O is for Obstetrician

Tips On Choosing An Obstetrician

An obstetrician, also commonly called an OB/GYN, usually offers a variety of women’s health services, such as annual Pap tests. Obstetricians are also trained to manage complications during pregnancy, birth, and postpartum.

What is an Obstetrician?

An obstetrician is a medical doctor who specializes in the management of pregnancy, labor and birth. They also receive specialized education in the area of the female reproductive system and surgical care. Much of their education focuses on the detection and management of obstetrical and gynecological problems.

Find an Ob/Gyn in Your Area

What services do Obstetricians provide?

The services offered may vary depending on the specialty and advanced training of the OB/GYN. Some physicians choose to practice only obstetrics; others may choose to practice only gynecology. Most OB/GYNs choose to practice both specialties and offer a variety of services.

These services may include:

Where do Obstetricians practice?

Many obstetricians practice in a private office, with or without a group of physicians. They may also practice in a hospital or clinic setting. Some experienced OB/GYNs maintain teaching positions at university hospitals.

How are Obstetricians trained?

Obstetricians must complete the requirements set by the American Board of Obstetrics and Gynecology (ABOG).

The requirements include:

  • Graduation from approved medical school
  • Completion of four years of residency training that includes: obstetrics, gynecology, gynecologic oncology, ultrasonography, and preventive care

After completing the residency training, OB/GYNs must pass a test administered by the American Board of Obstetrics and Gynecology (ABOG) to be board certified. Some OB/GYNs may choose to further pursue a sub-specialty such as infertility or maternal/fetal medicine.

What are the advantages of using an Obstetrician?

One reason many women choose an obstetrician for their pregnancy is because they are comfortable with their current OB/GYN. Other women choose to use an OB/GYN because they are experiencing a high risk pregnancy.

Some possible benefits to using an OB/GYN include:

What are the disadvantages of using an Obstetrician?

Approximately 60-80% of women experience a low risk pregnancy. Using an obstetrician may be a disadvantage if you desire a more natural, hands off approach to pregnancy and childbirth. Obstetricians are trained to manage complications using many medical interventions.

Some possible disadvantages to using an OB/GYN include:

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http://americanpregnancy.org/planning/choosing-an-obstetrician/

N is for Natural Birth

How To Have A Natural Birth

Congratulations! You’re pregnant and considering going natural!

But how can you make that a reality?

After all, you’re going against the grain with this decision. The system isn’t exactly set up for natural birth. You may not have a lot of supportive people around you. In fact, you may not know anyone who’s chosen a natural birth at all.

Is there even a midwife practice in your town? And, to that end, do you needa midwife? Or is it possible to go natural in a hospital?

Don’t worry, we’ve got your back. If you’re pregnant, or hoping to become pregnant, and want a natural birth, here are things you can do to help make that happen.

Step 1: Commit

Most women don’t just stumble into a natural birth. It takes determination and commitment.

Birth never happens exactly how you plan, so it’s good to be open to changing plans when need be. However, going into labor without fully committing to an unmedicated birth will make it hard to resist when the going gets tough and nurses are offering medication.

Knowing exactly why you want to avoid medication will be your driving force when labor gets tough.

Step 2: Prepare your mind and body

Labor and birth are their own kind of marathon, and just like you wouldn’t show up to run a marathon without training, you don’t want to show up to birth unprepared.

Labor is a very physical journey, and exercise will help keep you strong. Walking, swimming, and yoga are great ways to prepare for birth by keeping your body strong and pelvis open.

Sitting for many hours a day, as many of us do at work, is not the best thing for getting baby in an optimal birth position. If your pelvis is tight, baby may settle into your pelvis in a posterior position which can cause long labor and painful back labor.

There are some things you can do to help avoid a posterior baby including belly mapping, daily stretching and exercise, prenatal yoga, and just getting up and walking around every so often when you’re at work. It’s also important to avoid sitting in reclined positions like in big comfy chairs and sofas. Sitting on a birth ball is a great alternative.

What you eat while pregnant is what is creating your baby, so it’s vital to eat a high nutrient, real food diet. Be sure to eat enough quality protein, salt, and vegetables. Choose foods from different color groups (called eating the rainbow) so you can be sure you are getting what you and baby need.

Labor is also a mental, emotional, and spiritual journey. Many mamas have found that practicing mindfulness, prayer, or daily affirmations help them connect to their baby and prepare mentally for the birth they are going to experience together.

Step 3: Get a Doula

A doula is a professionally trained birth attendant who will meet with you throughout your pregnancy to establish a relationship, she’ll be with you and coach you throughout your entire labor, and will follow up with breastfeeding and newborn care. Doulas are seriously birth angels.

Women who have doulas are more likely to have spontaneous vaginal births and less likely to have:

  • Pain meds
  • Epidurals
  • Forcep or vacuum assisted births
  • C-sections
  • Negative feelings about childbirth

(Source)

Other benefits of hiring a doula include:

  • Higher breastfeeding success
  • Higher maternal self esteem
  • Lower blood pressure during labor
  • Lower pain experienced overall

The best way to find a Doula in your area is at doulamatch.net. When interviewing for a Doula make sure you choose someone you feel comfortable with. Here’s a list of doula interview questions.

Oftentimes it’s just a gut feeling about someone. She will see you at your most vulnerable during an incredibly intimate experience, so you will want to be sure you feel comfortable with her. Consider your own style during stress. Do you prefer to be left alone? Do you want someone to continuously encourage you? Would you like a doula who has massage or acupressure training? Choose someone who’s strengths match your needs.

Even if you have an amazing partner, a doula is still a great asset. Your doula knows birth and your partner knows you. Together they are a great team. Your doula will help your partner to help you, and will help your partner to take care of himself  as well. Some men feel a little uncertain about how a doula fits into the mix but, believe me, it’s a win-win.

