Day 2 - Birth Basics - Transcript

Let's get started. So today is day two of the birth basics class. Today we're going to talk about active labor and some other things that I threw in here, things that I think are important. And so if you were able to catch up and watch yesterday's class, then you learned about kind of inductions and contractions and hopefully you saw the link that I shared with the balloon demonstration on contractions and then prodromal Labor, which reminder, not everybody has, but I just wanted you guys to be aware of it so you're not shocked if something like that happens for you. And then early labor. So that's kind of where we left off and I wanted to get. Okay, so let's talk about what's to come here in this class. It's all active labor, but we're going to talk about your trip to the hospital, a natural comfort techniques because a lot of people have requested to find out more about that.

Um, different positions and different movements, pain management meds because you know, that's a super common thing too. So it's good to just know about all of these things that you know, you, you may or may not choose to use during your birth. Um, and then monitoring, I throw in some monitoring at the end because I think it's important and it kind of ties into what techniques you end up using and if you use pain management meds. So what kind of monitoring will you and the baby have during Labor? Okay, so we did talk about this yesterday at the end of the class, but I wanted to bring it back one more time to reiterate. So when you're, when you're going from early Labor to active labor, you'll notice that certain things start to happen. Contractions might feel a little bit different, um, more intense, you know, things are progressing and you might be wondering, you know, when is the best time to call second it.

Okay. To contact your provider. So I want to reiterate that these are all good time to go ahead and just make the call first. Anytime if you have questions or on your or you're unsure of what's going on. Contact your provider. And, you know, another thing I'll note there is, if you're in the middle of labor, um, and you've already contacted your, contacted your provider, but you still have kind of other things you want to talk about or questions or you want tips, um, if you are working with a Doula, you're probably going to be interacting with your doula during that time. If you're not working with a Doula, you know, I tend to do kind of digital or virtual doula services. So I'll kind of talk to moms and message back and forth during Labor to, um, just to kind of, there's tons of questions that come up in the moment.

We can talk about this stuff for hours, right? But when the time comes, um, there's a lot going on, you know, it's exciting and it's exhilarating. There's all these feelings, all these emotions and you might forget some stuff. So if you need to refer back to something or somebody and you don't have time to sit and re-watch videos and videos and you might not have the energy or anything like that, then those are options too, is to reach out to somebody. Um, you know, and you can certainly reach out to me and we can talk about what that looks like and what working with me in that respect looks like. So when else would you want to call your provider if your water breaks, you definitely want to be calling them or if you're experiencing any bleeding. Um, and then we mentioned yesterday the four one, one with a five slash one slash one rule.

So I want to reiterate that because I think people get a little confused. So it's basically, um, you know, in Camo and then into early labor, you might be feeling, um, like your contractions are sporadic or spaced out. There's no consistency. Now, once they, once they reach this consistency of being four or five minutes apart, lasting for about one minute each for a total of an hour. That's about the indicator of when your hospital, if you're delivering at a hospital, that's usually what most hospitals will consider you in active labor and bring you in and allow you to come in and be accepted. Now, if your, if your contractions are more spaced out, um, or sporadic, then don't want to say hopefully they'll turn you away, but if there's no other issues going on and it might not be the best for you to be in the hospital yet, um, we talked about that yesterday too, because they're going to stop you from eating.

I'm going to stop you from drinking unless you're on fluids. A lot of protocols might be thrown in your face as far as, um, you know, IVs and this and that and you know, just kind of their standard hospital protocols so it may or may not be the best thing for you. So something to keep in mind. Um, and again, in terms of keeping track of your contractions, highly recommend using a timing app. They're free. Um, I've used them before. I just feel like it's a lot easier than sitting with a pen and paper and a stopwatch and trying to figure things out. I'm just using that or let your partner using that for you. So then, okay. And if this is not your first birth, so if you've had a baby before, I'm statistically, you might be in labor for a shorter amount of time, so you might want to contact them sooner.

And then again, you hopefully you're having these discussions with your doctor at your prenatal appointments, especially the last few appointments because there may be things going on in your pregnancy where they might want to see you sooner than the average or the norm. And you can talk about what that looks like for you and your particular pregnancy. Okay. So let's get started in active labor. Once you reach active labor, your contractions have reached that pattern that we just talked about for 100, five, one, one, depending on who you ask. And you know, what different providers use different things, but basically once you've reached, um, and I think that the new thing is for one, one is the new 501, but once they're in that pattern and you have consistency, it's considered active labor and we're talking about your contractions are also lasting longer. So they might be longer than a minute and then they are much more intense once you reach active labor.

So we talked yesterday about in early Labor, a lot of moms can easily talk through contractions and tend to be pretty relaxed, you know, you might feel some, you're like, oh, it's uncomfortable, but you can talk and you can carry on a conversation, maybe even joke or laugh or whatever. You'll know you're in active labor if you have a hard time talking during a contraction. So when I wasn't skilled or trained or under, you know, when I didn't know how to deal with the contraction, um, the first couple times, you know, the first when I first had them, my instinct was to like tighten up and I know I couldn't talk, you know, and it was very difficult to communicate. Um, so what you'll find is breathing or moaning, even, like whatever comes naturally to make these noises, to try to keep your mouth open through the contractions will be helpful.

So if you're feeling that during a contraction, you're probably an active labor. I'm also, if you, if you're feeling rectal pressure, that's a good indicator that you're an active labor as well. Um, and then so dilation, yesterday we talked about dilation in early Labor today. Let's take it the next step. So during active labor, you're, you tend to dilate between five, from five to eight centimeters and that's kind of the benchmark for most hospitals. I'm also note, we mentioned yesterday how an early Labor, your dilation might take quite a while to go from zero to four or zero to six depending on who you ask, right? Um, it might take a long time, especially if you're a first time mom, but I also mentioned yesterday and I'll bring it up again, once you're in active labor, it might speed up, you know, your dilation probably will speed up.

Hopefully we'll speed up. So don't be discouraged if things feel slower in the beginning because chances are they probably will speed up, right? Especially if you haven't introduced any interventions. The ones we talked about yesterday, um, you know, pitocin or epidurals and things like that. Towson speeds them up, but epidural will slow things down. So if you haven't introduced those things, you'll probably notice, um, you know, the, that you might dilate faster, uh, you also might feel nauseous during active labor. Super Common and okay. It's actually okay. And a lot of midwives will kind of joke and I, if you, you know, if you've heard me ramble about different providers, midwives, um, do a lot of the same things that obese do. They're like doctors, they just don't do surgery in a nutshell. There's a lot more to that, but I'm totally summing it up for this video.

