Epidural anesthesia has become the most common form of pain medication for labor and birth, but it’s not for everyone.  Here are some common reasons an epidural might not be right for you:

1. Your Body Type: Sometimes, the doctor has no easy access to the epidural space. Factors that might make it difficult to find the right spot include obesity, scoliosis, scar tissue, unusual spinal archtecture or previous surgeries.
2. Drug interactions: Some medications, such as blood thinners, can make an epidural risky or ineffective.
3. Existing health issues: If you have a low platelet count, or other blood disorders, there is an increased risk of internal bleeding in the spine.
4. Timing: In some hospitals, anesthesiologists are available only at certain hours of the day, or certain days of the week. They may simply be busy and unavailable. Also, if you come into the hospital in advanced labor, or with a very quick labor, there might not be time to get an epidural in place.
5. Infection: If you have an infection on your back, you definitely don’t want your anesthesiologist putting a needle through that area.  It might cause the infection to spread to the spine and other areas of your body, which could lead to major problems.
6. Heavy bleeding or shock: Often, having an epidural lowers blood pressure. Therefor, if you are bleeding heavily or are suffering from shock, your already lowered blood pressure can make the situation even more dangerous.
7. Hospital restrictions: Some hospitals have policies about when you can have an epidural. Some stipulate that you must be at a certain point in labor (for example, four centimeters dilated) before an epidural can be given. Others may decide that epidural should not be given after a certain point of labor (for example when you’ve reached full dilation).

Source: About.com

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Did you have a birth that progressed so quickly that you couldn’t make it to your planned destination? Tell us about it!

Indybel Birthing Ball

1. Find a Soothing Environment

Your birth setting must feel safe to you. It should have space to walk and bathe, as well as a variety of options to enhance movement, comfort, and pain relief: a soft bed, CD player, rocking chair, birth ball, low stool, and/or squatting bar. It should also have policies that encourage you to try a variety of positions. Access to appropriate medical care is crucial if problems arise.

2. Choose Your Team Carefully

Knowledgeable, caring midwives, doctors, nurses, partners, loved ones and/or doulas create a supportive birth team. When you’re treated with respect and patience, stress and inhibitions decrease, and you can more easily find your best coping mechanisms.

3. Learn About Labor

The more knowledge you have, the fewer surprises you will experience. Find out everything you can about labor from books, magazines, Web sites, videos, classes, a hospital tour and discussions with your health-care provider, doula, family and friends. Familiarize yourself with the procedures and customs at your hospital or birth center. Such discussions are best had before labor.

4. Express Your Fears

Are you worried about pain and labor, needles, medicines or losing control? Speak with a knowledgeable and trusted friend, childbirth educator or doula. Voicing your concerns can bring relief as well as practical solutions to your concerns. Stating your preferences in a birth plan can also help calm fears.

5. Practice Rhythmic Breating

Breathe fully in a slow rhythm during contractions. Release tension with each exhalation and try moaning. Also try taking quick breaths, about one every 2 to 3 seconds (20 to 30 per minute). Your partner or birth coach may be able to help you keep your rhythm with eye contact, rhythmic hand or head movements, or by talking you through contractions.

6. Use Imagery and Visualization

Focusing on something that makes you happy (like your partner’s face, an inspirational picture or favorite object) engages your senses and decreases your awareness of pain. Listen to music, a soothing voice or a recording of ocean waves, and imagine yourself in a relaxing environment.

7. Take a Warm Shower or Bath

A warm shower is soothing, especially if you can sit on a stool and direct a handheld showerhead onto your abdomen or back. Bathing in warm water is relaxing, and it may even speed up labor.

8. Keep Moving

Move around as much as you can. Walk, lean, sway, rock and squat. Some positions will be more comfortable than others.

9. Seek Relief with Warm or Cool Compresses

Place a warm pack on your lower abdomen, groin, lower back or shoulders during labor. A cold pack or latex glove filled with ice chips can soothe painful areas. Cool cloths relieve a sweaty face, chest or neck.

