5 Unnecessary Hospital Procedures

Birth should be an awesome thing with as much focus on making it as easy and safe for you as possible, and of course, as safe as possible for the baby as well.

Today's labor and delivery wards are much more like an assembly line, and some typical L&D staff policies and procedures not only make birth harder and more painful, but can be the very reason for unnecessary medications and c-sections.

Here are the top five myths associated with hospital procedures that change your birth experience.

Myth 1: You need a monitor on your belly the whole time you're in labor.

Fact: You absolutely do not. Intermittent monitoring is shown to be just as effective, and actually allows the woman to focus on things other than her contractions. Consider that women are often made to lie down and stay relatively still with the monitors on as well, and you're put in a position where you have nothing to do but focus on and internalize any pain of contractions.

In fact, constant fetal monitoring often leads to unnecessary concern, and even intervention, including c-sections, so says the American Academy of Family Physicians, not some holistic home birth website, for those of you in doubt. In fact, only monitoring the baby's heartrate and your contractions every 30 minutes during early labor, and every 15 during transition and pushing is the current recommendation, but one that you almost never see actually practiced.

Myth 2: Lying on your back is a good position for pushing.

Fact: It sucks, big time. The only reason women end up on their backs is to make it easier for doctors to get in there. So, really, unless they NEED to be in there, it's a bad move. It's not only shown to reduce the size of the pelvis significantly, but it puts pressure on the vena cava, which reduces blood flow to the baby and your lower body -- why is it not okay during pregnancy, but they tell you to do it for hours on end during labor, and then are surprised at reduced blood flow to the baby?

The National Center for Biotechnology Information states that being upright, in addition to increasing blood flow also makes contractions and labor less painful, faster, easier, with a lot less trauma to the mother's birth canal, minimal to no tearing, and less trauma to the infant as well. It also makes for less postpartum complications, damage to the pelvic floor, incontinence, and in general, a much better, faster, less painful birth.

Also, if you opt for an epidural and can't feel your legs, you can't walk or kneel. So consider that you might not need that if you actually get up off the bed, and that just because you can't feel the pain with an epidural, your baby can, and you will once the drugs wear off. I wish I'd known as much about epidurals as I do now 15 months ago when I had my daughter. I was ashamed of myself for getting it then, but now I really, really wish I hadn't.

So why are 75 percent of births still done with the woman flat on her back? Back to the beginning of this point -- to make it easier for the doctor.

Myth 3: You can't eat or you'll barf it up and aspirate the vomit.

Fact: You wouldn't tell a marathon runner to skip breakfast, would you? Telling a woman about to engage in major physical work not to eat is almost as bad -- except what is at risk here isn't just a race, but two lives. Yes, there has been some concern that with intubation before anesthesia would come vomit, and then aspiration of said vomit.

MedScape discusses a study on the matter that says:

"Aspiration pneumonitis/pneumonia is significantly associated with intubation and ventilation," the study authors conclude. "In modern obstetric practice it is the use of regional anaesthesia, thereby avoiding intubation, rather [than] fasting regimens that is likely to have reduced mortality from aspiration. Although the National Institute for Health and Clinical Excellence has recommended, on the basis of consensus opinion, that women in normal labour may eat/drink in labour, our trial shows that this will not improve their obstetric and neonatal outcomes."

In other words, forcing women not to eat hasn't reduced aspiration -- not shoving tubes down their throats has. In their study, women who ate light meals showed absolutely no difference in anything -- no more vomiting, no more risk than women who were only allowed ice chips or water.

Myth 4: You need to be told when to push.

Fact: Do you need to be told when to poop? You no more need permission and direction to push out your baby than you do to push out a bowel movement. Just as your body uses contractions to move the baby towards the cervix and through it, it moves the baby down the birth canal, too. Your body will tell you what to do. You will feel when you need to push, and you will just work with it. When you feel the need to relax, do it. Push as hard as YOU are comfortable and if someone is yelling to you to push harder or longer than you feel you should, yell at them to shut up.

Pushing to the point of shaking, not breathing (called 'purple pushing' for the color your face turns) and breaking blood vessels in your face is not going to help you. In fact, it can cause the cervix to swell if you're not ready, it can make you exhausted, it can create much more severe tears, and is just a bad idea in general, even according to the World Health Organization.