And a lot of midwives will say like, they, like when a mom feels nauseous and throw up, you know, these are all signs that things are going normal and things are happening, progress is being made. So it doesn't feel great. It's not comfortable, but it's something that might happen, right? If you're in the hospital, if you're getting ivy fluids and things like that, they certainly can give you something for the nausea too. So make sure to let them know. All right, so let's talk about the trip to the hospital because now if you think you're in active labor, you might want to head in, you don't have to head into the hospital right away depending on what's going on with your, with your pregnancy and your birth. So as long as your provider isn't concerned that there's any medical issues or complications going on, um, and it's really, it's really your decision, right?

So whenever you make the decision and you're heading in, please do not try to drive yourself. Not a great idea. Driving with contractions is pretty dangerous. I wouldn't recommend it to see if you can arrange for somebody to be driving you to the hospital. Um, and so once you get to the hospital, you're going to go to triage. Triage is kind of the. So when you arrive, there's an area where we're laboring. Moms go there, various small rooms. You don't stay there long. They're really just checking to see if your in active labor and to see if they're going to admit you for birth, if you're not, or if they don't think you're ready or if you're not. Even in labor, they might send you home. Um, so what you'll, what you can expect when you get to triage is typically a vaginal exam. Um, and what they're looking for is how dilated you are, how effaced your cervix is, a where the babies at kind of the station maybe and position.

They're also going to check your contractions and they'll probably help you up and check and see what your contractions are looking like. I'm among other things, you know, they'll do a few other kind of monitoring test just to kind of look at you. They way you, which was a shock to me I think the first time because I'm like, I've been on a scale every, I feel like every day for the last two weeks of my pregnancy and they want to weigh you at this last second. So at triage they'll do that check to determine if you're in fact an active labor and then they'll send you up to a birth room. Now, one thing I would recommend is touring the hospital that you're going to birth, and I've talked about this in the group before and I'm big on that because you want to be, you want to have a lay of the land, you want to get an idea of where you're going to need to go, where do you need to park, where you're getting dropped off.

If somebody's dropping off at the front, uh, where's the best place to enter triage, you know, and when you tour the hospital you can ask all these questions too as far as um, you know, where the best places to park, you know, depending on your location and the country parking could be an issue and it's just kind of good to have familiarized yourself with the place and register with the hospital. Um, so make sure you're registered in advance so that when you get there, it's less paperwork that you have to do. You still have to sign things and you know, kind of check in. Um, but hopefully your registration is completed in advance. Right?

Okay. So let's transition to natural pain management first. So birth partner support. So how can your birth partner, whether it's your husband or a boyfriend, uh, your wife, whoever is there to be your person, right? So what are things that they can do during your labor, whether early labor, active Labor to naturally help you cope with, with your contractions. I'm even, I'm going to preface this by saying even if you're not planning a natural birth, there's going to be a period of time from when you began labor until if you're planning to get, let's say an epidural, there's going to be a period of time when you're laboring without an epidural, right? So you're not going to be able to just get an epidural immediately if that's your plan. It takes time. You know, you need to reach active labor for your hospital to, to admit you.

And even then, once they admit you, it could take an hour or two hours. It depends on where you're at, you know, what hospital you're at. It might take a while for the anesthesiologist to get to you and administer the epidural. So it might be awhile and if you haven't worked on or considered natural pain management techniques because you're not planning a natural birth and that might be a very challenging period of time for you, right, because you don't know what to do and you're just kind of going through these very painful, possibly painful. I'm uncomfortable contractions and you don't have any tools. So I like to bring these up, even if you're not planning a national birth for that reason because there will be a period of time and then if you think, you know, I might want to delay getting up epidural, maybe I'll try to, I'll plan to go as long as I can until I'm ready for it.

Then these are things that you can do in the meantime, right? And you never know, you may end up for. And altogether it really is like super personal preference and experience. Um, but I wanted to cover these things. So your birth partner hopefully is very comforting, very attentive, very encouraging for you emotionally for whenever you're dealing with. Now. I talk a lot about this in the, in the private group to, and when we put together our, uh, the know your options for a serious plan. So when we were doing the birth plans, I talked about creating your common relaxing birth environment and what that would look like for you. So I'll mention it briefly. Think about all of the things that would tend to relax you. I'm like, what's the most relaxing, comforting room in your house? And then think about how you can incorporate those elements of what you find most relaxing into, say a hospital room if you're going to be in a hospital room laboring or if you're at home laboring for a while, what can you do at home to make that particular space super comfortable?

Right? So if your partner can help you to maintain that relaxing, calm environment, that would be super helpful because in the moment when you get to the hospital, if you're in active labor, I'm pretty sure it's not going to be. You're going to be so focused on what's happening in your body. It might be hard for you to say things like, Hey, can you get my playlist out or can you turn on my music or can we do this? Can we do. You might be pretty focused on what's happening inside your body, so make sure your partner is aware of what you want and what you know, what your preferences are so they can do things when you reached the hospital, like dim the lights and shut the curtains if you want. Shut the door. If you want some privacy, turn a certain playlist on for you if that's something that you want to.

Um, okay. Sorry. And then anything else that you've kind of outlined? Make sure they're aware so they can kind of help maintain that. And then also the visitors or people that are going to be showing up. So if you don't want a whole lot of people at your birth and you know there while you're in labor, I'm consider, you know, having your husband or your partner, whoever is going to be there with you, making sure that they're kind of being that person guard gate, the door gate and the door guard and making sure that people don't come in, that you don't want an in the moment because it's a super personal time. So it'll just be really helpful for you if you're not having to make those decisions and you're not having to have those conversations or do physical things beyond just focusing on yourself.

You want to be able to focus on yourself. And then if you can have your partner follow your lead. So when we think of some examples of this, so like, see, you don't even know when you don't feel good, certain things are kind of annoying where sometimes when you, when you're feeling great, you really enjoy them. So let's say a certain type of massage or a certain type of, um, comfort or snug, like snuggling or whatever. And then if you're not feeling right or if you're in a mood or you're cranky, you're like, just don't touch me. So that's something that a lot of laboring moms will do. Say things like, okay, I don't want to be touched right now, or um, massage me but don't talk. Just stop talking, you know, so it, it's hard to know exactly what you're going to feel like in the moment and exactly what you're going to want.

But it's great for partners to kind of keep an eye on how you're responding to the different things they're doing. And so if you want quiet, be clear about it and tell them you want quiet. So whatever you're kind of guiding them towards and letting them know is ideal for you. Hopefully they'll kind of follow your lead there, right? Um, hydration, super important. So if you're not hooked up to IV fluids, if you're laboring at home or even at the hospital and you haven't been hooked up to anything and you're moving around and walking around, make sure you're staying hydrated. So make sure your partner is constantly has a cup of water with hopefully a bendable straw would be ideal because you're going to be moving around in different positions that they can provide you with water or ice chips or something that you can stay hydrated and go to the bathroom.

