5 Natural Remedies for Morning Sickness

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Nausea and morning sickness during pregnancy are some of the most common symptoms that women experience. You’re not alone if morning sickness has you feeling a little under the weather. In fact, about 70% of pregnant women get morning sickness.

This article discusses five natural remedies for morning sickness during pregnancy that have been shown to be safe and effective.

Ginger

Firstly, ginger has been used in a medicinal capacity for many many years. It is used to ease morning sickness, motion sickness, as well as cancer-related nausea. Research suggests that ginger may help settle an upset stomach in pregnant women experiencing morning sickness.

Ginger comes in many forms such as:

  • Ginger tea
  • Ginger chews
  • Ginger lollipops
  • Ginger ale
  • Natural form
  • Supplements

Moms to be can take ginger supplements three to four times daily after consulting with their health care provider.

Eat Smaller and More Frequent Meals

Eating smaller, more frequent meals can help reduce morning sickness. It’s important to make sure that you’re not eating too little during the day and making up for it by overeating in one sitting later on. This will only further upset your stomach allowing your blood sugar to drop.

Eat slowly and mindfully, adding nutrients into the body. Although you may feel the temptation to skip meals because of the nausea, remember you are eating for two. Try eating foods without additives and that are easy on the stomach

Some ideas are:

  • Fruit
  • cooked sweet potatoes
  • smoothies
  • rice
  • non-processed carbohydrates

Peppermint Aromatherapy

Another natural remedy for morning sickness is peppermint aromatherapy. Studies show that it can help reduce not only nausea during pregnancy but in women who have just given birth via C-section as well. Moreover, peppermint oil is thought to help ease morning sickness by stimulating the digestive system and calming the nervous system.

Try dotting your peppermint essential oil onto these parts of the body:

  • Wrist
  • Temples
  • Under the nose
  • Neck
  • Back
  • Upper chest area

Vitamin B6 & Magnesium

Additionally, some healthy vitamins and supplements that are known to help with morning sickness and nausea are vitamin B6 and magnesium. Vitamin B, as well as magnesium, can be found in many prenatal vitamins or supplements.

Eating more protein-rich foods like:

  • Meats
  • Fish
  • Poultry
  • Avocado
  • Bananas
  • Pistachios
  • Sunflower seeds

Magnesium can be taken in supplements, topically with magnesium spray, as well as mixed in a bath with Epsom salts.

Avoid Strong Smells

Lastly, and maybe a bit obvious, is avoiding strong smells that may trigger nausea. Many pregnant women experience heightened senses like smell, which you can blame on your pregnancy hormones. Due to our estrogen levels being so high, any small scent that passes our nostrils can seem like an all-out assault on our noses.

Try avoiding these items:

  • Cigarette smoke
  • Perfumes
  • Chemicals in cleaners 
  • Strongly scented foods
  • Candles

If You are Experiencing Morning Sickness

If morning sickness and nausea are a problem for you during pregnancy, there are many natural and at-home remedies that can help. Many women experience it and in most cases, it goes away by week 14.  However, if the nausea is severe, you may want to consult with your health care provider.

If you are looking for or have any questions about pregnancy, birth, and family planning contact Midwife 360. We not only provide holistic gynecology but pregnancy services, which include home birth and water birth to women throughout South Florida. We are here to assist you as well as educate you every step of the way.

Postpartum Hair Loss

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Hair loss is a natural process that many people experience. However, hair loss or thinning during postpartum can be especially challenging, since it’s often accompanied by breakage, and scalp irritation. The good news is that hair grows back.

The hair loss that many new moms experience a few months after having a baby is called postpartum hair shedding. This hair loss happens because the levels of estrogen and progesterone in your body are decreasing or going back to normal after spiking during pregnancy. This often causes your hair to grow slower and less full. It’s not true hair loss during postpartum because it will grow back. Dermatologists refer to hair loss as excessive hair shedding.

What Causes Postpartum Hair Loss

The hair loss most often associated with pregnancy is due to the hormonal changes during and after pregnancy. During pregnancy women notice their hair growing thicker and looking more full. The hormones during pregnancy keep your hair from falling out. However, following pregnancy, these hormones drop and the hair begins falling out and thinning.

The condition, which is also referred to as postpartum alopecia, is relatively common, affecting between 40-50% of women in the months following childbirth.

How Hormones Affect Hair Loss/ Growth

Estrogen is the leading hormone that affects hair growth during pregnancy, postpartum, as well as in menopausal women. Many women during their pregnancy experience fuller and thicker hair growth. This is due to the increase of the estrogen hormone in the body. Thus, producing more hair follicles during the growing phase of the growth cycle.

However, following the birth of your new baby, your estrogen levels drop and return back to the level pre-pregnancy. This causes the new follicles to enter the resting phase of the growth cycle. During this phase, the hair grows slower and produces fewer strands, and begins to shed. Postpartum Thyroiditis can also result in an imbalance of thyroid hormones, which can also affect hair growth.

