external fetal monitoring

One of the biggest obstacles facing a laboring mother who is attempting to minimize interventions is the external fetal monitor.  Most hospitals require it continuously rather than checking every half hour or so.  That means that you will be strapped to the bed. 

This is truly a enormous problem.  Being strapped down seriously limits your movement, and movement passes time, keeps endorphins flowing, and helps your baby wiggle around to find the best position.  And then of course there are the psychological benefits of movement; most notably feeling like you are able to work with the contractions and not merely be subject to them.

So what do you do?  Obviously it is very important to monitor the baby's heart rate, but is it necessary to do it continuously?  In "Childbirth Instructor Magazine", Leah Albers CNM, DrPH said:

"Many parents and health professionals believe that serious labor complications cause fetal asphyxia and that fetal asphyxia can cause permanent brain damage such as cerebral palsy in the newborn.  Those who believe that by identifying perinatal asphyxia, EFM (external fetal monitoring) can prevent neurologic impairment have unrealistic expectations of this technology.  In fact, EFM has not decreased the incidence of cerebral palsy.  Over the past 40 years, the rate of cerebral palsy has not changed and remains at about 2 per 1,000 live births."

So then, should we just get rid of fetal monitoring?  Not at all.  Fetal monitoring is extremely important in helping to prevent all sorts of things.  Even midwives at home births monitor the heart rate from time to time throughout labor.  Keeping a constant eye on your baby does not seem completely necessary, however.

Regardless of what your wishes are with all that, your hospital will have specific policies about fetal monitoring.  Keeping it on continuously has great advantages for them; they will have the entire labor mapped out with a written record of every contraction and every beat of your baby's heart, which is very useful if ever the hospital is taken to court.  Continuous montoring is also less work for the nurses, so if they happen to have many laboring women at once they can keep a better eye on them.

More than likely your hospital will require you to have the monitor on.  I know I have talked it down so much that you are probably terrified ... but don't despair!  There is still much you can do with the monitor on.  Be sure that at least you switch sides you are lying on in bed, but if you are able, you can also set up a chair next to the bed and move to that, which will get gravity on your side.  You can also have your husband or birth partner stand next to the bed while you lean on him.  You can lay the bed flat and get on all fours, which will take a lot of pressure off your back.  And you can ask to be unhooked and go to the bathroom every couple of hours.  You should be doing this not only for the chance to walk; it will also keep your bladder flat so the baby can put as much pressure as possible on your cervix to open it more quickly.  And if you can stand it (it often seems to cause contractions to become more frequent), stay and labor on the toilet.  It is really helpful, because you will have more contractions while at the same time keeping your pelvic floor loose, so things should open up more quickly. 

Learn what the procedures are at your place of birth, and talk to your nurses.  They need to follow the hospital guidelines, but they are usually more than willing to work with you and can come up with some great, unique positions to labor in.

a nod to technology

Most of my posts have been regarding natural childbirth; our own abilities and our potential to discover them.  But let me take a moment to say simply that technology truly is a blessing.

We live in a time where the physical nature of birth is fairly well understood; doctors are trained to look for warning signs and to prevent any serious threats.  Machines calculate heart rhythms, asphyxia, amniotic fluid content, and countless other things.  Labor can be sped up or stalled, the pain can be minimalized and even taken away.  Surguries are quick and many medications can help with the healing process afterwards.

Many, many lives have been saved.

As a doula I have already witnessed the benefits of having these technological safe-nets, and have seen them used exactly as they should be to improve the health and well-being of all involved.  They were not routine, they were not to save time, and they worked side by side with the laboring mother's body -- which, in my opinion, always seems to know more than of the machines.

We are blessed to have these options available to us.  I will continue to provide more information about more natural childbirth, as that is the kind of birth in which my abilities will be most utilized.  I have also chosen to provide this kind of information because in my own life, I knew quite a bit about all the technology available to aide birth, but I understood and trusted very little in the potential of my own body.  So most in most of my posts I'll be passing along the things I am learning.

But for heaven sake, if you are in labor and miserable, don't feel guilty.  Get the help you need to make your experience a positive one.  Your baby and your husband need you to be there, physically and emotionally.