So Go, go pee every hour and have your partner help you if you need help getting to the bathroom and make sure you're drinking tons and urinating as much as you can. And then comfort techniques. So, um, I have a bit more on this too, that we'll talk about, but start thinking in advance, and again, I go over a lot of this and the in the know your options vert series. So there's stuff there. Um, and in the birth plan template, there's a section on, you know, what natural techniques and natural pain management, um, things that you prefer. So think about what you usually like when you're not in labor. So if you're usually somebody who likes to be massaged or who likes to be touched a certain way, are you like your hair, your head massage or your hair brushed, you know, start to think what things usually calm me down.

Hugs, it's very grounding to feel somebody's arms around you and just give you a nice hug. It's very grounding, very comforting feeling. So start to think about those things, um, and communicate that with your partner so that they know how to best comfort you, you know, in a moment. And then if you change your mind, tell them which you probably will because if you're in labor and you haven't had any drugs, you'll probably be pretty honest and they'll know. Um, but you know, having those conversations in advance to can be really helpful for partners because think about if you were in their shoes, you're like, oh, I don't know how to help you. It's really helpful to know how people want to be touched and how they prefer to be comforted if possible. Right. Okay. So here's a few other natural comfort techniques that I want to show you in this picture is actually, um, this is my Doula, her name, her name is eml.

So her company is one log Doula services. She's in Tampa, so we took some pictures just to kind of have some, um, examples. Um, she's going to be my Doula at, at my next birth. She was awesome. So I have a couple of suggestions here. So one hydrotherapy, it's really, really soothing for a lot of moms and labor to get in the water, whether you're in the bath or in the shower with the shower head, kind of pointed at your lower back if you're having back pain especially, but water in any form. A lot of moms swear by it during Labor. So if you're at home and you're trying to labor at home, you're uncomfortable or what? Try getting in the tub. If that doesn't feel good, get out. You might end up getting back in, try the shower. That doesn't feel good. Get Out. But moms tend to like the water.

I'm breathing techniques. So we're talking slow light rhythms and I'm not going to teach you an exact rhythm because I think that it's more of something that you have to practice on your own and practice different rhythms. I find it really helpful to practice when you're going to sleep at night, even if you're trying to fall asleep, try taking real deep breaths, whether it's four, four, four, so in, for four, hold for four and now for four or something different, some type of rhythm, some type of pattern that slows your breath down, you'll find really helpful in labor for a lot of reasons. Um, the flow of oxygen. It's very calming and also it forces you to kind of open your mouth instead of clenching. So what you don't want to be doing is clenching your mouth tight when you're in pain or discomfort. So if you're breathing and focusing on these breathing techniques, your mouth is open, which is good because there's that connection between your mouth.

You know, they may gaskin talks about the sphincter law. So she's talking about the connection between the openings in your mouth and your jaw, like all these openings staying loose and connected and how they connect to your cervix and your, your vagina, opening it. And how if this was all open and relaxed, it'll all connect down and everything down there and all your girl parts will be open and relaxed to let the baby out. So breathing techniques and practice them and see what works for you. And like I said, when you're going to bed at night, that's the best time to practice on because I promise if you have trouble sleeping, it will help you calm down to try to get to sleep. Were you in practice with your children?

Okay. So the next is moaning, grunting, horse slips and raspberries. These are all things that are keeping your mouth open and also kind of helping your pelvic floor to relax. So think about your pelvis is supportive to your pelvic bones are supported by pelvic floor muscles, right? When those muscles are too tight, it's going to be a lot harder for the baby to come through. So doing things like cables, tighten the muscles and I'm not saying don't do those things and that you want to never do cables. I think it's fine to do them, um, but having a balance of the strength of the muscle and the ability to really listen in. So I can't tell you exactly what that balance is for you and where you are today. I'm a pelvic floor personal therapist, a women's health pt. They could because they will actually assess you.

Um, we have an interview in the group too if you haven't seen it, highly recommended because it is interesting. Um, but what you want is those pelvic floor muscles to be relaxed and things that will help you relax them. Our breathing techniques, water, hydrotherapy, and then moaning, grunting, horse slips, raspberries. And I know it sounds silly, but think about when you were a kid or when you play with your, um, you know, the kids you babysit or your nieces and nephews, whatever, because you've been around, I'm sure you've blown raspberries on a kid's belly before, right? That whole thing that you blow on their belly, just try it right now. Nobody can see you, nobody can hear you. So you're not going to feel stupid. Just try it and tell me if you can tighten your pelvic floor, like try doing a kegel naturally when your body can’t kegel while you're doing that or like the horse lips, it looks just like raspberries.

It's just not up against skin. So it's really that same thing. Um, and it looks so silly, but I'd rather look silly and labor then have super tight pelvic floor muscles and not be able to get the baby out. I'm like, you're going to kind of, you know, it's a super humbling moment anyways. Right? So blowing horse legs, it's not going to make it any worse. I'd probably be more concerned with like, you know, cooking. So just being honest and grunting, all those moaning, grunting feelings, if they come natural and they feel good to get it out, get it out. And I've heard doctors and nurses, you know, I've heard comments that some providers and some nurses are uncomfortable when laboring moms make noises. But that's, it's very primal. It's very natural. It's very normal. It's really good for you while you're in labor. It's good for your pelvic floor.

It's good for the birth. So do it. And if somebody has an issue with it, that's not your issue, that's their issue. Make as much noise as you want. It's good for your progress. It's good for the birth. Um, so yeah, and you don't have to practice those things because they might, a lot of moms I think feel really uncomfortable pack, practicing, moaning, grunting and all that. But in the moment, just follow your instincts and if it feels right to let out noise during a contraction, do it. That's what your body needs, right? So don't worry so much about what other people are saying or comments you're making about the noise you're making as much as what feels right to you. Okay? And that kind of theme. I always say stuff like that because I think, um, we're not really taught a lot to listen to our own instincts and to do exactly what, you know, what it is that we feel comfortable doing.

We're taught to kind of pay attention to what other people are telling us to do, be it our doctors or nurses, whatever. Um, and this is a great time in life if you've never kind of, um, you know, listen to your own instincts. Motherhood is a great time to start listening to your instincts and pregnancy. And I know a lot of you probably agree with that. All right, so next is the birth ball in the picture. You can see I'm kind of hanging over the birth ball and leaning forward. There's, you can, anything that feels good on the court, it's a yoga ball, it's really a yoga ball, but in the birth world we call it a birth ball, but if you order one on Amazon, it's just a yoga ball. And so you want to, you know, have the right size for your height and everything.

Um, but whatever, it's a great tool. And birth balls are like 20, 25 bucks. I'm. Most hospitals have them, so if you don't have one at home but you want one in the hospital, certainly asked for one. Uh, if you have your own, you can bring your own or even when you're at home you can use yours. And if you're, you know, during your pregnancy, I highly, highly recommend an urge you to use it as much as you can. I'm online all the time, rotating my hips, opening my pelvis, balancing all those things really good during pregnancy. And then during birth you can use the ball, like I'm using it here in the picture to kind of lean over and hang over to take the pressure. You can see I'm taking the pressure off of my back and my pelvis by leaning forward like that.

