So, the title of this post is also the title of a book I read while pregnant with Drake. It was easy reading, but it's not on my list of "must-reads" for pregnancy. But it's a cute and catchy title, I have to admit. I wanted to write my last post about unsolicited advice (that was actually solicited), with more reference and less bias. But I feel like I did my pregnant friends a disservice, because I did not say a lot of things that I feel are really important to say. This post is a lot more of my
opinion and
personal thoughts. But I really think they should be shared, in case my pregnant friends never hear them from anyone else. I got so sick of people constantly giving advice, opinions, and horror stories while I was pregnant. Especially when I didn't ask for it. For that reason, I'm just putting my two cents on my blog, rather than discussing it with each friend. It's much easier to just close out this website, than to tell me to shut the hell up. :-)
It kinda goes back to what I've already said a million times before- if you don't like what I have to say on my blog, then QUIT READING.
So here goes.
There is this little thing called the cascade of interventions. It's kinda like a slippery slope. You know, where you innocently choose one thing, which leads to the next, and the next, and the next, and before you know it you are in a situation you really didn't want? I have seen that happen WAY too many times. Every single C-section I've done at work that is indicated b/c of "Failure to Progress", is usually (or so it seems) because of this cascade of interventions.
So how do you not become a victim of this cascade? A- Educate yourself. B- Choose a care provider who does not routinely perform unneeded interventions. You'll read more about all the interventions throughout this post.
1. Inductions. Just don't do it, unless it's medically necessary. What do I mean? Basically, there are two reasons for inductions. Those that are medically necessary, and those that are for convenience. People have many reasons for convenience inductions. And if having a c/s doesn't bother you, then this probably doesn't even matter to you. (Go right ahead in other words). But I just want you to know that having your labor induced, especially with a first baby, will more likely lead to a c/s, than going into labor spontaneously. I don't care what your OB tells you, this is the truth. If you think about it, an induction usually works out better for your OB as well. They can hopefully have you delivered before their dinner plans. No surprise 3 am wakeup calls.
So, what about medically indicated C/S? This is where I feel women should really educate themselves if they are put in this situation. Do not blindly and ignorantly follow your OB's recommendations, without at least doing a little bit of your own research. Preeclampsia is a great reason for induction. So is a true IUGR. (Intrauterine growth retardation). A serious and severe decrease in amniotic fluid can be dangerous and a good reason for induction. But ask what your numbers are, and do some research about it. Make sure the fluid levels are as dangerously low as your OB claims they are. Do not blindly follow their advice!
You are not "overdue" until you are 42 weeks. Average gestation is about 41 weeks and 3 days, when pregnancy is left alone, and nature takes over. I'm sure it's miserable, but it's still a suck ass reason to induce. Another personal pet peeve of mine is inducing for "big babies". First off, ultrasounds royally suck at guesstimating weights. They can be TWO pounds off. Secondly, I happen to believe that our bodies don't grow babies so big that our bodies can't deliver them. I even mean that for Mom's with gestation diabetes!
So, if you have a medical indication for induction, it's important to consider your Bishop's score. There a few categories that go into determining your score, and I won't go into it here. But ask what your score is, and what it means. (The short version is that your Bishop's score helps tell you how successful your induction will be (or will not be).
2. Firing your OB/MW.
You are a customer. A paying customer. One with a brain, and a choice. You do NOT have to stay with your OB/MW. You can usually switch practices, all the way up to your third trimester. If you aren't having calls returned, or visits that answer your questions, or just aren't feeling a connection with your care provider.....then do NOT be afraid to switch. If your care provider degrades you or speaks down to you, then they aren't being respectful. If they do this while your pregnant, what's going to happen when you are in labor? You will be at your most vulnerable then, and probably unable to advocate for yourself. You really need a care provider that you trust and respect, and more importantly they should trust and respect you. Their care philosophies should match yours. And don't be afraid to ask blunt and difficult questions. This is YOUR body, YOUR baby, and YOUR birth. You are calling the shots here. Your care provider is not a god. Yes, they may have gone to med school or midwifery school, but they are still not a god. Do not blindly trust them. Educate and empower yourself. Make decisions WITH them, rather than sitting back and letting them make them for you. Our maternity system can sometimes be quite patriarchal, and encouraging of Mom's to sit back, shut up, and do as they are told. But you are the patient, and you have a choice. A choice about EVERYTHING. From who takes care of you, to whether you eat in labor, to what you feed your baby. Educate yourself, empower yourself, and STAND UP for yourself. You deserve it.
3. Hospital policy.
This is kind of a spin off from number two. Don't feel like you have to be a "good little girl" as a patient. No matter what "hospital policies" exist, they aren't going to kick you out for breaking the rules.
- If you want to eat and drink, then by all means do. The most recent research encourages this anyway. It's just gonna take a while for the hospitals to catch up. I had lots of goodies and sports drinks packed in my labor bag.
-You don't have to wear the awful tent gown they give you. I labored in a sports bra. I only wore that dreaded gown for about 3 hours after delivery, and that's b/c my dad was in the room. I was in my own night gown very quickly. I was comfortable and happy in it! As long as you are aware that birth is a messy business, and what you wear may be ruined, it's not a big deal. Put whatever you want on. (Or off).
