Giving Birth: Postpartum

A Few Hours After Birth

• Call pediatrician to schedule baby's appointment.
• Drink iced orange juice to help restore depleted blood sugar, potassium and fluids.
• Eat food! Chipotle was wonderful :)
• Encourage the uterus to retract.
• Lay on stomach. Place a pillow on the bed and lie on it a few minutes each day to help the uterus contract, expel blood clots and get back to its normal size.
• Massage stomach.
• Nurse! 
• This gets way more painful from first to second kiddo.
• Round Two: This was way more painful than actually giving birth.
• Drink red raspberry tea which will strengthen uterus muscles.
• Walk around to help restore circulation and expel blood clots.

USE POSTPARTUM CARE KIT!

• Start using postpartum care kit 
• Religiously take stool softener and ibuprofen.
• Ibuprofen helps limit the release of prostaglandins.  This is super important!
• Use postpartum care pads!  These things were amazing!

Few Weeks Following Giving Birth

• "Afterbirth pains" are normal
• Continue to encourage the uterus to retract. See above notes.
• GET VICODIN in case of pain.  
• Definitely going to be necessary for round three.
• Exercises to avoid: 
• Complete knee bends
• Leg Lifts
• Sit ups
• Get social security card for baby.
• Get baby on health insurance.
• Have a list of things I would like to have help with around the house and groceries we need for people to help out with.
• Lochia is the bloody discharge that can last up to six weeks.
• Saturating 2 pads hospital size within an hour is too much and call the doctor.
• If bleeding increases you are overdoing it.
• Lovemaking is up to your discretion. Go slow and can wait up to six weeks after postpartum check up to ensure have healed.
• Stay hydrated!
• TAKE IT EASY!
• Use lanolin, ibuprofen (800 mg every four hours) and stool softener (1-2x/day).

Exercises to do the Rest of Life

• Kegels: Helps with bladder control.
• Pelvic Rocks: Especially great for afterbith "pains", backache and strengthening abdominal muscles
• Tailor Sitting: Strengthens core and back.

Giving Birth: Reflections

• Packing List for Birth Center and Hospital

Reflections 

• The Environment
• Could not have done it without Geoffrey's help and the Bradley classes. 
• Dim lighting and soft music helped with relaxing. 
• Using a water bottle with a straw was super helpful.
• For Myself
• Focus, focus, focus on one contraction at a time and controlling my breathing. 
• Keep grunting/yelling/groaning deep in chest. Don't go high pitched.
• The pain prompts you to adjust your position which can help with the alignment of baby.
• Don't panic! 
• It hurts like crazy but was not hell on earth. 
• Bring on the pain because it means my baby will be here soon :) 
• For Us
• If have to give birth in a hospital a doula could be very helpful. 
• Make sure coach is eating too. 
• Both of us needed to be persuaded that giving birth naturally was the best thing for me to do was crucial for me to succeed.
• The biggest concern was doing the best we could to prepare for a natural birth because we were convinced it was the best thing to do and then we were to actively trust God with whatever happened.

Round Two

• No back labor is amazing!!!!!
• Being on knees causes baby to come way faster.
• Dim lights, have music playing and try to keep interruptions to a minimum.
• The two things better about the hospital in contrast to the birth center are that the bed can sit up with the push of a button and the supply of postpartum care products.
• There's a lot of nurses, monitors and changing of rooms at the hospital.

THE WHY'S

• The Midwives
• Believe pregnancy is a natural and normal event. 
• Believe the parents are the best people to care for the baby.
• Are not quick to jump to medication and interventions. 
• Have lower rates of C-sections. 
• Listen to and trust the mother's instincts.
• Constantly check the baby's position from about 30 weeks on and if the baby is not positioned well do all they can to help.
• Have an arsenal of strategies to help you be comfortable and address problems as they come up.
• Are willing to gently stretch you to minimize tearing when giving birth. 
• Will not cut the umbilical cord until it has fully drained to the baby giving it all the blood and nutrients.
• Believe nursing is best and are quick to place baby skin to skin so baby can nurse within a half hour of being born.

• Not the Hospital
• Hospitals are more likely to do interventions.
• Any intervention adds risk.
• The more interventions the more likely you are to have a C-section 
• Babies born by C-section are more likely to experience respiratory complications because birth canal squeezes the fluid out of baby's lungs. This squeezing kick-starts the breathing through the lungs which is critical for the suck-swallow-breathe reflex. 
• Drug interventions can cause breast swelling which can make nursing more of a challenge. 
• Didn't want an epidural.
• A massive needle in my spine scares me.
• The drugs in the epidural cause the baby to be drowsy for a little while once it is born making it harder to nurse.
• Epidurals almost always require pitocin because epidurals slow down the body's natural laboring process.
• Pitocin is way harder on your body than normal contractions. It squeezes from both sides and the top while contractions only squeeze from the sides.
• Without being able to feel what is happening you don't know what pushing correctly feels like and are not able to discern how hard you should push. 
• Convinced feeling how you should push minimizes tearing.
• There's a very small risk of being paralyzed with the epidural. 
• Hospitals hook you up to IVs and monitors which require you to stay in bed.
• Laying on your back with back labor is one of the most painful positions to be in.
• You are not allowed to eat any food.
• Didn't want Baby C in the nursery without our supervision.
• The nurses just took Baby C from us without asking when we checked in to make sure her blood sugar levels were ok.