The cost of a Doula becomes negligible when you consider how much more expensive an epidural or a c-section is. Not to mention the emotional toll those things would take when you are hoping and planning for a natural birth.

Step 4: Pick your provider

When choosing your provider you have 4 options:

  • OB/GYN – Traditional route. These providers are the least likely to be low intervention.
  • Family physician – Tend to be more holistic. Will be able to care for you and your baby after birth.
  • Certified Professional Midwives (CPM) – Are midwives, not nurses; they’re only licensed in some states.
  • Certified Nurse Midwives (CNM) – Nurses who have additional midwifery training.

When choosing a provider, interview a few candidates. When you ask them questions, you want numbers and percentages. If they don’t know or can’t tell you, that’s a good sign to look somewhere else.

Some important questions are:

  • What is your c-section rate?
  • How many women have unmedicated births (don’t say natural because providers have different definitions)?
  • What if my water breaks and I haven’t gone into labor yet?
  • What happens if I go overdue?

Here’s an expanded list of midwife interview questions, and here is an explanation of types of midwives.

Who is the safest provider?

Evidence shows that midwives are the safest providers for low risk women, because they result in fewer interventions and better health outcomes for mom and baby (source). For example, midwives in the U.S. have an average 5-20% c-section rate (depending largely on location of the delivery), while U.S. OB’s have closer to a 33% c-section rate.

However, some people have a hard time leaving a doctor they like. Some women really like their doctor because he or she is nice and has a good bedside manner. But unless she is also natural birth literate, she may not be the best choice. Keep in mind, you can always return to this trusted provider for your well woman care after you deliver your baby.

If you are choosing a doctor, be sure that the other doctors in their practice are aligned. When women only meet with one doctor, they sometimes assume all the doctors in the practice are on the same page, which is seldom the case. Some women just hope they’ll get the doctor they like when the big day comes, which is taking a huge risk.

Another reason it’s important to be sure that all of the doctors are natural birth literate is because if they aren’t, some women are tempted to accept an induction when their preferred doctor is on call. This isn’t the best option when you’re seeking a natural childbirth because one intervention, like induction, usually leads to more. Not to mention, induction can be a lengthy process for a first time mother, so even guaranteeing your doctor would be there for the induction is its entirety is unlikely. Here is more info on labor interventions during childbirth.

Some doctors are lower intervention but work in hospitals with high c-section rates or that aren’t baby friendly. Interview a few providers, but also look at where they practice and compare those locations too.

Call the hospital that your doctor practices at and ask the same questions as above. If they don’t know, it’s not a good sign. Consider looking elsewhere.

And remember that it’s never too late to switch providers! This is one of the most important experiences of your life, and you should choose someone who will help you achieve the natural birth you desire.

Step 5: Pick your birth place

Choosing a birth place is just as important as choosing your provider. You have 3 choices.

Hospital

A great place for a woman who anticipates needing more interventions. There’s a hospital bed, monitors, oxygen, etc. on the walls, fluorescent lights, baby warmer, so, not so cozy. The hospital is the only place you can have a cesarean or get pain medication. If you’re having multiples, have significant health problems, or otherwise have a high risk pregnancy, this is exactly where you want to be for you and your baby’s health and safety. And keep in mind, just because interventions are available doesn’t mean they have to be a routine part of your care.

Birth center

A birth center is like giving birth at someone else’s home. Birth centers are comfy environments, usually with a large bed, and a warm homey feel. They contain medical equipment, but it’s usually hidden away out of sight. Birth centers can provide some interventions but not many, and their safety rests on the premise that if a mother deviates significantly from what is normal and healthy during the course of her pregnancy or labor, she will be transferred to the hospital to give birth there. However, low risk women tend not to need many interventions, and the vast majority of complications during pregnancy and birth come with some forewarning, so emergent transfers are extremely rare.

Many hospitals have caught on that birth centers are popular so they are calling their labor and delivery units “birth centers.” Check to make sure your birth center is run by midwives and is accredited by the Commission for Accreditation of Birth Centers.

Home

At a home birth, midwives bring the same equipment that is at the birth center. They have a plan for transfer of care in case something comes up during pregnancy or labor. However, transfers are rare. Birth usually happens smoothly on it’s own when it’s left to just happen. Home birth midwives are skilled at categorizing women as low risk or high risk, so they only take women into their care who are good candidates for home birth.

Which is the safest?

The safest place for low-risk women to give birth is at a birth center (source). Birth centers are run by midwives who are the safest providers for pregnant women and have the lowest intervention rate and best outcomes for mom and baby. They have the environment of home, but also have some of the equipment of a hospital. They are usually located close to a hospital for practical reasons, so a transfer will be quick if needed.

That being said, if you need to or want to give birth at a hospital, that doesn’t mean you can’t have a natural birth. It’s possible to have a natural hospital birth, it just takes some extra preparation on your part.

Step 6: Know the benefit and risk of each intervention

You already know that the cascade of interventions is something you want to avoid if possible, but how do you know when an intervention is necessary?

Well, first, you need to ask, “Is this an emergency, or do we have time to talk about it.” Usually it is not an emergency and there is time to talk.

Then you can talk to your partner and doula and run the intervention through your B.R.A.I.N.

B.R.A.I.N.  is an acronym for:

  • Benefits
  • Risks
  • Alternative
  • Intuition
  • No/not now

SaveMama NaturalCongratulations! You're pregnant and considering natural birth! Here's a step by step guide to making your dreams of natural childbirth a reality. http://www.mamanatural.com/how-to-have-a-natural-birth/14Mama NaturalMama Natural  Blog Posts

Let’s run an example: Pitocin.

Benefits: Can help increase the chances of a vaginal birth when your uterus becomes exhausted.

Risks: Pitocin can cause contractions that are longer stronger and closer together than your body would normally do. This can cause fetal distress which can lead to a c-section.

