I just read a great article on mothering.com about Pain in Labor. It is very informative and I highly recommend reading it. It talks about why there is pain, what can affect your pain and how to manage it. There is also information about possible risks to taking pain medication during labor.

Natural Childbirth

Natural Child birth is about understanding what your body is doing, working with it to help your body do what it needs to do for the baby to move down and out and doing what comes instinctually to help this process. Natural child birth is not about pain. It is about the experience of being present with your body. It’s about doing what is best for your baby and your body. It is about a good experience for the birth of your child.

Although, I completely understand that medical interventions are there for a reason and they are sometimes necessary, there are many preventative measures a women can take throughout labor to prevent interventions later in her labor. Some basic things are staying hydrated and energized with food, emptying your bladder regularly during labor and movement. These are all necessary things that women need in labor to help the baby to not become stressed, help her labor progress and help her contractions work for her body. Sometimes even with all the preventative measures, a women may need an intervention. Sometimes interventions are suggested when they are not truly needed. Couples must inform themselves on all the interventions so that they may make the best decision for their situation during labor. Sometimes that decision is to take the intervention and sometimes it is to try something new in their labor like position changes if they haven’t already tried them.

With all that being said, some women opt for an epidural long before her labor begins, sometimes long before she even becomes pregnant. I fully believe every women should make her own choices and have the birth she wants. However, she needs to understand the risks of this decision and how to make the best of the epidural by minimizing those risks. For instance, getting it later rather then sooner in labor. Also, many hospitals automatically give pitocin with an epidural, know what your hospital’s policy is so you know what you are getting.

Planning for your birth

Once you become pregnant, you should inform yourself about all the “standard” procedures for a laboring woman and a newborn. You will want to have enough time to research your options and decide for yourself what you want for you and your baby. Once you decide what you want it is extremely important to talk to your doctor about your choices. Under each section, I have included important links that will have valuable information to take to your doctor if they do not want to allow one of your choices.

First, KNOW your hospital’s standard procedures: I have recently found out that St. Joseph and Hoag Hospital’s routinely give a shot of pitocin after ALL births. This is to prevent excessive bleeding. Please ask the doctor what are the standard drugs given at anytime you will be there so you may make your decision before you get there. There are ways to avoid hemorrhage after the birth.

Also it is extremely important to inform yourself about all the reasons or inductions and c-sections so you can be more proactive for your care. Things that may concern the doctor, but are not necessarily a concern and further test should be done are:
Low fluid - This can change with your fluid intake and the position of the baby. Make sure you well hydrated particularly in the end of pregnancy
Going past your “due date” - It should be a due month, not a due date. Most babies are born, when not induced somewhere between 38 and 42 weeks. Most women naturally go past their due date when allowed to go into labor on their own. If the doctor wants to induce simply because of your due date, ask if the baby can stay in you as long as he or she is not stressed. They can do a non-stress test and an ultrasound, that way both you and your doctor can be confident your baby is healthy.
Here is a great article that gives all the reasons you should wait till your baby is ready to be born:
http://www.npr.org/2011/07/18/138473097/doctors-to-pregnant-women-wait-at-least-39-weeks?ft=1&f=2&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NprProgramsATC+%28NPR+Programs%3A+All+Things+Considered%29

Pitocin - Medically managed births lead from one procedure to another and are more likely to have complications. Being induced with pitocin can cause complications. Your baby may not be ready to be born and your body didn’t go into labor naturally producing its own oxitocin. When you don’t produce your own, it isn’t released to your brain so your pain tolerance isn’t increased as it would be if you were to go into labor naturally, therefore a pitocin induced labor is much more difficult to handle. When a woman is allowed to labor naturally in her own time, she has a very specific cocktail of hormones that your body needs and it produces a wonderful feeling once the baby is born. You also get a burst of natural energy after your baby is born so you can bond immediately.
Pitocin to augment - Typically hospitals want women to progress at a rate of about 1 cm of dilating per hour, others like 2 cm per hour. If a laboring women is not dilating at this rate they suggest pitocin for augmentation. When you receive pitocin, the baby must be monitored constantly because the pitocin may be too strong for him or her, she must also have IV fluids. However, when this is suggested, it is usually before there is any stress on the mom or the baby. There are many other things that she can do to help her labor along. Another consideration is that this particular mom’s labor is progressing in other ways or for some unknown reason, her body must progress slower. Ever women is different and every labor is different. It is important to know your options and when the pitocin is necessary. Typically one intervention leads to another.
Eating During Labor - Many hospitals don’t allow you to eat during labor, however many nurses are starting to go by the don’t ask, don’t tell policy. Eating some high energy foods during early labor is important for both you and your baby. You both need the energy to get through your labor. Here is a study published in the British Medical Journal, http://www.bmj.com/content/338/bmj.b732.full

