Can I Go To The Hospital For Problems When Not In Labor?

A friend recently asked me about this after a frustrating experience. She had been experiencing some intense pain and with it being the weekend it was not an option to go to the doctor's office to be looked at and was advised to go to labor and delivery.

If you are uncertain as to what is going on and you are concerned that something could be wrong, call your doctor's office and tell them the situation. In an after hour situation it is quite legitimate to go to labor and delivery at the hospital to be checked out, and the nurse adviser, doctor or midwife can tell you if this is best. 

If you are bleeding a lot or are having intense abdominal pain, go to the hospital ASAP and call your provider on the way. These can be emergencies that need to be addressed immediately!

Labor and delivery is there to help you, so do not be afraid to use them if you are really uncertain as to what is going on and you are concerned. 

Labor Preparation Exercises

There are a few exercises that are good for helping prepare for labor as well as helping with some discomforts you have in pregnancy.

Tailor Sitting

This is not an exercise in the truest sense of the word, but a way of sitting that helps stretch your legs. You sit with your feet close together (like the butterfly) and gradually push your knees down. As you grow in your exercise this will stretch your legs and help with comfort in pushing.

Squatting

This is not like squatting with weights, but is meant to stretch your legs and perineum. Put your feet on the floor about a foot apart and gradually move down into a squatting position, keeping your heels on the floor. You can lean forward to help your balance. Use your elbows to push your knees out. This also helps with flexibility.

Pelvic Rocking

This is a great exercise to help with back pain! Get on your hands and knees and rock your pelvis back and forth. You want to move only your pelvis. Keep your upper back stationary. There is no need for speed. Be intentional with your movements. Later in pregnancy and during labor this can help in positioning the baby.

Leg Apart Exercise

This exercise is done with the help of you husband. Sit with your knees up in front of you and have your husband place his hands on the outside of the knees and apply light pressure. You will then push your legs out from this position.

Kegel Exercise

Many of you may be familiar with this already, but this exercise is very important in preparing for labor. When you are pushing, the muscle the Kegel exercise works is very much involved as it surrounds the vaginal wall. To find the muscle stop urinating mid-stream. This will help you know where to focus your attention. Throughout the day flex and relax this muscle to keep it strong.

Are there other exercises you have found beneficial for labor prep? What is your experience with these?

*These are from Natural Childbirth the Bradley Way

When Can I Exercise After Delivery?

This will vary for each individual. Assuming that you have an uncomplicated vaginal delivery, you can start low-impact exercises about 2 weeks after delivery. You will likely want to avoid water since it is likely you will still be bleeding some, but walking or mild gym exercises are generally OK. If you have an uncomplicated C-section you will likely need to wait 3-4 weeks before beginning exercise. Do not dive into exactly what you were doing before. Ease into it.

If you have any complications with your delivery, check with your provider as to what they think is best. Remember to be gentle with yourself, especially to help prevent DR. Be wise and listen to your body.

How soon do you get back into exercise?

What Types of Exercise Are Good For Pregnancy?

During pregnancy you want to do exercises that are low impact. What is best for you, you will have to figure out. If you are already exercising and it is not jarring, you should be able to continue. If you are not a regular exerciser but want to start, there are many options for you.

Some great options include water aerobics, swimming, walking, indoor cycling, elliptical and low-impact aerobics.

Being in the water during pregnancy is wonderful! Just being in the water and moving around is helpful as the water adds natural resistance and can give you a full body work out that is low-impact. It also helps alleviate some of the pressure you may have on your body and light. Getting out of the water can feel a bit overwhelming as you feel the extra weight when getting out, but it is worth it for the benefits of exercising in the water.

If you are more of a gym person there are a few low impact choices available to you. Elliptical and indoor cycling have very minimal impact as your feet stay on the peddles. You can also use a stair stepper, though it can have a little more impact depending on how you step. Walking on an indoor track is also a great option as you are in a temperature controlled environment and walking on a track does not cause as much jarring as cement.

Low-impact aerobics is also a good option, but I would advise working with someone who has been trained in leading aerobics as they should be able to help you know your limits.

What should you avoid?

Any activity that would pose a  great risk to your baby or your health should be avoided.

Stay away from exercise that involves jarring or lots of bouncing such as jump rope, intense running, etc.