Pitocin also automatically comes with other interventions like continuous fetal monitoring, which can keep you from moving around and getting more comfortable. Sometimes women who otherwise didn’t plan on getting an epidural end up getting one because they can’t handle the stronger, closer contractions, especially when they aren’t able to move around fully.

Alternatives: Wait it out. Labor is not linear and can ebb and flow. As long as you and baby are doing ok, you can wait. Breaking the bag of water and nipple stimulation are other ways to get labor going without Pitocin.

Intuition: After thinking through the benefits, risks and alternatives check in with your gut. What is it telling you? Sometimes women have a strong reaction and just know.

No/not now: Declining an intervention. If you choose to decline an intervention start by validation your providers concerns and give them your plan for how to proceed. for example: “I know you’re concerned that my cervix hasn’t dilated more. Since baby and I are doing fine we would like to wait a while before starting Pitocin. Can you come back in an hour and we can talk about it again?”

 

Step 7: Attend a natural birth class

A natural childbirth education class is key in helping you and your partner prepare your mind, body, and spirit for a natural childbirth. A good class will demystify the process, teach you how to prepare, and equip you and your partner with information on what to do during various stages of labor. It’s a great way to reduce stress about birth and become empowered to give birth naturally.

Be sure to choose an out-of-hospital birth class!

This is important because many hospital birth classes are geared more toward how to be a good patient as opposed to really understanding your birth options.

A natural birth class will arm you with the information you need to make the best decisions for you and your family. It will help you prepare for natural birth and make informed choices if at some point in your labor you are confronted with a need for interventions

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https://www.mamanatural.com/how-to-have-a-natural-birth/

Perselle Baby.JPG

M is for Meconium

10 Things You Never Knew About Meconium

Think dark, gross, and sometimes dangerous. Here's what you need to know meconium.

1. It's poop! Meconium is a fancy name for a newborn infant's first stool.

2. There's hair in there. The very first poop your baby passes doesn't contain breast milk or formula just yet. Instead, it's jam-packed with materials your baby ingested in utero, like skin cells that have been shed, mucus, amniotic fluid, bile, water, and lanugo, which is the fine, soft hair that covers baby's body.

3. It's greenish black. Baby's first BM is viscous and sticky, thick, and a super-dark (almost black) greenish black. Essentially, your newborn's poop is greenish black tar.

4. There's no stink. It's disgusting, for sure, but it carries no vile aroma. Win!

5. It clings to baby's skin. Thanks to meconium's high viscosity, it can cling to your baby's buns (and, let's face it, back) like nobody's business. The trick to an easy cleanup is to apply a thin coat of petroleum jelly to your newborn's clean dry skin before the poop flies. This pre-poop lube helps the meconium slide off with minimum elbow grease.

6. It's sterile. It's believed that the very first stool to leave your newborn is free of bacteria because her teeny intestines have yet to be colonized by microorganisms.

7. It doesn't last long. By definition, a baby's first poops can't stick around for too long. Generally, infants continue to pass meconium over the first day or so. Next up: greenish-brown poop, followed by yellow-y stuff that smells bad and has the consistency of diluted Dijon mustard. (Breastfed babies' BM may also have small white bits that resemble seeds.)

8. It can be passed in utero. Up to 25 percent of newborns simply can't wait to have their first poop and do it in the womb—or on their way out. This pre-birth poop taints the color of the amniotic fluid, which gives health-care pros a heads-up that meconium has passed. The doc or midwife can then monitor the baby carefully to ensure that he doesn't develop any complications.

9. There's an inhalation risk. When poop is passed in the womb, there's always a chance your unborn baby will inhale it. This complication, dubbed meconium aspiration syndrome (MAS), is rare in babies born before 34 weeks. But once your baby is overdue, her risk ekes up. MAS can also happen before, during, or after labor and delivery, when a newborn inhales a mixture of meconium and amniotic fluid, which can partially or completely block the airways.

10. It may thwart your water birth. While there are no hard-and-fast rules about laboring in a tub after meconium is present, many pros will put the kibosh on the practice. The reason: Your birthing team will want immediate access to your baby to be able to clear his airways if needed.

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L is for Lochia

Lochia or Postpartum Bleeding (aka the Longest Period of Your Life)

Mothers enter what has been referred to endearingly as “The Fourth Trimester,” a magical time when baby and mama continue almost as one. Baby sleeps and feeds; mama rests and recovers. But you know what isn’t as magical? Having the longest period of your life! This bloody flow is called lochiawhich comes from the Greek word lokheíos, meaning “of childbirth.” 

What Is Lochia?

Lochia is a combination of blood, placental tissue, mucus, cells, and bacteria coming from the wound that occurred when your placenta tore away from your uterine wall.

Why Does Lochia Happen?

Lochia is part of your postpartum healing process, whether you give birth vaginally or by cesarean section.

During pregnancy, your uterus expands, thickens, and softens to house 500x more than its usual capacity.

It basically goes from a cupboard to a luxury condo; and that’s a lot of building material! Your body also grows an entirely new organ: the placenta.

After all this miraculous growth, the luxury-condo-uterus needs to shed a few pounds and get back into cupboard-shape. Following birth, contractions push out the placenta, shrink the wound where the placenta grew, and begin the process of shedding the extra “padding.”

The uterus returns to its usual size and weight in about six to eight weeks. Congrats, uterus, you fit-tastic female organ! Those six weeks, however, require care and patience as you experience period-like discharge.

What Should I Expect?

Since the lochia stages vary woman to woman, the most important thing to remember is that lochia should taper off in volume and brightness. Volume should go from heavy to light to spotting. Color should go from red with some clots to pink/brown to yellowish white. This process can take anywhere between 4-8 weeks.

(FYI, moms who gave birth to twins or triplets will generally have longer and heavier lochia periods.)