Sometimes our mindsets about pain and performance get in the way of the body's natural process of birth.  Sometimes our body's natural process is to be in labor for many days.  Sometimes our own health or the health of our babies are not up to the processes. 

We are blessed to have the option of life-saving medical advancements.

it is easier to love when you are loved

In "The Doula Book" and in "Birthing Within", a study was cited that took place in Johannesburg, South Africa.  They took 189 women having their first babies, and assigned doulas to half of them.  These doulas were to "remain with the laboring women constantly and use touch and verbal communication to focus on comfort, reassurance, and praise." The purpose was to study the long-term effects a doula has on the first several weeks after the birth of a baby.  Their findings were amazing.

To quote from "The Doula Book":

"Fewer doula-supported mothers considered the labor and delivery to have been difficult, fewer thought it was much worse than they imagined, and more believed they had coped well during this experience.  When the mothers were asked about their experiences with their babies, the doula-group mothers spent less time away from their infants.  These results suggest that doula support during labor has effects similar to those of mother-infant contact directly after delivery; both appear to increase the mother's interest in her baby and her interaction with the newborn."

Here is a graph I pieced together from numbers found in "The Doula Book":

Johannesburg Study
	CONTROL GROUP	WITH DOULA SUPPORT
Feeding Behavior at Six Weeks
Breast-feeding only	29%	51%
Demand feeding	47%	81%
Feeding food other than milk	53 %	18%
Feeding problem	63%	16%
Average number of days breast-feeding only	24 days	32 days
Infant Health Problems at Six Weeks
Vomiting	28%	4%
Cold or runny nose	69%	39%
Cough	64%	39%
Poor appetite	25%	0%
Diarrhea	33%	19%
Maternal Outcome at Six Weeks
Mother brought baby to postnatal visit	47%	64%
Mother always picks up baby when crying	40%	80%
Hours away from baby/week	6.6	1.7
Emotional State of Mothers at Six Weeks
Reported anxiety	40%	28%
Reported high self-esteem	59%	74%
Reported depression	23%	10%
Satisfaction with Partner
Before pregnancy	63%	65%
During pregnancy	48%	49%
Since the baby was born	49%	85%
Reported their relationship being better right after the birth	30%	71%
Maternal Perceptions at Six Weeks
Perception of baby
Cries less than others	17%	55%
Special	71%	91%
Easy to manage	27%	65%
Clever	47%	78%
Beautiful	67%	89%
Regards baby as a separate, sociable person by 6 weeks	80%	100%
Perception of self
Feels close to baby	80%	97%
Pleased to have baby	65%	97%
Managing well	65%	91%
Communicates well	68%	91%
Becoming a mother was easy	11%	45%
Can look after the baby better than anyone else	31%	72%

The differences here really are amazing.  If you are able to find a doula that you connect with, please use their trained services. 

But most importantly, make sure you surround yourself with people at your birth who will be supportive, loving, positive, and completely on your side.  Find a doctor you agree with.  Ask if you can trade nurses if the ones assigned to you aren't fitting.  Talk with your husband about the hopes the two of you have for this experience.  And find an experienced mother or doula to help the two of you bring about those hopes. 

Our thoughts and emotions are tied to our health just as much as the food we put inside our bodies.

for your partner

Having now been on both sides of the coin during birth, I have a lot of respect and empathy for your support person.  Typically this will be your husband, mother, or close friend.  In all cases it is someone who loves you and wants the best for you, but is often unsure of how to best help. 

If your birth partner is desiring to be very involved in the birth of your child, have them read "The Birth Partner" by Penny Simkin.  I absolutely loved this book.

Here are some of my favorite parts of a guide created by Penny Simkin for training doulas.  It is also meant to be used by the birth partner. 

1.  Pre-Labor

• The cervix will ripen, efface, and move forward.  May experience non-progressing contractions
• Mother may feel tired, discouraged, anxious.  May overestimate progress or focus too much on contractions.
• You might distract her, if possible.  Alternate with restful activities.  Try some natural labor stimulating measures.  Encourage food and drink, there is a long road ahead.  Stay with her.

2.  Latent Phase

• The cervix continues ripening, effacing, begins dilating.  Progressing contractions, some bloddy show, rupture of membranes. 
• She may feel excited, confident, optimistic, or anxious and distressed.
• You might ask what she thinks about during the contractions, suggest more positive thoughts, give her feedback and not false praise.  Try a few relaxation techniques, focus your attention on her, and remind her to drink, pee, and change positions regularly.

