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can my baby be too big for my pelvis? August 7, 2007

Posted by guinever in : birth, health, labor, pregnancy , comments closed

I frequently get questions in the comment section of my article, cervical dilation 101, frequently asked questions. Every once in awhile, a question comes up that doesn’t have a simple, short answer so I’ll write a new article. The following comes from a pregnant reader:

Just an update,
I went to the doctor today, I am 38 weeks and 3 days. I am 3 cm dilated and 70% effaced. My cervix is still posterior, but the baby is head down and -2. My blood pressure has been slightly elevated the last 2 weeks and the doctor thinks the baby weighs around 7 pounds. He is also concerned that I could need a c-section because I have a small pelvis. All this in account we are inducing labor Thurs morning. Do you think it could be a long labor? Or could it be pretty quick given I am already 3 cm and this is my second child?

Thanks for all of your help, Christina

Dear Christina, Your pelvis is not too small. You do not need a c-section. A doctor has absolutely NO business telling a woman her pelvis is too small before she is even in labor and tries to push the baby out. (did you have a c-section for your first baby?) Your pelvis is not fixed in place. Hormones right now are working on softening the ligaments, loosening your pelvis so that it may move and widen and change shape to accommodate your baby. And your baby’s head is not hard and fixed in place either. Your baby’s skull has plates that move and mold to fit through your pelvis. These are the baby’s soft spots. This is why some babies are born with pointy heads; their heads have merely changed shape so they can be born and will quickly regain a more normal shape within hours. Please just be confident in your ability to birth your baby! Put the word c-section out of your head. There is a huge mind and body connection when it comes to labor. If you believe that you can’t birth your baby, or if your doctor’s words are in the back of your mind, then it might come true.

Also, why are you being induced in a couple days? High blood pressure, out-of-control blood pressure is definitely a valid reason for induction, but in your words, yours is “slightly elevated.” Although many doctors are quick to induce, most wait until the due date unless there is a medical reason and you still have a week to go. I hate to say this, but is your doc going on vacation? Sometimes, a doctor will induce his patients so they’ll give birth while he’s still in town and so that he will get paid for the births (rather than whoever is on call for him while he’s gone). He is getting you used to the idea of having surgery just in case you don’t have your baby before he wants to leave in the morning. He has already told you that you might need a c-section. He’ll have the induction started in the wee hours of the A.M. and be checking in periodically throughout the day with the nursing staff. He’ll go home for dinner and then come back and say you’re not progressing or your baby is just too big for your body so it looks like you need surgery after all.

Now having said this, this may not be the reality in your case, but you should consider it. Ask your doctor, why are you inducing me? What happens if we don’t induce this Thursday as planned?

To answer your question as to how long the induction may take, like I tell everyone, I have no idea! There is no magic formula that says a woman dilates 1 cm an hour even though some OBs like to tell us that’s the way it should happen. Read my article, what does being 2 centimeters dilated mean?

You are 3cm dilated and 70% effaced. With these numbers, a pitocin induction will most likely be successful and lead to a vaginal birth if given enough time. If your body and baby are ready for labor, you could have your baby in only a few hours or it could take all day. You also said the baby is at -2 station so your baby is still floating and very high.

Zero station is “engaged” or “dropped” where your baby’s head is fixed in your pelvis and not going anywhere. But at -2 station, your baby is still “floating.” It is common to break your water during an induction. Please know that if they break your water , called artificial rupture of membranes (AROM) before the baby is at 0 station or lower, then there is the danger of cord prolapse. This is a dangerous situation because the head will compress the cord, cutting off the baby’s oxygen supply. You do not want that to happen. So if you do get induced and if they talk about breaking your water, be sure that your baby has come down to at least 0 station.

To sum up, just trust in your ability to give birth! You can do it. To answer the question posed in the title of this article,

“Can my baby be too big for my pelvis?” Watch this inspiring video for the answer.

The answer is probably not! Be inspired by the pygmy women in Africa who are only 4 feet tall. Gloria Lemay writes for Midwifery Today that the average weight of their infants is eight pounds. In relative terms, this is like a woman five feet six giving birth to a fourteen-pound baby.

Birthing Blessings, Guinever

To read other pregnancy related articles, please refer to my welcome page .

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help! I’m having Braxton Hicks: is this ok? August 2, 2007

Posted by guinever in : birth, doula, labor, pregnancy , comments closed

for-braxton-hicksBraxton Hicks contractions are sometimes referred to as false labor or pre-labor. They prepare the uterus and start the cervix effacing and dilating, getting you ready for labor.

But if you’re not at least 36 weeks along in your pregnancy, when the baby’s lungs are fully developed and its “safe” to give birth, how do you know if the contractions you’re having are ok? In other words, how do you know that you’re not in real labor and about to have the baby?