And if you haven't tried sitting in a position like that pregnant, especially in your third trimester, tried it. It feels really good whether you're leaning over the ball over our kitchen counter and just kind of letting your stomach hang. It's, it feels very good. Um, so during birthers there's so many things you can do with, you know, during Labor with a ball rotating sitting on it, I'm kind of bouncing a little bit to help baby further engage, but the birth ball tends to be like one of the, probably one of the best uses of 20, $25 for a tool for national comfort techniques. Okay. So the next one is, so were bozos scarf. Um, if you haven't heard of her, a Bozo scarf, it is, it's this, um, say like this. They come from Mexico. So they originate the Rebozo. The real bozos originated in Mexico and it's basically a long scarf that is used in tons of different ways during birth and you can use on postpartum as well.

Um, to do a lot of different things. So comfort techniques, I'm going to try to explain some of them to you. I don't have a lot of photos of rebozos. I think there's one more later. Um, but there's a lot of things you can do with it. So think about, which I'll talk about, kind of you'll see. See My doula here is doing a bit of a counter pressure hits squeeze on my hips. So a lot of moms find that super helpful to push that pressure on the pelvic bone right there and apply that pressure to the hips, the issue or not issue, but the kind of challenge sometimes is that over hours and hours of doing that motion, your support person's arms are exhausted. It's exhausting. You're probably exhausted too, but you know, your support person might be having a hard time continuing that. So what you can do, for example, was a rebozo scarf, tie it around your hips, and then you can actually take like a wooden spoon and wedge it in the back in the knot and turn it like torque.

So turn it and tightened so that it tightens and applies that similar feeling of hip pressure without exhausting your purse supports arms. So that's just one of the examples of things you can do. I'll show you some other pictures, but it's basically just a very large scarf. And they do have them on Amazon. They're not like, they're not the, um, they're probably not the traditional, the best Mexican rebozo is out there, but they certainly do the trick and you can reuse them later as throw pillow, throw blankets, people use them to carry babies and tie them up. I'll show you some pictures. Um, but that's another option. Aroma therapy. So I'm talking essential oils. I'm also, I have an essential oils interview in the group and on the blog that you're welcome to go check out with, um, my oils lady who I love. She's with young living and we talked all about what oils are best during pregnancy, during birth and for babies.

So there are certain essential oils that are known to be really good for labor. Um, one thing I would caution is to test them out during labor before you start really pulling them into your birth room because you might not enjoy that particular smell that day. So it's like pregnancy, you know, think about, I compare it to like food aversion, so something your whole life you may have enjoyed peanut butter and then suddenly during pregnancy you can't see on the side of it. So it's going to be that kind of feeling. So be careful not to overdo it with your own, with therapy until you make sure that you can handle that sent in birth. All right, so this next one is kind of big, so acupressure, massage and counter pressure. So you're seeing my here kind of massaging and applying counter pressure to my hips.

Acupressure. There are points throughout your body, acupressure points, several of them that if they are, you know, pushed or massaged or um, you know, you applies gentle pressure, acupressure to them, they can actually help labor to kind of progress, encourage contractions, things like that. So there's a series of them and I'm happy to share more info if you guys want it, um, but there's a series of natural places on your body that you can press to help things move along and it's been really effective for a lot of moms massage. Um, what I'll say about massage, like I mentioned before, is your feelings might, your preferences might change in labor. So just be open minded, kind of know in advance what kind of massage you prefer, but know that in the moment you might want something a little bit different, firmer or softer or emotion as opposed to like just study from pressure and that might change whether you're having a contraction or you're in a rest period.

So a lot of moms during a contraction don't want like this steady stroking type of massage. A lot of moms prefer like a firm steady pressure grounding pressure during a contraction because it helps them to not get. It helps them mentally to focus on what's going on, on the contraction. Um, where I think the stroking a lot of moms will feel like a massage stroke during a contraction can be too distracting. Um, so, you know, you'll want to be open to see what works for you in the moment, right where during your rest periods. So in between contractions, if you have a minute to three, four minutes, you might prefer a kind of stroking massage where you're kind of rubbing out some kind of pain that you might be having an a part of your body. All right? So I hope that's helpful. Um, and you know, there's a lot of great massage tools online on Amazon, you know, any of those rolling tools, there's a lot of great things you can use instead of just your hands.

So keep that in mind to, um, the next one. Hypnosis. So if you've heard of like hypnobirthing or hip, no babies are like the two big ones. Um, if you're considering doing something like that, you'd have to set it up a little bit earlier. It's ideal to be doing it. It's, they're usually about six to eight week courses and you sign up for them during your third trimester. You can do them online or home study, but hypnosis is, um, a lot of moms swear by it. So I'm just an option. And then again, with the hot and cold therapy. So if you're at the hospital and they don't have labor tubs or you're not able to access a shower, um, there are other ways that you can access hot and cold therapy as a pain management technique. Um, let's, let's just throw some examples out.

So if you have a water bottle and you fill it with warm water and kind of use it to a massage up and down your back, you know, warm water compresses. I'm cold. Wet towels across your forehead can feel really soothing on your chest if your chest, if you're feeling hot or nauseous. Um, so the, you can bring a heating pad, you know, you can bring a heating pad into the hospital. That's an option. I would caution you about using a heating pad if you've had an epidural because you might not, you don't want to bring your skin right, and if you've had an epidural, you might not feel it and you might not feel how hot it's getting. So I would caution against that. Um, but you know, applying it off and on for some heat therapy, um, moms tend to really like that too. So let's see what else I've got here.

Alright. Positions and movements. So if you haven't had any pain management drugs yet or if you're not going to get them, um, you'll want to be moving around and changing positions and take advantage of the fact that you can be moving to see what feels good for your body. It's really good for progressing Labor to be moving. Our bodies were not designed to lay flat and hospital bed to give birth. That's not what they were designed for. Um, it's, it's easy for the doctor because they can very easily come in and out and check out and see the baby's position. It's not always ideal for you, um, for a lot of reasons. So if you can be moving around, um, that's, that's going to help you tremendously. Um, some ideas, so walking, if you're feeling up for it, some light walking around the hospital or walking around your house, standing up and leaning maybe into your partner and kind of doing this dancing motion or rocking some moms like to kind of just lean into the wall for a minute.

Um, again, I'm going to say, listen to your instincts and kind of see how your body's feeling doing different things and try different things. See what your body's telling you to do. Listen to your body. Don't you? Don't necessarily have a nurse tell you, okay, time to get up in the bed and lay down and put your head back and put your feet up in the stirrups. And let me check you out. And this is the best position. If it doesn't feel good to you, don't do it. I'm hands and knees is a really good position. It's great for taking pressure off your back and if you're having some back labor, being on your hands and knees is super helpful. It's also really good for the baby to move, move down because of the way your pelvis is, uh, is shaped. Let me show you.