Newborn standard procedures:

Clamping the cord immediately after birth - This is standard in most hospitals, however if the cord is left to pulse and clamped after it has finished pulsing it gives the baby more of their own cord blood. Some believe it makes the transition into this world outside of the mother’s womb more gentle. Allowing the cord to pulse also allows more of the clotting factors to pass to the newborn. There are now many studies done on this and there is tons of evidence in favor of allowing the cord to pulse after the baby is born. Discuss this with your doctor BEFORE you arrive at the hospital. Here is some helpful information and studies:
http://academicobgyn.com/2009/12/03/delayed-cord-clamping-should-be-standard-practice-in-obstetrics/

Vitamin K injection or oral dose - There are some controversies regarding vitamin K and there is a lot of information out there and it seems to be all over the place. It is really important to look and decide for yourself based on what will happen during the birth of your child if you are going to get the vitamin K injection, oral dose or not at all. One key point regarding the vitamin K is allowing the baby’s cord to pulse completely before clamping and cutting increases their blood and their clotting factors. Also, another extremely important factor related to the Vitamin K is weather or not you will breast feed. If you are, Vitamin K will pass to your newborn. The website I have listed here has a lot of good information that is worth reading. http://www.gentlebirth.org/archives/vitktop.html This next one is a blog written by a midwife: http://www.homebirth.net.au/2008/03/vitamin-k.html

You can buy oral vitamin K if your hospital does not offer it at
Birth With Love Midwifery Supplies

Hepatitis B Vaccination - All vaccines should be researched by every parent. I recomend, The Vaccine Book, By Dr. Robert W. Sears. Hep B is a virus that is sexually transmitted or it can be transmitted through the use of IV drug needles, improperly sterilized tattoo needles or accidental stick with an infected needle. The disease is potentially dangerous, however your baby is unlikely to get it unless sharing a home with a person infected. If a mother has Hepatitis B, there is a Hep B antibody called HBIG that can be given to the newborn and you may consider the vaccine as well. This particular vaccine does include aluminum and formaldehyde, every parent should consider the risks and benefits of giving and not giving a vaccine before they choose for each one. All vaccines are different. The CDC also recommends waiting to give vaccines if a person is ill and they are not recommended to persons with a weakened immune system. Also, breast-fed babies are much less likely to contract illnesses even more so if they are not in daycare at a young age. Mother’s should consider breast-feeding for at-least 2 years, daycare is usually not an option.

Bath - Babies can have a hard time regulating their body temperature. This is most commonly a problem when the baby is bathed. In many hospitals the standard procedure to ensure the right body temperature is to place the baby in a warming bassinet. This causes unnecessary separation of the mother and baby. A better way to regulate the baby’s temperature is to place the baby on the mom’s stomach skin to skin and cover both with blankets. Studies have demonstrated that skin to skin warming is faster at achieving correct body temperature for the baby and more effective at maintaining that temperature. The mother’s body actually helps to regulate the baby’s temperature as well as their breathing.

PKU -A heel prick to test for phenylketonuria - an inability to digest a particular protein. This be done can within the first week, it does not have to be done the first day. The test may even be more accurate after the baby has had a chance to digest.

Eye treatment - If the mother has gonorrhea or chlamydia it can be transfered to the baby as he or she passes through the birth canal. So to prevent the baby from getting infected, antibiotic ointment is placed in their eyes. Some feel it is better to wait an hour to administer the drops so the baby has bonding time with the mother first and others feel the antibiotic ointment should only be used in babies whose mother’s tested positive for the infection. There is a concern that using antibiotics is creating more resistant stains of the infections.

Other concerns you may have or want to think about:

Rooming in
Breast-feeding
Diapering
Circumcision
Early discharge


Conscious Birth is serving Placentia, Yorba Linda, Fullerton, Brea, Anaheim, Irvine, Newport Beach, Alicia Viejo, Mission Viejo and other Orange County, CA cities. I am also very near, some Riverside and San Bernardino County cities. If you are interested in meeting with me, please e-mail kristen@bestocdoula.com or call 714/269-0172.