Saturday, January 19, 2013

Second Prenatal Class Part 2

Prenatal Class 2, part 2

At this point, the nurse brought up the idea of having a birth plan.  Some questions to ask yourself as the mom or dad to be… Who is the support person/people that will be in the delivery room?  What positions would you want to try?  What type of pain medicine?  Will you breast feed?  What about circumcision if you are having a boy?  Do you want your child given a pacifier right away?  Do you want the pediatrician in the room with the baby during the check ups or to have the baby at the nursery?  Do you want the baby mostly in the nursery or in the room with you?

The nurse also advised to be our own advocate, to ask questions.  She used the example of, “If you doctor says he or she wants to break the water bag, you should have a list of questions in mind… such as… why break the water bag?  What are the side effects?  How are you going to do this procedure?  What’s the next step if the water bag doesn’t break?  Can we wait?  What’s the risk involved in waiting?”

Then the nurse passed around what looked like a very large crochet hook…. And that… is what they use to break the water bag.  EECK!  My friend, Kim, said that when they broke her water bag it HURT.

One scary thing the nurse mentioned was – breaking of the water bag causes some of the umbilical chord to slip out before the baby’s head and when this happens, the baby’s head pinches the cord and no necessary supplies are brought to the baby.  This causes an emergency c-section.

Next up:  Induction.  The not-so-favorite topic of the night.

Artificially creating labor when your body isn’t ready.  The hospital staff won’t do this unless there is a medical reason.  They use a litany of qualifications, (called the Bishop Screening System) – dilation, effaced, position of baby, etc.

So, you might think.. ok, inducing versus naturally occurring labor, not much of a difference right?  Ehh, not so.  When a woman’s body is forced into labor, the contractions are much more powerful.  Whereas, when a woman’s body naturally goes into labor, it goes from not so hard contractions to increased levels of contractions…  Inducing goes from 0-90, skip the softer contractions.  It’s a shock to the body.

These medicines are used for inducing:

Cervidil or cytotec tablet, Pitocin IV and AROM.

Cervidil is used to soften the cervix.  I think the nurse said this can take 12 hours.
Pictocin is an IV and creates the contractions.

The nurse staff can use external and internal monitoring of how the baby is doing;

External is similar to the non-stress test – two belts go across the mother’s stomach, add some gel and a heart rate monitor.  This external measurement doesn’t show the “strength” of the contraction – just the heart rate of the baby.

Internal can include IUPC – this is a tube that goes inside and will measure the strength of the contractions.  Scalp Electrodes can be placed - this is used if no heart beat is found during contractions via the non-stress test.  It does leave a mark on the baby’s head, as that is where it’s attached.

The nurse then brought out some down right scare tactics. 

She said, “If the mother is nearing the end of the delivery and finds she doesn’t have the physical strength to push or the baby is in the wrong position….”

There’s a vacuum extractor – a suction cup is used to put on the baby’s head.  Use this when the baby is not coming, but the mom is pushing.  This helps to deliver, but the doctor doesn’t pull the baby.  It will leave bruises, can cause jaundice and possibly tear the mother.

And forceps…Uh huh, if I see those long silver salad tongs coming near me, I’m likely to find enough energy to jump off the hospital bed and run out of the hospital screaming like a banshee!

Some things just should NOT be shown at show and tell!  Forceps are also to help deliver the baby if the baby needs moving or the mother doesn’t have strength.. it can leave bruises on the baby’s head, paralysis of the face, tearing… yeah, scary stuff.

Now, if you’ve made it this far into the discussion, it’s likely that nobody has any questions.  I think there was a collective sigh of relief when the nurse covered the forceps and vacuum with a blanket.

Next up:  C-Section.  In our group, there were two mothers who knew they had scheduled c-sections.  One in Four women have c-sections.  Reasons for having this:  in labor 24 hours and not progressing, uterus rupture, placenta previa (placenta covers the cervix), breech position, problems with the baby’s heart rate, shape of the pelvis, etc.

The nurse explained that if the mother already had an epidural, they can use this for the c-section.  But if the c-section is planned, then they will give a spinal epidural.   Other than the video where they show the procedure, not much more was discussed about the c-section.

Though, the nurse did say that there’s an increased likelihood of  a c-section if a woman is induced.  Inducing does not necessarily mean c-section, but it increases the chances.

The class ended with ways to prevent infection:

Shower with an antibacterial soap (Dial or Hibiclens) the night prior to and the morning of coming to the hospital

Do not shave anything – legs, abdomen, etc.

Sleep in freshly laundered sheets and pjs.

Whew.. that was a lot.  Yes, I know, a long one.  But… a lot of stuff to digest and I wonder why my stomach was in knots and I was such a grump after this class…  I DO appreciate all of the information and I trust my doctor to know what is best.  Every week that goes by, I count it fortunate that our baby is still in the womb and growing.  And I keep praying… 


Cyndy Newsome said...

I had 3 c-sections. I had huge babies who did not want to come out the natural way. I'm sure we could discuss whether or not they were 100% necessary, but I'm not up for that at the moment - lol.
My point here is to tell you this - #1 c-sections are not that bad, so please don't stress yourself out horribly (with my first child a c-section was my worst fear so you can imagine how I felt when the doc said I needed one). #2 - the end result, you'll have a baby and a birth story. The birth is one, maybe two days out of your lives. As long as it ends in a healthy baby and mama- all is well.

Amanda said...

The suction and forcepts had to be so scary to think about!!! Sounds like you've had a very comprehensive birth class that has covered all the what if questions.

Glynis Jolly said...

I forgot to tell you something in my last comment about your pregnancy. As I said, my labor was induced, there was pain that I don't really remember afterward, and the labor was a lot short. Something else that was positive for me was that once they got me on the gurney to go to the delivery room, all pain stopped. This is amazing because I did not have any pain killers, just the stuff to induce labor. Moreover, not having any pain in the delivery room helped the delivery. It was one, two, three, he's out just as if it were a baseball game.

Don't be afraid of labor being induced, Aleta. It will be so much easier on you. With a healthy baby, he or she is fine too. Maybe a little more red-faced than if it was purely natural childbirth. My son was definitely a healthy baby.

Lilly said...

I was induced too and while it hurt a lot it was over relatively quickly. In some respects it is far worse reading and hearing about it then living it.

And yes breaking the water really hurts. In fact I remember that pain more than the labour pain, strangely enough.

I also remember my mother saying to me that it is only 24 hours out of your life at most. As soon as the baby is born the pain goes away. I kept that in mind while it was happening.

You are healthy, Gregory is healthy and you and Greg will be well prepared. And it sounds like you have wonderful medical staff too.