So I have to show that I don't know how well you can see this. Okay. So here's your pelvis, right? So this is the front of your pelvis. Here's the bag. This is your spinal cord. So if you're laying down flat on a bed, this is what your, your pelvic bones, you know your pelvis looks like. I'm going to turn it a little bit so you can see this. There's a bone in the back. Turn it right there. You see the bottom back part of your spine, how it curves in like that if you turn your pelvis and lay it on its back, your baby has to go up, has to travel up around that bone. That's pointed up. They have to travel that way to get out. It's you're, you're fighting gravity and the baby is fighting gravity. It's not a great position to get the baby out.

So anytime we're in a position where we're vertical, it's a lot easier because you have gravity working with you to help me out and even if I turn it this way, and so now you're on all fours. This is kind of an all fours position. Here's that curved bone, see how it's pointing down. So you have kind of gravity working, but then also the baby can just move seamlessly through there a lot easier than having to go up against this bone. So I hope that kind of helps you visualize why hands and knees or even any vertical position is super helpful for labor and pushing because you're, you know, they're not fighting gravity, they're moving down. So if you're laying flat against like this, like the baby, it's a lot harder for the baby to get out. So, um, I feel like that demo is pretty helpful squatting.

So a lot of moms tend to really like squatting and labor and it is so good for opening up your pelvis. So while you're in labor doing, you know, and I don't mean up, down, up, down, squatting, but getting down, even if you're being supported, even if you're being like holding onto something, holding onto, for example, that were bozos scarf that we talked about, or if you don't have a scarf, a towel, if your husband or partner is holding it up and you hold onto something and kind of squat down and just open your pelvis. I'm really good for opening your pelvis and helping baby to engage. I'm sitting on the toilet. So this one's kind of funny and we've talked about this in the group. I think I'm alive when I did one of the digital Dildo, q and a's and a mom was asking, um, about sitting on the toilet.

Well, think about all of the muscles that you're using and labor to push the baby out. Those are like the same muscles that you use to cook. So sitting on the toilet is a natural position that your body is used to, to kind of use those muscles to push something out of you, right? Um, and so a lot of moms find that like they want to just go and sit on the toilet. Um, some don't, some do, but again, listen to your instincts and it's a great position because it's opening everything up now you might not want to push in that position, but we'll talk about that tomorrow. But for laboring, a lot of moms really like it. Um, another reason why moms tend to like it is because of where the toilet is located. It's in a bathroom with the door shut. You can dim the lights, it's private.

And so we talked about creating this calm, relaxing environment and related to coping. When you're going to go poke like you're, you don't want to sit in a big bright, open room with white song and windows and doors and people staring at you. Like that's not an ideal situation to be pooping, right? You go to the bathroom and shut the door, you have some privacy and then your body can kind of relax and your pelvic muscle, all of those things can relax and let something out. Right? It's like that same feeling. So a lot of moms like going in the bathroom because they like the privacy too, so sitting on the toilet, super common and you might really like it rocking and slow dancing. So this is kind of if you're standing up and just kind of rocking and moving around like this with the, you know, with, with the contractions or even during rest periods, slow dancing, any kind of movement, whatever feels good, listen to your body and do it right.

Stair climbing, okay? So don't go out and climb like a ton of stairs, but if you're able, if you're trying to move things along and you have the strength and you have somebody supporting you and helping you walk and helping you climb a little bit of stair climbing can be really good to progress labor. Um, you're using all those muscles down there, right? And you're moving things around and stretching and those, it's a very effective thing that you can do. Now, sideline, I'm not a super active thing, but you need rest too. So if your body needs a bit of a break and you need a little bit of rest, try lying on your side instead of lying on your back. So the picture that I have here, I'm laying on my side with a peanut yoga ball and I think I mentioned that later in the slides.

I'm not certain, but um, this is a peanut shape yoga ball, super, super helpful for Labor. Um, most hospitals have them and when you go in your hospital to ask them if they have them, especially if you're planning on getting an epidural because this is one position that you can be in during labor. In fact, I'm going to say that you should be in. I'm going to urge you to be in a sideline position if you've had epidural, not on your back, and you can do this with a peanut ball and now you're allowing your pelvis to continue opening if you've had epidural by using the peanut ball. And then try switching sides that we see every 30 minutes or so. Get Your Doula, get your husband and get your wife, whoever's there nurse to help you switch sides if you've had the epidural. I'm so sideline peanut ball, great position for pushing too. I mean you have to take the peanut ball out of the way to push the baby out, but somebody can hold your leg up while you're pushing. So sideline, great position, great resting position. Much better than laying flat on your back.

Okay. Here's a couple of other pictures. Um, this one on the left is a good use of the rebozo scarf. So that's a rebozo scarf that I have. Um, that's in my doula bag. And so what my Doula here, what she's doing is they call it like belly sifting. So she's got it wrapped around my belly, kind of creating like a hammock for my belly and holding, pulling up just a little bit to take some pressure off for me and it feels really good and you can actually kind of move it back and forth and sift a little bit. Um, there's a website that I'd recommend if you're interested in more about were Bozos. There's a website that you can actually learn all about, like the original uses and how to properly use your Bozo. You'd want to be careful in that particular position if you have an anterior placenta, I'll just mention that too.

So if your placenta is upfront, um, I would be cautious not to use the rebozo like that and you know, you're probably not going to be there jerking it around anyways. You probably going to be a bit more gentle, but that's just a kind of visual of what that looks like. Um, and then I also have a picture here of me doing some scare lunges, so she was kind of guiding me on what that looks like if you're, if you're, um, if you're trying to move things along, moves some labor along. That's a really good movement. Again, this is from one lab doula services is, um, is the July, her name is cml. Okay. So now we're going to move on to pain management meds.

Um, I want to cover, let's start with a little bit of a background. Um, I want to give you a heads up on kind of the categories before we do each one. Um, so if you can't read this on your phone or you're having trouble, then I'll just kind of skimmed through them. I'll talk through them really quickly. So there's different ways that some of the pain management drugs are administered. Some of them you take orally, some of them you inhale, so you take kind of like breathing and gas, some of them are injections, whether they're to your muscle or an injection in the vein, and then some of them are injected into the space around your spinal cord. So those are kind of the different ways you can, you know, that some of the medications are administered. Um, and then there's different classifications depending on what part of your body that they will affect during labor.

So if it's, if they're calling it a local medic, local pain management med, that means it's only affecting a certain, specific, smaller part of your body. Um, regional is a larger part, but still, I'm not your whole body, but a specific region. She's bigger than the local. Local is more of like, I would, I would, um, associate like a little numbing shot if you're about to get a stitch that's like a local, regional would be more like your epidural. So it's, it's kind of affecting a larger part of your body, right? Kind of your boobs down under your boobs are, you know, abdominal area down systemic, um, it's kind of an injection that affects your entire body, so it affects your whole body. And then there's two different types of effects that these drugs will have depending on the drug. And I'll mention them as we go drug by drug and Analgesia and anesthesia.