Drugs can inhibit the feeling of needing to push (or the ability to know if you need to stop), though, but that's a whole 'nother topic all on it's own.

Myth 5: A break in contractions/labor stalling is a bad sign.

Fact: Women can get fully dilated and have the baby ready to go ... and then have a period that has been appropriately nicknamed the "Rest and Be Thankful" stage. It is nature's way of giving you a break after all the work to get your body ready, before the final hurrah. You can also have a break like this earlier in labor as well. Sometimes you can even be in early labor for what ends up being days, often called prodromal labor. We are mammals, first and foremost, and our bodies aren't stupid -- if a woman gets really stressed or really exhausted, often her body will sense that she doesn't have the energy for birth, or deems that it's an unsafe situation and halt labor until mom is rested or calmed. Think of a mother rabbit in labor realizing a predator is nearby -- she NEEDS to get safe before she can birth the babies.

Doctors often start up pictocin here, when the recommended things are anything but that -- squatting, moving around, getting in a bath all are proven safe methods to help the mother relax and get her contractions going in a normal pattern again. In fact, my midwife told me that studies show nipple stimulation and relaxing in water had been shown to be as effective, if not moreso, than pictocin. Considering that pictocin is an artificial chemical designed to mock those from things like nipple contraction, it's not exactly a far leap in logic.

If your labor stalls, don't rush for the meds -- relax, move around, have a light meal for energy, try to take a nap. In and of it's own, it is NOT an emergency

For Fun

PREGNANCY Q20& A & more!

Q: Should I have a baby after 35?
A: No, 35 children is enough.
 
Q : I'm two months pregnant now. When will my baby move?
A: With any luck, right after he finishes college.

Q : What is the most reliable method to determine a baby's sex?
A: Childbirth.

Q: My wife is five months pregnant and so moody that sometimes she's borderline irrational.
A: So what's your question?

Q?: Is there any reason I have to be in the delivery room while my wife is in labor?
A: Not unless the word 'alimony' means anything to you.

Q: Is there anything I should avoid while recovering from childbirth? 
A: Yes, pregnancy.

Q?: Do I have to have a baby shower?
A: Not if you change the baby's diaper very quickly.

Q?: Our baby was born last week. When will my wife begin to feel and act normal again?
A: When the kids are in college.

'ESTROGEN ISSUES'
10 WAYS TO KNOW IF YOU HAVE 'ESTROGEN ISSUES'
1. Everyone around you has an attitude problem.
 2. You're adding chocolate chips to your cheese omelet.
 3. The dryer has shrunk every last pair of your jeans.
 4. Your husband is suddenly agreeing to everything you say.
 5. You 're using your cellular phone to dial up every bumper sticker that says: 'How's my driving-call 1- 800-'.
 6. Everyone's head looks like an invitation to batting practice.
 7. Everyone seems to have just landed here from 'outer space.'
 9. You're sure that everyone is scheming to drive you crazy.
 10. The ibuprofen bottle is empty and you bought it yesterday.

TOP TEN THINGS ONLY WOMEN UNDERSTAND
10. Cats' facial expressions.
 9. The need for the same style of shoes in different colors.
 8. Why bean sprouts aren't just weeds.
 7. Fat clothes.
 6.. Taking a car trip without trying to beat your best time.
 5. The difference between beige, ecru, cream, off-white, and eggshell.
 4. Cutting your hair to make it grow.
 3. Eyelash curlers.
 2. The inaccuracy of every bathroom scale ever made.
AND, the Number One thing only women understand:
1. OTHER WOMEN

Eating During Labor

What are the facts??/

You may already know that eating in labor is a big no-no here in the United States - as it is in most industrialized countries. However, you may not know why...

What you do know is to expect an IV in labor...no drinks and certainly no food. So let's discuss the facts and the myths of this practice.

Eating and Drinking in Labor

Historically, women have always been advised to eat and drink during labor as long as they could and were able to do so.

So what is the thought behind not eating in labor?

Well, simply put the concern was in case you had to be put under general anesthesia. The fear was that if you vomited you could maybe potentially aspirate food into your lungs.

The facts are:

1) This level of risk is minimal and even more so since - even if you need a c-section - general anesthesia are no longer favored. Most women would receive an epidural instead.
2) Anesthesiologists are well trained and know how to avoid such an incident from occurring.
3) This line of thinking is faulty from the start since your stomach is never truly empty as it always contains gastric juices.
4) Prolonged fasting increases the amount of hydrochloric acid in your stomach which can in turn increase the complications with aspiration.
5) We would not call "good science" to make recommendations on only one study done 60 years ago.

