June '14 L&D Questions Thread

ElTrain5

Mease8 said:

So I thought if you need pitocin they can start you off with a really small amount to see if that gets things going and then maybe you don't need an epi? True? False?

Also I read that a study done on naturally inducing labor showed that nipple stimulation is most effective in comparison to other methods like sex, however it is like hours of nipple stimulation...

Again, FTM here, but my midwife covered this on our tour, what she told us was that if someone needed Pitocin for stalled labor at the birth center,  you'd be transferred to the hospital regular L&D unit, and be given a little bit to see if that "got things going" again.  If it did, and your contractions became regular again, they'd unhook you and you had the option of transferring back to the birth center (they don't allow Pitocin in the birth center).  So according to her, it's definiltey possible to start off small to see if that's enough to do the job.

ElTrain5

I knew I'd read some threads about Pitocin induction and people who still went med free, I found a couple:

https://forums.thebump.com/discussion/8555509/pitocin-and-natural-birth

https://forums.thebump.com/discussion/8560918/talk-to-me-about-pain-med-free-birth-and-induction-pitocin

https://forums.thebump.com/discussion/9085310/birth-story-pitocin-induction-without-pain-meds

https://forums.thebump.com/discussion/8646585/adrian-alexander-birth-story-natural-birth-with-pitocin-induction

RaeJ004

efino87 said:

Since the big baby thing has been brought up a few times lately, what would STM's who have had a 9lb+ baby recommend as far as prepping for a successful vaginal delivery of a suspected large baby? I know the growth ultrasounds can be very wrong and I could be worrying about a whole lot of nothing but I would like to be prepared if the end of June comes around and its time to deliver a 10lb baby.

My original plan was to labor as long as possible on a ball and only get the epi when I am close to transition if I really can't handle it. I know that there are better positions to labor/push in than on your back but are they at all possible with an epi? I have tried talking to the doctor about this the last two appointments but the response has been, "We will see, you have two months left" and then the "you may need a c-section to avoid major complications" conversation comes up b/c of his head size.

I know I could just be blowing smoke, I still do have two months left till my due date and I'm still not out of the PTL/birth woods yet but I wasn't sure if things like perrinal (sp?) massage needed to be started months or weeks ahead. My goal is whats best for baby however we get there, just looking for some insight.

A 10lb baby should still fit through your pelvis just fine.  My family has big babies and none of us have had to have C-sections.  DD was only 8lb15oz but I'm sure this one will be bigger.  I'm not worried about it at all. 

It will depend on your doctor, some will let you push on your side if you've had an epi.  I had a good friend who had an epi and was still allowed to push using a squat bar, but I've never heard that from anyone else.  It just depends on your doctor and the policies of the hospital. 

I would really push your doctor to talk to you more about what your options are.  A big head size doesn't necessarily mean you have to have a C-section. 

LilyGracesMommy

I was induced both times with DD at 41 weeks and with DS at 40 weeks 3 days. I was maybe a fingertip dilated and not effaced. With both I went in the night before and had cervidil over night and then started pitocin in the am. With both labors I got an epidural, I'm curious to see if I do go into labor on my own this time, if the contractions are any easier... but I've never actual felt a non-pitocin contraction. Even though this is my third time around, I still feel like a newbie when it comes to going into labor naturally( i.e. normal contractions, water breaking, losing mucous plug) as non of these things have ever happend to me.

As other posters have said, I have heard of people who get pitocin, not getting an epidural, but I personally have not gone that route. 

Overall both induction experiences were great and I got my healthy babies in the end and literally felt nothing while pushing and getting stitched up after, as much as I hope to go into labor on my own this time, I would be perfectly happy being induced again ( at least I know what to expect with the induction process)

RaeJ004

Tdonatoni said:

@efino87‌ FTM here, but from all that I've read and what my birth instructor said, when you get an epidural, you can't feel anything/can't control anything below the epidural so you don't really get to move around and try different birthing positions. Nurses and your DH/partner will have to help put you into position to birth the LO.

