Is An IV Necessary?

This is another common question that I hear frequently that has a simple yet complicated answer. Is an IV necessary?

NO!

However, very few hospitals will allow you to labor and deliver without one, even if you plan to have an un-medicated birth.

Why?

This is a precautionary measure, like not allowing you to eat, in case there is an emergency and you need a c-section or other surgery of some kind. IV access is important in those cases and can be difficult to get if needed quickly. This is why most doctors will require you to have access, known as an INT, a hep-lock or saline lock, if you are delivering at a hospital.

If you plan to be induced or plan to have an epidural, an IV is necessary because of the medicines given for induction, and an IV fluid bolus is necessary for an epidural.

For those who are healthy and have had an uncomplicated pregnancy who are completely opposed to an having an IV, consider a home birth or going to a birth center to avoid an IV.

What is your experience with IVs?

Can I Eat During Labor?

This is a very common question from first time moms, with both easy and complicated answers. Can you eat while in labor?

Absolutely! 

However, if you are in a hospital they will not let you have anything but clear liquids or Popsicles (find out what the rules are for where you are delivering). If you have an epidural, you cannot have anything but ice chips.

Why is this?

Primarily health care providers are concerned about the need for a c-section. If there is an emergency and intubation is needed there is a risk of aspiration, which is when stomach contents are thrown up and go into the lungs and can cause many problems. The likelihood of these things happening is not great, but hospitals are not likely to take chances with this.

Therefore, if you are wanting to eat while in labor, I recommend staying home as long as possible or plan to have a birth at home or in a birthing center that allows you to eat.

Did you eat during labor?

Can I Become Tolerant of Epidurals?

One of my friends who has four children asked me if it's possible for epidurals to become less effective because of becoming tolerant of the medicines in the epidural as hers had become less effective with each birth. I did not know the answer. So at one of my prenatal appointments I asked my doctor about this.

My doctor said that this is not really possible because of the way epidurals work. An epidural is a temporary block on the nerves that is there and then goes away. There is not a way to build up the medicine because it is not metabolized like medicines that you ingest. He said that it could be possible if you were given epidurals every day, but this is not likely for women having babies.

Why then were the epidurals less effective each time? I have no idea and neither did my doctor.

Have you had the experience of epidurals being less effective with each delivery?

Barrett's Birth Story

So, here's the story of how little WB came into this world.... I was scheduled to be induced Monday morning, since my specialist didn't want me to go past 40 weeks due to my history. I had planned a natural waterbirth and did everything to try to naturally induce my labor, but nothing worked. When We arrived at the hospital, they too, tried to start labor without drugs, the balloon method dialated me to 5cm but did not start labor, so, then came the pitocin! The one thing I wanted to avoid the most (besides epidural). So, finally after enduring 14 hours of pitocin induced labor, I hit transition (which is right when you are just about ready to deliver) it came hard and fast. We stopped the pitocin which made my contractions less intense, and I finally felt like I COULD continue to birth without asking for an epidural. However, during this time, most women throw up, myself included. Well.....as I was throwing up and convulsing, my body decided to rip the muscle off of my rib bone, I heard a pop, and instantly felt EXCRUCIATING pain and pretty much became immobile. I continued to get sick, adding to the rib pain, while contracting causing more pain than than I could have ever imagined. Which meant there was literally no possible way at all I could have pushed through that pain even if wanted to. My body simply would not have let me if I tried. So, in came the epidural. Well, the anesthesiologist hit a nerve, thus, causing EVEN MORE extreme pain, and then yelled at me for moving because it made my back spasm, which was not something I could control. So he stuck me again and hit another nerve! He spent a full 2 minutes jabbing nerves, and me begging him to stop! At first, it only worked on half my body, but it finally caught up to the other side. So after a quick nap I was finally ready to push, the pain had subsided, and I just wanted him here. The nurses came in, I pushed for less than 10 mins, and then he was in my arms! FINALLY! So after everything we did to prepare for our peaceful, natural birth, we did not, however, prepare for craziness that actually happened. But in the end none of that even mattered, he's here safe and sound and I couldn't be more thankful.

When I asked Ivy about sharing her story this is what she said:
"I would love to share my story on your blog, I'm sure it will help other women understand that no matter what our plan is, essentially, it's out of our control."

