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You’re pregnant and overwhelmed with information overload. Every woman who stops you at the supermarket asks you if you’re pregnant with twins and tells you their childbirth horror story.

First of all, ignore them. You’re beautiful, you’re growing a human that could save the world, and their experience does not dictate yours.

I’m a Certified Nurse-Midwife with more than a decade of experience in birth- and birthed four babies in very different ways. I encourage you to find a birth provider who shares your views. It’s the best way to make sure that you feel empowered, listened to, and supported. According to the research, Nurse-Midwives produce great outcomes and fantastic care.

What should you expect in labor & delivery?

Now it’s time to get acquainted with the real story and try to alleviate those pre-birth jitters. Let’s take a look at the different birthing options and what to expect in labor and delivery.

  • Natural childbirth
  • Pain medication in childbirth
  • Epidural anesthesia
  • Cesarean delivery (C-section)
  • Vaginal Birth After Cesarean (VBAC)

What are the possible options for birthing your baby?

Natural Child Birth

Natural childbirth is childbirth without pain medication. Often times, moms wish to avoid invasive medical interventions and maintain autonomy during labor. Most of the time, labor and birth are perfectly healthy periods of time. If you’re low risk and you and baby are doing well, it’s perfectly acceptable to eat, drink, and give birth in the position that she desires.

  • Find a supportive provider who will try to avoid unnecessary induction of labor and pain medication and one who is open to different positions and movements for laboring and birth.
  • Find a supportive birthplace. There are options like birth centers, home births, and hospitals. Do your homework on the safety of each of these. If you choose a hospital, ask about natural childbirth accommodations and c-section rates.
  • Exercise throughout pregnancy. The more stamina and flexibility you have mentally and physically, the better your chances are of having an unmedicated birth. Yoga, swimming and walking are excellent options.
  • Get a doula! Doulas reduce the likelihood of medical interventions in labor and increase your likelihood of having an unmedicated childbirth. She can provide help in finding natural pain relief methods and often knows where to touch you to improve your pain!
  • Learn coping techniques beginning earlier in pregnancy. Options include music, aromatherapy, birthing balls, positioning, warm water, meditation, deep breathing, and progressive relaxation.
  • Water, water, water. If you notice a theme with the words hydrotherapy, hydrating, and warm water immersion- it’s because water is fabulous for labor and birth. Some facilities encourage water birthing- if that’s an option you’re interested in, go for it! Water is so important for relaxation and the processes of labor and birth.
  • Eat! If your hospital doesn’t allow eating, eat on your way in. Drink lots of water. Make sure that you stay nice and hydrated. Labor and birth are hard work! If you get dehydrated, your contractions may become ineffective and it could affect your baby and your heart rate. Drink up!
  • It’s normal to feel like you want to give up. When that happens, you are normally in the transition phase of labor and ready to begin pushing.
  • Trust your body! It instinctively knows what to do.
  • Let it go. If you don’t have the birth of your dreams, look at the positive outcomes. Focus on your strengths, and snuggle that sweet little baby!

What method did you use for childbirth?

I polled the readers of this article for the method they used during labor between 2016 and 2019. I am pretty shocked that only 24% had an epidural. I can reopen this poll, if needed!

  • 50% Natural childbirth
  • 12% Opiate pain meds (Nubain, Stadol, Morphine, etc)
  • 24% Epidural Anesthesia
  • 15% C-section

34 people have voted in this poll.

What is epidural anesthesia?

Epidural anesthesia is currently the most popular anesthesia method during labor. An anesthesiologist or Certified Registered Nurse Anesthetist (CRNA) inserts a thin catheter into the epidural space in the spine and then infuses medication.

Epidural anesthesia is regional anesthesia meaning it blocks pain receptors in only a specific region of your body. It reduces discomfort by blocking pain receptors involved in labor and childbirth.

Epidural anesthesia gives both pain relief and decreased sensation in the portion of your body (lower abdomen) that works so hard during labor!