• The Birth Center
• Significantly cheaper than any hospital. 
• Works with TMC
• The midwives at the birth center can be in touch with the doctors at TMC if any problems and/or concerns arise 
• The hospital is less than five minutes away from the birth center in case medical interventions are necessary. 
• Could snack on food while in labor.
• The privacy and home like setting of the birth center was very comfortable.
• WATER BIRTH was amazing! 
• Not having an IV and not being hooked up to a monitor allowed me to move around to be in the most comfortable position. 
• Baby C never left us after she was born while at the birth center. 
• Got to hold her immediately. 
• Being able to nurse within a half hour with a baby who was completely awake and alert was amazing. 
• The baby checks were not at all intrusive. 

• The Bradley Classes
• Wanted my best friend to be my coach. 
• Equipped my best friend to be my coach!  And he did phenomenal!
• Agreed with their belief that my body was created to give birth. 
• Gave us an arsenol of ideas and suggestions on how to manage pain and have the type of birth we wanted.

Geoffrey's Responsibilities

• Being an advocate for me. 
• Helping with pain management. 
• Making sure I was hydrated. 
• Encouraging me. ("You can always do one", "Take one at a time", etc.)

Giving Birth: Pain Management & Resources

Pain Management

• Breathe slowly and deeply*
• Do a hand massage on lower back*
• Do lunges and/or squats
• Do pelvic rocks on hands and knees*
• Drape arms over hubby shoulders and do partial squats*
• Drape over birthing ball or backwards over chair
• Have hubby do hip squeezes
• Massage
• Move around
• Rock and sway back and forth
• Sit backwards on a chair and lean over it*
• Sit on birthing ball and bounce
• Spray hot water onto lower back*
• Stay hydrated
• Take a warm bath or shower
• Use hot or cold rice socks to press against lower back*
• Use long sock with two tennis balls inside to massage shoulders and back*

*Specifically helpful with back labor

Pushing

• Breathe in, breathe out, breathe in and hold my breath to push (Supers super helpful!!!!!)

Resources

• Bradley Classes
• Birth Center
• Friends

Giving Birth: The Stages

First Stage: Early Labor

• 0-4cm
• Spread out contractions.  May be 10-15 minutes apart lasting up to 30 seconds.
• Hydrate and rest!
• If think might be going into active labor switch up the activity: naps/resting on bed, shower, relaxing in tub, walking, etc.

Second Stage: Active Labor
For a normal labor* will feel pain for about 10 minutes with 50 minutes of rest for each hour.

• 4-8 cm
• Contractions will be 3-5 minutes apart.
• Contractions will last 45-70 seconds.
• Breathe deeply and slowly.
• Labor can plateau during this stage.  Don't panic!
• See Pain Management.

Third Stage: Transition
For a normal labor* will feel pain for about 22.5 minutes with 37.5 minutes of rest for each hour.

• 8-10 cm
• Feel like baby is coming out :)
• See Pain Management.
• If you make it this far, this is when you want to quit.
• Super close to baby's arrival!
• Round Two: Happened super fast and caused me to panic.

Birth of Baby

• Urge to push.
• Less painful than transition.
• You will be tired.
• Once the baby comes out your body will shake uncontrollably for several minutes.  Some people do this up to two hours.
• Round One: Pushed two hours because Baby C had her fist by her head.
• Round Two: Pushed maybe three times and Baby A was out!

Birth of Placenta

• A piece of cake compared to baby :)
• Can be more painful as you have more kiddos.
• Round Two: Didn't seem to be much more painful but the contractions afterwards were awful!

*Normal labor: Baby positioned correctly and no complications.

Pregnancy: Last Three Weeks

Last Three Weeks

Things to Do

• Get packed for birth center and hospital
• Have postpartum care kit ready
• Most helpful resource
• Have newborn clothes and bedroom ready

Exercise & Health

• Do 1+ mile walk every night.
• Take a primrose oil capsule every day.
• Drink  at least 16 oz of red raspberry tea daily.
• Get tons of rest!  Take naps, showers and soak in a warm tub.
• Stay hydrated!
• Be super careful of posture to help avoid back labor.