Eating in Labor: Why is it Good for You?

1. Eating small amounts of easily digested foods during labor can give you the energy you need to keep going. We would not think of starving an athlete before a performance now would we? Labor is equivalent to a 50 mile hike!
2. In 1989, a National Birth Center study including 11,814 women 22% of whom had a c-section, none of them aspirated even though they were allowed to eat and drink at willduring labor.
3. Being able to eat and drink during labor gives you a sense of control which is very important to your emotional well being.
4. Midwives and doulas know that if your labor is not progressing, often eating and drinking during labor helps to get things moving.

Eating in Labor: Latest Research

Professor Andrew Shennan at King's College in London felt that five previous trials on "eating in labor" were inconclusive...so he decided to do his own research.

He concluded that eating in labor did not affect delivery rates, but let's look at this research more closely.

Dr. Shennan's study took place at Guy's and St Thomas' Hospital in London between June 2001 and April 2006 and it involved 2,426 healthy women, having their first baby.

The mothers were randomly split into an "eating in labor" group or a "water only" group. The eating group was advised to eat small regular amounts of food, such as bread, biscuits, fruits, low fat yogurt, isotonic drinks, and fruit juice.

The mothers in the water only group were advised to have ice chips and water only.

Note: In most American hospitals, you do not even have a choice of water or food since you will be hooked to an IV. Keep on reading to see that IVs cause more harm than good and that given a choice, water - or even ice chips - is a much safer choice!

Age, ethnicity, food intake for six hours before and during labor, vomiting and the need for intravenous fluids were recorded.

The results:

The spontaneous vaginal delivery rate was the same in both groups and was 44%.

The duration of labor was 597 minutes for the eating group and 612 minutes for the water group which the researchers did not determine to be significant. HOWEVER, any woman who has gone through labor will take a shorter labor even if it is "only" by 15 minutes!

The c-section rate was about the same for both groups 29 and 30 respectively.

There were no differences in the condition of the babies at birth or in admission to NICU.

The researchers felt that according to their results eating was not detrimental.

Eating in Labor: IV use in Labor

If you give birth in a hospital, you should expect to be hooked to and IV in labor. The fluid you receive from an IV is supposed to compensate for the lack of food and water...it is also used to facilitate the administration of various drugs including pitocin. If you want an epidural...an IV is mandatory.

What fluids go into your IV? Well, to put it simply: water and sugar.

This is such a mixture which presents a hazard for you as well as for your baby.

Usually the sugar that is used in an IV is called Dextrose. So what is Dextrose? It is often used to replace glucose and it is a refined sugar which has been known to have nasty side effects:

Dextrose is known to rapidly elevate your blood sugar. As with any refined sugars, at first, it will cause an energy boost followed by a rapid drop in blood sugar as your body tries to go back in balance. To compound this problem, you do not receive Dextrose just once but continually during the courseof your labor which according to Drs. Abrahamson and Pezet and their research creates havoc on your body.

My IV will contain sugar in the form of glucose...so it's okay...right?

We'd love to say yes and put your mind at easy but this is not the case.

Studies comparing laboring mothers who were allowed to drink versus mothers who received an IV in labor showed that IV use in labor causes a fluid overload. This is not a good situation as it can lead to:

Electrolyte imbalance

Cardiac arrhythmia - irregular heartbeat

Pulmonary edema - fluid in the lungs

There is more...since IV fluids are just sugar with no protein...a laboring mom can experience a"negative nitrogen balance" which is a condition of starvation and therefore not a good thing.

Yes, there is still more: in a study 11.4% of the IVs were colonized with bacteria ...so receiving an IV in labor increases your chances of infection. This is very scary because little germs that can survive in a hospital environment are known to be very very bad and in some cases deadly.

If this was not bad enough, studies have shown that these "sugar cocktails" reduce a mother's pain tolerance levels!!! And who wants that?

IV use in labor also affects your ability to move which in turn affects the speed and the quality of your labor. 

Eating in Labor: The Risk of an IV to your Baby

These are the risks to you...but that is not all. Your baby is also at risk:

Hypoglycemia after birth - low blood sugar

Increased chance of jaundice at birth

Increased weight loss after birth

What is a Doula? Is a Doula for me?