How Long Do You Bleed After You Have a Baby?

You’ll go through three normal stages of lochia:

Stage 1: Lochia rubra — First 2-4 days after delivery

  • Significant cramping as your uterus starts to shrink in size; this is especially true if you breastfeed since nursing releases oxytocin, the love hormone that also helps to contract the uterus.
  • Blood will be bright red in color and similar to a very heavy menstrual flow.
  • You may also see blood clots, mucus, and tissue in the discharge of your vagina. (Contact your provider if you see blood clots bigger than a golf ball or you soak through a large menstrual pad every hour.)

Stage 2: Lochia serosa — Starts about day 4 and lasts a week or two

  • Blood flow is less.
  • Discharge lightens from pinkish-brown to yellow for about a week.
  • The discharge will be red blood cells from the placental wound and white blood cells that is mucus from the cervix.

Stage 3: Lochia alba — From about weeks 4-6 after giving birth

  • Discharge is light yellow or yellowish-white in color, with the bleeding virtually gone.
  • It should smell like regular menstrual blood.
  • No clots.
  • The uterus has dried up, and the discharge is mostly white blood cells and cells from the uterus lining.

When Do I Need Medical Attention?

Head to your doctor’s office or the emergency room if:

  • One pad has been soaked within one hour or less. This may be postpartum bleeding or part of the placenta may be stuck to your uterus.
  • You’ve passed lots of clots.
  • You’re passing clots in the lochia alba stage.
  • Your bleeding has a foul smell instead of smelling like normal menstrual blood.
  • You have a fever or chills above 100.4˚ F.

Any of the above indicates infection or the beginning of possible postpartum hemorrhaging.

Call your doctor or midwife if:

  • You don’t see any lochia for the first two weeks.
  • Your lochia becomes red in the serosa or alba stages.
  • You’re passing clots in the lochia serosa stage.
  • One or more clots are sized as large as golf balls.
  • You feel sharp pains low down in your stomach, which only become worse.

Rest if:

You see infrequent bright red spotting after lochia has already lightened.

What Causes Postpartum Hemorrhage?

Postpartum hemorrhage rarely occurs. You may be at special risk if you’ve birthed a large baby, carried multiples, or gone through induced labor—all of which can bloat your uterus to double its normal size.

Looks Like Postpartum Hemorrhaging. Now What?

Heavy bleeding is to be taken seriously. You may need a minor operation to contract your uterus or to remove the placenta. Treatments include the oxytocin drug called Pitocin, uterine massage to stimulate your uterus, a blood transfusion if there’s massive blood loss, and hysterectomy if there’s damage to your uterus.

What Can I Do to Reduce Lochia Bleeding?

You’re more in charge than you may think, since bleeding slows as the uterus contracts. You can rush that process by:

  • Have your caregiver or nurse to massage your uterus.
  • Breastfeed, if you can. It produce oxytocin which contracts your uterus.
  • Pee as often as you can. It helps your uterus contract.
  • Don’t overdue activity—this can get in the way of healing.
  • You can get a shot of Pitocin to help your uterus contract faster, but it isn’t necessary for most moms.

What Else Should I Know About Lochia?

For that same reason, take it slow. Try not to lift anything heavier than your baby, and delegate your tasks if you can. If you notice an uptick in bleeding, it could be because you pushed yourself too much that day. Kick your feet up and rest—your body is still healing.

Can You Take a Bath After Having a Baby?

Your placental area is raw and open during this time, so bacteria can easily infect your vagina. Keep away from tampons, sex, swimming in public pools, or inserting anything in your vagina, for at least six weeks after birth to prevent infection. You’ll want to give that area a chance to rest.

The Bottom Line About Lochia

Lochia is a pain—and a gift.

It will remind you that you just have gone through a tremendous and transformative process—from nurturing the life within for 9 months, to delivering your baby, to now breastfeeding and caring for your young one.

Lochia can also be very cleansing. It’s almost like your uterus is being scraped or scrubbed in some ways. You’ve had a baby plugged up there for almost a year. Now it’s gone, and your vagina’s going to purge its unwanted leftovers.

It’s time for you to rest. Let your visitors and family pamper you. You need all the rest and recovery you can get for the weeks and months that follow.

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https://www.mamanatural.com/lochia-postpartum-bleeding/

 

K is for Kegel

Pushing your baby through your pelvis and into the world is demanding not only on you, but also on your pelvic muscles — which have to stretch to proportions previously unimaginable. So even if you’ve never thought much about them (or maybe never even realized you had any), you’ll want to pay attention to your pelvic muscles during and after pregnancy. And not only do they play an important role in delivery, but when they work correctly, they hold your uterus, bladder and rectum in place, as well as help to keep your urine from leaking when you cough or laugh (a skill set you’re only likely to notice when it’s gone).

Fortunately, there’s one exercise that experts agree can help prevent problems with your pelvic muscles after birth and may even make your labor go a little smoother: Kegels.

What’s a Kegel?

Named after gynecologist Arnold Kegel, these exercises engage and strengthen your pelvic floor, which is a group of muscles and ligaments that hang like a sling between your hips to support your bladder, uterus and other organs and control the flow of urine and the contraction of the vagina and anal sphincter.

The goal of a Kegel is to contract and then relax the pelvic floor muscles for short periods of time and it's best to aim for several short sets a few times a day (more on just how much below). The exercise is fast and free, and once you know how to do them, you can do them just about anywhere — when you’re stuck at a red light, waiting in line or watching TV.

The Benefits of Kegels

As your baby puts on the pounds inside your uterus during pregnancy, your pelvic floor muscles have to support more and more weight. Sometimes, they’re not fully up to the job. If you notice occasional urine leaking — when you cough, sneeze or try to go on a jog — that’s because your over-burdened pelvic floor muscles aren’t able to fully support your bladder the way they usually do.