10. Indulge in Gentle Touch or Massage

Have your partner or doula massage you in whatever way provides the most relief for you.  Whether it’s someone holding your hand, stroking your cheek or hair, or patting your hand or shoulder, touch conveys reassurance, caring and understanding.

Should men be allowed to witness their children’s birth?  This controversial question seems to be one that depends heavily on each spouse’s temerpament and ability to cope with pain and stress. While many women would never consider giving birth without their husbands, there must be many more who wish he wasn’t there. Conversely, while some dads would be devastated at missing the birth of their child, there are others who would secretly breath a huge sigh of relief at being excluded.

“Barely survived the delivery” Tshirt by Zazzle

I came across a very interesting article by Michel Odent, a top obstetrician, on why men should NEVER be at the birth of their child. You can take a look at it here, and it is an interesting read, whether or not you agree with him.

Dr. Odent states: Having been involved in childbirth for 50 years, and having been in charge of 15,000 births, I have reached the stage where I feel it is time to state what I – and many midwives and fellow obstetricians – privately consider the obvious… That there is little good to come for either sex from having a man at the birth of a child.

Personally, I have delivered two babies in the presence of my husband, and was a wonderful source of support and comfort to me. I also think it was a positive experience for him (although maybe I’ll ask him about that later, just to clarify!).  Then again, I gave birth in relative comfort (I have to say I love that epidural) but I’m sure it would have been a much more stressful experience for both of us if I’d done it without.

Dr. Odent talks about his observations as to why it is better that husbands stay out of the delivery room, and let their wives birth in peace. The phenomena of men being present at childbirth is relatively recent, beginning in the 70’s, as more and more women started to give birth in the hospital. Up until that point, it was mainly a woman’s event, with the mother surrounded by other women including her mother, aunts, sisters, or midwives. The husband was left to boil the water, pace the hallway, and smoke his pipe.

Although there is a lack of scientific study on this subject, Dr. Odent has observed that often men are a hindrance to the ease of his wife’s labor, causing it to be are longer, more painful and more likely to result in intervention.

This may be for two reasons. One, a woman in labour needs to be in a quiet, private world where she doesn’t have to think or talk.  When she tries to “share the experience”, with her husband, the focus is taken off her personal experience and directed toward including, intuiting, and often soothing, her husband.  This complicates the process.

The second reason is that, quite naturally, the sight of his wife in pain causes dad to release the stress hormone adrenaline.  No matter how much he tries to appear relaxed and positive, he cannot help but feel anxious.  And anxiety, even hidden under a reassuring smile, is contagious. His tension prevents the woman from being as relaxed as she needs to be during labor, making the process longer and more difficult.

Then there is the affect that childbirth has on the father. No doubt the miracle of childbirth is something beautiful and uplifting, a family bonding experience that some men wouldn’t give up for anything.

But for others, the experience may be more traumatic than they’ll admit. Dr. Odent  says that over the years he has seen something akin to post-natal depression in many men who have been present at the birth.  This will cause them to exhibit strange behaviors, like take to bed for a week after the baby is born, leaving their wives to care for the newborn. Or, they may try to escape to the golf course or local bar.  In extreme cases, the experience may even cause deeper psychological damage, or lead to divorce or the father abandoning his family.

One last point that Dr. Odent makes, is that there are some things we prefer to do in private, in order to preserve a degree of modesty and mystery.”And,” adds Dr. Odent, “For the benefit of our sex lives, it may be worth adding childbirth to this list.”  I don’t think I need to elaborate on this point…

He sums it up by saying, “It is time to go back to basics, and turn modern convention on its head.  When it comes to the delivery suite, men would be well advised to stay away.”

These observations are based on one man’s personal experiences, and not on large scientific studies. But it doe give you something to think about! What’s your opinion?