Contact sports such as softball/baseball, basketball, volleyball, football, etc should be avoided.

Avoid exercises or activities with a high risk of falling such as horseback riding or skiing.

Be wise in stretching and muscles toning. Avoid exercises that will put a lot of pressure on your abdominal muscles (this also helps with preventing DR), such as sit-ups, deep knee bends and double leg raises.

It is also unwise to exercise in hot humid weather, so check the weather before heading outside.

What exercise do you enjoy?

Can I Exercise During Pregnancy?

Generally speaking, if you are a healthy woman and are having a healthy pregnancy the answer is yes. In fact, it is recommended that you exercise during pregnancy as it helps with weight gain, diabetes and overall feeling better.

If you are already exercising, you can continue the exercise you are doing, though you may need to decrease the amount of time or intensity. Listen to your body and do not over do it. Be wise.

If you have a health condition such as heart problems, diabetes, or joint problems it may not be OK for you to exercise.

If you have any questions at all about exercising, ask your health care provider.

Do you exercise while pregnant?

Diastasis Recti

Diastasis Recti (DR) is a condition in which the muscles on the front of your stomach (rectus abdominus) separate due to pressure in the abdomen. This can happen to anyone, but pregnant women are one of the highest risk groups for developing this condition. The pressure from a growing uterus is the primary reason this occurs. Hormones secreted during pregnancy also play a part in this separation because they loosen connective tissue. This can happen at any point during pregnancy or after pregnancy when there is nothing to give support. Premature separation can occur as early as 20 weeks.

Other factors that can contribute to developing DR include:

• Pregnancy with multiple babies
• Pregnancies that are close together
• Being over 35
• Having a large baby
• Poor posture
• Daily activities
• Incorrect exercising

Pushing can also make this condition much worse.

During pregnancy you want to avoid any exercises that put additional pressure on your abdominal muscles such as crunches, sit-ups and planks as these can also increase the gap between the muscles. 

Postpartum take adequate time to heal before diving into exercise.

This is just a basic overview. 

See this site for additional information. 

Do you have any experience with this? Share your thoughts below.

Reconcile

Right now you are probably thinking, "what does reconciliation have to do with preparing for birth?" In Redeeming Childbirth, Angie Tolpin shares how having unresolved problems with loved ones or sin we have not repented of can effect our progress in labor. Reading this after my 4th delivery made some things make so much sense.

I remember as I labored thinking that it was hard. It didn't feel any worse than my other labors, but after it was over something was just not the same as it had been with the other three. When I read about riffs between us causing difficulty in labor I knew that that was what had happened. Right before Gabriel was born I had been hurt deeply, but did not dealt with it. I took it to the Lord, but never approached the other person about how they had hurt me and open up for reconciliation. I honestly believe this effected me so much in labor and I even resisted pushing! My deep emotional pain greatly effected my birth.

Do you have an issue with someone that needs to be dealt with? Have you sinned greatly and not reconciled with God and others you have sinned against? I encourage you to deal with it now! Do not delay. We are told many times in Scripture to take care of sin immediately, so do it. If you have been hurt, graciously make it known. Allow God to heal your relationships and you so that you are not hindered.

Praying for Yourself

Yes, pray for yourself! No, you are not being selfish. Being pregnant and giving birth is hard work that requires a lot of strength. But we are not strong! We are weak and pregnancy and childbirth makes it so obvious how much we cannot do on our own. Motherhood makes it exponentially more obvious. We need God and His perfect strength to help us as we go.

How should we pray for ourselves?

As we prepare for birth pray for strength and health. Pray for God to show you how strong He is in your weakness.

"My grace is sufficient for you, for my power is made perfect in weakness." 2 Corinthians 12:9

Ask for God to prepare you for your birth. Hopefully you are talking to God all along about what your desires are. Continue to bring your desires to Him, but also seek His will above all else. Ask God to prepare you as much as is possible for an emergency, but also to hope for a healthy delivery. Ask Him to reveal Himself to you

This is a great post from Passionate Homemaking to help you prepare spiritually for giving birth.