~Shared by Ivy L.

When Should I Get An Epidural?

This question is one I get frequently from new moms wanting to make the best decision possible about getting an epidural. This is an easy and tough question all at the same time, so I will share my general guidelines from what I have seen in the hospital.

For first births I recommend waiting as long as possible simply because first births can take awhile so if you get it too early you could end up lying down for hours and prolonging your labor. If you are looking for dilation, I would recommend waiting until you are at least a good 4 cm dilated before getting an epidural for the same reason. If you are able to wait until 6 or 7 cm this is ideal because you will be getting it right around transition, which is the hardest part of labor, but is generally quick compared to the rest.

What if you are having trouble dilating? These recommendations are thrown out the window. If you are having trouble dilating, it is likely that your body is struggling to relax to dilate. In this case, an epidural may be very beneficial in helping you to dilate. This is not a, "I haven't made any progress in an hour" recommendation. This is a, "I have been stuck at 5 cm for a few hours" recommendation, because the first part of labor can be long and slow and can take quite some time to get to 5 or 6 cm, especially if it is your first.

Trouble dilating could also indicate there is some kind of complication, and having an epidural may be a good idea in case a c-section becomes necessary.

If you are being induced, then it does not matter as much when you get an epidural because your labor is being done for you. The question you need to ask yourself is how long to I want to be stuck in bed?

For subsequent births, there is a little more ambiguity. Your first birth will likely give you a good indication of when you should get an epidural with your next.

As with everything else, pray about when the best time to get an epidural is because everyone is different. These are my recommendations based on years of experience. Often times you will know if and when you need it, even with your first.

How did you decide when to get your epidural?

Epidural

What is an epidural?

An epidural is placed in the epidural space in your spine. A needle is used to place a catheter in this space and medicine is giving continuously through the catheter. What is put in the epidural depends on where you are and is typically a combination, for example, fentanyl (an opiod) and bupivacaine (a local anesthetic). Ask your provider what they use in their epidurals.

What are some pros of an epidural? 

• If placed well there is complete pain relief with the ability to feel pressure when it's time to push (yes feeling this pressure is a good thing)
• Ability to sleep/rest during your labor
• If you have been in labor for a long time with out progressing it can help speed up dilation
• If a c-section is needed you already have it in place

What are some cons of an epidural?

• Can cause your blood pressure to drastically decrease- If too low can lead to distress with the baby
• Unable to get out of bed in most places
• Cannot eat or drink (ice chips only)
• Can slow down labor process- (if this happens you may be given pitocin)
• May not be able to feel to push
• Catheter is needed to empty your bladder
• Other unforeseen complications

When needed, epidurals are great tools to have. Again I encourage you to pray over whether or not this is the best option for you. 

What have been your experiences with epidurals?

Updated from "Epidurals" posted on February 19, 2014

Keaton's Birth

From the Archives

We waited five very long years to begin trying for our second child. Wanting to be rid of our tiny, two bedroom duplex and secure in a house, my husband insisted on waiting for what felt like an eternity to me. Being a teacher, I had to consider and plan when the ideal time to become pregnant would be during the school year. We felt that February would be the earliest reasonable time for me to take maternity leave, so we counted down the days until May of 2006 when we could begin trying.

To our surprise conception occurred very quickly, after only a week and a half. I was suspicious that I was pregnant for several days before I decided to take a pregnancy test. I had been experiencing food aversions, intense fatigue, and endless weeping over unusual circumstances, such as watching a Memorial Day parade. My five year old and I went to Walgreen’s where I bought a pregnancy test for me and apple gum for him. I brought the test home and left it in the bathroom where I refused to think about it for two hours. In the middle of an episode of Oprah, I said a quick prayer, retrieved the Walgreen’s bag, and took the test, which was of course positive. I immediately dragged my husband off the computer to the bathroom where I showed him the test and then promptly burst into tears.

Almost two weeks after discovering that we were expecting, we told our son that “The Baby Boss” had answered his prayers and had put a baby in Mommy’s tummy. He was very excited and asked a lot of questions. That evening he gave my tummy a kiss, explaining that “the baby’s never had a kiss before.” After a few minutes of playing with his Legos, he changed his mind and said, “Actually, Mommy, that was probably the baby’s second kiss. I bet Jesus gave the baby his first kiss before he left heaven.” We knew then that he would be a very thoughtful big brother.