How Long Does Postpartum Hair Loss Last?

In most cases hair loss after postpartum is temporary. Hair will start to grow back within a few months. Excessive hair loss usually starts eight weeks after giving birth and will last for six to 12 months. If your hair does not begin growing back by your baby’s first birthday, you may consult with your dermatologist or healthcare provider. Month 15 is the lucky number where most women feel their hair is back to normal.

How To Help with Hair Loss/ Growth

There are natural and home remedies that a new mom can implement into her daily routine to help with postpartum hair loss. Some of these can include all-natural shampoos that are specifically for hair loss and helping with new growth. Fenugreek seeds are also helpful when soaked and used as a scalp/hair mask. This herb is also helpful for the production of breast milk.

Adding “hair-healthy” foods into your diet can also promote healthier and quicker hair growth. Including things like:

  • Leafy greens
  • Eggs
  • Healthy fats (avocado, nuts)
  • Vitamin B12
  • Berries
  • Sweet Potatoes

Before the consumption or use of any of these listed always check with your healthcare provider to ensure the safety of you and your baby.

If You Have Any Other Questions

For all pregnancy and women’s care needs contact the professionals at Midwife360. We provide holistic gynecology and pregnancy services, including home birth and water birth to women throughout South Florida. We support and educate women every step of the way through family planning, healthcare options, and birthing. Contact us today to schedule an appointment or speak with one of our midwives.

A Guide on Postpartum Thyroiditis for New Moms

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Women go through a lot of changes after pregnancy. Some are physical, some are emotional and others cognitive. These changes can be attributed to the pregnancy itself or postpartum depression, which is very common for women in this time period. However, what if these symptoms are actually signs of something more serious like Postpartum Thyroiditis?

Postpartum Thyroiditis is a condition that primarily affects women and it has many symptoms that overlap with pregnancy-related issues such as fatigue, weight loss struggles, hair loss, anxiety, and trouble sleeping. This article will explore all you need to know when you’re expecting.

Know the Symptoms of Postpartum Thyroiditis

It is extremely common for women, especially new mothers, to experience postpartum depression following the birth of their baby. Some of the symptoms are mood swings, withdrawal, loss of appetite, insomnia, and fatigue. Oftentimes, mothers feel extremely depressed as a result of the excess weight they may have gained during their pregnancy.

On the other hand, these symptoms are very similar to what one may feel if one is experiencing postpartum thyroiditis. Some of the common symptoms of both postpartum depression and signs of postpartum thyroiditis are; weight gain, depression, lethargy, muscle weakness, and trouble sleeping. Although it is uncommon for many women to develop postpartum thyroiditis, it can happen and be missed. Due to the similarities in symptoms, many women can have the misconception that they are only experiencing postpartum depression when something much more severe is occurring.

Can It be Detected

Postpartum thyroiditis is a condition that impacts postpartum women. This can occur after the birth of your child and most commonly arises in the first trimester or early second trimester. If you test positive with this antibody during early pregnancy, there is a 40% to 60% higher risk of developing postpartum thyroiditis. Thus, more reason to get checked by your healthcare provider early on.

Types of Postpartum Thyroiditis

It is important for mothers to be aware that they may be experiencing one of the two types of thyroiditis. These being:

  • Hyperthyroidism
  • Hypothyroidism

Knowing and being aware of symptoms of both types is important to be aware of during your term. Although it is easy to miss diagnose these symptoms as something less severe, it is important to report all of them to your healthcare provider.

Hyperthyroidism

This type of postpartum thyroiditis refers to an overactive thyroid. This means the thyroid gland is producing too much thyroid hormone. Thus,  causing the body’s metabolism to speed up, in turn, speeding up other parts of the body.

The symptoms of hyperthyroidism include:

  • Nervousness/ anxiety
  • Spead up heartbeat/ palpitations
  • Weight loss
  • excessive sweating/ heat flashes
  • Increased appetite
  • Insomnia
  • Fatigue
  • Frequent or loose stools

Hypothyroidism

Exactly opposite of hyperthyroidism, hypothyroidism is when the gland is deficient in thyroid hormones. When an expecting mother has this type of postpartum thyroiditis, the body functions a lot slower.

The symptoms of hypothyroidism include:

  • Depression
  • Extreme fatigue
  • Decreased milk volume
  • Muscle weakness
  • Constimaption
  • Dry or brittle hair/ nails
  • Hair loss
  • High cholesterol
  • Always cold
  • Weight gain

When mothers experience either type of postpartum thyroiditis it can feel as if they aren’t able to fully enjoy their new baby. The symptoms are hard to overcome making everything feel stagnant.

Prevention

One form of therapy that has worked to help prevent postpartum thyroiditis in women who have high antibodies during pregnancy is giving selenium. Selenium is an essential trace mineral that helps to support many bodily processes. When taken during pregnancy, selenium acts as an anti-inflammatory, helping to reduce the chances of developing postpartum thyroiditis. 