Pray for becoming a mother, or adding to your children. Each time you have a child there are challenges and difficulties that come. Ask God to prepare you for that. Ask Him to help you love this baby and to sanctify you through motherhood. There are days I wonder at why God would bless us with another child and I see how much more I am becoming like Christ as our family grows. Pray for that and that you would have the ability to see it a midst the chaos and transition.

Again there are more things you can pray for, but these are at the top for me. How do you pray for yourself as you prepare for birth and motherhood?

Praying for Your Baby

As I draw close to giving birth to my 5th child, I have realized how little I have prayed for this baby as I have the others. I firmly believe you should be praying for your baby from the day you find out you are pregnant. Unfortunately we live in a fallen world. We get busy and we forget! I hate to think how I much I have neglected to pray for our newest member, but God is gracious to us, reminds us and we can pray fervently when we do remember.

What, then, do I pray for the child as I wait? I pray first for health and safety for the baby in delivery. I pray for the child to know God and have a relationship with Him through His Son, Jesus Christ. (I completely believe this should be first, but honestly it comes out second most of the time.) I pray for the baby to move, to be strong and active as it waits to be born. I pray that the delivery will be quick and smooth for the child and that it will not have trauma. I pray for Christlikeness in the baby as it grows. I ask God to reveal ways that I can specifically pray for the baby that I do not yet fully know. Go to the Bible and pray Scripture over your baby. Find your favorite passage and pray if your your child.

There are many specific things you can pray. Ask the Holy Spirit to reveal how to best pray for your baby.

What do you pray for your baby?

Mama's Day

Yesterday was my scheduled "Mama's Day". Perhaps it would be better labeled "Mama's Afternoon", but you do what you can when you have 4 little ones. So here is a little of my Mama afternoon. Thanks to my parents birthday gift I was able to get a pedicure this afternoon, which was wonderful. I have not had one in a couple of years and it was such a treat. The massage chair was actually pretty nice too.
After my pedicure, I went down the street to Quills and found the perfect 2-topper where, contrary to my nature, I was able to face away from everyone and focus on praying, reading and writing. While sipping on my decaf mocha, I journaled, prayed for the baby, me, the delivery, a lot of things. I read over the thoughts and Scriptures posted on Passionate Homemaking's preparation blog post, which helped me in focusing my prayers and thoughts. I was very tired, which was challenging, but it helped me in seeing how much I need God all the more. I really thought I was quite unprepared for this birth, but I found as I prayed that in some respects I was more prepared than ever before. Perhaps I have learned to prepare throughout more than I realized. I still need much time to rest and pray as the day draws near and I seek His timing in all of this. After this I decided to read some for fun without any thought. It was refreshing to sit and read just because and feel no guilt. I listed dates I need to attempt to be intentional in resting or having extended prayer time, then headed to the store.
It is always nice to end a relaxing day with good deals. It was short and I could really do it again. If it is possible I might. There is more I probably could have done, but it was good.

Here is a post to read another's thoughts on preparing for motherhood.

How would you spend your Mama's Day?

Preparing for Birth With Kids

As I prepare for the birth of my 5th child I have realized how little preparing I have done! Around 34 weeks I discovered that I had not prayed, stretched, breathed or thought much about this birth and how not good that really is. We should be preparing to give birth from the moment we find out we are expecting. Why? Because it really does take that long to prepare. There is a reason that God gives us around 40 weeks (generally) to prepare to bring a life in the world. Much needs to be done in our hearts, our minds and sometimes our bodies to help us do this. So at 34 weeks, when life was at a whirlwind and all I wanted to do was quit I started thinking about really preparing for what will be happening soon. Some thoughts on what I am seeking to do to prepare.

1. I'm planning a Mama's Day to spend time relaxing and praying
2. I'm being more diligent in taking long showers to have a few minutes of quiet to talk to the Lord without other voices in the back ground
3. I'm getting up earlier to spend more time in the Word and praying before beginning the day
4. I'm scheduling rest times that, if possible, can turn into naps
5. I'm writing in my journal more
6. I'm finding times to practice relaxing and breathing to prepare for these things in labor
7. I'm seeking to pray more throughout the day
8. I'm preparing music that I find helpful in worshiping for labor
9. I'm getting my house and daily life things in order
10. I'm seeking more help to get done what needs to be done

These may seem like normal everyday things, but when they are purposed toward preparing yourself for labor and delivery they are more than just everyday things. God wants us to purpose our time well, and preparing to have a new life in your home is a great purpose that brings God glory.