You need to evaluate your activity and the frequency of your contractions and how many you have had. Take all three into consideration.

First of all, MOST false labor contractions are caused by dehydration. Many women go to the hospital and are given a big glass of water to drink. The contractions stop and they go home. OR they’re hooked up to an IV. Once re-hydrated, the contractions stop and they go home. You can do this at home. Drink water. If you think you’re having too many contractions, just drink a big glass of water and see what happens. If they don’t stop, be concerned and call your doctor or midwife.

Another time a woman experiences Braxton Hicks contractions is while exercising. If you’re walking, swimming or doing some other form of aerobic exercise and you’re having lots of contractions, that’s ok if they stop once you stop your activity and drink some water. So it’s ok to walk for an hour and have these contractions every 5 minutes or so while you’re moving.

On the other hand, if you’re lounging around and having contractions every 5 minutes and you’ve eaten and have had plenty of water and they won’t stop, this is the time for concern. Call your doctor or midwife and tell them what’s going on.

If you have 2-3 contractions once in awhile, that’s ok. But if you’re having contractions every 20-30 minutes all day long, it sounds like you might be in a pattern of early labor and this would be cause for concern.

So in conclusion, a few contractions that are about 5 minutes apart are ok especially if you experience them during physical activity. In contrast, having consistent contractions 20-30 minutes apart that don’t stop when you drink water or change or activity would be cause for concern.

I hope this has answered your question about Braxton Hicks contractions. You might find my other articles on dilation useful. 

For more articles about pregnancy and birth, please refer to my welcome page.


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what is a birth doula and should I have one? July 12, 2007

Posted by guinever in : birth, doula, labor, midwifery, pregnancy , comments closed

your questions answered about the purpose and value of labor support

What is a doula?

doulak1A doula is a trained birth professional who is knowledgeable about the progression of labor, pain management and coping techniques, and breastfeeding. She is familiar with your local hospital or birth center routines, medical terminology and procedures. She offers continuous support during labor and the immediate postpartum period.

What kind of support does the doula offer?

She offers physical, emotional and informational support. She will do her best to meet your needs during labor. Physical support during labor can include shoulder and foot rubs to help you relax, and counter pressure to help ease the pain of back labor. She can suggest position changes that will help your labor progress or ease your pain. She can go find more pillows or blankets, get you a cool wash cloth, re-fill your water cup or get your husband a cup of coffee.

Labor can be emotionally challenging especially if you are having your first baby. She can talk you through those really hard contractions. Labor can be especially difficult if you have a long labor or an unusually quick labor. Having an experienced woman there who you trust has a calming effect on both you and your husband. When you think you can’t possibly labor anymore and you want to give up, she’ll be beside you, the voice of experience, reminding you that you are doing it and that you’ll meet your baby soon.

Although not a medical practitioner, she is knowledgeable with medical terminology and procedures and can answer your questions or clarify something for you. When you’re in labor, you may be afraid of the unknown. A doula is there to reassure you that everything is alright. And if something isn’t progressing as it should, she’ll help to explain your options. If you have family members in the waiting room, your doula can give them periodic updates especially if you don’t want them in the labor and delivery room with you.

What are the benefits to hiring a doula?

The benefit is hiring someone who will always be with you. Nurses are busy and have many patients to help. Your midwife or doctor checks in with you only occasionally. Research indicates that when a doula is present, labors are shorter, less pain medication is requested, fewer births require forceps, vacuum extraction or cesarean. Additionally, more women breastfeed, and women are more satisfied with their birth.

What about my husband? He thinks he might want us to be alone during labor and birth. Will the doula take his place?

One of the best thing about having a doula at your birth is that she can help your husband help you if that’s what he wants to do. When hard labor kicks in and you start moaning, she can give him the thumbs up, letting him know that everything is ok. She can show him just the right place to do counter pressure on your back. A good doula stays in the background and jumps in when needed.

Understanding how labor progresses and knowing the physical changes that will take place, she anticipates your needs and is able to meet them. You don’t know how long your labor will be. Your husband may need to step out for a few minutes. With a doula there, you’ll never be alone, and if your husband never wants to leave your side, your doula can go get him coffee or dinner if necessary. It’s important that your husband meet your doula during one of your pre-natal meetings so the three of you can clarify what both their roles will be during birth.

What are the responsibilities of a doula?

A doula will be on call for you around your due date and come to your house or meet you at the hospital when you need her. She is available for phone support in those last days of pregnancy and in early labor. She stays with you during labor, birth and a few hours postpartum. She’ll come back and visit you in the first couple of days to answer any questions you might have about the birth. You’ll meet with her one last time after a few weeks postpartum.

What are some of the things a doula will not do?

