When to go to the Hospital

Deciding when to go to the hospital can cause laboring couples a lot of stress. If you get there too early, you may get sent home or you run the risk of labor slowing down or stopping. If you go in too late, you run the risk of not making it. So when is the best time?

Well, for most first time couples the chances of not making it to the hospital in time and delivering in the car or at home are pretty slim. That’s a much more likely scenario with subsequent births, but for most first timers labor is long enough and the signs are pretty clear when it is time to go. Here are the signs to look for:

1.  Contractions are strong. What does that look like? Mom has to stop during a contraction and pay attention to it. She can’t walk or talk through her contractions very easily and needs to do something to cope with them, like breathe and sway. Most likely at this point she will also not feel very comfortable sitting or lying down during a contraction.
2. Contractions are long. Contractions can start to be considered long when they last close to 60 seconds. It can be good to get a contraction timer app so you can be accurate with this when it comes time to measure them.
3. Contractions are close together. You don’t need to worry about timing the contractions with the app until you feel like the contractions are consistently under 6-8 minutes apart. It may make you feel better to start measuring earlier, but you shouldn’t do it if it stops you resting or keeping distracted with other activities until the contractions hit that 6-8 minute mark. Even then, you have time. You’re looking for the contractions to be 4-5 minutes apart and staying that way for at least one hour.

Put them all together and you get a simple formula: You don’t need to think about going to the hospital until after you have seen strong, long contractions that are 4-5 minutes apart for at least an hour. Once you reach that point, it’s time to think about making your move.

Pro tip:  If discussing going to the hospital makes your contractions space back out, wait a little bit before going. If the stress of talking about going is enough to slow them down, then she is probably not quite ready.

Of course if your water breaks, you have a fever, excessive bleeding, sharp pain, or anything else you are worried about, be sure to call your doctor and get their opinion on when to go in.

People need people – Find your laboring tribe

We all need a community; friends, family, the guy who makes our coffee. But when you are pregnant and preparing for the big life change that comes with labor and birth, human connections are especially important.

Pregnancy, labor, and becoming a parent all have steep learning curves associated with them and one of the best ways to not be overwhelmed is to surround yourself with those who are on the same journey. Being around others who are in your same boat will help decrease anxiety and increase your enjoyment as you sail through this time.

Where can you begin to look for this tribe? Prenatal yoga classes are a good way to prepare physically for birth and connect with other moms in a relaxed, consistent way.  Pregnancy support groups are also becoming more common in hospitals and birth centers. If your physician group offers prenatal appointments in a group centering format, that can be an excellent way to meet others. And mom’s groups in your area might offer pregnancy meet-ups.

Look around, each community is different. But finding ways to connect with other expectant moms and couples can ease the transition – and sometimes lead to lasting friendships that you will treasure as your kids grow older.

Photo by Julie Johnson (@thirdwheelphoto at Unsplash)

A VBAC Story

I recently had the experience of helping a wonderful couple achieve their goal of a VBAC (Vaginal Birth After Caesarean). When they hired me, they explained that for their first birth they had not taken any classes and had not prepared for the birth, trusting that the hospital staff would tell them what to do.

The thing is, that isn’t really the staff’s job. They are supposed to keep mom and baby healthy, which of course is extremely important. But they won’t necessarily suggest positions to help baby move down, offer ideas for staying comfortable or strategies for making make labor efficient, although some do all that and more.

So when this first-time laboring mother told the nurse she was feeling uncomfortable and anxious, the nurse advised her to get an epidural, even though it was very early in the labor and the mom wasn’t then able to be up and changing positions to help move baby down. Next, when the mom was fully dilated and couldn’t feel any urge to push, no one suggested to turn the epidural down. Almost inevitably, a C-section followed.

This couple felt that perhaps the surgery was avoidable and so to their credit, when they became pregnant a second time, they spoke with their doctor about a VBAC, took classes, read books, and hired support.

She went into labor a few days before her due date and after a few hours at home contractions were close enough to go to hospital. When we arrived, the couple’s doctor was not on call. The doctor who met them was more conservative and told them that he thought she was not a good candidate for a VBAC and that they should just do another surgery.  They talked about it and because they had done lots of research and had spoken at great length with their OB, who thought they were good candidates, they felt strong enough to say they wanted to proceed with trying for a vaginal delivery.