Other Way To Encourage Labor

• Spicy food: didn't seem to work
• Castor oil. Never going to try.
• Membranes stripped: small risk of water breaking, releases prostaglandins which help soften and ripen the cervix
• Black cohosh: so nasty!  Never again.
• Dum dum suckers: to push pressure point on roof of mouth, no idea if it worked, won't do again unless resort to black cohosh too
• Sex: the semen has prostaglandins in it, don't do if water has broken
• Nipple stimulation and orgasms

Other Random Thoughts

• An average pregnancy is actually 40 weeks 5 days if there are no interventions.
• First babies typically come at 41 weeks if there are no interventions.
• There is nothing you can really do when you get a pinched nerve in your leg.  Try pelvic rocks.  Wait it out.  It hurts like crazy.
• Unless there are complications the baby knows when it is ready as baby's brain emits hormones to trigger labor.
• Timing contractions is super annoying and distracting.  Probably won't keep track of them next pregnancy until I start having to really focus on breathing through them.
• When water breaks stay on the toilet as much as possible.  The birth center uses infant diapers to hep absorb the water because they're way more absorbent than pads.
• Have distractions for the last two to three weeks before due date.  Only necessary with baby one because kiddos keep you busy after that.

Giving Birth: Why Give Birth Naturally

THE WHY'S

• The Midwives
• Believe pregnancy is a natural and normal event. 
• Believe the parents are the best people to care for the baby.
• Are not quick to jump to medication and interventions. 
• Have lower rates of C-sections. 
• Listen to and trust the mother's instincts.
• Constantly check the baby's position from about 30 weeks on and if the baby is not positioned well do all they can to help.
• Have an arsenal of strategies to help you be comfortable and address problems as they come up.
• Are willing to gently stretch you to minimize tearing when giving birth. 
• Will not cut the umbilical cord until it has fully drained to the baby giving it all the blood and nutrients.
• Believe nursing is best and are quick to place baby skin to skin so baby can nurse within a half hour of being born.

• Not the Hospital
• Hospitals are more likely to do interventions.
• Any intervention adds risk.
• The more interventions the more likely you are to have a C-section 
• Babies born by C-section are more likely to experience respiratory complications because birth canal squeezes the fluid out of baby's lungs. This squeezing kick-starts the breathing through the lungs which is critical for the suck-swallow-breathe reflex. 
• Drug interventions can cause breast swelling which can make nursing more of a challenge. 
• Didn't want an epidural.
• A massive needle in my spine scares me.
• The drugs in the epidural cause the baby to be drowsy for a little while once it is born making it harder to nurse.
• Epidurals almost always require pitocin because epidurals slow down the body's natural laboring process.
• Pitocin is way harder on your body than normal contractions. It squeezes from both sides and the top while contractions only squeeze from the sides.
• Without being able to feel what is happening you don't know what pushing correctly feels like and are not able to discern how hard you should push. 
• Convinced feeling how you should push minimizes tearing.
• There's a very small risk of being paralyzed with the epidural. 
• Hospitals hook you up to IVs and monitors which require you to stay in bed.
• Laying on your back with back labor is one of the most painful positions to be in.
• You are not allowed to eat any food.
• Didn't want Baby C in the nursery without our supervision.
• The nurses just took Baby C from us without asking when we checked in to make sure her blood sugar levels were ok.

• The Birth Center
• Significantly cheaper than any hospital. 
• Works with TMC
• The midwives at the birth center can be in touch with the doctors at TMC if any problems and/or concerns arise 
• The hospital is less than five minutes away from the birth center in case medical interventions are necessary. 
• Could snack on food while in labor.
• The privacy and home like setting of the birth center was very comfortable.
• WATER BIRTH was amazing! 
• Not having an IV and not being hooked up to a monitor allowed me to move around to be in the most comfortable position. 
• Baby C never left us after she was born while at the birth center. 
• Got to hold her immediately. 
• Being able to nurse within a half hour with a baby who was completely awake and alert was amazing. 
• The baby checks were not at all intrusive. 

• The Bradley Classes
• Wanted my best friend to be my coach. 
• Equipped my best friend to be my coach!  And he did phenomenal!
• Agreed with their belief that my body was created to give birth. 
• Gave us an arsenol of ideas and suggestions on how to manage pain and have the type of birth we wanted.

Round Two

• Chose the hospital because it would be significantly cheaper.
• Having the midwife there was helpful.
• Overall a really good experience but not my preference.

Pregnancy: Terms & Vaginal Exams

Terms to Know

• Pregnancy Terms to Know
• Labor and Birth Terms to Know
• For Round Three maybe try to find more about medications used during labor and birth to be prepared.
• Learned from round two that it's normal to be give pitocin after you deliver to help contract the uterus.

4 Things Measured During Vaginal Exams

1)  Dilation of the Cervix

• Measures how many centimeters the cervix has opened.

2)  Effacement of the Cervix

• 100% means the cervix has completely thinned because the baby's head has dropped.
• Dilation and Effacement Diagram

3)  Presentation

• Describes the baby's position.
• Occiput (back of the head or skull of the baby)
• Anterior (nearer the front of the mother's body)
• Posterior (nearer the back of the mother's body, toward her rear or hind end)
• Right and Left (of the mother)
• Spinning Babies is a really helpful resources with instructions on how to change baby's position.

4)  Station 

• Tells how far the baby has moved down the birth canal.
• Negative is above the pelvis and positive is below it.
• Zero position means the head is engaged and has entered the vaginal canal within the pelvic bones.
• +5 means the baby is crowning.