How do you prepare to give birth? What are things you find useful or needed?

Should I Breastfeed or Use Formula?

How do you decide between breastfeeding and formula? With great prayer! There are certainly advantages and disadvantages to both, and ultimately only you can decide which is best. Here I want to discuss the pros and cons.

Breastfeeding Pros

There are many advantages to breastfeeding that are widely known that include health benefits and also saving money. Some of them include:

• Giving the baby your immune system
• Decreases maternal bleeding by clamping down the uterus
• Cheaper 
• Decreases infections and constipation in babies
• Convenient (no warming up or mixing bottles)
• Decreases the risk of breast cancer in the mom

Even breastfeeding for a month can have these benefits.

Formula Pros

There are some advantages to using formula, though not as many as with breastfeeding.

• Mom does not have to do all of the feedings allowing for more rest
• Can help the baby to sleep through the night sooner
• You are able to leave the baby for longer periods of time
• Not as much work for the mom, especially if she is working outside of the home

The cons of each of these are the opposite of the pros above. It is also possible to do a mix. Remember that breastfeeding runs on a supply and demand feedback loop, so the more you breastfeed the more milk you have. 

What has been your experience? How did you decide?

How Soon Can I Breastfeed?

As we think about newborn care, many want to know how soon they can put their baby on the breast. Generally speaking, as long as there are no complications you can breastfeed as soon as you want. There are some women who give birth and immediately put the baby to the breast. If you are able to do this and are comfortable it is a great thing to do as nursing naturally helps with postpartum bleeding by clamping the uterus. Even if you cannot do it right away within the first hour is ideal. 

You need to ask your provider to make sure they are OK with is and check that the hospital does not have any unusual policies. If your provider or hospital are not OK with breastfeeding as soon as possible, you might want to switch if possible, so please ask this early!

If there are complications and the baby is unable to stay with you, start stimulating as soon as you can with a pump or your hands. 

How soon were you able to breastfeed? Share your experience!

Circumcision

I am well aware of how controversial and sensitive the discussion of circumcision can be. That being said I want to simply give an overview of circumcision and the ways they perform circumcision.

Circumcision is when the foreskin is loosened from the head of the penis and then removed. This is a very quick procedure in newborns and generally has no major side effects as long as everything goes well. There are 3 major ways they perform circumcisions: Mogen Clamp, Gomco Glamp and Plastibell.

Mogen Clamp

The Mogen clamp is a metal hinge shaped device. Using this device does not require a cut in the foreskin before using it. The foreskin is pulled through the hinge of the clamp. The clamp is then closed and locked for about 90 seconds to crush the foreskin, which helps to decrease bleeding. The foreskin is then surgically removed.

The Advantages of this device are that it takes less time than the other two and it is the least likely to lead to infection, excessive bleeding and/or swelling.

The Disadvantages are that there is a greater potential to accidentally remove the tip of the penis and fewer doctors know how to use it or are less comfortable with it.

Gomco Clamp

The Gomco Clamp is a metal device that is shaped like a bell that fits over the end of the penis. The baby's foreskin is stretched over the bell and the clamp tightened. If the foreskin is not retractable I cut in the foreskin will be made. Once the clamp is tightened the foreskin is then surgically removed.

The Advantages of the Gomco are that it allows for easy removal of foreskin and tissue, has good cosmetic results and many doctors are familiar with it.

The Disadvantages of it are that it is more complex than other circumcision procedures, more likely to cause excessive bleeding and more likely to remove too much skin from the shaft of the penis.

Plastibell Device

The Plastibell Devise is a plastic device slipped between the foreskin and the penis. A cut in the foreskin is usually required to place the device properly. A sterile string is tied around the device and over the foreskin to cut off the blood supply. Foreskin tissue is trimmed and the device removed leaving the string in place. The tissue under the string dies and falls off about 10-12 days after the procedure.

The Advantages to this device are different sized bells allow for custom fit to each baby, has good cosmetic results and many doctors are familiar with it.

The Disadvantages of this are an increased risk of excessive bleeding than the Mogen and infection is more likely.