-If your baby looks good on the monitor at the initial 15 minute strip, then you can take it off!!! No matter what their policy is, you can take it off yourself and walk, rock, chill on the ball, or get in the shower. Be blunt- ask if your baby was okay on the monitor, and if so take it off and do as you please. (This is assuming you aren't attached to necessary antibiotics, an epidural, or pitocin). Laying on your back, in the bed, is the worst thing you can do to help your labor progress. (Side note- Continuous fetal monitoring (CFM) is NOT a recommendation of ACOG (American college of obs/gyns). So feel free to share that with any nurse trying to bully you into staying on the monitor.
-Ask for what you need. I suggest asking for a birth ball as soon as you get there. Sitting and rocking on it can help tremendously with the contractions, and with helping your bambino move down in the pelvis. Ask for a birth squatting bar. It attaches to your bed, and you can hold onto it to squat. Squatting is another fabulous thing to help move a baby down into the pelvis.
- You can leave when your baby is 24 hours old. You just have to let them know that's what you want to do. Be persistent! We left the hospital at 8:30 at night. A little untraditional, but I couldn't wait to get out of there. As soon as Drake's bilirubin results were back, we were dashing out of there. I didn't even wait for a wheelchair, lol.
4. Uh oh, your water broke. What's next?
I think it's hilarious how in movies, women always have babies about ten minutes after their water breaks. As if. Oh how I wish that was so simple. The truth is many women don't even go into labor when their water breaks. I know it can sound confusing. But in essence, your water breaking doesn't mean you are truly in active labor. Dilation and effacement of your cervix, along with effective contractions, are what mean you are in labor. So what should you do if your water breaks? First- go eat and drink whatever fits your fancy. You will need that energy later. Second, go take a shower or bath. You can do all that while your hubby loads the car, and makes sure everything else is in order for the new family addition! You'll be wanting to pay attention to your body during all this, and if you do have contractions, then you probably won't be able to ignore them. So, what happens if you do start having contractions? Great! Follow the 5-1-1 rule, and go to the hospital when your contractions meet that. But, what if no contractions start? Well, there are a few things you could do. A- Walk! B- Move around! C- Nipple stimulation. Get out your breast pump for nipple stimulation if you have one, and if not go old school and enlist your husband. This is probably what got you into this situation in the first place. One thing I would not personally do is call my midwife just to tell her my water broke. Why you ask? Because there is this ridiculous and imaginary clock that starts when your water breaks, for most OB's and some midwives. They will tell you that because of the risk of infection, you automatically need a c/s at 24 hours. In my humble opinion, that is bullshit. The biggest contributor to infection is repeated and unnecessary vaginal exams, not ruptured membranes. You need to ask important questions if this is the situation you find yourself in. First, does Mommy have a fever? Second, does baby look good on the monitor? If those answers are no and yes, then there is no reason to pressure Mom to consider a C/S. You may also very well be pressured to consent to a pitocin drip if your water has been broken a while, and progress isn't being made. Pit is hell on earth (from what I've heard), and has ruined many women's goals of NCB. However, if you know you want an epidural, and aren't worried about Pitocin causing undue stress on the baby, then getting started on a pit drip probably isn't that big of a deal for you. I will repeat that Pit can cause distress in your baby!!!!!! It can cause long and excessive contractions that suppress bloodflow and oxygen to your baby. If your nurse and doctor/midwife are in a hurry for you to deliver, then they probably will leave out the negative aspects of starting on Pitocin.
5. YOUR baby; Not the staff's.
Again, it does not matter WHAT the nurse claims the hospital policy to be. You DO NOT have to let your child go to the nursery for any routine care or exams. This can all be done in your room. If all is not well with bambino, then by all means let them take them to where they can be more closely monitored and cared for. But that's not what I'm referring to here. Healthy babies belong with Mom. Feel free to refuse to let them go to the nursery, "just because" it's easier for the staff since that's their normal routine. Your body, your baby, your choice.
6. Taking probiotics and avoiding sex for two weeks before your GBS swab can contribute to a negative result. The GBS swab is usually done at 36 weeks. Just another helpful FYI from my very favorite midwife Tina. (You want to be negative)
7. Packing for the hospital
There are tons of lists out there for this, so I won't go into huge detail. My essentials were: chapstick, hair ties/hairbands, ipod with earphones, my own sportsbra and nightgowns/lounge clothes. As far as toiletries, I found the hospital lacking. The solution is Target's travel size section. They have EVERYTHING a girl could ever want. And since you pack it all so far in advance, it makes it easy so you won't need it before D-Day. Toss in your tube of lanolin for your boobs. The hospital provides monster sized pads, and "peri bottles" to clean your vajayjay with. Steal as many of those peri bottles as you can. The hospital will provide everything for the baby, including diapers. Mine even gave Drake a sweet knit hat made by the volunteers.
Now, for the baby. You only need two outfits, b/c the hospital will provide little shirts and blankets. One outfit for the infamous hospital picture, and one "going home outfit". I'd pack a newborn size, NOT the 0-3 month size. You can leave the carseat and blanket in the car until the last second.
That's all I can think of for now. I've been in the process of writing this for forever it seems. Life got in the way of finishing it. Hopefully it will provide some of my friends with info they didn't have, and also make some feel empowered. You may be a patient, but you aren't a prisoner. You don't have to "follow all the rules" if you realize that some are pointless. I hope everyone gets a birth experience like mine with Drake!!! (I'm certainly hoping for that with Eli)