My second pregnancy proved to be very different from my first. I suffered from severe “morning sickness” that occurred from the moment I woke up to the moment I went to bed at night. Not only was I ravenously hungry but also intensely repulsed at even the idea of food. I was thrilled when this misery finally stopped at 14 weeks. During the second and third trimesters, I experienced the typical pregnancy ailments: Heartburn, leg cramps, back pain, and an inability to take deep breaths. I was very much looking forward to the conclusion of my pregnancy.

At twenty weeks, my mother, husband, son, and I gathered in the ultrasound room in my OB/GYN’s office. After several minutes of checking the baby’s heartbeat and measurements, the technician informed us that another little boy was on his way. After pausing a moment, my son excitedly declared, “Mommy, it’s a boy fiesta!” Laughing, we all agreed with him.

My due date was Sunday, February 4^th. Unfortunately, that day came and went without a contraction. My doctor scheduled an induction for the following Friday. Having heard multiple horror stories about inductions, I prayed that one would not be necessary and that my little boy would appear on his own.    

On Tuesday, February 6^th, I went to work as usual, feeling very annoyed that I was still hugely pregnant and having to teach. After school, I went to Target to pick up curtain rods for the nursery as the curtains had just been delivered, and they were the final item I needed to finish the nursery. That evening I went back to school for my grade level’s PTA performance. Despite being over 40 weeks pregnant, I conducted over 80 second graders as they sang a Japanese song about frogs. Occasionally, I would experience a contraction, but none that made me think that my baby would arrive soon.

That night I went to bed irritated that I would have to teach the next day when I would have much preferred to stay home and mentally prepare myself for my baby’s arrival. I fell asleep quickly about eleven o’clock. At three o’clock, just four hours later, I was awakened by my first real contraction. This contraction was painful, but I chose to ignore it, because I was convinced that this baby would come out only by an induction. Ten minutes later I experienced another contraction that was as painful as the first. At 3:30, I experienced a third contraction that was followed by a noisy pop. Having read hundreds of birth stories during my pregnancy, I knew this sound was my water breaking. The pop was followed by a loud and very painful clanking sound, which was the baby’s head descending into the birth canal. I knew at this point the baby was finally on his way and an induction was not going to be necessary.

I chose not wake my husband yet because I assumed that we had many hours until we would have to leave for the hospital. I was even considering going into work for a few hours. Having had a 39 hour labor with my first son, I was not in a rush to leave for the hospital.

After hearing the pop and feeling the baby start his descent into the birth canal, I got out of bed and waddled down the hall to the bathroom. I noticed I had a slow leak and then decided to crawl back into bed to rest for a while longer. After getting back into bed, my contractions immediately increased in frequency and intensity. I grabbed my husband’s hand and squeezed through each one. Around 4:00, he awoke and asked me groggily if this was it.

By 4:30, I was crying and telling my husband that this labor was so much worse than my first and that I couldn’t bear it. If I had paid closer attention to what I was saying and how I was feeling, I would have realized that I was probably in transition at this point and should have rushed to the hospital. Instead I headed for the shower, insisting that I needed to be fresh and clean for my delivery.

The shower was a miserable experience. Each flurry of cleaning was halted by an excruciating contraction. I turned the shower massager on full blast and let the spray hit my stomach where the pain was most intense, desperately trying to find some relief. Repeatedly, I mumbled through my tears “What time I am afraid, I put my trust in Thee.” After an agonizing thirty minutes, I was finally shampooed, conditioned, scrubbed, and able to leave the shower. 

Upon exiting the shower, I instructed my husband to call our families and his boss. Between contractions I quickly texted my friends and co-workers, letting them know my water had broken. My mother-in-law was due to arrive soon to pick up our son, while my mom was getting ready to meet us at the hospital later that morning.

Our son woke up during this time and was very excited to learn that his baby brother was on his way. However, I was unnerved at the thought of him watching me in pain. I told my husband to keep him out of the room as much as possible. Before he left to put on his clothes, my son said a prayer for me, asking God to “help Mommy be very brave.”