I hope this is helpful in giving an overview. Please feel free to ask additional questions. Also please share your experience. I ask you be sensitive in sharing your opinion on any of this.

Other Newborn Care

About 24 hours after birth other newborn care options come in to play. Here is a brief description of them.

Hepatitis B Vaccine

If you are planning to start the hepatitis vaccine with your newborn the first dose is given in the hospital around 24 hours old. Hepatitis B is contracted through body fluids and unless you are infected or at risk for contracting Hepatitis B your baby is not likely at high risk. It is considered safe by the CDC, but has the risk of side effects as with all vaccines. This is a matter of prayer and decision to be made between your spouse and you.

PKU Screening

The PKU screening is done between 24 and 72 hours old for best results. This is done by pricking the baby's heel to draw blood. This tests for PKU as well as other metabolic disorders. PKU is very serious and needs to be caught early to prevent serious complications or death. You can refuse this screening, however I would not recommend this. The risks of doing a heel stick clearly outweigh the benefits from knowing if your child has a metabolic disorder so you can properly care for their needs.

Circumcision

Circumcision is very controversial in our culture, but is still an option, to be done around 24 hours old by your OB/GYN. This entails removing the foreskin from the penis. It is considered a cosmetic surgery and can be refused. If you do not want your son circumcised, make sure it is clearly marked on your baby's chart.

CCHD

This is a new screening to determine if there is a possibility of congenital heart defects in the baby. This is done by putting a pulse oximeter on two of the baby's extremities to see if the readings are equal. A positive screen would require an echocariogram to follow up.

Hearing Screen

The hearing screen is done by stimulating the ear drum or brain stem to verify there is a response. This is a non-invasive procedure that allows you to know if your baby may have hearing loss.

What are your experiences with these?

Afterbirth Newborn Care

One of my friends asked me to talk about some of the interventions done with newborns in the hospital after birth. Here is a basic overview of those done in the delivery room.

Cord Clamping

There is much debate about when the cord should be clamped. On the natural side people argue that you should wait for the cord to stop pulsating before cutting. On the medical side you have people saying it doesn't matter when you cut it. The truth is probably somewhere in the middle and dependent on each child. Generally speaking there is no harm in waiting to cut the cord and there could be some harm in cutting to early, though not likely.
The reasons for waiting include increasing the blood supply, increasing levels of vitamin K and helping the circulatory system as it transforms.
This is a matter for you to pray over and discuss with your spouse and provider.

Vitamin K Shot

After birth newborns are given a shot of Vitamin K to help with blood clotting. This is to prevent possible bleeding, especially in the brain that can happen due to birth trauma. Thankfully, this is not very likely, especially in an unassisted birth. There is some evidence to show that if you delay in clamping the cord, there may be less of a need, if any at all for the Vitamin K shot.
This is again a matter to pray over and discuss with your spouse and provider to decide what is best for your baby.
These first two are closely related and should be considered together

Eye Antibiotic

After birth, newborns are given erythromycin ointment in their eyes to prevent infection. The infections that typically cause issues are STDs such as chlamydia and gonorrhea, therefore if you do not have a known infection the antibiotics are not necessary.

What are your thoughts on these interventions?

VBAC

What is a VBAC?

A VBAC is a vaginal birth after Cesarean (c-section).

Can I have a VBAC?

Generally speaking most women can have VBACs and is a safe option. There are factors to consider, such as how many c-sections have you had and why was the first c-section done, which should be discussed with your provider and prayed over at great length.

What are the benefits to having a VBAC?

• Avoiding more scarring on your uterus 
• Usually less painful recovery
• Shorter recovery period
• Decreased risk of infection
• Being active in the birth of your child

What are the risks of a VBAC?

• Uterine rupture- the previous incision may come open due to the pressure of labor
• Other risks associated with C-sections: increased infection, increase in bleeding, 

When is it not possible to attempt a VBAC?

If you have a vertical incision on the uterus instead of the common horizontal incision providers will not allow you to attempt a VBAC due to the much higher risk of uterine rupture with this type of incision. Also if you have had 3 or move previous c-sections, it is not likely you will be permitted to attempt a VBAC.

Have you had or attempted to have a VBAC? What was your experience? 