Other helpful prevention ideas can include changing your diet to a more anti-inflammatory diet. Reducing or stopping gluten intake can help reduce inflammation. Choosing BPA-free, phthalate-free, and paraben-free also helps avoid toxins that can be a factor in causing thyroid issues.

More Questions?

If you are looking for more information about thyroid issues and the threats of postpartum thyroiditis, talk to your healthcare provider or give us a call at Midwife360. We are a holistic evidence-based practice for women’s care, family planning, pregnancy care, and birthing throughout South Florida. Our practice is designed to meet the individual needs of each woman and family we care for. We believe women should be informed and educated about their healthcare options and empowered to make their own choices.

A Complete Guide About Shoulder Dystocia

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What is Shoulder Dystocia?

Shoulder Dystocia is a birth complication that happens during vaginal delivery. When this occurs, one or both of the baby’s shoulders get stuck inside the mother’s pelvis during labor. This causes a stall in the delivery process, which can be life threatening. In most cases, babies born with this complication are delivered safely. However, it can cause problems for both the baby and mother. 

Shoulder dystocia happens in 0.2 to 3 percent of pregnancies, and sadly, is unpredictable and unpreventable. When complications happen during labor, doctors turn to urgent cesarean delivery or surgery to avoid further issues. Although this may work in most cases, urgent cesarean delivery or surgery cannot correct this condition. 

Continue reading below for answers to all questions regarding this topic. 

Frequently Asked Questions:

What Does Shoulder Dystocia Look Like?

When Shoulder Dystocia occurs, the fetal head is delivered but the shoulders are not seen and are not being delivered with normal maneuvers. In other words, this delay in labor causes the baby to be trapped mid delivery. When this is happening, your midwife or provider tries to move your body and baby into better positions to continue natural delivery. 

The shoulder of the baby normally gets stuck behind the mothers pubic bone or sacrum. During this delay, the baby cannot breathe and the umbilical cord may be squeezed or wrapped around the baby’s neck. It is dire that everyone stays calm but acts quickly and efficiently to prevent further complications. The midwife will ask the mother to cease pushing so she can reposition her and the baby as needed.       

Why Does This Happen?

Shoulder Dystocia can occur during any vaginal birth, and without warning. Some of the most common causes for this are that the baby is too big, the baby is in the wrong position or the mother being in a restricting position. Oftentimes, your midwife or provider will change the mothers position to help free the shoulders from the pelvic area. 

It is nearly impossible to predict the risk factors of whether or not your baby will have this complication, but there are some things that can make it more likely. This includes:

  • Shoulder Dystocia occurred during previous pregnancies
  • Fetal Macrosomia (having a larger baby)
  • Having twins or multiple babies
  • Mother is overweight
  • Mother has diabetes
  • Labor induced 

Although these factors may increase the risk of a baby being born with Shoulder Dystocia, it is not clear why some pregnancies experience this complication while others do not. One statistic states that women with a history of having a delivery with Shoulder Dystocia are 10- 20 percent more likely to have a recurrence. 

What are the Complications?

Although most mothers and babies may not experience any further issues regarding this complication, it can bring about further issues. When delivering a baby with Shoulder Dystocia, a midwife or provider may have to break the baby’s collarbone to help with removal of the shoulders. This is a last resort, but may be necessary. This is only one risk that may come from this condition. 

Further risk for the baby may include:

  • Fractured collarbone (clavicle) or arm
  • Fetal brachial plexus injury
  • Lack of oxygen to the body
  • Brain injury due to lack of oxygen (this is rare)
  • Loss of baby (this is rare)

Further risk for the mother may include:

  • Maternal hemorrhage/ postpartum hemorrhage
  • Repairs for episiotomy or tearing during delivery 
  • Uterine rupture

Can You Prevent or Treat Shoulder Dystocia?

Like we touched on above, Shoulder Dystocia is extremely unpredictable and there is very little prevention. Being mindful of potential risk factors like diabetes and watching your weight during pregnancy are all things to help lower your chance of complications during labor. At Midwife360, we recommend our mothers to give birth lying on their side or on all fours to help natural movement of the delivery process. This will help prevent complications like Shoulder Dystocia. 

It is important to inform the expecting mother about the complications and risks of Shoulder Dystocia.  As well as reassure her that, as a midwife, we are trained thoroughly on how to deal with these complications in the safest and most efficient way for the safety of you and your unborn child.  

If You Have Further Questions

If you have any questions unanswered or need more information contact us at Midwife360. At Midwife360 we provide holistic gynecology and pregnancy services, including home and water birth to women throughout South Florida. Our mission and practice is designed to meet the individual needs of each woman and expecting family we care for. We believe women should be informed and educated about their healthcare options for routine care, family planning and birthing.