I could move my legs and could easily get myself out of bed (got in trouble for that) with my full epi, but could feel no contractions.  It just depends on the patient!

jwarnerb

Thanks for looking those up @ElTrain5! All the induction info has been great- thanks, ladies!  FWIW- I am keeping an open mind about my own birth situation and plan on being flexible re:drugs, etc. but want to know a little bit about everything before I go in there, ya know?  

Savvy122

RaeJ004 said:

Tdonatoni said:

@efino87‌ FTM here, but from all that I've read and what my birth instructor said, when you get an epidural, you can't feel anything/can't control anything below the epidural so you don't really get to move around and try different birthing positions. Nurses and your DH/partner will have to help put you into position to birth the LO.

I could move my legs and could easily get myself out of bed (got in trouble for that) with my full epi, but could feel no contractions.  It just depends on the patient!

I was the same way.  I had no problem moving around with the epidural and pushed in a bunch of different positions.

efino87

Thank you, this is really helpful information! I could always have the epidural turned down or off for pushing so I can move around better. Last time i didnt have a full dose so i was able to feel enough to push. I really appreciate the encouragement. @CDK211‌ you're right I shouldnt get discouraged!

nunzchucks

@nutmegs8 I don't know if this is helpful, but I was GbS+ with DD and I don't even remember them giving me the antibiotics. I assume they did it when they gave me extra fluids. It was NBD.

Savvy122

Tdonatoni said:

Savvy122 said:

RaeJ004 said:

Tdonatoni said:

@efino87‌ FTM here, but from all that I've read and what my birth instructor said, when you get an epidural, you can't feel anything/can't control anything below the epidural so you don't really get to move around and try different birthing positions. Nurses and your DH/partner will have to help put you into position to birth the LO.

I could move my legs and could easily get myself out of bed (got in trouble for that) with my full epi, but could feel no contractions.  It just depends on the patient!

I was the same way.  I had no problem moving around with the epidural and pushed in a bunch of different positions.

Love hearing this because I've only been told, "get an epi, no movement for you, push on your back". Maybe it varies by hospital???

They didn't want me to get out of bed for obvious reasons, but I was definitely not numb to the point where I was unable to move around in/on the bed.  I was numb enough where the contractions were pretty mild, but I could still feel my legs.  Maybe I just didn't click the button enough to numb myself to that point?

jshrop

Tdonatoni said:

Savvy122 said:

RaeJ004 said:

Tdonatoni said:

@efino87‌ FTM here, but from all that I've read and what my birth instructor said, when you get an epidural, you can't feel anything/can't control anything below the epidural so you don't really get to move around and try different birthing positions. Nurses and your DH/partner will have to help put you into position to birth the LO.

I could move my legs and could easily get myself out of bed (got in trouble for that) with my full epi, but could feel no contractions.  It just depends on the patient!

I was the same way.  I had no problem moving around with the epidural and pushed in a bunch of different positions.







Love hearing this because I've only been told, "get an epi, no movement for you, push on your back". Maybe it varies by hospital???

Maybe do some research and talk to the anesthesiologist who is doing it about movement (safe vs not). That way if your ob says no but anesthesiologist says yes, you can go with the expert opinion. I mean, they can't strap you to the bed right?

Mia081081

Merie412 said:

Quick random question-I know a few people have said coconut water is good for hydration during labor-specifically @StrawberryDreams219‌. Is this a good one? Not sure if it's the "real thing" or if I need to be looking at a natural foods place for something else. TIA!

That's a good one! I had 2 on the way to the hospital with DD and I think it definitely helped my stamina.

ElTrain5

Merie412 said:

Quick random question-I know a few people have said coconut water is good for hydration during labor-specifically @StrawberryDreams219‌. Is this a good one? Not sure if it's the "real thing" or if I need to be looking at a natural foods place for something else. TIA!

