Labor
It may be unpopular to say but labor medications really can have negative consequences. Babies and young children often have paradoxical reactions: meaning, what makes us drowsy will put them in a hyper state. You may have heard one of your friends complain about giving her child cold medicine that knocks her out, only to have the child climbing the walls later. I’ve witnessed over and over again babies who were frantic and inconsolable for several hours after delivery. Mom’s feel guilty because they were not informed it could happen. Additionally, many parents can’t stand their baby crying like that so mom gives in and allows formula, thinking that’s the solution. It’s not, but now she feels even worse!
The other end of the spectrum is when the medications suppress baby’s ability to breathe. This depends on how much has been given as well as how soon you deliver after it’s been administered. It’s very scary for parents to see their baby undergoing resuscitation measures. Plus mom and baby get separated, which increases the risk of problems latching later.
Medication can also delay or slow your labor progress to the point your doctor recommends surgery instead. I know c-sections have become common place but it carries its own set of risks and should never be done electively or simply because a doctor is impatient. Same with inductions, especially because the medications they give you to jumpstart your labor cause a type of contraction that often can’t be tolerated without medications for pain relief.
So what can you do? Number one has to be to educate yourself! Fear of the unknown increases the perception of pain. There are many great resources out there; books such as Birthing From Within, Birthing Without Fear, and The Pocket Midwife among others. There’s an excellent video at www.globalhealthmedia.org showing moms delivering without medications. Attending a childbirth class that offer alternatives and doesn’t just describe how their facility does it can be a major advantage. Other suggestions:
- No inductions or caesareans unless medically necessary. Please make sure the doctor explains the rationale and risks if either is medically indicated.
- Notify your caregiver - but don’t go in at the first twinge. Go when contractions are coming regularly and getting stronger such that you’d rather not talk during them. Home is your turf where you feel safe, which helps you progress.
- Decline Pitocin for “augmentation”. Again, that’s impatience at work. And yes, you get to tell them no.
- Consider hiring a doula. Let your partner watch the miracle unfolding and let the doula who has the training support you.
- Empty your bladder frequently. A full bladder can interfere with contractions and your baby’s descent into the birth canal.
- Change positions! Squatting decreases length of labor and length of pushing. Dance if you can. You can try gentle bouncing on a birthing ball, rocking in a rocking chair, or switching to hands and knees. Walk if allowed.
- If you do need to use labor medications, use the least amount possible. Give yourself grace, it’s not any sort of failing on your part. Recognize your baby may need extra time for the first feed.
Delivery
Ask for delayed cord clamping if your caregiver doesn’t mention it. This is your baby’s lifeline. Babies don’t have to breathe immediately if they are still connected to you. It is important your provider waits until the cord has turned white and stopped pulsating!
Baby should be placed facing you, on your upper abdomen just below your breasts; their little naked selves on your bare skin. Skin to skin is not just a nicety; it is vital to your baby’s overall wellbeing but it has to be done correctly. Baby’s head should be in a “sniffing” position and where you can see their face for any color changes. They will be alarmingly not pink the first minute or two but should be getting pinker as they cry. They need to be dried and the wet linen removed, then covered with a dry and preferably warm blanket plus a hat to keep them from getting cold. Your body also helps warm them. Suction is usually not needed as gravity assists the airway clearing in this position. Skin to skin should be uninterrupted time for the first hour regardless of feeding method (until latch and 1st feeding is complete if breastfeeding) unless a medical emergency exists.
- Babies will go through nine stages to self-attach and need to be allowed to do so.
- Birth Cry – needed, to expand the lungs and clear the fluid
- What just happened to me? – right after crying; it’s a pause where baby is quiet and just breathes
- Where am I? – opening eyes, becoming active
- Crawling – babies can get themselves to your breast, see breast crawl videos online and be patient
- Rest – can be between any of the stages but particularly after the crawl
- Familiarization – starts about 40 min after delivery; baby is learning what to do – let them
- Self-latch- approx. 60min after being born
- Suckling – baby’s first experience with suck/swallow/breathe
- Sleep – as feeding completes, usually by the 2 hour mark after delivery; now baby can be weighed, measured, fully assessed, etc.
See Breastfeeding in the First Hours video at www.globalhealthmedia.com