A Complete Guide to Miscarriage at Home

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Is Miscarriage Normal?

Pregnancy and miscarriage carry a ton of emotions, and one may feel devastated or uneasy when going through a natural miscarriage. Although this is can be an extremely tough time mentally and physically, it may be comforting to know you’re not alone. 

An estimated 10%-20% of women who know they are pregnant will have a miscarriage. Also, most women (87%) who do experience a miscarriage will have a successful pregnancy and birth following that miscarriage. 

Maybe your pregnancy test was positive after missing your period, or some women have that gut feeling without having missed a period yet. Feeling excited, scared, happy, nervous, or just numb are all in the normal range of emotions when you first discover a pregnancy. Or maybe you’ve been trying for months to get pregnant and now you finally are. 

Just when you feel like you are beginning to get comfortable with your pregnancy, you start to have some spotting, maybe a little red bleeding, and then some light cramping. 

Next Steps

Contacting your health care provider and making them aware of what is going on is important. They may offer to have an ultrasound or blood work done. The bleeding becomes heavier and the cramping gets stronger and you no longer have the pregnancy symptoms you were starting to feel prior. Unfortunately, you are most likely experiencing a miscarriage. 

If your body is already starting to bleed and cramp, this is a sign your body is getting ready to expel the products of conception. Sometimes there’s not an actual fetus present. This means it could be a chemical pregnancy with no fetus, just a gestational sac. 

If there are no complications, you can safely miscarry at home. You may want to have some ibuprofen on hand and a hot water bottle. Soaking in a warm bath can also be very soothing. The worst of it can take about 2 hours with some pretty intense cramping and heavy bleeding. 

When to Seek Help

You would need to seek out medical care if you have pain that you cannot tolerate, or if you begin to hemorrhage. The definition of a hemorrhage is, soaking a maxi pad to where you can wring it out, and doing this for 2 hours. Of course, if the bleeding is much heavier than that or you feel unsafe, don’t wait to get medical help. 

Missed Miscarriage

A ‘missed miscarriage’ is where the fetus stops growing but there’s no signs of bleeding or cramping right away. It’s usually during the first ultrasound that this will be diagnosed. Or if you were following the beta HCG hormone, and it isn’t doubling or rising appropriately in the first 10 weeks, a miscarriage can be diagnosed this way, as well. 

If you do have a missed miscarriage, do not wait before seeing your provider for an intervention. It is dangerous for the pregnancy to sit in your womb for months, as it can cause some dangerous bleeding when the natural miscarriage begins. You will most likely be given several options, depending on the preference of the provider. It is always best to be informed ahead of time, in case your provider does not offer all the common or available options. 

Intervention Options for Missed Miscarriage

  • D&C or Dilation and Curettage

A D&C is a fairly common procedure to eliminate uterine lining and pregnancy contents. This procedure is very safe and complications are rare. Light spotting and cramping is common in the first few days after a D&C. 

  • Medications

Medications like Misoprostol are also an option, which cause your uterus to cramp. This process usually takes about 24 hours to complete. This option is also very safe and complications are rare.  

Miscarriage is Common

Miscarriage is very common, you would have to have 3 in a row before it is considered a medical problem. An option is to see a Maternal Fetal Medicine doctor to have a consult regarding any specific blood tests needed to determine if you have a genetic predisposition to miscarriage. These may include: Anticardiolipin, TSH, Lupus anticoagulant, beta 2 glycoprotein, and maternal karyotype. 

Some providers will recommend taking a baby aspirin every day to reduce the risk of miscarriage. And sometimes they may recommend taking progesterone to help you maintain the pregnancy. These all depend on the results of the blood tests and the actual medical diagnosis that is causing the miscarriages.

Next Cycle and/or Pregnancy After Miscarriage 

You can have your beta HCG levels checked, or simply wait for your next cycle. You should have a period by 4-6 weeks after the miscarriage. If you don’t have your cycle within 4-6 weeks, contact your care provider for further testing or ultrasounds. It is recommended to actively prevent pregnancy for 2 cycles following a miscarriage to lower your risk of having another miscarriage right away.

Holistic Gynecology and Pregnancy Services

If you are looking for holistic gynecology and pregnancy services, including home birth and water birth in South Florida, contact Midwife 360 for all of your questions and needs.

What to Expect From a Home Birth

So you’ve decided to have your baby in the comfort of your own home. What should you expect? As a CNM who has provided home birth services for nearly 6 years, I am going to provide you with an overview of the general expectations that await you in this experience.

We visit your home 

Your provider will come to your home at least once during the prenatal period to assess home readiness for birth. We like to see that our clients have acquired all of the supplies that were recommended, including the kit of supplies that was provided by our practice. Some examples of supplies provided by the practice are sterile gauze, sterile gloves, a peri bottle, chux pads, a fish net (for pooper scooper if having water birth), a waterproof mattress cover, and potentially other items depending on the practice. The items that you are responsible for include a drinking water safe water hose, adapter for the faucet, receiving blankets for the baby and towels of various sizes, snacks for the laboring person and birth team, adult diapers or maxi pads, a waterproof covering for the floor and extra padding for under the pool. We like to see that the intended birth space is clean and clutter-free and in an intimate space where the birthing couple can get privacy if desired. It should be in close proximity to the bed and bathroom.