The mom, who thought she had a low pain tolerance, handled contractions beautifully without any medication and gave birth in 5 hours. The first time she said she didn’t really push because she couldn’t feel any urge and didn’t really know what to do. This time the baby was born with about 20 minutes of pushing that she instinctively did perfectly. After the birth, the doctor told them they had made the right decision.

Being a doula is amazing because I get to help people do the things that they didn’t believe they were capable of doing. With a little bit of support and education couples can access their own strength and realize that they are capable of much more than they might have believed – and that can help them on more than just their labor day.

The Path

At a birth recently, the doctor asked if I’d had unmedicated births myself. I was surprised that I hesitated in answering “yes,” even though I did.

Right after the births of my children, I would have wanted to shout my accomplishment from the rooftops. And then as a inexperienced doula, I felt like everyone could and should follow the same path I did.

But over these 17 years of watching women’s experiences vary in length, in intensity, and in levels of anxiety, I now feel like it is not the avoidance or acceptance of an epidural that defines her accomplishment but the way that an expectant mom experiences her path.

My job at the end of the day is not to check the box that says “unmedicated, vaginal birth” but to help comfort and empower all women with whom I work to make on their own best journey.

Praise for “Deliver!” from a Childbirth Educator

Deliver! Books

We just received this five star review for “Deliver!” on Amazon from childbirth educator Sandra Caldwell.

“Just finished reading “Deliver!” in preparation for a childbirth class I’m teaching. As a parent educator and birth and postpartum doula, I am very impressed with the content and its concise nature. It was easy to read in one sitting and it provides a lot of information for the partner of the laboring mother, primarily, on how to ‘be with’ her during labor and birth. Well done, Julie!”

Thanks Sandra, we always appreciate feedback from prenatal professionals and our hope is that our book can be a useful addition to all those who work with expectant mothers.

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Birth Story from a (repeat!) “Deliver!” Mom

Deliver! Books

“Your book and previous advice still helped us so much this time around. Thank you! I am going to make a little “pregnancy pack”, including your book, and give it to every friend who gets pregnant. ” – Julie M.

We couldn’t be more excited to hear this in an email from Julie, who recently shared with us the story of her second V-Bac. Julie is a woman of amazing determination and faith and we are so glad to have been part of helping her welcome a new member to her family.

You can read all about her latest birth on her blog. Julie says Deliver! was “succinct and easy to review again before each birth. I want to buy it for every pregnant woman.”

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Great Study from a few years back on the benefits of labor support, both by partners and doulas.

Deliver! Books

Continuous support for women during childbirth | Cochrane

http://www.cochrane.org/CD003766/PREG_continuous-support-women-during-childbirth

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Reading “Deliver!” a first time dad “learned so much in a very short time.”

Deliver! Books

We just noticed this new five star Amazon review of “Deliver!” from earlier in the fall. Reader Nmat83 said:

“This book is simply great. As a first time father to be, I learned so much in a very short time. This book was a short, easy read with great information on every page. I felt much more at ease and knowledgeable after reading. I also got major kudos for dropping facts I learned from my wife! I definitely recommend this book to any father to be!”

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The Peanut Ball: A smart labor tool

Deliver! Books

I just supported a couple where the doctor was very doubtful that the mom would be able to deliver without a C-section. Based on my experience, I had to agree, but the mom really wanted to avoid surgery and so we did everything we could to help her to achieve that goal.

It was a long labor, but she did it (yeah!) and here’s what I think tipped the scales in her favor: The peanut ball.

More and more hospitals are providing these inflatable, peanut-shaped cushions for moms with epidurals and I have found them to be amazing tools for shortening labors and helping babies turn and descend when nothing else has seemed to help. They are especially good for moms who have to be in bed because of an epidural or other health concerns.

Here is an article with pictures and details if you are interested in seeing how…

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“My “go-to” gift for friends who are expecting”

Deliver! Books

The five star reviews keep rolling in for “Deliver!” Here’s our latest from Amazon:

“This book is wonderful! It gave very practical advice and a clear overview of the birth process, which helped my husband feel more confident in his role, though I benefited greatly from it as well. Having read several other birth books, I appreciated this one the most because it was a great step-by-step manual that helped us think through all our options before labor and empowered us with knowledge to make decisions when it came time to “deliver!” It will now be my “go-to” gift for friends who are expecting. Thank you, Julie and Simon!”

Thank you, Julia – and congratulations to you and your husband.

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