Nov 18, 2010

Mistakes in Labor: Part 2

Doulas are so important!! A doula is a hired non-medical support person and they are invaluable for support of the mother *and* the father during the pregnancy, labor, and immediately postpartum. Doulas can help you find comfortable positions to labor in, advocate for the parents wishes and birth plan, offer encouragement, comfort, support, massage, hip compresses, etc.
Why this is important to know: Moms and dads play very different role in the labor and delivery room. Moms are often focused on trying to do the biggest job of her life, where some fathers often just want to do anything to make their wife comfortable, even if she has elected to have a natural delivery. A doula acts as a cheerleader for the family, as well as a lookout to make sure her care providers are following her wishes.

Anecdotal evidence: I had a doula in my last two deliveries, and I have hired one once again for my upcoming delivery. The role of a doula in a home birth or a hospital birth are both extremely important. My doula in Matthew's birth was my eyes and ears when I was being told one thing, but the nurse was doing the exact opposite. She helped me find ways to get comfortable. In the end, the Pitocin proved to be more than I could handle, and I opted for an Epidural. It was my doula who helped distract me while I tried to rip my flesh on my face and chest off because I was itching so bad while I waited for another medication to take away the itching. It was the doula who recognized that I was probably complete (by my actions and descriptions, she didn't examine me).
In my homebirth I was lucky enough to have two doulas; my own doula was helping another doula get her certification and she needed some births under her belt. Both played an amazing role, from keeping spirits high, to helping me move my baby into the correct position, to keeping me hydrated and confident. I really wish I had a doula in my first delivery (I had never even heard of them), because although I had support from my mom and husband, they didn't like seeing me hurting and didn't try to talk me out of medication when I started to have a hard time coping. The didn't know different techniques I could use to get through the contractions, they didn't know ways to help ease back pain. Remember: Each person wears one hat. You may think your midwife would make an excellent doula, but doulas they are not! Don't expect your birth team to come in with more than one role! :)

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The freedom to move, eat, and drink is invaluable! Being stuck in bed, tied to monitors is counterproductive to labor. Along the lines of my last post about declining procedures, finding an OB or Midwife that will allow you the freedom to labor as you need will help make the process a lot more comfortable.
Why this is important to know: In the normal labor process, movement is important. Nurses will typically have you "walk the halls" in early labor, but then as you get farther along will want you to stay in bed for continuous monitoring. Contractions are typically harder to handle if you are stuck on your back unable to sway your hips, bounce on a ball, or listen to your body and baby to find a comfortable position.

Anecdotal evidence: I found laboring with an empty bladder was more comfortable, but waiting for the nurses to unhook my monitors made emptying my bladder a huge hassle, especially if I had to drag around a pole with IV fluids hanging from it. And once an epidural is in place, most providers will place a catheter to keep you from leaving the bed. Once you are laying down, you remove gravity from the equation and you no longer have the option of allowing the baby to move down with the help of movement and gravity. I also have little faith in contraction monitors, I don't feel their are exactly effective as I have had very productive contractions barely show up on monitors, and even though my body was making progress, these strips were used as a reason to "move things along with the help of some Pitocin" or tell me I just wasn't making progress when I was. My babies hate the doppler and like to run away from it, so I felt a lot of the time nurses were spending more time chasing the baby or moving the strips and disrupting my concentration. Finally, some women want to eat and drink in labor, I know I loved cool sips of water or gatorade between contractions with my daughter, and ice chips just doesn't do it for my thirst.

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Don't forget about dad! Often times dad is overlooked when mom is packing her bags, touring the hospital, or making birth plans.
Why this is important to know: Your partner is your most important support person, and if they don't keep their strength up, they can't be as effective as a support person.

Anecdotal evidence: I typically have prodromal labor (early labor that starts and stops for several days or weeks) and this can be exhausting for all. In my first birth, my poor husband hadn't slept in probably 24 hours before the birth. When he had a chance, he would nap in a hard chair and we never thought to ask if there was a better option. Turns out, two of the chairs turns into beds. We also were not told this when I was in the postpartum room and he ended up leaving the hospital to stay with a friend so he could sleep. We also didn't think to have clean clothing for him, cash for food, snacks, etc.

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Do your research. This is the most important part of pregnancy, delivery, and parenthood! Don't have regrets, you don't get a do-over.
Why this is important to know: Just like you cannot un-ring a bell. Choices you make the first time around can affect the rest of your life. Something as simple as consenting to an induction because you are tired of being pregnant at 3 days overdue can cause a domino effect you cannot predict or stop. One intervention often leads to another and you may be left with an experience that you still regret decades later.

Anecdotal evidence: I have tons of regrets that are so personal to me I won't go into them, some that didn't just cause regrets with my first child, but every child after that. However you live and learn, you do your research, and you try to get past regrets knowing you did the very best you knew how.

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