What happens when you go into labor? 

Once you have decided that you are in labor you will be in contact with your midwife and doula. We like our clients to set up a group text with their partner, doula, midwife and assistant so communication is transparent for all involved. This way the laboring couple are not asked the same questions by different people and everyone knows what’s going on. Typically the doula will arrive first, and if the laboring person desires a cervical check to see where things are at, the midwife or assistant will come to do a labor check. We will assess her contractions, her coping, when she last ate/drank/used the bathroom. We listen to fetal heart tones, take vitals and get an overall feel for what’s going on – including the emotional environment. 

Sometimes we have to reassure the partner more than the laboring person of the normalcy of the situation. If the cervical exam isn’t 4-6cm and the labor doesn’t seem to be progressing quickly, the midwife will leave and the doula may stay to help the couple perform some Spinning Babies circuits. Usually the doula will help to set up the tub when it’s time and let the couple know when it’s time to call the midwife back. At any point, if the couple wants the midwife to come, we will come and assess the situation.

Active Labor 

Once the laboring person is clearly in active labor, the midwife or assistant will stay and perform checks on the baby’s heartbeat and mother’s vitals on a schedule at least every half hour. We listen for a period of time through and after the contraction to get a feel for the response of the baby to the contractions. We are watching for anything outside of the normal range as well as for specific things like maternal bleeding, fever, or lack of coping. We have many tools we can employ – depending on the midwife and her range of experience. 

Our Toolbox 

We use herbs, homeopathic remedies, essential oils, posture changes, and of course, hydrotherapy. We make sure she stays well hydrated, well nourished, and well rested – these three elements are crucial to avoid exhaustion which is a laboring person’s enemy. Sometimes we use alcohol to aid relaxation and sleep if mom becomes exhausted and her labor is stalling out. Once she gets rest she is much more capable of continuing and usually the labor will pick up on its own. We have found that labor has its own waxing and waning rhythms much like each individual contraction and it works much better to flow with it rather than trying to force it to conform to some ideal pattern.

A note on hospital transferring 

If at any point along the way the laboring person changes her mind about being at home, for any reason, we will shift gears and transfer to the hospital setting. Of course we first assess if she is in transition as many people have doubts about their ability to birth in the crucial moments just before the baby makes his final descent. However, if we determine that she is no longer comfortable at home we will get her quickly into the car and to the hospital of her choice. We call ahead to give report and accompany her to the hospital.* Once there, we would stay until her care is fully transferred to her new care provider or until the baby comes if financial arrangements have been made.

Staying home 

Most people are happy to stay home as this has been something they have prepared for physically, emotionally, and spiritually, sometimes for years. Most also birth in the tub if they have rented one and are comfortable in it. 

Whether in the water or on land, baby comes out as slowly and gently as possible with lots of encouragement and coaching from the team. We have found that the slower the expulsion of the head and body, the less trauma to the mother’s vagina, labia, and perineum. Contrary to what we hear from our clients who transfer to us, we are well equipped to sew almost any tear that happens during birth. We carry Lidocaine for numbing and sutures for sewing.

“Self Starters” 

Most babies are what I like to refer to as ‘self starters’. They will spit or cough and utter a birth cry and then they are breathing. Most of them do not cry as their birth has been so gentle they have no reason to cry. We know when to employ helpful measures such as postural drainage, stimulation, rescue breaths, and suctioning and are fully equipped to perform a full on cardiac resuscitation on the newborn if necessary. 

I have seen 1 instance out of 250 home births, and 0 instances out of the over 1600 hospital births that I have assisted in my career of babies needing full on cardiac resuscitation. BIRTH IS A NORMAL, PHYSIOLOGIC FUNCTION OF A WOMAN’S BODY THAT RARELY NEEDS HELP FROM OTHERS. As long as the body is healthy with no underlying medical problems, giving birth outside the hospital is actually safer for the mom and the baby.

Post Birth Procedure 

We keep a close eye on both mom and baby right after birth, assessing vital signs and mom’s bleeding every 15 minutes or more often as needed. We carry 3 different drugs to treat hemorrhage, and one of them, methergine, we have both pill and injectable form. We will not hesitate to call 911 if there is any emergency event that requires hospital intervention. We stay for 3-4 hours after the baby is born, assessing vital signs and the baby’s transition. 

Once the placenta is birthed, we ensure that mom has eaten, showered and urinated. We perform an Eldon card so we know the baby’s blood type and can make recommendations for jaundice prevention or give Rhogam to the mom as needed for Rh negative moms. We make sure the baby is breastfeeding well and the parents are comfortable in their new roles. 

