Friyay Workout and The {Labor} Birth Plan

Friday, October 30, 2015
It's Friday! We're very excited for the Halloween Weekend! I can finally bring out Aria's fairy costume that I've had hidden for the last month and a half.

After we got it, she wouldn't take the wings off. Although it was extremely cute to see her bounce around in her fairy wings...I could just see the downfall of the wings, and the sadness that would have ensued once they were ruined.
Mommy made a judgement call and hid that sucker.

For a fun Halloween themed workout, check out The Great Pumpkin Workout by Katalyst Health!
So fun and completely awesome that she created this! I did the workout during nap time, making a couple of modifications for the belly, and it was great!!!

Let's talk about birth!

A few weeks ago I wrote a post about Preparing for Birth. You can find it here
I have had a number of questions about making a birth plan, what each of the options I talked about in that post meant, and why it was important to us. So, I decided to break down how we made our birth plan, into a series of posts to help other mama's out there prepare for their births as well.

The series will include:

Birth Plan: End of Pregnancy - Last week's post. You can find it here
Birth Plan: Labor
Birth Plan: Birth
Birth Plan: Postpartum
Choosing a Care Provider

We left off last week talking about the End of Pregnancy Birth Plan. This week we're picking up discussing the different options we weighed for the labor portion of our birth plan. 
During labor there are a lot of different directions things can go. Knowing what is important to you and what options you have to work with, can help you feel as comfortable as possible, which is very important for the birth process. 

These are the options we discussed for our labor process: 

Internal Exams: 
During labor, internal exams are a hands on way for your care provider to check your progress (ie. how many centimeters you are dilated). Generally, you will be checked upon arrival at your birth place. After that initial check, there are a number of factors that determine how many more times you are checked. Something to think about is that every time you are checked, bacteria are being introduced into your vagina. Additionally, being checked too often can be disruptive to labor because it can interfere with a mothers rhythm, or if she hasn't progressed to where she thought, it can be disappointing. 

I am not a fan of multiple internal exams. I'd prefer not to have anything disrupt my rhythm during labor. I trust my body and know that without constantly being checked, this baby will come out.  Unless anything out of the ordinary arises, we wanted a care provider who would be comfortable checking only when I arrive at the birth center, and not again until I am displaying signs that I'm ready to push. 

Routine IV: 
Many birth places require a routine IV. This allows them to be able to administer pain medication, antibiotics or fluids, in a timely manner, should they be needed. Now, many birth places allow a hep lock (which is just a port for the IV), rather than a full IV. That's a nice option if you aren't all in for an IV. 

With the type of birth we are planning and me being low risk, pending everything heads in the direction of a normal birth, an IV is not necessary. It was important to me to find a birth place where an IV was not protocol. 

Mobility During Labor:
There are a number of reasons why freedom to move around can be so important during labor! 

1. Contractions are often so much more difficult to manage laying down! It's natural and it feels better to move during labor. 

2. In labor, gravity is your friend! Contractions work by pulling open the cervix, while moving baby down towards the birth canal. Being upright and active is a very effective way to use gravity to help the cervix open. Using gravity to help open the cervix can also help avoid failure to progress. 

3. By moving into different positions, you're allowing the baby to shift and also move into the best positions to move his/her way down. Remaining in one position doesn't allow baby to move as he needs to for birth. 

4. Your pelvis is made of two halves on either side and the sacrum. These bones shift and move during labor, to allow baby to move down and ultimately to be birthed. Mom being able to move allows baby to use the space your pelvis is making, to move into optimal birthing position. 

5. Once you have reached 10cm and it is time to push, the position of the baby is important. If the baby is still in an odd position, it can make pushing much harder and much less effective. By taking advantage of movement during contractions, you are doing everything you can to help baby move into the best position. 

Even if you are planning an epidural, taking advantage of movement prior to having the epidural can do wonderful things for baby's position and managing contractions! Once you have the epidural you are generally restricted to the bed, however you can still move in bed. You can ask to be shifted from side to side, helping baby move his way down. You can also place pillows or a peanut ball between your legs, while on each side, to open your hips and make room for baby to move down. 

During my birth with Aria I was restricted to the hospital bed in triage. My contractions were coming very quickly and fiercely, yet I was only 2cm dilated. The nurses thought I was being a huge wimp and they treated me as so. They would not let me out of bed, and told me "You  need to lay down and relax". Yes, they actually said those words. That didn't help me relax. For an hour and a half I was in so much pain because I wasn't allowed to get up and move with my contractions or get into a comfortable position.

Finally they moved me to a labor and delivery room, and I begged them to let me walk, instead of being wheeled. The moment I got up, the world changed. I was also in transition at this point, which no one knew. Even still, just being able to get up and move the way my body was naturally trying to, helped an unbelievable amount with how I felt emotionally and physically. 
Of coarse within minutes of getting into the room, I was pushing out a baby and everyone was all "Hm. I guess she wasn't being overdramatic". 

For this birth it is most important to me to have the freedom to move and let my body do one of the most amazing things that it was designed to do. 

Eating/Drinking during Labor:
Whether long or short, labor and birth are the hardest work your body has ever done. When labor does end up being long, having some calories in way of food or drink, can help you sustain your energy for the duration, as well as giving you the energy when it comes time to push. 

Fetal Monitoring:
Fetal monitoring monitors your baby's heart rate and your contractions during labor to see how he is coping. For different situations, you may be required to have continuous fetal monitoring (ie. epidural, induction). Some birth places offer intermittent fetal monitoring, where they check the baby's heart rate periodically. 

It was important to me to have the option for intermittent fetal monitoring. I had continuous fetal monitoring last time and it severely restricted my movements during labor. Additionally, according to the American College of Nurses and Midwives, for low risk birth, intermittent fetal monitoring is associated with better outcomes, fewer cesareans and forceps and vacuum deliveries. 

Water can be an amazing tool to cope with contractions and help you to feel relaxed during labor. As a doula, I have seen it do marvelous things! I did not have the option to use it last time and that was very important to me this time around. 

Pain Management: 
Pain management is important to discuss with your birth team, so they know where you stand and can support you in any way possible. There are other pain management medications in addition to the epidural (various narcotics, nitrous oxide). Not every birth place offers them all, which is why this is a good question to ask. Asking this question early on will also give you the opportunity to research the pain management and medication options, and decide which one(s) you are open to during labor. 

Aria's birth was so fast and furious, and I had no idea what was happening to me. I was begging for pain relief, even though I swore up and down that I wouldn't want it. This time I wanted to birth in a  place where there wasn't any medication available, so that I'd know it wasn't even an option. 

An episiotomy is a surgical incision of the perineum and the posterior vaginal wall, done during the second stage of labor, to enlarge the opening for the baby to pass though. 

The necessity of episiotomies vary by circumstance, but overall they are not typically necessary for a normal birth situation. Some care providers do them more freely than others. Some will give you the option to tear instead. 
And the really good ones will help direct you when the baby's head starts crowing, when to breathe, when to push and when to stop, while massaging the area, to guide baby's head gently through and keep you from tearing too badly. 

If this is one of the things you have feelings towards, I'd suggest looking around online for some information on the subject and thinking about what you feel most comfortable with. There are a few different strong view points on this topic. Then talk to your care provider and see where they stand. Knowing ahead of time is nicer than finding out at the last minute.

The one thing I can say was amazing about the woman who delivered Aria was that she expertly coached me through crowning, while massaging my perineum and I did not tear at all.

For this birth we were looking for a care provider who would provide the same awesome care in that area!

What was/is in your labor birth plan?

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