As the experts at theCradle point out, “Something you wouldn’t think twice about doing under ordinary circumstances will be remembered as appalling if you do it during labor. No one wants to be the guy that’s remembered for taking a call from his stockbroker while his wife was in labor.”

Here are some tips from the authors of Don’t Just Stand There: How to Be Helpful, Clued-In, Supportive, Engaged & Relevant in the Delivery Room (via theCradle).

In the womb, a baby’s lungs are filled with fluid, and it receives oxygen through the umbilical cord. When the infant is born, the placenta and cord continue to pulse, delivering a burst of blood volume to the infant’s system. This blood is needed to help the the lungs of the newborn to expand.  According to this startling article, Are Doctors Causing Infant Brain Damage by Clamping the Umbilical Cord Prematurely?–

Without the burst of blood from the placenta, the infant suffers a drop in blood pressure as its lungs fail to open as they should, creating a chain reaction of effects that can include brain damage and lung damage. Immediate cord clamping can cause hypotension, hypovolemia and infant anemia, resulting in cognitive deficits. Some have even theorized that the rise in autism could be linked at least in part to early cord clamping.

image from Mayo Clinic

Interestingly, the umbilical cord, if left intact, actually “clamps” itself in as little as five minutes. Wikipedia explains that shortly after birth, the reduction in temperature starts a physiological process which causes the Wharton’s jelly (that’s what the cord is made of) to swell and collapse the blood vessels within. This, in effect, creates a natural clamp, halting the flow of blood.

According to Dr. Mercola, the time between between birth and natural clamping, allows blood to flow from the placenta through the baby’s lungs. The natural process protects the baby’s brain by providing a continuous oxygen supply until the lungs are functioning well. While most full-term babies have enough blood to establish lung function and prevent brain damage, the early clamping can still leave them weak, pale, and gasping for air. For premature babies, the process can be even more devastating.

Immediate cord clamping could possibly be linked to:

• Brain hemorrhage
• Respiratory distress
• Autism
• Cerebral Palsy
• Anemia
• Brain injury
• Learning disorders
• Behavioral disorders

On the flip side, G. M. Morley asserts that “the child which is delivered without the use of a cord clamp receives a full placental transfusion with enough iron to prevent anemia for the firs year of life… this is only a reflection of how much of the infant’s blood volume was left clamped in its placenta. ” (Read more here.)

Today there is no consensus about the optimal time to clamp the umbilical cord after birth. But I think it’s interesting to note the observations of Erasmus Darwin (Charles Darwin’s grandfather) from 200 years ago:

“Another thing very injurious to the child, is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases.

As otherwise the child is much weaker than it ought to be, a portion of the blood being left in the placenta, which ought to have been in the child.”

Moving forward, this 1963 Time article suggests that there are sound reasons for a slowdown in cutting the umbilical cord. It is based on a study by a group of pediatricians from the University of California:

The California pediatricians base their theory on a study of 129 infants. Among 41 whose umbilical cords were clamped before they took their second breath, 21 showed moderate to severe respiratory distress. In another group of 52 infants whose umbilicals had been clamped some time after the second breath, only six suffered the same symptoms. The condition of the infants who retained their umbilical cords longest was by far the best.

Given the overwhelming research about the potential harms of early cord clamping, both the World Health Organization and the International Federation of Gynecology and Obstetrics (FIGO) have dropped the practice from their guidelines. (Mercola) But it is still widely done in the United States and other developed countries, which I find hard to understand.

Syphilis develops in three stages. The first state, primary syphilis, is characterized by an open sore called a chancre, which usually appears on the genitals, either internally or externally. If untreated, the disease can progress to secondary syphilis and tertiary syphilis. Other symptoms include fever, sore throat, a rash, hair loss and swollen glands. In its final stage, syphilis can cause dementia, blindness and damage to the nervous system.

How Would I Catch Syphilis?