When you finally go into labor, these muscles will be stretched out even more to make room for baby to pass through. Around a third of women, researchers have estimated, have some tearing in the pelvic floor muscle tissue during birth. You won’t notice this (it doesn’t bleed or look any different from the outside), but it's one explanation for why up to an estimated third of women have problems with postpartum loss of bladder control. An even smaller number of women — usually those who had severe, third-degree tears or a major episiotomy during birth — experience postpartum fecal incontinence.

But here’s the good news: Study after study has shown that regularly doing Kegels during and after pregnancy can help decrease the odds of incontinence and other pelvic floor issues. What’s more, research has also suggested that women who do pelvic floor exercises may have a slightly shorter active phase of labor than other women. And as if that's not enough, Kegels have even been shown to boost your sexual health and pleasure and help you reach orgasm more easily.

How Do I Find My Pelvic Floor Muscles?

If you’re not sure where to find your pelvic floor muscles, try stopping urination mid-stream. The muscles you’re tightening to do this are the same ones you’ll want to contract when you do a Kegel. But once you find them, don’t repeatedly engage those muscles while you’re urinating — this can actually lead to urinary incontinence, urinary tract infections and other problems. 

If you’re still not sure you’ve found the right muscles, put a clean finger in your vagina: If you’re doing a Kegel correctly, the vagina should contract around your finger (try not to hold your breath, and avoid clenching your thighs, stomach or butt muscles at the same time).

Still having trouble? Don’t hesitate to ask your healthcare practitioner to coach you next time you’re having a pelvic exam — that’s what she’s there for!

How Often Should I Do Kegels?

Once you’ve located your pelvic floor muscles, here’s the recommended Kegel routine:

  • Start out by tightening the muscles for about three to five seconds, then relaxing them for as many seconds (relaxing is as important as contracting). Do it four or five times in a row, a few times a day.
  • As it becomes easier, start contracting and relaxing the muscles tight for longer — working up to 10 seconds at a time — and doing more repetitions.
  • Ultimately it’s recommended that you do at least three sets of 10 Kegels every day.

Don’t get frustrated if you’re nowhere close to that goal when you start: Quality is much more important than doing a bunch of Kegels incorrectly. And remember, these are muscles like any other in your body. With time and consistent, mindful work, they can only get stronger.

When Should I Do Kegels?

It’s never too early to start doing Kegels, but the earlier and more regularly you practice them throughout pregnancy, the greater the benefits.

After you’ve delivered, you can restart your Kegel routine immediately. Make it a habit to do them regularly (while, say, you’re feeding your baby) to stimulate circulation, promote healing and improve muscle tone. Don’t worry if you can’t feel yourself doing them initially — the perineum will be numb after birth, but feeling will return gradually over the next few weeks.

In the meantime, the work is being done even if you can’t feel it. If you’re doing your Kegels regularly and correctly, you should expect to see improvement in your bladder control within a few weeks to a few months.

How long should you keep doing Kegels? If you want to keep your pelvic muscles in shape, many healthcare practitioners recommend making them a regular, lifelong habit.

How to Make Kegels Fun

If you’re having trouble remembering to do your daily Kegels (or they just seem like a drag), there’s no better way to mix business with pleasure than performing Kegels during sex — which can double the pleasure for you and your partner. Your partner can also use his or her fingers to check whether you’re tightening the right muscles.

If you’re looking for ways to make Kegels more fun on your own, try a smartphone app. A number of options send you daily reminders, track your exercising and even provide musical routines for your pelvic floor workouts.

There are also devices known as vaginal exercisers that claim to help you isolate the pelvic floor muscles or work them for you. Some are shaped like cones and are held in place in your vagina by your tightened muscles. Others provide electrical stimulation to the muscles. While they might be fun to try, there’s no evidence that they work any better than contracting the muscles on your own (in fact, some studies have found them less effective). What’s more, they could introduce bacteria into the vagina — so skip them if you’re pregnant or recovering from childbirth, and check with your doctor first before trying one for the first time.

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https://www.whattoexpect.com/womens-health/kegels

 

J is for Jaundice

A yellow tint to the skin or eyes caused by an excess of bilirubin, a substance created when red blood cells break down.What is newborn jaundice?

Newborn jaundice is a yellowing of a baby’s skin and eyes. Newborn jaundice is very common and can occur when babies have a high level of bilirubin, a yellow pigment produced during normal breakdown of red blood cells. In older babies and adults, the liver processes bilirubin, which then passes it through the intestinal tract. However, a newborn’s still-developing liver may not be mature enough to remove bilirubin.

The good news is that in most cases, newborn jaundice goes away on its own as a baby’s liver develops and as the baby begins to feed, which helps bilirubin pass through the body.

What causes newborn jaundice?

-premature babies, or babies born before 37 weeks’ gestation

-babies who aren’t getting enough breast milk (or formula, for babies that are not being given breast milk), either because they are having a hard time feeding or because their mother’s milk isn’t in yet

-babies whose blood type isn’t compatible with the blood type of their mother

How is newborn jaundice treated?

-Mild jaundice will usually resolve on its own as a baby’s liver begins to mature

-More severe jaundice may require other treatments. Phototherapy is a common and highly effective method of treatment that uses light to break down bilirubin in your baby’s body. In phototherapy, your baby will be placed on a special bed under a blue spectrum light

-In very severe cases, an exchange transfusion may be necessary. In an exchange transfusion, a baby receives small amounts of blood from a donor or a blood bank. This replaces the baby’s damaged blood with healthy red blood cells. This also increases the baby’s red blood cell count and reduces bilirubin levels.

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https://www.healthline.com/health/newborn-jaundice#prevention

I is for Induced Labor

 Inducing labor is the artificial start of the birth process through medical interventions or other methods. Induction not done for medical reasons or as an emergency is considered elective. Induction of labor has recently been on the rise for purposes of convenience or to accommodate busy schedules.