The word doula is a Greek word that meanswomen’s servant. Women have been serving other women in childbirth for centuries and have proven that this support from another woman has positive effects on the labor process.

My husband (partner) is my left hand and my doula is my right. - from Doulas Making a Difference

What is a doula?

A doula is a professional trained in childbirth who provides emotional, physical and informational support to the woman who is expecting, in labor or has recently given birth. The doula's role is to help women have a safe, memorable and empowering birthing experience.

Find a Doula in Your Area

Most often the word doula is referring to the birth doula, or labor support companion, but there is also the antepartum doula and the postpartum doula. In the following information, the word doula will be referring to the labor doula. Doulas can also be called labor companions, labor support specialist, labor support professional, birth assistants or labor assistants.

What does a doula do?

Most doula and client relationships begin a few months before the baby is due. During this time, they establish a relationship that gives the mother complete freedom to ask questions, express fears and concerns, and take an active role in creating a birth plan. Most doulas make themselves available to the mother by phone to answer questions or explain any developments that may arise in pregnancy. Doulas do not provide any type of medical care. However, they are knowledgeable in the medical aspect of labor and delivery so they can help their clients get a better understanding of procedures and complications that may arise in late pregnancy or during delivery.

During delivery, doulas are in constant, close proximity to the mother at all times. They can provide comfort with pain relief techniques, such as breathing, relaxing, massage and laboring positions. Doulas also encourage participation from the partner and offer reassurance. A doula acts as an advocate for the mother, encouraging her in her desires for her birth. The goal of a doula is to help the mother have a positive and safe birth experience, whether the mother wants an un-medicated birth or is having a planned cesarean birth.

After the birth, many labor doulas will spend a short time helping mothers begin the breastfeeding process and encouraging bonding between the new baby and family members.

What are the benefits of having a doula?

Numerous studies have revealed the benefits of having a doula present during labor. A recent Cochrane Review, Continuous Support for Women During Childbirth, revealed a very high number of positive birth outcomes when a doula was present. When a doula was present, women were less likely to have pain relief medications administered, less likely to have a cesarean birth, and reported having a more positive childbirth experience¹. Find a Doula Now.

Other studies have shown that having a doula as part of the birth team decreases the overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40% and the request for an epidural by 60%².

Doulas often use the power of touch and massage to reduce stress and anxiety during labor. According to physicians Marshal Klaus and John Kennell, massage helps stimulate the production of natural oxytocin. The pituitary gland secretes natural oxytocin to the bloodstream which causes uterine contractions and also secretes it to the brain, which results in a feeling of well being, drowsiness and a raised pain threshold. Synthetic IV oxytocin cannot cross into the blood stream and brain, so it increases contractions without the positive psychological effects of natural oxytocin.

What about the father's role when using a doula?

The role of the doula is never to take the place of the husband or partner in labor, but to compliment and enhance their experience. Today, many husbands are taking a more active role in the birth process, but some partners feel that this is a huge expectation and would rather be able to enjoy the delivery without having to stand in as labor coach. With a doula as a part of the birth team, a father can do whatever he feels comfortable with at each moment. Doulas can encourage the father to use comfort measures and can step in when he needs a break. Having a doula allows the father to be able to support his partner emotionally during labor and birth and also enjoy it himself without the pressure to remember everything he learned in childbirth class!

Are doulas only useful if planning an un-medicated birth?

The presence of a doula can be beneficial no matter what type of birth you are planning. Many women do report needing fewer interventions when they have a doula, but the role of the doula is to help you have a safe and pleasant birth, not to choose your type of birth. For women who know they want a medicated birth, the doula still provides emotional support, informational support and comfort measures to help the women through labor and the administration of medications. Doulas can work alongside medication by helping mom deal with possible side effects and filling in the gap that medication may not cover; rarely does medication take all discomfort away.

For a mother who faces a cesarean, a doula can be helpful by providing constant support and encouragement. Often a cesarean is an unexpected situation and moms are left feeling unprepared, disappointed and lonely. A doula can be with the mother at all times throughout a cesarean, explaining what is going on throughout the procedure while the partner is able to attend to the baby and accompany the newborn to the nursery if problems arise.

www.americanpregnancy.org