This is the one the doulas at my midwives office are always sipping also it comes in different flavors. The pineapple is yummy.

efino87

@jshrop That is a really good point! I need to talk to them ahead of time anyway. I have scoliosis and last time getting the epidural placed was pretty awful and took awhile.

ElTrain5

@ugabamafans if it helps, my midwives also told us that a breast pump can be an extremely effective way to start labor/get it going if it stalls. So effective in fact that it's considered an "intervention" and can't be used at the birth center (although they did say whatever happens in the bathroom behind closed doors is 'our business')

So I guess that's another good alternative to manual stimulation. Just be sure you're close to your delivery location in case it's "too effective"?

brooklyngirl46

Has anyone had any experience with having a low platelet count? Mine was at 120. I'm nervously waiting the newest results. I know it can affect whether you can get an epi, or have to go under general anesthetic, etc, and I'm trying to mentally prepare myself for a situation where I have less or different choices than I planned on having. If a platelet count stays low, when do they make the call about what your options are? 

katekat8721

Dammit, now I want coconut water lol

RaeJ004

Too many people talking about nipple stimulation to tag:  You guys might look into acupressure as well.  You basically apply pressure to different trigger points in your body, some of which are associated with getting labor started.  I have a friend that swears by it and says it put her into labor twice.  I didn't get far enough along to try it though.

vv826

RaeJ004 said:

Too many people talking about nipple stimulation to tag:  You guys might look into acupressure as well.  You basically apply pressure to different trigger points in your body, some of which are associated with getting labor started.  I have a friend that swears by it and says it put her into labor twice.  I didn't get far enough along to try it though.

I took cosmetology in high school. Our instructor always told us never to massage behind the ankle of somebody who was pregnant because it would send them into labor. Idk how true it is but I figure it can't hurt.

flojo973

Are you guys going to use an app to time contractions?  If so, which one?

katekat8721

flojo973 said:

Are you guys going to use an app to time contractions?  If so, which one?

I have Pregnancy Companion (I think it's like $1.99) that I've used for everything else during pregnancy. It has a contraction timer thing I'll try.

SecondTimeinMSU

mullenem said:

LilyGracesMommy said:

Even though this is my third time around, I still feel like a newbie when it comes to going into labor naturally( i.e. normal contractions, water breaking, losing mucous plug) as non of these things have ever happend to me.

ME TOO!  Yesterday at my appt, they went over the "when to go in" stuff then followed it with "Sound familiar?"  And I just said, "Nope!"  I was induced last time.  I have no idea how labor starting naturally feels like.

I also feel the same about my induction going really well and not minding another one.

Me three. My water broke out of nowhere and I hadn't even had my strep B test so I got a ticket straight to the hospital. I am really anxious about knowing when I really am in labor enough to warrant heading to the hospital if my water doesn't break again. I had a quick labor and they say each labor is shorter so I don't want to end up having my baby on the side of the road or something. @mullenem if you hear on channel 6 that a local woman has baby in her car can you announce it to the BMB for me =P

RaeJ004

thankusweetLordbaby2 said:

Too many people talking about nipple stimulation to tag:  You guys might look into acupressure as well.  You basically apply pressure to different trigger points in your body, some of which are associated with getting labor started.  I have a friend that swears by it and says it put her into labor twice.  I didn't get far enough along to try it though.

I took cosmetology in high school. Our instructor always told us never to massage behind the ankle of somebody who was pregnant because it would send them into labor. Idk how true it is but I figure it can't hurt.

Totally.  But you better believe I'm talking it up to DH and using it to my advantage and going for regular pedicures from 39 weeks on!!  Why not?

tbmadeamistake

I didn't use an app to track my contractions last time, a clock with a second hand worked fine, I stole DH's for a while.  Mark when each one starts and stops, that's how long they last.  The time between one start and the next start is considered how far apart they are (not the time between the stopping and starting of the next one). 