So one type is analgesic or not painkillers. They reduce your perception of the pain. So they're, they're kind of like commonly referred to as taking the edge off, but they're not actually painkillers where anesthesia is actually a pain killer and you have no, you know, you've lost the sensation and you don't feel anything if they're working properly. So I wanted to kind of preface the pain management medication discussion with, um, you know, making sure you understand that these are kind of some of the classification things, right? Alright. So the first one we're going to go into this is, these are things like these are systemic ivy, so intravenous or interim muscle, narcotics, um, and these systemic meaning they affect your entire body. Um, we're talking about examples, morphine, fentanyl, state, all of these are all things that can, again, it's an injection that would affect your entire body.

Um, they had that analgesic effect, so it's not a pain killer, but it's taking the edge off. Uh, once you have these injections you do, you are required to be on Ivy. Um, you are usually, most hospitals will require id fluids, continuous electronic fetal monitoring, which we're going to talk about later too, and you'll be restricted to bed. So, um, keep that in mind. Moms that get the systemic injections tend to feel lethargic or disoriented. Um, you know, it's pretty common, but they don't last very long. These injections only lasts for about an hour to an hour and a half. Um, common side effects, itching, nausea, vomiting, and lower blood pressure. What are the risks? Uh, they can slow your labor, they can affect the baby's heart rate, so they do pass to the baby, um, and it can cause her to say her, but it can cause her or him to breathe slowly and have poor muscle tone.

Um, so systemic ivy drugs, to recap, they do, they do crossover to the baby and these are things that you will be confined to bed and be hooked up tonight and all of that. All right. The next one is a nitrous oxide gas, so it's commonly referred to as laughing gas and if you've ever been to the dentist for a procedure and had laughing gas and it's the same concept but it's not as strong so it's a little bit different of a mixture. So the concentration of is a little less so you're not going to feel quite as good a job as you did at the dentist office. Um, but there are some pretty great benefit. So it also has the analgesic effect where it's not a painkiller, it's just, again, one of those things. It takes the edge off and a lot of moms really like it because it helps them feel really relaxed.

So, um, also you can control how much you're getting. So moms tend to like that too because you feel like you can kind of control it if you're using it a little bit for a contraction that you don't like the weights feeling, you just don't use it for the next one and that's it. It's done. You don't have to wait for this drug to get out of your body. Um, another thing that I really like about it or a great benefit that a lot of moms like I should say, is that it does not interrupt the release of natural oxytocin. So yesterday we talked about how certain interventions and certain pain management drugs, once you introduce them to your body, um, you're interrupting the flow of natural hormones. So which, which can be really not great for Labor, right? The nice thing about nitric oxide as it does not interrupt that release, so your stop, your body will still be releasing natural oxytocin, which is really good for labor and good for a lot of things, right?

And it does not cross to the baby, it doesn't impact breastfeeding. So this is a really, um, a lot of moms really like nitrous oxide. This is one of those things that if you're interested in it, I would ask when you do your hospital tour, find out if they have it in advance, see if that's an option for you. Um, there are some risks associated, but they're pretty minimal sedation, dizziness, nausea and vomiting. Again, one of those things, if it's not feeling good, it's pretty easy to stop and stop using it, right? But it doesn't have any risk to the baby or things like that. So it's quite, it's quite preferred by a lot of moms. And then the journal, if you can't read the slide, I'll read to you the journal of Midwifery and women's health considers nitrous oxide safe for both mom and baby. So even if you're not, um, it might be something you only use if you're waiting for the epidural and you're planning to get an epidural or it might be something that you say, you know, I'll use this, um, even after birth if you need some stitching or something like that and you want to use some nitrous oxide during being stitched up. So there's different times you can use it too and different reasons. So keep that in mind too.

Okay. So here's the big one that everybody knows about epidural. So epidural is a regional drug, meaning it affects a large portion of your body, not your entire body, but it will affect, I'm like just under your boobs and all the way down, right? It's a combination of anesthetic, so painkillers, opioids, narcotics, and sometimes you'll also get some systemic drugs in there too, if you are curious to see what your hospital uses. I would ask at your, um, at your hospital to work to find out what kind of combination they're using and what the anesthesiologists uses, um, how they're administered. Okay. So this is an, a lot of you probably heard about this gigantic needle goes into your back and let me kind of explain it to you a little bit about what it's like because I've had two epidurals now. Um, I had one for Assyrian and I had one for math, national birth, my feedback.

So when you're getting an epidural, you'll go into the room where you need to get it. Typically your or your husband or your partner can not go in with you. So it's usually just you. I'm going in there. You are in the hospital gown. You have to kind of sit over the edge of the bed and bend forward so that your back is like very easily accessible and they will sometimes give you like a pillow to hold onto and like lean forward. Um, and it is uncomfortable. You do get an injection and then they place a catheter. So what you see here, that picture, they're placing a catheter so that you can be hooked up to, um, the drugs basically. And then you get a pump. So once it's all set and you get established, they'll take all this stuff down, um, and you are confined to the bed.

You get IV fluids, you get a catheter that you can urinate, you're setup to continuous monitoring, of course, because of the effects the epidural can have on you. Uh, you're restricted with your eating or drinking your movement, all of those things, and you get the pump. So once you get set up in your bed, you have this pump and you can control how much you're getting and if you want to kind of, you know, you can adjust based on how you're feeling. Right? A little bit more about epidurals. Um, the pros, they are super effective for the most part and very accessible. Most hospitals in the United States is very easy to get an epidural, a, the cons. So it disrupts your natural label. Hormones, like we were just talking about, once you get an epidural, your body is not going to be releasing those hormones that would occur naturally during birth.

So it's really not great for that. Right? Um, you are restricted with your movement. You can't do all the things like being up, walking around, changing positions, I'm sitting on the toilet, sitting in water, all those things that are really good for progressing labor you, you won't be able to do. Right. Um, and I mentioned the one thing you can do as far as laying on the side and using the peanut ball and switching positions. I recommend doing that. At least I'm. Another con is women who have an epidural tend to have a longer labor overall and a longer pushing stage. Not Great, but it's a side effect. Risks so it can affect the baby's heart rate because it certainly passes over to the baby and you are more likely if you've had an epidural, you're more likely to need other interventions. And we talked about some of these things yesterday, like pitocin or vacuum or forceps during delivery.

So just keep that in mind too, is that you're more likely to need some of those other things, more risks. Um, I have to let you know, um, there's the risk of developing mom developing a fever with an epidural, which is pretty bad for the baby because it can cause infection. Um, it can make initial breastfeeding more difficult. So if you're curious more about that, I would recommend you google or looking at youtube. I'm like a natural birth. The babies breast crawl, the breast crawl videos are remarkable. If you've ever seen a baby who has not had epidural or other pain management drugs, how well they actually like crawl to the breast and breastfeed and how good they can do it. It's not saying that if you've had an epidural you won't be able to breastfeed. Of course you can. It can just make it a little bit more challenging.