Postpartum Visits 

After the birth we make sure our clients know that they can call us for any problem with mom or baby and that we will be coming back to the house between 24-48 hours after the birth. At that visit, we perform the CCHD**, jaundice, and weight checks. We give the Vitamin K injection if the parents have chosen to have it. We would give the Rhogam shot if Mom is Rh negative and baby is Rh positive. We assess breastfeeding again and refer to the pediatrician if there are any concerns with the baby. We assess moms bleeding and comfort and any issues with depression. We return again to the home at 1 week postpartum to reassess all of the above concerns for the mother. And we will schedule the final postpartum visit at 5-6 weeks in the office to talk about family planning, pap smear schedule and any other concerns that arise.

This article gives an overview of what to expect when planning a home birth. Stay tuned for more educational articles from Midwife360!

*There have been a few instances where we have not accompanied a client to the hospital. These were rare and individual circumstances and not the normal scenarios.

** CCHD = Critical Congenital Cardiac Defect A screening test performed on the baby between 24-72 hours after birth to rule out any critical congenital heart defects.

What to Expect from a Hospital Birth

What happens when you choose to have your baby in the hospital? The specific answers to this question depend on whether you are sent there for induction or are arriving in labor. It also depends on your planned mode of birth – vaginal or cesarean. We will talk about planned vaginal birth in this article. 

Know what you’re signing for

If you arrive at the hospital for a planned induction, you will be registered for your stay, then sent to the L&D unit to check in. If they have an available room for you, you will be admitted to that room, given a hospital gown to change into and asked to leave a urine specimen in a cup. A nurse will then come in and hand you a clipboard with a stack of papers to sign. Most of them are consent forms and she has likely perfected a quick synopsis of each form. You aren’t encouraged or discouraged from reading them thoroughly, and she will answer your questions. However, this part of the intake usually goes pretty quickly – if you get my drift. The forms include consent to treat for vaginal or cesarean birth, consent for blood products, consent for Vitamin K, eye ointment, (maybe Hepatitis B vaccine, circumcision for boys, and a new eye exam that includes dilating the baby’s eye and holding it open with a metal cup). Your provider is really the one who should be giving you the risks and benefits of each intervention that you are signing for, but in reality that almost never happens.

Triage and cervical checks

If you are in active labor, unless the baby is imminently coming, you will be processed through the labor triage room where you will be given a gown and asked to leave a urine sample and get hooked up to the monitors to determine your labor pattern. Then one of the nurses (or your provider if available) will do a cervical check to see if you are at least 4 – 6 cm. You will stay depending on your contraction pattern and your cervical dilation. If your contractions are not frequent enough or lasting long enough or too long, and your dilation isn’t at least 6, you may get an ultrasound and then (if everything is good on the ultrasound) sent home. This may happen several times before you are finally admitted in labor. It is not a bad idea to stay home as long as you feel safe before going to the hospital to avoid being sent home multiple times.

When you arrive in labor, whether breathing through your contractions or feeling like pushing, the above- mentioned forms still have to be signed once you are admitted – by you, the ‘patient’. If the baby is coming and you absolutely can’t sign, they will give them to you after.  You get the idea.

So what happens when you’re admitted? 

From here on out, whether induction or active labor, everything is basically the same. After the forms, they will come in with all of the IV equipment to start your IV and draw blood. Everyone gets an IV unless you make prior arrangements with your provider, and most providers prefer you to have the IV. You are also then hooked up to the monitor with a toco that documents the timing of your contractions and an US that displays the baby’s heartbeat. 

Things you need to know

Now you are basically tied down with 2 monitor wires and an IV line which makes it difficult to get out of the bed or even change positions. Unfortunately, this goes against one of the main aspects of efficient labor – that of free movement. Even L&D nurses are getting hip to Spinning Babies – a system of postures and movement that help the baby shift into the best relationship to the mother’s pelvis for a smooth birth.

You will likely have a cervical check once you’re all settled in, and you may or may not be asked for your permission. If you are not already 6 cm or do not achieve 6 cm within a couple of hours, the provider will likely want to start pitocin to speed things up. Again, you may or may not be asked permission for this. 

Induction process 

If you are there to be induced, sometimes they start with a cervical ripening agent. In south Florida, most providers use Cervidil which is a tampon-like insert that stays in the vagina for 12 hours. Some still use Cytotec which is ¼ of a pill that is less predictable than Cervidil and can cause strong contractions that come too frequently. It has been associated with fetal intolerance and uterine rupture. You have a right to decline this. Two hours after the Cervidil is finished and taken out, they will want to start the Pitocin and break your water bag.