The bacterium that causes syphilis can be acquired through sexual intercourse (the most common method), kissing, passage from mother to fetus through the placenta, blood transfusion or accidental contact with an infected lesion. (Your Total Health)

Syphilis During Pregnancy

Syphilis is extremely dangerous for a fetus, who can contract the disease through the placenta that nourishes it. It can cause miscarriage and result in a stillborn birth. It can be also transmitted to your baby through vaginal birth and possibly through a cesarean section.  Congenital syphilis can have some very severe symptoms, although they may not appear right away.

False Positive Lab Tests

If you do test positive for syphilis, don’t panic! NO TEST IS 100 PERCENT ACCURATE. According to Lab Tests Online, screening tests for syphilis are not highly specific, and a false positive result is quite common. The VDRL has a high sensitivity but low specificity, and is used as a screening test. Today, treponemal FTA-ABS or MHA-TP tests,with high specificity and sensitivity, are used to confirm the results.

How is Syphilis Treated?

Syphilis is treated with penicillin (PenVK), which is considered safe in pregnancy. t is not common for a fetus to be infected before the fourth month, so testing and treatment should be done as soon as possible. If you have a history of penicillin allergy, you should undergo skin testing. If skin tests are positive, you will be ” desensitized” and then treated with penicillin.

A baby that is born with syphilis will also be given penicillin injections to fight the bacteria.

If your tests keep coming up positive, even without any physical signs of syphilis, your doctor may recommend treating you with penicillin, just to be on the safe side.

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I know that breastfeeding causes many problems for new mothers, including painful, bleeding nipples, infections, and babies who don’t seem to be getting enough milk. Breastfeeding also requires quite a time commitment, especially for working mothers who need to pump or take time off to feed their baby. It’s not always simple, for many reasons that are personal to each individual woman. I  had a hard time in the beginning, and have had many friends and family members who were so frustrated they’ve given up breastfeeding altogether.  But I also think that the benefits of breastfeeding are NOT widely known, so if you’re on the fence about breastfeeding, here’s another list of reasons to remind you why nursing your baby is one of the greatest things you can be doing for him/her!

image from HerDaily: Breastfeeding increases IQ

1. Breastfeeding Builds Your Baby’s Immune System

Newborns do not have a mature immune system to protect them from illness. Antibodies, or immune molecules, in a mother’s breast milk are transferred to the baby, giving them immunities to illnesses that the mother is immune to.  Beyond that, if your newborn is exposed to a germ, she will transfer it back to the mother while nursing. The mother’s body will then make antibodies to that particular germ and transfer them back to the baby at the next feeding.

Studies have also shown that babies who are breastfed exclusively have better functioning immune systems in the long-term as well.

Formula-fed babies have higher rates of:

• Middle ear infections
• Pneumonia
• Gastroenteritis (stomach flu)
• Urinary tract infections
• Necrotizing enterocolitis, a digestive tract disorder that is a leading killer of premature infants

Breastfed infants have added protection against:

• Heart disease
• Immune system cancers such as lymphoma
• Bowel diseases such as Crohn’s disease
• Juvenile rheumatoid arthritis
• Asthma and allergies
• Respiratory infections
• Eczema
• Type 1 and type 2 diabetes

2. Breastfeeding Improves Baby’s Brain Function

Breast milk is not only good for the newborn’s immune system, it is also good for the brain. Breastfed infants tend to have higher intelligence than formula-fed infants. This may be due to certain compounds found in breast milk, including omega-3 fatty acids.

For instance, one study found that the verbal IQ of 7- and 8-year-old children who had been breastfed was about 10 points higher than those who were not. Another 18-year study of over 1,000 children found that those who were breastfed had higher intelligence and greater academic achievement than children who were formula-fed as babies.

It is interesting to note that babies who are breastfed naturally spend more time in what is known as the “quiet alert” state, which is not only soothing for parents but also it is the state most conducive to the newborn’s learning.

3. Breastfeeding Reduces Obesity

Breast milk contains a protein that could reduce the risk of obesity later in life. In fact, the longer a child is breastfed, the lower their risk of obesity, according to a study by U.S. researchers. The protein affects the body’s processing of fat.