However, according to the American College of Obstetricians and Gynecologists (ACOG), labor should be induced only when it is more risky for the baby to remain inside the mother’s uterus than to be born.

What Are Some Medical Reasons For Inducing Labor?

Labor is likely to be induced:

  • When a complication develops such as: hypertension, preeclampsia, heart disease, gestational diabetes, or bleeding during pregnancy.
  • If the baby is in danger of not getting enough nutrients and oxygen from the placenta.
  • The amniotic sac has ruptured but labor hasn’t started within 24-48 hours.
  • The pregnancy is prolonged beyond 42 weeks with possible risk to the baby from a gradual decrease in the supply of nutrients from the placenta.
  • There is an infection inside the uterus known as chorioamnionitis.

How Is Labor Induced?

Labor can be induced by the following methods:

1. Medications

Prostaglandin: Suppositories are inserted into the vagina during the evening causing the uterus to go into labor by morning.  One advantage to this method is that the mother is free to move around the labor room.

Oxytocin: The body naturally produces the hormone oxytocin to stimulate contractions. Pitocin and Syntocinon are brand name medications that are forms of oxytocin. They can be given through an IV at low doses to stimulate contractions.

What are the advantages of taking oxytocin?Oxytocin can initiate labor which might not have started on its own, and it can speed up the pace of labor.

What are the concerns when taking oxytocin?Labor can progress too quickly, causing contractions to become difficult to manage without pain medication. Oxytocin may need to be discontinued if contractions become too powerful and close together.

2. Artificial rupture of the membranes (AROM)

When the bag of water (amniotic sac) breaks or ruptures, production of prostaglandin increases, speeding up contractions. Some health care providers might suggest rupturing the amniotic membrane artificially.

A sterile, plastic, thin hook is brushed against the membranes just inside the cervix causing the baby’s head to move down against the cervix, which usually causes the contractions to become stronger. This procedure releases a gush of warm amniotic fluid from the vagina.

What are the advantages of artificial rupture of the membranes?

  • Labor may be shortened by an hour.
  • The procedure allows the amniotic fluid to be examined for the presence of meconium, which may be a sign of fetal distress.
  • The heart rate can be monitored with direct access to the baby’s scalp.

What are the disadvantages of artificial rupture of the membranes?

  • The baby may turn to a breech position, making birth more difficult if the membranes are ruptured before the baby’s head is engaged.
  • It is possible for the umbilical cord to slip out first (prolapsed cord).
  • Infection can occur if there is too much time between rupture and birth.

3. Natural: Nipple Stimulation is a natural form of labor induction that can be done manually or with an electric breastfeeding pump. The hormone oxytocin will naturally be produced to cause contractions. The concept is the same as when a baby nurses right after birth, stimulating contractions, which slows bleeding.

What Expectations Should I Have About Induced Labor?

  • You can still do breathing exercises and push at your own pace if you prefer to avoid pain medications throughout the delivery.
  • You can also request an epidural anesthetic or some other form of pain relief if needed.

The following questions can be helpful when you do not understand or feel comfortable with suggested interventions:

  • Why do I need this procedure?
  • How will it help me and my baby?
  • Are other options available? If so, what are they? What are the risks?
  • What are the risks if the procedure isn’t done?
  • What are the risks of delaying the intervention for an hour?

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 http://americanpregnancy.org/labor-and-birth/inducing-labor/

 

H is for Heal Prick

How is the test done?

If parents consent to screening, a midwife or nurse will perform the test by pricking your baby’s heel and putting a few drops of blood on a special filter paper.

The heel prick may be uncomfortable and your baby may cry, but it’s all over very quickly. You can help by making sure that your baby is warm and comfortable and by being ready to feed and cuddle your baby.

The filter paper is allowed to dry and is then sent to the newborn screening laboratory where several different tests will be performed. 

What is being screened for?

Newborn screening helps to identify babies thought to be affected by one of the following conditions:

Phenylketonuria (PKU) 

Congenital hypothyroidism (CHT)

Cystic fibrosis (CF)

Galactosaemia

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https://www.pregnancybirthbaby.org.au/neonatal-screening-test

G is for Gestational Diabetes

Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby's health.

Any pregnancy complication is concerning, but there's good news. Expectant women can help control gestational diabetes by eating healthy foods, exercising and, if necessary, taking medication. Controlling blood sugar can prevent a difficult birth and keep you and your baby healthy.

In gestational diabetes, blood sugar usually returns to normal soon after delivery. But if you've had gestational diabetes, you're at risk for type 2 diabetes. You'll continue working with your health care team to monitor and manage your blood sugar.

Glucose screening tests during pregnancy

A glucose screening test is a routine test during pregnancy that checks a pregnant woman's blood glucose (sugar) level.

Gestational diabetes is high blood sugar (diabetes) that starts or is found during pregnancy.

TWO-STEP TESTING

During the first step, you will have a glucose screening test:

  • You DO NOT need to prepare or change your diet in any way.
  • You will be asked to drink a liquid that contains glucose.
  • Your blood will be drawn 1 hour after you drink the glucose solution to check your blood glucose level.

If your blood glucose from the first step is too high, you will need to come back for a 3-hour glucose tolerance test. For this test:

  • DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.)
  • You will be asked to drink a liquid that contains glucose, 100 grams (g) .
  • You will have blood drawn before you drink the liquid, and again 3 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked.
  • Allow at least 3 hours for this test.

ONE-STEP TESTING

You need to go to the lab one time for a 2-hour glucose tolerance test. For this test:

  • DO NOT eat or drink anything (other than sips of water) for 8 to 14 hours before your test. (You also cannot eat during the test.)
  • You will be asked to drink a liquid that contains glucose (75 g).
  • You will have blood drawn before you drink the liquid, and again 2 more times every 60 minutes after you drink it. Each time, your blood glucose level will be checked.
  • Allow at least 2 hours for this test.