Here comes the epidural

Once things get rolling, if you choose to get an epidural, the anesthesiologist or Registered Nurse anesthetist will come in to evaluate you, give you the risks and benefits of the procedure and forms to sign. If you are a good candidate for the procedure, they will ask everyone to leave the room, prep and drape you and place the epidural catheter. Afterwards, they lay you flat in the bed for about 20 minutes and then you will be able to sit up and turn side to side with help, but will no longer be allowed out of the bed.

It is not impossible to do some of the Spinning Babies postures while tied to the bed or with an epidural, but it is much harder and requires a dedicated doula or very motivated nurse to accomplish them.

Once you become fully dilated you may be asked to start pushing, even if you don’t feel ready. Alternatively, if your baby is high and you don’t have a strong urge to push (or have an epidural and can’t feel that urge) you may be allowed to ‘labor down’. This refers to the process of allowing the labor contractions to bring the baby’s head down through the birth canal so that the pushing phase can be much shorter. 

Let’s talk pushing + birth

Pushing in the hospital is typically more like an athletic event with everyone yelling at you to “PUUUUSH” and instructing you to hold your breath while you push for a count of 10. You will likely have your knees up in the air with someone helping you hold your legs back. There is a definite air of adrenaline inspired action and rush to get the baby out at this point. Once the head is born, you will be told to push again to effect birth of the body and the baby may or may not be placed on your belly. Typically the cord is cut shortly thereafter and then the baby is taken to the warmer to be stimulated and dried and “eyes and thighs” (eye ointment and Vitamin K shot) are done. The baby will then be swaddled in a receiving blanket and handed to you. Some L&Ds are supporting skin to skin with the parents and may not wrap the baby up before giving him back to you. 

That is a typical hospital labor and delivery scenario. There may be individual providers that do things slightly differently, but for the most part this is the way we do it in America.

Evidence Based Birth

In general, you are not asked permission for any of the procedures and interventions that are performed in the hospital. The general idea being that you have presented yourself there so you must be ok with whatever they feel is appropriate. The truth is that most of what is done in the hospital is NOT evidence based and you would significantly benefit from educating yourself on the different possible interventions (ask your provider what the typical birth scenario looks like to her). A web resource such as Evidence Based Birth is invaluable for expecting parents whether they’ve had a baby in the hospital or are expecting their first.

Interventions 

Another trend that I’ve witnessed is the trove of interventions that are performed on the newborn – especially if she is a premie. Our hospitals and hospital providers are making A LOT of money off the backs of our most precious and fragile resource – the next generation of human beings, who cannot speak for themselves. Please educate yourselves as parents and protect your little ones from these unnecessary interventions!

*As a nurse midwife who worked in the hospital Labor and Delivery units from 2005 – 2014, both as a Labor and Delivery nurse and as a CNM, I have had a substantial amount of experience seeing thousands of women and families come through to experience the birth of their babies. Since 2008, I have worked in my own home birth practice where we have periodic exposure to the hospital L&Ds with the clients that we transfer in for one reason or another. I have not seen many substantial changes happening for the process of hospital birth, other than perhaps a nod to the delayed cord clamping movement with a reluctant delay of a minute or two or milking of the cord in some cesareans (which is now thought to contribute to brain bleeds and not such a good idea). The only real change that has occurred has been the elimination of the regular newborn nursery, and this seems to have resulted in a greater number of babies being sent to the NICU – negating the potential positive outcome of having less babies experiencing separation from their parents.

Top Ways to Prepare for a Positive Birth Experience

The top ways to prepare for a positive labor and birth experience begin long before the actual labor starts. At Midwife360, we talk about our “Recipe for Success” when we are discussing a client’s birth plans. 

The core of our recommendations include self-education through reading books and online resources (see the reading and web organization list at the end of this article) and commitment to a healthy lifestyle through clean eating and regular exercise. We strongly advise eliminating processed foods, dairy, and inorganic foods. Through clean eating and regular exercise, it is likely that there will be an absence of disease processes such as diabetes and high blood pressure which can make a pregnancy cross the line into a truly high-risk status. If the pregnancy can be maintained in the low-risk status range, then recommendations such as induction of labor are more easily declined. 

Our “Recipe for Success”

Our “Recipe for Success” also includes hiring a doula and taking a deep meditation for labor course such as Blissborn or Hypnobabies. Many times the doula will be the one who teaches these courses. Doulas are invaluable as educational resources and typically have a wealth of information regarding comfort measures and labor preparation activities. They will meet with the client usually two times prenatally and will be the first to show up at the labor. They help with labor support if things are not progressing, and will let you know when to call the midwife or leave for the hospital. Meditation or hypnosis is a tool that can be used to cope with the surges of labor. It helps to keep the mind occupied with positive thoughts to allow the body to perform the work of releasing the baby unimpeded.

Positioning of the Baby 

The most common reason that labor doesn’t progress is the positioning of the baby. We recommend becoming familiar with an online resource called “Spinning Babies” that teaches postures that can be used prenatally to help ensure proper positioning of the baby in relation to the mother’s bony pelvis. This will ease the baby’s passage and create a more efficient labor process. Your doula will most likely be familiar with this resource and have the ability to guide you through the postures as well as know when to employ them in labor.