I believe that your body won't go into full labor until it's ready, regardless of home remedies to get it kick-started.  Nipple stimulation, spicy foods, castor oil (which my sister says NOT to try), sex, etc...if you're body isn't ready, it likely won't go into full labor on it's own.  I had a fabulous prenatal massage the other day and the woman was awesome and did a full massage, not just  a rub down, including my ankles...and no labor.  Also, the spicy food/castor oil remedies...what bothers your colon will bother your uterus, thereby potentially causing contractions.  Basically, you're giving yourself diarhhea in an attempt to get it also make your ute cramp up.  Sounds uncomfortable to me!  

katekat8721

Re: mucus plugs

I know there's been some girls here who have partially lost theirs... is there a point where it won't regenerate and your body's like "eh screw it let's just go into labor!"

brooklyngirl46

@nutmegs8 thanks! This is super calming and helpful. Hope your levels keep going up!

fsumom

This might sound like common sense but don't go to the hospital too early especially if you're a FTM and unsure of what true labor is.  Looking back on it now, I should have known that I wasn't ready to go to the hospital.  I was 2 days early and admitted too early IMO.  I was induced with Pitocin and didn't respond well to it.  I had a c-section 14 hours after being admitted.

I am very much hoping for a VBAC this time around.  

temursgirl

@StrawberryDreams219‌ those recipes sound really tasty! Will try them out, even maybe just for dessert. Thanks.

ncbelle

efino87 My last baby was 10 pounds.  I think the biggest thing to being able to vaginally deliver a large baby is position in labor - I'm going to sing this song 11 million times in the next month but flat on your back is the WORST position to birth in from the mother's perspective.  Squatting or hands and knees open up the pelvis far more.  But most OBs aren't going to tell you that or encourage that positioning - speak up for yourself!!  I also would say skipping the epidural helps - one because you can then get in those positions and two because you can actually feel what your body is doing and work with it.

FWIW I didn't tear at all with my 10 pounder and had two stitches only with my first (who was only 8.5 pounds but had an off the charts head).  I didn't do anything special but I do think have a med free birth helped because I could feel what I was doing in regards to pushing (vs. being directed when to push which is less effective).  But I think it can be luck of the draw as well.

ON the induction - there are really very few cases where induction is truly warranted.  Most inductions in the US today are not - so it's not hard to avoid pitocin in most cases!!  I posted this above but will again because I think it's a must read (it's based on peer reviewed research so not just something flakey!): https://www.childbirthconnection.org/article.asp?ClickedLink=1072&ck=10650&area=27

Finally I'll just say again YOU are your best advocate in labor.  Make a plan - not because you have to stick to it but because it forces you to do your research.  You don't want to be making decisions about what interventions to accept or not while in labor! 

ncbelle

katekat8721 - Not really on the mucous plug.  I wouldn't ever count seeing some of it as a sign of impending labor  I actually never noticed loosing mine in either of my (non-induced) labors.

catsinawindow

nutmegs8 said:

@wareagle1220said:

nutmegs8 said:

@brooklyngirl46said:

Has anyone had any experience with having a low platelet count? Mine was at 120. I'm nervously waiting the newest results. I know it can affect whether you can get an epi, or have to go under general anesthetic, etc, and I'm trying to mentally prepare myself for a situation where I have less or different choices than I planned on having. If a platelet count stays low, when do they make the call about what your options are? 

Mine have held steady in between 111-113 throughout the pregnancy and I get CBC's done every two weeks to make sure they aren't dipping lower.  OB did mention that if they do get too low, it could affect not getting an epi, but she didn't give me a number. There is someone on the board (can't remember who) that went through this in a prior pregnancy. Good question and I'll ask in my appointment today.

I have no personal experience but a good friend of mine wasn't able to have an epi for any of her births (3 so far) due to low platelet count.  I want to say that with her last baby, when they checked before her induction, she was in the low 90s. I bet that's a doctor specific number though. 