A doula does not perform any clinical tasks including taking your temperature or blood pressure, monitoring your baby’s heart tones, or doing cervical checks. She also will not give you any medical advice or make decisions for you. A good doula will accept the kind of birth that you want and not try to force her own birth philosophy on you.

doula200I’m planning on having an epidural. Could I still benefit from having a doula?

Absolutely. Even if you can’t feel the physical intensity of your labor that can often be overwhelming, you’ll still experience the intense emotional changes. Your doula can help put your mind at ease and of course she’ll be there after the birth to make sure breastfeeding gets off to a good start.

It turns out that I’m going to have a cesarean because my baby is breech (or some other reason.) Can a doula still help me?

A doula can be very helpful during surgery to help you stay calm. If your husband wants to go with the baby to the nursery after the birth, she can stay with you so you’re not alone during recovery. When you and baby are reunited, she can help you position the baby for breastfeeding. You won’t be very mobile so she can grab pillows for you and make sure you and baby are fully supported so you can nurse more easily.

Can a doula help me if I’m having a homebirth?

Of course! Most doulas love having the opportunity to attend homebirths. In addition to all the duties already discussed, your doula might cook breakfast or tend to your other children if needed (although if other children are there, you should have someone at your birth whose specific job is childcare). Just remember, a doula does not take the place of a medical care giver so you will need a midwife and, if applicable, her assistant there as well.

How can I find a doula?

You can find a doula through DONA International or by calling 1-888-788-3662. If you can’t find one in your area, ask around. Your friends, childbirth educator, doctor or midwife might also be able to recommend a doula.

It’s a good idea to talk to more than one potential doula so you can see the differences in philosophy and personality to find the best choice for your birth team. Your doula should meet with you a couple times during your pregnancy to discuss your expectations for birth and her role in it. These getting to know you sessions are crucial for her to be able to offer you the kind of labor support that you need.

Do you have another question that isn’t addressed here?

I am a birth doula in Lexington, KY.

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nine ways to keep nausea away during pregnancy March 16, 2007

Posted by guinever in : pregnancy , comments closed
  1. Try to eat whenever you feel queasy; it doesn’t have to be a lot–just a couple grapes, a cracker or slice of cheese
  2. Stay hydrated. Sip on beverages all day long. But sometimes even drinking plain water can make a pregnant woman gag. Add some freshly squeezed lemon. (real lemon works too)
  3. Drink some mint tea first thing in the morning and whenever you need it
  4. Eat ginger snaps or other food with ginger in it
  5. Wear sea wrist bands available at most drug stores; they’re also called travel bands or acupressure bands
  6. Always have food on hand–keep a baggie of oyster crackers, cheese sticks, or a protein bar in your purse
  7. Toothpaste making you gag? brush your teeth with mouthwash instead
  8. Take papaya digestive enzymes (or eat the real fruit either dried or fresh)
  9. Don’t lie down until your food has a chance to digest
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cervical dilation 101: frequently asked questions March 11, 2007

Posted by guinever in : birth, birth stories, doula, health, labor, pregnancy , comments closed

What is the cervix? The cervix is the bottom part or neck of the uterus. The cervix opens during labor so the baby may pass through the womb into the birth canal and be born.

What is effacement? Effacement is the thinning and softening of the cervix which is measured in percentages. Usually the cervix is long, hard, and closed, and at this point the effacement would be at 0%. Towards the end of pregnancy, Braxton Hicks contractions occur (sometimes you aren’t aware that you’re having contractions) which start this effacement process. Once the cervix starts to efface, then it can start to dilate too. As effacement continues, the cervix softens, becomes mushy, and then slippery. When fully effaced at 100%, the cervix has virtually disappeared against the baby’s head.

What is dilation? Dilation is the opening up of the cervix and is measured in centimeters. A fingertip dilated means about 1 centimeter dilated. Full dilation is 10 centimeters. Once full dilation occurs, the cervix is completely gone and over the baby’s head, and the mother may push the baby out to be born.

What causes the cervix to change? The uterus is a muscle that contracts or tightens. During a contraction, the baby’s head (or other presenting part), pushes down on your cervix, causing it to dilate and efface.

Why does backward dilation sometimes happen and is it normal? First of all, yes it’s normal and is not something to be worried about. Backwards dilation can occur if the baby’s head isn’t pressing as hard on your cervix as it once was. If your labor slows down and you’re not having any contractions, the cervix can close up a little. Don’t worry, once contractions pick up, you’ll soon be dilating again. A change in dilation can occur when someone new is checking your cervix. One nurse’s five cm dilated, 85% effaced may be another nurse’s six cm dilated, 80% effaced.

Feel free to ask a question and then check back later for an answer, but please don’t ask me when I think you are going to have your baby. You will find additional clarification of when your labor may start by reading  What does being 2 centimeters dilated mean?

How long does it take the cervix to dilate 5 centimeters?
For more articles about pregnancy and birth, please refer to my welcome page.

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