Using a Birth Tub 

The final recommendation in our “Recipe for Success” is to use a birth tub for labor and birth. The benefits of hydrotherapy have been recognized by midwives and laboring women for years. Some people call it a ‘liquid epidural’ as the sense of relief is so great when entering a warm tub of water in active labor. Sitting on a yoga ball or stool in the shower can have some of the same sense of relief, but immersion in water is better and helps lift the belly to remove the heaviness caused by gravity. Also, releasing the baby into the water helps with vaginal and perineal stretching and reduces tearing.

Visiting a Chiropractor and Acupuncturist 

In addition to the “Recipe”, we strongly recommend developing relationships with a chiropractor and acupuncturist who are skilled in caring for pregnant people. Get regular massages and take yoga classes or do yoga at home. All of these adjunctive therapies contribute to a body that is well adjusted and free from muscular and energetic blockages that can inhibit the passage of the baby when it’s time for birth. 

Preparing for a positive labor and birth experience ideally starts before pregnancy. However, with a determined mindset and a willingness to do the work, preparation for a positive experience can easily be accomplished in the 40 weeks of pregnancy. Decide where you want to give birth and hire a care provider that you trust. Check out the resources listed below and prepare to have an amazing, informed, respectful labor and birth experience!

Natural Birth After C-Section

Can I have a vaginal birth if I already had a c section?

The short answer is, “YES! YOU CAN!” While the long answer requires a conversation about various risks – risks of a VBAC, or vaginal birth after cesarean, AND risks of repeat surgery. Unfortunately, it is the second set of risks that are routinely left out of the conversation when you speak with a hospital provider (OB or CNM) about it. And, also, unfortunately, these same providers often offer the VBAC and then find a reason at the end of the pregnancy that either induction of labor is ‘necessary’ (not the best plan for a successful VBAC) or a repeat surgery if the pregnancy goes beyond 39 or 40 weeks. 

Where can I have a successful VBAC?

This drives many women to seek an out-of-hospital birth provider for their planned VBAC, even though everyone agrees that the hospital is the best place due to the easy and quick access to emergency services. Since VBAC is prohibited in Birth Centers, this leaves home birth as the only option. And home birth is not for everyone. It is certainly not the best idea for someone whose main reason for choosing it is to avoid the hospital. It is always better to run towards something rather than running away from something. In other words, the choice to have a home birth should be driven by the desire to have your baby in the comfort and safety of your home, not by the fear of the hospital.

Successful home birth requires dedication and preparation

We have seen a situation like this where the client chose to have her baby with us because of her fear of having another c section and her inability to find a hospital provider who would support her decision to birth vaginally. She did not have a doula or take a birth preparation class. (These are 2 of Midwife360’s 3 keys to successful, efficient birthing. The 3rd is using the birth tub.) Consequently, she was unprepared and unsure when her labor did start, and did not request the midwife presence in a timely manner. She birthed on the toilet and her baby actually went into the toilet! They had the midwife on the phone throughout the process and she was able to guide them verbally (the part about the toilet came out later!) and everything turned out well. 

This is an example of how normal the process is for most people – even those who have had previous c sections – and for most babies. Babies are resilient and born to survive and know how to start breathing with little to no help in most cases.

Most predictions by OB providers are wrong

“Your baby is breech, and even if it turns, your pelvis is too small to push. There’s an 80% chance you’ll have to have a c section if you try, and then it would be an emergency surgery, which is more dangerous. So let’s just schedule the c section as this will be safer.”

I’ve heard this same speech from many clients over the years. This particular client told us this story of her first birth – the baby turned out to be 5#5oz. When she got pregnant the second time, they said she would have to have another surgery – it would be safer, they said. “But my mom had a c section and then pushed my brother out right after – he was over 10# – can’t I at least try?” “No”, they said, “it’s not safe”. There was no discussion of the risks of surgery, all focus is on the risks of trying a vaginal birth.

You can do it!

When this woman got pregnant a third time, she knew that she could birth her baby vaginally. She drove an hour away from her home to find a provider that believed in her and would support her. And although she did not take advantage of the 3 keys to success, (she used the birth tub only), she was so determined and dedicated that she was able to adequately prepare herself mentally for the big day. She was able to birth an 8#3oz baby vaginally in the birth tub with her sisters, husband, mother-in-law, and daughters all present and cheering her on! She pushed for over 2 hours, but barely tore and the baby came out quickly with no problems.

Our bodies and our babies are made for birth

When will OB doctors and other birth providers stop telling women what their bodies cannot do? Women are created with the social imperative to create life and deliver it to the outside world. Among many other things, we are very well designed birthing machines! If you didn’t know this already, then you do now!

Be empowered, be informed, stand up for yourself and your baby!