While I struggled to put on my makeup and fix my hair, my husband called his boss to notify him that he would not be coming into work. While he was on the phone, I yelled at him to hang up and hold my hand because my contractions were more than I could bear alone. At this point, I told my husband there was no time for him to take a shower and to call his mother to question where she was.

A few minutes before six, my mother-in-law arrived and took our son to her house. After having my husband snap my last pregnancy picture, I headed for the car. My husband grabbed my bags, tossed them in the back seat, and quickly took off. Giving him instructions to drive fast, I suffered through several contractions on the short ride to the hospital. As he drove, I begged my husband to pray that I was at least four centimeters and could get an epidural upon arriving. I was convinced that in the five years since my son was born I had become a complete wimp as this labor was so much more intense than I ever experienced with my first child.

We pulled into the hospital parking lot at 6:10. After struggling through a contraction, I quickly exited the car and headed for the registration desk. To my dismay, no one was at the desk when we entered the lobby. After two or three very long minutes passed, a receptionist meandered up to the desk and inquired about my social security number. Unable to speak for myself, my husband managed to correctly supply this information after three failed attempts. I was extremely agitated that he could not remember my social security number, but I was neither able to voice my frustration nor the needed numbers. The receptionist took my insurance card and after I endured fifteen minutes of painful and very loud contractions, she declared that I was ready to go to triage. The receptionist questioned if I wanted a wheelchair. I asked her if she could get me one quickly. Her response was so slow that I determined walking would be faster and barked at my husband to get me to the elevator.

Upon entering triage at 6:30, I was met by the gazes of five nurses. I noted that I was their only patient and hoped that this meant I would be checked and given my epidural quickly.  I was shown a room, given a gown, and told to undress. I quickly shed my clothes and put on the hospital gown between contractions. I lay down on the bed, grateful to be in a horizontal position to endure my contractions. When the nurse entered my room to hook me up to the monitor, I asked her to check me. She explained that she had to ask me a few questions first.

With agonizing slowness, the nurse inquired when my water had broken, when I had last drank anything, what my religious affiliation was, and when I had last had a b.m. At this last question, I lost my patience and yelled that I needed to be checked immediately because the baby was right there. While the nurse was scrambling to find someone to check me, I demanded that my husband pray for me and then promptly yelled at him because I could not hear his prayer over my own moans and screams.

A new nurse entered the room and had me roll on to my back. Upon checking me, she said, “She’s nine centimeters, 100% effaced, and at a plus one station! Get her to delivery!” I was shocked to learn of my status, and then in the next moment my body was consumed by its first urge to push.  As several nurses ran me from triage to the delivery room, I asked, “Am I going to be able to get my epidural?” I knew the answer even before the nurse replied, “Honey, you’ll have this baby before the anesthesiologist can even get up here.” Unhappily, I resigned myself to a natural child birth.

As I was rolled into the delivery room, I told my husband to call my mother and tell her to hurry. Medical personnel scurried around the room as I lay on my side and screamed through what felt like never-ending contractions and an all-consuming urge to push. I begged for water or ice chips as my throat was completely dry from my continuous screams, but I was ignored.  

The nurse checked me again and said, “She just has a small lip left.” My body paid her no attention as it pushed of its own accord. The midwife hurried into the room and had me begin pushing along with my body. After my first intentional push on my side, I realized that I was solely responsible for getting this baby out of my body and for ending my pain. I rolled on my back to be able to push more effectively. With the next contraction, I pushed as hard as I could, screaming, “Get out!” as he crowned. My mother ran into the room at this moment, having been directed upon exiting the elevator to “follow the screams.” She ran quickly to me to support my neck as my husband and a nurse supported my legs. 

As I cried and gasped for breath before my final contraction, the midwife asked if I wanted to touch the baby’s head, and I quickly replied, “No!” I knew that doing so would make the delivery longer than necessary, and I wanted it over immediately. With one more push and several screams of “Get him out,” Keaton Parker entered this world at 7:08 a.m., just four hours after my first contraction.

My little boy weighed 8 pounds 2 ounces and was 20 and ½ inches long. His arrival was unexpectedly fast and extremely tough.  However, God knew that this baby would be an enormous blessing to our family and worth every painful contraction. I am grateful that He was right. 

~ Shared by Ashley B.