I asked my OB today.  She said that I'm above 100, so I'm def in the clear. Had another CBC today and I'm at 119, so I'm slowly going up. She said 20-99 is the low side that would affect getting an epi, more specifically, anything below 90 would probably be a definite no. At my hospital, the anesthesiologist on call will make the decision of yay or nay.  Apparently my hospital has 2 anesthesiologists.  She said that if it were a 90, one would say yes, the other would say no. So, it sounds like the cut-off might be somewhere in between 90-99. Again, hospital/doctor/anesthesiologist specific, so definitely ask at your next appointment. The nurse that called me with my results said they will do one more blood draw when I'm admitted to L&D to have the most accurate number.

I had low platelets with DS due to complications of PreE.  My platelet counts were hovering right around 100, just below or just above.  I was told that 100 was the "cut off" to get an epidural, but that there was a little wiggle room if I was just below 100 (ie. 97 vs 100).  There was also another test that the anesthesiologist could order to see how well I was clotting beyond just platelet count.  I unfortunately have no idea what test this was.  I just know that I was nervous about getting an epidural when I was "on the edge" and they recommended this additional test.  It turned out that I was still clotting surprisingly well considering my low platelets and so they were very comfortable with allowing placement of an epidural. 

mercy0606

babygabe614 said:

This thread is fantastic!

I have a question about doctor-patient interaction. My practice has 5 OBs, and whoever is on call when I go into the hospital is who will deliver. I have spoken with my favorite OB about some reservations I have about one of the doctors, and she kind of gave me the "inside scoop" on how to avoid him, if possible (which days he is typically on call, etc). I am totally comfortable with the rest of the docs but obviously will be a little anxious if I end up with the one I don't mesh well with on d-day. If anyone had to deal with a doctor that they just didn't see eye to eye with, how did you handle it, and did it actually have any effect on your L&D experience or were you too involved with what was going on to really be bothered by them? I have a typed birth plan and have discussed this at length with my DH about how he needs to be my advocate but I am still worrying about it. 

I have a doc in my practice that I also dislike and am hoping to avoid. Fortunately, all of my experienced friends reassure me that the nurses do most of the work anyway! Let's hope we don't get stuck with the ones we are less comfortable with!

JulieSmiles

I bought a can of the red dermoplast, but then read that the blue can is better. Does anyone have any experience with either type?

k318

Never tried the red can but the blue one was like heaven after delivering ds

potterybygrace

What is wrong with Pitocin? My Dr is already talking about the possibility.

tbmadeamistake

@potterybygrace, pitocin is said to make contractions worse than if it was natural contractions.  I had pitocin with my first, but having never experienced a natural contraction can't back up if it's true or not.  I've had people who had one with and one without tell me it's awful, and others tell me it was no different.  I'd prefer to go on my own this time, but if I end up needing pitocin again, eh. 

I didn't use dermoplast last time and I survived without it, so I wouldn't worry too much.  I also didn't notice losing my mucous plug last time. 

LKHoffa

When contractions first start, do they start out weak and get stronger? Or are they always strong but just get closer together?

sparklenshine_89

LKHoffa said:

When contractions first start, do they start out weak and get stronger? Or are they always strong but just get closer together?

Sometimes you can have contractions and not know it. From my experience they start out weak and get stronger and closer together. With my first son I felt them in my belly like waves and with my second son, my lower back was in the most pain and my mom had to put pressure on it until the contraction was over.

LKHoffa

sparklenshine_89 said:

When contractions first start, do they start out weak and get stronger? Or are they always strong but just get closer together?

Sometimes you can have contractions and not know it. From my experience they start out weak and get stronger and closer together. With my first son I felt them in my belly like waves and with my second son, my lower back was in the most pain and my mom had to put pressure on it until the contraction was over.

How long did it take for you to know it was labor, @sparklenshine_89‌ ? (And thanks for the answer!)

sparklenshine_89

@LKHoffa I was a week late for both and had to be induced both times so I'm no help here I had consistent contractions though. hopefully some other ladies can chime in on this.

Also, did any of you ladies use an app to track your contractions? How did you like it?