3.  Active Phase

• The cervix dilates from 4 to 8 or 9 cm.  The head of your baby will rotate into the best birthing position.
• She may feel she has reached "the moment of truth".  She may feel trapped, or realize that labor is not within her control.  She may become quiet and go inward, resenting interruptions.
• You should speak quietly and positively, and remind her of her progress.  Follow her lead; if she is quiet, be quiet.  Help with different comfort measures and changing positions, bathroom, and fluids.  Help her to follow her original preferences regarding pain medications.

4.  Transition

• The cervix dilates the last two centimeters, and the baby begins to descend.  Contractions will be close and the intensity will be at its height.
• She may feel lost in the intensity of it.  She may tremble, need guidance and reassurance, and vocalize or find a soothing rhythmic physical movement.
• You may need to take charge if she seems to loose it; remind her how strong she is, how far she has come, and how close she is to the end.  Hold her, do not rub her, and acknowledge her pain.

5.  Possibly a Resting Phase

• The uterus may "catch up" with the baby, whose head is now out of the uterus and in the birth canal.  There may be little or no observable activity.  Care giver may relax, or worry and start calling for pushing or pitocin.
• She may feel relief at the break, confidence, and optimism.   She may feel renewed, more aware of her surroundings, and possibly a desire to get on with it.
• You should help her change positions, and remind her of the importance to release pelvic tension.

6.  The Descent

• The baby rotates and descends.  The head will rock back and forth between bearing down efforts. 
• She will push with contractions or on demand if she is on pain medication.  She may feel inadequate, need reminders of what to do, or feel alarmed at the feeling of her baby's head.
• Be positive, report on progress.  Help her achieve effective pushing.  Remind her to release tension in her perineum, and suggest changing positions to speed progress.

7.  Crowning and Birth

• Baby's head no longer rocks back and forth, it emerges.  Perineum is most vulnerable to tearing.
• She may feel a "rim of fire", a stretching or burning.  She may avoid pushing by panting.
• Don't rush her, let her do what she needs to.  If the caregiver is directing her efforts, stay close to her and support her position.

I love this list.  I have simplified it for your partner; Penny's is a bit more detailed and useful.  But this is something, and I hope it helps.  It is important for you both to feel confident and prepared as you welcome your child into the world.  Probably my favorite thing about being a doula is witnessing the process of change between a couple as they work together to bring their baby into the world.  It humbles and amazes me.  There is nothing more incredible than witnessing the birth of a family.

everything you need to know

Happy New Year!  I hope it is everything you want it to be for your family.

I just read a quote from a seasoned midwife named Susan Stalls.  She was asked how to prepare her mothers for childbirth, and this is what she said:

"There are three things that are givens about labor:  It's hard work, it hurts a lot, and you can do it.  That's the bottom line.  All the rest you learn about is icing on the cake."

I will continue to provide a little icing for you here and there, but this quote absolutely sums everything up.

where should you birth?

Over the holidays, I have been reading "Birthing From Within" by Pam England and Rob Horrowitz.  Its a little hippie-ish, but it has some really great suggestions and helpful thought-provoking questions.  I will now suggest to every client to read this book.  There are lots of things I want to post about, but here was one helpful little list:

"Home Birth is for Women Who Are:

• Healthy
• Eating a sound prenatal diet
• Non-smokers
• Able to envision taking an active role in giving birth, with minimal intervention
• Willing to cope with the pain and hard work of labor (without drugs)
• Living where midwives are available
• Laboring within thirty minutes of a hospital
• Able to cover additional expenses (if their insurance coverage is limited to hospital births)

Hospital Birth is for Women Who Have:

• Chronic medical problems (e.g., diabetes, high blood pressure)
• A prenatal problem (e.g., gestational diabetes, preterm labor, preeclampsia, breech, or at least two weeks overdue)
• A desire to birth in a hospital and/or have access to drugs
• Strong fear and/or mistrust of birth as a natural process
• Planned a home birth, but whose labor did not prgress normally"

when labor stalls

I have a good friend who is worried quite a bit about her labor stalling and then ending up with a c-section.  So ... this post goes out to you!