And I wanted you to be aware of that. Okay. And then it does increase your chance of having a c section because if you have had the epidural, it can really impact the baby's heart rate. And so if your doctors are watching baby's heart rate and it's looking like the baby's in distress, some doctors will say, well, we'll call it the CSECTION, right? Um, and then you run the risk of it not working. So there's a lot of moms, it's not super common, but it happens sometimes it doesn't completely work or only one side work. So just keep that in mind and severe headaches. So it's the only one in 100 moms. But I have heard moms tell me that they suffered pretty, pretty badly from migraines after they had the epidural. And then there's extremely rare complications. Um, but they are out there. They can happen and you'll be made aware again that day if you choose to get an epidural.

So we're talking nerve damage, seizures, severe breathing difficulty and even death. Um, but they are extremely rare. I just wanted you to be aware of them. I think more common side effects a epidural can make your blood pressure go down. Um, it can cause itching and nausea and fever, which we mentioned at the beginning. Okay. So here's another option, um, that some moms like if they're planning to use pain management meds, sometimes what they'll do is get a combined spinal epidural. So if you remember we talked about, um, the spinal, a few slides back. So basically what you're doing when they go in to do the epidural, they'll place the catheter and maybe or maybe not necessarily go ahead and start pumping the epidural drug in, maybe they'll just place the catheter. So some moms really like that because they'll try the spinal effects, which is just an injection in the back.

They'll try the spinal effect first lasting an hour or two and kind of see how they're feeling and if they need more raw, more pain relief, they have the epidural catheter already placed and they can pump the pump to get more pain management drugs. So if that kind of makes sense, it's kind of taking both of your are already going to be back there getting injections. It's kind of, you know, um, if you start with the spinal and feel like you need more, you can add the epidural. So you're getting the effects of having the spinal meds earlier in the labor, allowing you to not be completely numb, you know, and things like that. So remember the spinal has the analgesic effect. So it's not a pain management. I'm sorry. It's not a, it's not going to take away the pain. It's taken the edge off. So how'd that effect immediately? And then you can decide if you want more with the epidural drugs. Hope that's clear. Yeah, hope that's clear. So that's an option that some moms really like to. And if you're interested, ask when you do the hospitals who are, find out if that's something that they do and that they offer to moms and see if you know, if you can include in your birth plan if you want it.

All right? So here's some tips if you're going to be getting an epidural. I talked a little bit about the peanut ball. This mom here in the picture. And this is um, this is my Doula as well with one love. Her name's eml. Um, this is a different mom that gave us permission to use her photo. So she's just had the epidural and she's resting, she needed a rest, she had been laboring for a long time and you need some Ras, got an epidural, which is fine. Right? And that's a good time to get one right. If you're really, really been going hard and laboring for a long time, um, sometimes girls can be really helpful to kind of give you a chance to take a break. So she's resting and you can't tell very well from the photo, but her leg is actually wrapped around a peanut ball here and she's angled like sitting up, see how her bad is kind of tilted up.

Um, so again, she's not completely flat. She sideline and at an angle on a peanut ball, which is great. And then another chip you can actually. So I put light epidural because you're controlling the dose with the pump. So if you start to allow the drugs to wear off a little bit, kind of see how much you feel like you want and if you want to try to feel the urge to push when the time comes, maybe you know, cut back on the pumps. And just see how you feel and see how it's going and you might want to feel more. Maybe you just wanted a little bit to kind of take, you know, give yourself a rest and then you know, if it starts to wear off, you're like, okay, I'm good now. You always have the pump and you can always come to yourself more because you have that catheter placed.

Another option is delaying the epidural so you don't have to necessarily say I'm not getting one or I'm going to get one as soon as I get there, you can have it in your plan to delay it as long as you choose to. So if you say, I want to go, you know, ideally this far, this long and you know, we'll see how I go when I'm ready for it, I will let you know, um, and take that control over the conversation at the hospital even. Um, and so if you want to kind of minimize your chance of running into that cascade of interventions that we talked about yesterday, maybe delay it a little bit. Not saying you don't have to get everything, you know, you shouldn't get it, but maybe just postpone it a little bit, right. Because the longer you put it off, the more your body is doing all this stuff naturally and it's really good for your body to be doing those things.

Right. So if you put it off for a little while, you know, I'm not a bad option. Okay. The last section is monitoring what is going to be happening to you and your baby during Labor in terms of monitoring. And a lot of this depends on whether or not you've had pain management drugs. Right? So how has mom monitored during labor? The nurse will be coming in quite a bit. I think a lot of moms are surprised at the nurse's interaction and the nurse's job and role in, in your birth. Um, they do a lot of monitoring. They're very busy, busy people. They have a ton of stuff to do. Um, they're amazing, but they have a lot to do, right? And they have a lot of things to be monitoring that they're reporting to the doctor, to the hospitals. Um, and they're in charge of keeping all of these records of your labor, so they're looking at your blood pressure, your temperature, your pulse, your urine outtake, your fluid intake, whether it's ib or if you're not hooked up to an ivy, you know how much you're drinking a, your activity and your emotional state.

I'm your nurse is probably also going to be doing your vaginal exams. So we mentioned this earlier about when you get to triage, they do a vaginal exam. They'll do them periodically throughout your birth to. It's pretty protocol throughout labor. Again, I mentioned this in the know your options series, that you don't have to have a vaginal exam. You don't have to. There's a lot of women who don't want to, they don't want to know, they don't care to know and for a lot of reasons, so just know that it's not something you're required to do, but it is protocol. So most, if you are delivering in a hospital, most often you'll, you'll see the nurse coming in offering you a vaginal exam. They're checking your cervix for effacement, for dilation that we talked about yesterday. And the baby's station and positioning. So when we talked about the station, I remember it was that negative three, so back here in the pelvis, so it was that, that negative zone and then you get down to the zero negative three negative two negative one zero s and then you get to one, two, three.

So they're looking at baby station, um, and positioned to see if the baby's and optimal fetal position for birth. And don't be super discouraged if the baby's not in the perfect birth position, um, because baby does a lot of moving during labor during birth, baby is moving around and so you moving a lot helps him or her to have that space and opening your pelvis, like I mentioned before, helps the baby have space to keep moving. And I have a great video that I'll share with you guys after the class where you can actually see what it looks like and how much the baby is moving during, during birth. Right. I'm going to show you a quick, a quick little thing. It might be kind of hard to see here, but okay. So it might be kind of hard to see. So this is the top of your pelvis, see how this is so wide up here, and then more narrow at the bottom part, right?