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https://www.mayoclinic.org/diseases-conditions/gestational-diabetes/symptoms-causes/syc-20355339

 https://medlineplus.gov/ency/article/007562.htm

F is for Fundal Height

What's the significance of a fundal height measurement?

Fundal height is generally defined as the distance from the pubic bone to the top of the uterus measured in centimeters. After 20 weeks of pregnancy, your fundal height measurement often matches the number of weeks you've been pregnant. For example, if you're 27 weeks pregnant, your health care provider would expect your fundal height to be about 27 centimeters.

A fundal height measurement might be less accurate, however, if you:

-Are obese

-Have a history of fibroids

-Are carrying twins or other multiples

A fundal height that measures smaller or larger than expected — or increases more or less quickly than expected — could indicate conditions such as:

-Slow fetal growth (intrauterine growth restriction)

-A significantly larger than average baby (fetal macrosomia)

-Too little amniotic fluid (oligohydramnios)

-Too much amniotic fluid (polyhydramnios)

Depending on the circumstances, your health care provider might recommend an ultrasound to determine what's causing the unusual measurements or more closely monitor your pregnancy.

But fundal height is only a tool for gauging fetal growth — it's not an exact science. Typically, fundal height measurements offer reassurance of a baby's steady growth. If you're concerned about your fundal height measurements, ask your health care provider for details.

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https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/fundal-height/faq-20057962

E is for Ectopic Pregnancy

An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. Almost all ectopic pregnancies occur in the fallopian tube and are thus sometimes called tubal pregnancies. The fallopian tubes are not designed to hold a growing embryo; thus, the fertilized egg in a tubal pregnancy cannot develop properly and must be treated. An ectopic pregnancy happens in 1 out of 50 pregnancies.

What causes an ectopic pregnancy?

Ectopic pregnancies are caused by one or more of the following:

-An infection or inflammation of the fallopian tube can cause it to become partially or entirely blocked.

-Scar tissue from a previous infection or a surgical procedure on the tube may also impede the egg’s movement.

-Previous surgery in the pelvic area or on the tubes can cause adhesions.

-Abnormal growths or a birth defect can result in an abnormality in the tube’s shape.

Who is at risk for having an ectopic pregnancy?

-Maternal age of 35-44 years

-Previous ectopic pregnancy

-Previous pelvic or abdominal surgery

-Pelvic Inflammatory Disease (PID)

-Several induced abortions

-Conceiving after having a tubal ligation or while an IUD is in place

-Smoking

-Endometriosis

-Undergoing fertility treatments or are using fertility medications

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http://americanpregnancy.org/pregnancy-complications/ectopic-pregnancy/

D is for Due Dates (Guess Date)

I like to refer to Due Dates as Guess Dates. No one knows exactly when babies are ready to be born. We cannot put an expiration date on when a pregnancy should be done.

What is an estimated due date?

An estimated due date (EDD) is a “best guess” as to when baby might be born based on a conception calculator. However, only 4% of babies are born on their due date! Whereas 80% of babies are born within the window of two weeks before and two weeks after your estimated due date.

How are the weeks of pregnancy calculated?

The pregnancy calculator estimates your due date from the first day of your last menstrual period. If you have a 28 day cycle and discover you are pregnant on the day you should have had your period, you are already considered 4 weeks pregnant. This means that you have completed your 4th week of pregnancy (even though you conceived just two weeks earlier. I know, confusing). The following day, you are considered to be four weeks one day pregnant.

What is a “due month?”

A “due month” is a more accurate timeframe for when you can expect to deliver your baby. Only 4% of babies are born on their due date. Whereas 80% of babies arrive either two weeks before the due date or two weeks after. Hence the term “due month.”

The length of a natural pregnancy can vary by as much as five weeks.

A due month helps some mamas reduce the stress and fear of going past their due date.

To calculate your due month, simply subtract two weeks from your EDD given by your practitioner and also add two weeks to your EDD. Voilà, your due month!

Yet another way to handle this tricky business of calculating your pregnancy calendar is to add two weeks to the end of your EDD and say, “Baby will likely be here before [that date].”

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https://www.mamanatural.com/due-date-calculator/

C is for Colostrum

What is colostrum exactly?

It’s light yellow, gold, or sometimes clear in color, and is a thick, creamy liquid. And wow, is it packed with amazing properties that protect and nourish your baby in his first days of life!

When will I begin to produce colostrum?

It varies from woman to woman. Some moms start producing colostrum as early as the first trimester. More commonly, women start producing it in the third trimester. If you’re later on in your pregnancy, you can squeeze your breast (or express) and watch some liquid gold emerging from your nipple.

But don’t worry if you don’t see any fluid yet. It’s not until after the placenta is expelled that the true hormonal shift signals the breasts to begin lactating—and produce colostrum. And it makes sense, as this enables your baby to start feeding immediately after birth.

How long will I produce colostrum?

For the first 2–5 days after birth, your body will produce only colostrum, later switching over to regular breast milk. While each woman’s body is different, colostrum tends to stick around closer to 5 days.

How is colostrum different than breastmilk?

Colostrum is richer than breast milk and has a different nutritional profile. In regards to composition, colostrum actually has more in common with blood than it does with breast milk since it’s chock-full of white blood cells and immune-boosting properties. This liquid gold is also higher in protein, and lower in sugar and fat, so it’s an easy first food to digest.

Breast milk is designed to sustain your baby, build the immune system, and contribute to development long-term. Colostrum, however, is more like, “hit it hard and fast.” One study even showed that it is much higher than breast milk in cell-defending antioxidants.