Because it decreases the sensation in your legs, you can’t get out of bed after the epidural is placed. Usually, a nurse will empty your bladder with a catheter. Because your baby is navigating the passageway out, it’s important to continue with your position changes so that baby can get into a good place!

Epidural medications usually combine local anesthesia, typically your “numbing” medications: bupivacaine or lidocaine. They may be given concurrently with narcotics like fentanyl.

What do I need to know before I get an epidural?

In order to have an epidural, you will have to have an intravenous (IV) catheter inserted and fluids are given. You will need to have had your complete blood count recently checked to make sure your platelets are an adequate level. This will help ensure there are no issues with clotting or bleeding.

The anesthesiologist or nurse-anesthetist is the professional who inserts your epidural. You can sit or sometimes lay on your side during the placement. A nurse will monitor your vital signs during the process.

You will push your back out like an angry cat. Cleaning your back with a cold antiseptic solution reduces your chances of infection. After that, you may feel a pinch or a bee sting as they inject local anesthesia (a numbing solution).

The anesthesiologist or CRNA wait until your back is numb and then insert a needle into the epidural space in your back. They place a small catheter through the needle into your epidural space. The needle is taken out, but the catheter remains to provide medication constantly.

All done! The catheter is taped down very well. While removing it may feel like a back waxing, many patients would gladly endure a little tape ripping for the pain relief of an epidural.

I’m a midwife and talk to pregnant people every day. While the process sounds scary, contractions usually distract you during the placement. Sometimes the medication can cause your blood pressure or the bay’s heart rate to drop. You will know this occurs if you feel dizzy or lightheaded. This is temporary. A medication called ephedrine can reverse the effects.

What are the options for pain medications?

Pain medication in childbirth includes opiate pain medication, which is generally given through an intravenous (IV) port or an injection into your muscle. Nitrous oxide is another example of pain medication used in labor.

  • Opiates: An analgesic or medication given to relieve pain. These are considered after traditional measures like deep breathing, massage, and movement have been tried. These medications are given in small doses and early on in labor to avoid side effects to the infant at birth. They may reduce the overall pain level, but will not affect a patient’s ability to push. Side effects include nausea, vomiting, itching, dizziness, and respiratory depression.
  • Nitrous Oxide: Patients who use Nitrous may still have an awareness of labor pain, however, it can help you relax, reduce anxiety, and decreases the perception of the strength of pain. It is self-administered, so the woman can choose how big of a dose of the medication to use. The effects of nitrous disappear within five minutes after stopping. Nitrous generally has fewer side effects than opiates.
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Cesarean Section: Operative Delivery

Cesarean delivery (C-section) is a surgical procedure to birth a baby through an incision in the uterus and abdomen. This is done for a number of medical and elective reasons.

There are several types of c-sections:

  • Scheduled (planned)
  • Urgent
  • Emergent

Scheduled: If you have had a c-section in the past, you may schedule a repeat cesarean. You also have the option of vaginal birth after cesarean (VBAC). VBAC candidates may have to meet specific criteria, like a provider who performs VBACs and 24-hour anesthesia. Other requirements include a healthy BMI, adequate spacing between children, and the type of incision from your first surgery.

If you have certain pregnancy complications, like placenta previa, the baby will usually be delivered by c-section.

Finally, if you have a breech (bottom first baby) presenting baby, and an external cephalic version fails, your provider is not skilled in breech birth, you may be scheduled for a c-section. An external cephalic version is where they try to manually turn the baby from outside of your stomach.

Urgent: A timely cesarean delivery performed due to deteriorating maternal or fetal state, but not an impending risk of maternal or fetal harm.

Emergent: A cesarean delivery performed due to imminent fetal or maternal demise, where every effort is made to expedite the time between decision for surgery to surgical birth.

I hope you understand your birthing options and what to expect in labor and delivery. In my personal experience, the most essential part was feeling empowered and supported in my choices.

Was your experience different than discussed? Let me know in the comments!

This content is accurate to the best of my knowledge and does not substitute for diagnosis, prognosis, and treatment from a licensed health professional. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

caitlingoodwin Midwifery, Motherhood ,

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