So for the baby to fit through properly, he has to go through in such a way so that he, he's turning, he's turning throughout your, your birth so that he can fit properly. And so I'll show you the video because it will be easier for you to see. It's hard to see with me on this little screen, um, but the video makes it really clear that baby's moving and turning and your contractions are helping him do that, right? Uh, so they're also going to be monitoring your contractions of course, and your amniotic fluid. So whether or not your water broke and kind of where you're at with your fluids. Um, little side note, just a comment on amniotic fluid and your water breaking. Um, so I just want to try and give you a visual. If your water hasn't yet broken and your baby is sitting inside your uterus, inside the amniotic sac with all this water, it's a lot easier for him or her, like it's easier for him or her to move when there's water cushioning him.

Right? So if your doctor suggests, let me go on and break your water. You can, you don't have to, but just know that sometimes when the less water you have a, it can be a little bit more difficult for baby to move. So if your water hasn't broken on its own yet, something to keep in mind is just that, um, maybe the baby's not an optimal position yet, right? Maybe he needs that extra cushion of water to help him have the space to move a little bit. So I know breaking water, a lot of people are like, yes, break my water, let's get this party started and get things moving. Um, but, you know, I just want you to be aware that sometimes that water is still there to really help baby to move. So I hope that make sense. I'm not saying don't do it. Just know that there's that as all say above it.

So in terms of monitoring the baby, um, there's different ways that you can be monitored when you are either at a birth center, at the hospital, um, and it's going to depend a lot on whether you're low risk, high risk, you know, what your, it's your preference really also. So this is kind of the old school way, right? Stethoscope, super basic, very manual. So the doctor or whoever, the nurse will have to actually come out, sit and, and hook up the stethoscope for a minute and listen. Um, it is super common for low risk women and um, easy and simple and possible if that's what you want to do, right? Um, if you've been going to your prenatal visits, this is probably what you've seen. This is a doppler monitor. So when they use the doppler, it's also more manual because they have to actually stand there and use this thing and hold their hand and whatever. Um, but it's when you can actually hear the heartbeat or you know, you can hear it loudly in the room. So this is a doppler, an option if it's something you want to do, if you want to have, you know, movement and you don't want to be strapped down and tied down to something, this gives you a lot of freedom of mobility, right? And you could certainly request these things, especially if you're low risk.

Okay. This is what most of us associate with heart rate monitoring once you get to the hospital when you're in labor, right? So this is a laboring mom in the hospital who appears to have some ivs in her hand. So she's been confined to a bed. She's got a blood pressure thing on her arm, and then you can see those straps around her stomach. So that is electronic, fetal monitoring and continuous. Um, it's a strap that they set up that's just constantly checking babies heart rate. Um, you, there are debatable, you know, discussions if you're interested in them and you're not sure if you really want to use these things because there are a lot of people that believe that these electronic fetal monitoring systems can sometimes show signs of distress when there might not be distressed. So almost like false alarms, they can certainly show you if there's a problem, um, but sometimes it can appear that there's a problem when there might not be a.

So just something to keep in mind that if you're interested in that, I would urge you to, uh, to, you know, do your research on it. They are standard protocol in most hospitals because it's easy, it's easier for nurses who have a ton of work to do and a ton of monitoring. Um, it's a lot easier for them to have this machine. It's all electronically done. Um, so it's easy for them to have, you know, monitoring statistics and things to look back on for your birth, for your labor. Can't limit your mobility. So once you have this on, it can be a little bit harder to be out moving around and all those things. Um, if you're not hooked up to any other equipment and you're not on Ivs, you can certainly ask to take it off for certain periods of time to go to the bathroom and to get up and walk around.

You might say, you know, I need 20 minutes to get up and move around, or giving me a few minutes to do some moving and I'll come back and get it hooked back up in a minute. So if you haven't been hooked up to the two pain management drugs or epidural or Ivs, ask if you can take it off to do different things and move around. Um, it sits across your stomach. It's an external belt. And let's see, it may, I already mentioned this, but they're probably going to be recommended or pretty, um, pretty much protocol if you've had a pictocin drip, if you've had an epidural, if the baby's heart rate based on one of the more manual techniques is showing that there may be signed distress, this might be the next step up is okay, we need to take a closer look. Let's try this or if you are high risk.

So when I talk about the next step up, um, this is where we start talking about internal, a fetal heart rate monitoring. I'm, I don't have a great image of it, but I'll try to explain it. Not one that I can legally use, right? And share, um, but if you're interested. So here's what I would let me show you what it looks like first. So when you talk about internal monitoring, this is kind of the next step up. If things are starting to look questionable and they want to get a better look at what they do is take an electrode and insert it that generally up to baby's scalp, so it's going to go up into your vagina, up through your cervix and beyond the baby's scalp to get a more accurate reading of their heartbeat. They're also going to put a catheter, you know, check for you with a urine catheter.

You're not having any urine catheter during this. So what I would say about the internal monitoring, if you're using the belt monitor and things are starting to maybe signs of distress, um, and you want to have a, have some peace of mind before jumping to conclusion and maybe doing something a little bit more serious. If there's time, maybe you say, okay, can we try the internal monitoring first to really get it, get an accurate more accurate? Look, that could be an option, right? What are some other options? So some hospitals, and I would ask about this is some hospitals will have intermittent monitoring, so they'll allow you to take breaks, um, and to take it off for a certain amount of time so you can get up, walk around, dance, go to the bathroom whenever you want to do a and then put it back on and check the baby's heart rate again.

Um, some hospitals also have wireless, continuous monitoring, even waterproof, which is quite nice. So if you want it to labor in the shower, a lot of birth rooms at hospitals do have bathrooms equipped with a shower and sometimes they have wireless waterproof monitoring that you can actually use in the shower, which is really great. Um, a lot of VBAC moms tend to really like this. So if you're not sure what I mean, VBAC is a vaginal birth after Cesarean. And one of the biggest risks and concerns a VBAC moms is uterine. Um, I know there's some feedback moms that are watching this because there's a lot of them in my group. Um, I'm a VBAC mom and so I'm aware of this. It's not that it's a huge number of risk, but it's a risk that a, it's out there and applies to vbac moms.

So uterine rupture. I'm one of the ways that you would know if you're having uterine rupture is through heart rate monitoring. So a lot of vbac moms feel much more comfortable having some type of continuous monitoring, but they also want to be able to experience being up and moving around switching positions and trying all these different things and labor so they love when the hospital has wireless or waterproof, even continuous monitoring because you kind of get the best of both worlds. You're being monitored constantly, so you've got that checked off, but you can also have the, the um, ability to move around freely. Right? So what I would recommend in summary for this is to talk to the hospital when you did a tour and find out what the monitoring options are and how they align with what your plans are for your birth, right, birth preferences, birth plans, whatever you want to call it, you know, um, what you would like to, what you would like to experience. Okay. So that's it for the class to um, tomorrow is day three and we're going to talk about transition pushing and your placenta. So pushing is kind of a hot topic too. And I like talking about it because there's, I think it's just such a great area. So that's it for today. I hope it was really helpful for everybody and see you guys tomorrow.