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https://www.mamanatural.com/colostrum/

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B is for Braxton-Hicks

You might have heard this funny phrase before you were pregnant, but now you want to know what it means. The term originated in 1872 when an English doctor named John Braxton Hicks  described the contractions that occur before real labor.

Imagine constantly thinking, “This must be it,” only to find out that it wasn’t. Doctors and pregnant women have Dr. Hicks to thank for eliminating the confusion. The following information should be helpful in determining the difference between true labor and Braxton Hicks contractions.

What are Braxton Hicks contractions?

Braxton Hicks contractions can begin as early as the second trimester.  However, they are most commonly experienced in the third trimester. When this happens, the muscles of the uterus tighten for approximately 30 to 60 seconds, and sometimes as long as two minutes.

Braxton Hicks are also called “practice contractions” because they are a preparation for the real event and allow the opportunity to practice the breathing exercises taught in childbirth classes.

Braxton Hicks are described as:

  • Irregular in intensity
  • Infrequent
  • Unpredictable
  • Non-rhythmic
  • More uncomfortable than painful (although for some women Braxton Hicks can feel painful)
  • They do not increase in intensity or frequency
  • They taper off and then disappear altogether

If your contractions are easing up in any way, they are most likely Braxton Hicks.

What causes Braxton Hicks contractions?

There are possible causes of these contractions. Some physicians and midwives believe that they play a part in toning the uterine muscle and promoting the flow of blood to the placenta. They are not thought to have a role in dilating the cervix, but might have some impact on the softening of the cervix.

However, as Braxton Hicks contractions intensify nearer the time of delivery, the contractions are often referred to as false labor. When this occurs, it can help the dilation and effacement process.

What triggers Braxton Hicks contractions?

The following are triggers of Braxton Hicks:

  • When mother or the baby are very active
  • If someone touches the mother’s belly
  • When the bladder is full
  • After sex
  • Dehydration

What can I do to alleviate Braxton Hicks contractions?

  • Change positions. You can lie down if you have been standing or go for a walk if you have been sitting or laying
  • Take a warm bath for 30 minutes or less
  • Because contractions may be brought on by dehydration, drink a couple of glasses of water
  • Drink a warm cup of herbal tea or milk

If none of these steps work, you should contact your health care provider.

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http://americanpregnancy.org/labor-and-birth/braxton-hicks/

A is for APGAR

The APGAR was developed in 1952 by obstetric anesthesiologist, Virginia Apgar, and has become a standard tool in assessing newborn babies.

What Is The APGAR Test?

The APGAR is a quick, overall assessment of newborn well-being.

When Is The APGAR Test Used?

The APGAR is used immediately following the delivery of a baby. Test scores are recorded at one minute and five minutes from the time of birth.

Why Is The APGAR Test Necessary?

The one minute APGAR assessment provides information about the baby’s physical health, and helps the physician determine if immediate or future medical treatment will be required. The five minute assessment measures how the baby has responded to previous resuscitation attempts, if such attempts were made.

What Conditions Does The APGAR Test Evaluate?

APGAR measures the baby’s color, heart rate, reflexes, muscle tone and respiratory effort.

What do the APGAR scores mean?

APGAR scores range from zero to two for each condition with a maximum final total score of ten. At the one minute APGAR, scores between seven and ten indicate that the baby will need only routine post delivery care.  Scores between four and six indicate that some assistance for breathing might be required. Scores under four can call for prompt, lifesaving measures.

At the five minute APGAR, a score of seven to ten is normal. If the score falls below seven, the baby will continue to be monitored and retested every five minutes for up to twenty minutes. Lower than normal scores do not mean that there will be permanent health problems with the child.

Heart rate:

0 – No heart rate

1 – Fewer than 100 beats per minute indicates that the baby is not very responsive.

2 – More than 100 beats per minute indicates that the baby is vigorous.

Respiration:

0 – Not breathing

1 – Weak cry–may sound like whimpering or grunting

2 – Good, strong cry

Muscle tone:

0 – Limp

1 – Some flexing (bending) of arms and legs

2 – Active motion

Reflex response:

0 – No response to airways being stimulated

1 – Grimace during stimulation

2 – Grimace and cough or sneeze during stimulation

Color:

0 – The baby’s entire body is blue or pale

1 – Good color in body but with blue hands or feet

2 – Completely pink or good color

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http://americanpregnancy.org/labor-and-birth/apgar-test/

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Meet the Doula

Hello! I thought I should take a moment to introduce myself and tell you a little about me and why I decided to become a Doula. 

I am the oldest of three kids. I remember always loving babies, so much so that I became a Candy Stripper at our local hospital when I was only 5 years old. I wanted to be in the room with my mom when she had my baby brother. 

As I got older I had a babysitting business, which I enjoyed doing. I was that teenage girl that  preferred babysitting over going and hanging out with my friends. I was considered to be “the go to babysitter”. This gave me lots of opportunities to take care of babies and young children. 

I also have always found pregnant women to be beautiful and amazing. As a child I remember longing for the day I could be pregnant and have my own babies. I am lucky enough to be blessed with 3 wonderful children of my own. I love being a mother!

When I was in high school I decided that I wanted to work in the medical field in one way or another, however my first priority would be raising my own children. While my husband was attending Notre Dame I met an amazing friend who told me all about being a Doula and I fell in love with the idea of becoming a Doula. This was a prefect mesh between working in the medical field, helping expecting mothers/families during pregnancy, birth, and beyond, and helping with babies, all while being a mother to my own children.  

I have trained with Birth Arts International to become a Birth and Postpartum Doula, Breastfeeding Educator, and Bereavement Specialist. I have also trained with Hypnobabies to become a Hypnobabies Doula. I am a Babywearing Educator. And soon to be trained in Spinning Babies. I enjoy expanding my knowledge in all things that relate to pregnancy, birth, babies, and beyond.  

I love being a Doula and being able to watch families grow!