4. Breastfeeding Helps Babies Emotionally

Babies have an intense need to be held and one of the most comforting things for a newborn is the physical act of nursing. Leaving a baby alone with a bottle is not emotionally satisfying to the child and does not make them feel safe or secure.

Breastfeeding also promotes bonding between mother and baby in a way that bottle-feeding cannot. Most women naturally feel a strong desire to hold their baby and there are physical and emotional reasons for this. Breastfeeding ensures that mother and baby have some intimate time together and actually stimulates the mother’s release of the oxytocin hormone, which is known to promote maternal behavior.

5. Reduces Mom’s Risk of Cancer and Other Health Conditions

Breastfeeding is a mutually beneficial experience in that it helps both mother and child. Women who breastfeed have a reduced risk of breast and ovarian cancers and osteoporosis later in life.

6. Moms Return to Pre-Pregnancy Weight Faster

Breastfeeding women lose weight faster than those who do not. This is because producing milk and breastfeeding requires about 500 calories per day. This is the equivalent of jogging about five miles! Breastfeeding also stimulates contractions in the uterus that help it to shrink back to its normal, pre-pregnancy size faster. It also helps to reduce lower body fat.

7. Save Time and Money

Of course, your primary reason for wanting to breastfeed is for your baby, but the more material advantages of breastfeeding are hard to ignore. If you breastfeed you don’t have to prepare bottles and formula–breast milk is always fresh and ready to go. This will save you a substantial amount of time at a period in your life when you will need it!

Breastfeeding also saves you the expense of buying formula, which typically costs at least $800 per year. The savings continue to accumulate as your child grows, as breastfed babies tend to have fewer doctor’s visits and lower overall medical expenses. One study even found that a group of formula-fed babies had over $68,000 in health care costs for six months, compared to only $4,000 for the breastfed group.

From: Seven Reasons to Breastfeed Your Child That You Need to Know

More info: Breastfeeding A-Z Index

One thing I want to share about the birth is what got me through… is the TENS machine. It was fabbbbulous!!!! I highly recommend it, but no one seems to know about it – so please look into it, and know that it was amazing for me!!! www.bodyclock.net or www.babycaretens.com

Actually, this is not the first time I’ve heard about the TENS machine, but I didn’t know much about it so I took a look around online to find out more.  If it’s something you want to use for your childbirth (or any other type of pain management) you can buy or rent one online, as most hospitals do not provide a TENS machine.

What is a TENS Machine?

TENS (Transcutaneous Electrical Nerve Stimulation) machine is a small box with a clip that attaches to your clothes. There are four pads with electrodes connected by wires to a battery operated pulsar. The pads are smeared wtih gel (to ensure the best connection) and stuck onto your back (2 below your bra line and 2 above the panty line). Using a hand held control, you give yourself weak electric currents which then travel through to the points where you have the electrodes.  You control the frequency and strength of the pulses using dials on the machine. There’s also a “boost button” when you want maximum output from the machine to help you with a difficult contraction.

The pulses of electricity feel sort of like “pins and needles” and help combat pain during childbirth.

How does a TENS machine work?

It is unclear exactly how TENS works, although there are a number of theories. The stimulation from a TENS machine is thought to affects the way pain signals are sent to the brain. Pain signals reach the brain via sensory nerves and the spinal cord, which are blocked by electrical pulses. Another theory is that they electric currents stimulate your body to produce higher levels of its own natural pain killers called ‘endorphins’ .

TENS also gives you a feeling of control over your contractions, which helps you feel more relaxed and less anxious, and may provide a distraction from the pain.

When to use the TENS Machine

It takes about an hour for your body to respond to the electrical impulses by releasing endorphins, so it’s best to start using it as soon as regular contractions (or backache) begins.

Start at the lowest setting, and turn it up gradually as your contractions gets stronger. Use the “boost button” at the peak of contractions.