Prolonged Labor

Prolonged labor can sometimes be used as a reason to do a c-section, in spite of everything else going well. What is prolonged labor? That is hard to say. Every woman is different and every labor is different. Medically speaking it is greater than 24 hours in a first time labor and greater than 16 hours in subsequent labors. However some can last even longer if there early labor takes a while. 

If you are wanting to avoid a c-section or other medical interventions if at all possible, stay home as long as possible. Doctors will watch the clock and time closely. If things seem to be going well and you are comfortable at home, wait until labor becomes more intense before going in to the hospital, generally speaking. Again pray the whole time and seek God's wisdom in knowing when to go to the hospital, if that's what your choosing. 

Prolonged labor can put added stress on the baby. Again, ask for wisdom throughout. Labors can take 36 to 48 hours if you are slow moving. This does not necessarily mean that anything is wrong, but it could be a sign of complication. 

Have you had long, drawn out labors? Did you have interventions? Share your experience!

Breaking Your Water

What is involved with my provider breaking my water for me?

The provider will do a pelvic exam, locating the cervix and amniotic sac, and use a tool called an amniohook to break a hole in the amniotic sac.

Should I let my provider break my water?

This is something that must be bathed in prayer. From a professional standpoint, I think it generally unwise if done too early in labor, especially with first births. The reason for this is I saw this happen to many people who ended up with infections, c-sections that could have been avoided or both. 

For some, breaking the water really speeds up labor and it is a good idea. For others it has no effect in the labor process. With a first delivery you do not know how your body will respond to the water breaking so pray for lots of wisdom on whether or not you should allow this. If you have been in labor for a long time and are desiring to see if it will help speed up the process, I recommend waiting until at least 5 cm if not 7 cm dilated, as those are the 2 numbers people seem to stall out at. Again this is based on my experience. 

Your water breaking puts you on a clock as well. Generally speaking providers like for you to be delivered within 24 hours of your water breaking. If you are not delivered by 24 hours it makes most providers nervous. It also increases likelihood of infection and antibiotics may be started to hopefully prevent infection.

I cannot emphasize enough, pray for guidance in this. Allowing them to break your water can be of great benefit, but it can also cause issues. God knows, so ask Him!

CPD Myth or Fact?

It's been said that a woman will not grow a baby she cannot physically birth. In a perfect world this would be true. However, sometimes a woman has a poorly shaped pelvis or a small pelvis that does not allow for a vaginal delivery. This is known as cephalopelvic disproportion or CPD. Thankfully this is not common but many times you will not know if this is true for you until you are in labor. This can also vary from pregnancy to pregnancy. Because one baby cannot be born vaginally does not mean others cannot in the future.

Therefore CPD is a fact, however it is not as common as people think it is. 

Fetal Heart Rate Monitoring

Is Fetal Heart Rate (FHR) Monitoring Necessary?

From a research standpoint, there is nothing to indicate that FHR monitoring is needed nor does it improve the outcomes of moms and babies. There is some thought that FHR monitoring can catch problems early, and it can, but it can also lead to more c-sections. If you are in a hospital you will have at least external monitoring some of the time.

What does the monitor show?

The monitor reads the baby's heart rate along with a monitor to show the contractions. They are looking for how the baby's heart rate reacts to the contractions. The reaction shows generally how the baby is doing. Throughout the labor process we want to see accelerations in heart rate, as this is healthy.

There are also decelerations that indicate different things. An early deceleration occurs as the head is compressed, typically as you near the time to deliver. This is considered normal. A late deceleration happens after the contraction and indicates a problem with placental profusion. This can happen for a number of reasons including cord compression or placenta issues.

With labor there is also the risk of prolonged deceleration. This was mentioned in our discussion of c-sections as it is quite serious. It can indicate that the baby is ready to be born, but if it's not then usually there is a more serious issue and you may be heading for an emergency c-section.

Should I use FHR monitoring in labor?

If you are laboring at a hospital you will have some monitoring without question. How much depends on your doctor. If you are wanting to have as little monitoring as possible, talk to your provider early to find out what their thoughts and policies are as well as the policy of the hospital you will be delivering at. If you are being induced you will have to have continuous monitoring. Like everything else this is a matter of prayer as God is the only one who knows how your labor will go.

What is your experience with FHR monitoring? What do you think about it?