone too far. She talked more about the impact to the moms, all very unsavory for someone like me who is impacted really heavily by meds. We all agreed it probably wasn’t a good option given my track record, so I didn’t jot down everything.
Epidural–first is the numbing shot and then the large gauge needle into the back, which then has the epidural catheter strung through it. Once you have an epidural, you can no longer get out of bed and will need some sort of catheter to empty the bladder. The baby can be lethargic and it can impact the sucking reflex for quite some time after birth. There will also be constant monitoring of my blood pressure and it can impact baby’s heartrate as well.
Sterile water injection–this is only for back labor, but is four injections right below the skin in the back. It disrupts the signals for pain from back labor only, but not contractions.
Labor stages and going to hospital
Early labor is from 1-4 cm and the contractions can be inconsistent in strength and timing. This can go on for days or weeks.
Active labor is from 4-7 cm. Signs that you are transitioning to active labor include contractions every 2-3 mins, can’t talk through contractions, may be shaking, emotional and/or vomiting. They want to see 1 cm every hour or so to show it is progressing.
Transition is from 7-10 cm. With each stage, the key is to get over the step up to the next level and then settle into the contractions.
I am thinking we’d wait until active labor to go to the hospital and she did give us some tips on that. One is that once we get to the hospital, they will check baby’s heartrate and determine if we need constant monitoring or not. To ensure a good reading, I’ll need to eat something and have a cold beverage with sugar and caffeine before going to the hospital. Depending on if the water breaks before hand, I’ll need to check it to determine how soon we should go to the hospital. If it is clear, we can labor at home. Once you call the doc, they will say to come to the hospital and may not allow you to leave. If there is meconium, with a neon yellow/green tint and some feces, it is important to get to the hospital, but we have time to pack the car and get organized. If it is like pea soup, drop everything, call hospital, then call her on the way.
Things to eat and drink at home (and possibly at hospital) are smart water or vitamin water for the electrolytes (she even recommended drinking 1 per day throughout summer), tea and emergen-c (this can even be sprinkled on ice chips.) Snacks are somewhat up to personal preference, but seemed to be a combo of protein for long lasting energy and sugar that you can quickly metabolize. It reminded me of what I used during the marathons, so that was cool. It will remind me of doing those and times where I’ve been challenged and successful.
We talked about exercise and I told her I do a combo of prenatal yoga, walking, elliptical, biking and weight lifting. She recommended again being in the pool at least 2x a week, floating on my belly. Other things to do….
Sitting position–sit straight with hips wide, feet touching each other. Or sit with feet on floor, hips wide, elbows on knees and stretch back.
Standing–stand with hips wide and sway from side to side or in circles.
Pelvic tilts–on all fours, with a flat back, do pelvic tilts. By 37 weeks, she wanted to see me doing 100x a day! Do last set before sleeping.
Sleeping position–if on the right side, just kinda be in fetal position with knees bent and stacked. Use as many pillows as I want along right side. On left side, this is tricky to describe. Kinda have left arm and leg straight and behind you. Then right knee and arm can be bent in front of you. The idea is that you are tilting towards your left. I can’t really describe it better than that.
All of these things are to get baby in the ideal birth position. Our next steps are to work on the birth plan (complete mid-July) and meet again in early July. Overall, I’m really happy we have made the decision to use a doula. There is so much to think about and I love that we have someone to guide us along this path.