The benefits of using  TENS machines include:

• It is totally natural, safe, and drug free.
• You are in control.
• It is portable, so you remain mobile while using it.
• It allows you to use other drugs simultaneously.
• It is every effective if used from the onset of labor.
• Once the correct strength of the current has been set, the effects can be felt immediately.
• There are no side effects for you or your baby.
• It can be used at a home birth with no need for a doctor’s or midwife’s supervision.

There are some minor disadvantages to using a TENS machine:

• You will need someone to help you put the pads on.
• It only helps if begun during early stages of labor
• It may have to be removed if your baby’s heart has to be monitored electronically
• TENS cannot be used in water, so you need to remove it to use a birthing pool or take a bath.
• It pads get in the way if you want a massage, which can also be an effective form of pain relief.

You can use if AFTER labor too!

You can use your machine for:

• shoulder pain from breast feeding
• menstrual pain
• back pain
• after pains (as your uterus contracts back to its normal size)
• post-operative pain following a caesarian section

feature image from BodyClock

Here are some signs to watch for that tell you labor is near!

1. Dropping. Some time during the final few weeks you may notice that your baby has moved down lower in your abdomen. Most first-timers notice their babies dropping within two weeks of delivery, though some mothers “drop” as many as four weeks before D-day. Second-time mothers often find their babies do not drop lower until labor begins, because mom’s pelvic muscles have already been stretched, and no warm-up is needed. Baby’s head settling into the pelvis is also called “lightening” (because the lower-riding load seems smaller and lighter) or “engagement” (since baby’s head engages the pelvic opening). Whether baby “drops,” “lightens,” or “engages,” you will feel and look different. Your breasts probably no longer touch the top of your abdomen. You might be able to sense baby’s head resting just beneath the middle of your pelvic bone.

2. Frequent urination. Now that baby’s head lies closer to your bladder you may be going to the bathroom more often.

3. Low backache. As baby gets heavier and drops lower, count on some aches or pains in your lower back and pelvis as your uterine and pelvic ligaments are stretched even more.

4. Stronger Braxton-Hicks contractions. You may notice that your warm- up contractions go from feeling uncomfortable to being rather painful like menstrual cramps. Even though these prelabor contractions are not as strong as labor contractions, they are strong enough to be starting the work of thinning out, or effacing, your cervix from a thick-walled cone to a thin-walled cup. While these contractions will get even stronger just prior to labor, they can continue this way, on and off, for a week or two before labor starts. They become less intense when you change position or start walking.

5. Diarrhea. Birth hormones acting on your intestines may cause abdominal cramps and loose, frequent bowel movements — nature’s enema, emptying your intestines to make more room for baby’s passage. Those same hormones can also make you feel nauseated.

6. Increased vaginal discharge. You may notice more egg white or pink- tinged vaginal discharge. This differs from the “bloody show.”

7. Bloody show. The combination of baby’s head descending into the pelvic cavity and the prelabor contractions thinning the cervix can “uncork” the mucus plug that previously sealed the cervix. The consistency of this mucus varies from stringy to thick and gooey. Some women notice the one-time passing of an obvious mucus plug; others simply notice increased blood-tinged vaginal discharge. Some of the tiny blood vessels in your cervix break as your cervix thins, so you may see anything from a pink to a brownish-red-tinged teaspoonful of bloody mucous. If your discharge shows more blood than mucus – like a menstrual period or a lot of bright-red blood — report this to your practitioner immediately. Once you notice a bloody show, you are likely to begin labor within three days, but some mothers hang on for another week or two.

8. Bag of waters breaking. Only 1 in 10 mothers experience their bag of waters breaking prior to labor. For most mothers this doesn’t happen until they are well into labor. If your water breaks before labor has started, plan on your labor starting intensely within the next few minutes or hours, or at least within the next day.

For more labor and childbirth information, please visit Dr. Sears.

Feature image from Real Simple.