It is quite common for labor to stall at some point.  Anxiety, exhaustion, dehydration, frustration, poor fetal positioning, and lying still for long periods of time are a few contributing factors.  Some women just have weaker contractions and are in some sort of labor for days.  Some women have not had any sleep the last few days or weeks, and so their bodies will take breaks to try to reserve energy for pushing.  Whatever the case, if the mother is coping well and the infant is tolerating the contractions just fine, there is no reason to immediately turn to a c-section.

The only problem is, some women could be in labor for days.  This is far from appealing to anyone.  The mother and her partner will be emotionally and physically exhausted, and the care provider will not only be tired, but they will be losing time they could be spending with other patients.  Everyone has their limit that they are willing to let things go naturally, and you will have to decide what yours is.  You should definitely be aware that hospitals have the shortest amount of time that labors are allowed to endure, especially as it seems so very much easier to wheel down the hall and cut the baby out.  Most hospitals have a 24 hour policy; from the moment you check in you are on a time clock.  You will also be likely to hear people saying things like, "Let's get this kid out on my shift!"  or, "Your doctor will be here in a couple more hours,"  which is kind enough, but does definitely put pressure on the mother to achieve some sort of schedule.

Birth does not happen that way.

I would suggest making a birth plan, having a good idea of what is most important to you, and then once labor starts .... just don't worry about it.  Let your partner handle schedule stuff while you go inward ... get in that mammalian brain that actually does know the best way to get that baby out.  Sometimes the less you think, the better.

Here are a couple of good articles:
http://www.spinningbabies.com/research-and-references/268-patience-when-labor-stalls
http://www.ncbi.nlm.nih.gov/pubmed/18978113

a thought on nurses

I recently attended a birth in the exact same hospital that I delivered my son at.  My experience was far from "natural", and I was extremely frustrated with the nurses.

But when I went back as a doula, I was amazed at the difference.  The nurses were attentive, aware, and always asking my client's opinion.  One of the nurses was in school to be a midwife, and knew about different birthing positions, pushing techniques, and so on.  My client was able to have her baby placed directly on her stomach, and left there for a solid hour before they took her to the nursery.  She was permitted to labor on the toilet, push as she felt appropriate, did not receive an episiotomy, and delayed cord clamping.  All of these were things I had hoped for but did not experience.

What was the difference?

I think it was her doctor.

Nurses do not know you personally; they do not understand your experiences, your preferences, your strengths or your weaknesses ... but you can bet they know your doctor's.  They understand how your doctor works, and they will treat you accordingly.  My client had a midwife who was well respected in this hospital, and I had the king of c-sections (who is actually in jail now ... oops).  It only makes sense that they will tailor their treatment to the doctor's style more than your own.

So, yet another reason to be sure you find a doctor that you absolutely agree with.  You cannot take someone who is good at doing one thing, and ask them to do another.  It will be frustrating for everyone involved.

delayed cord clamping

Delayed cord clamping is exactly that .... delaying the clamping of the cord for around two minutes; or when it stops pulsing.  This is something that is not done too often in hospitals unless the couple requests it.  It allows the last of the nutrients from the placenta to be delivered to the baby, and has some definite benefits; there was a marked improvement in the content of the babys' blood -- particularly their iron levels -- extending throughout their infancy.

I found a great medical article on it here.

The article concludes with:

"Delaying clamping of the umbilical cord in full-term neonates for a minimum of 2 minutes following birth is beneficial to the newborn, extending into infancy. Although there was an increase in polycythemia among infants in whom cord clamping was delayed, this condition appeared to be benign."
 

my firstborn son

This is my personal experience with the birth of my son, and greatly influenced my view on birth as a doula.  I wrote this about two weeks after he was born.

"Okay, so labor is intense. Extremely intense. But now that it's over, I'm surprised by how do-able it is! Don't get me wrong though, it was the most physically difficult thing I've ever been through. Of course, I only have a few broken bones and some stitches from Mom's sewing scissors compare it to, and it definitely outdid all of those. But your body just . . . works. It knows what to do, and you find yourself just saying, "Okay, here we go!"

I did find myself having moments where I just wanted to cry and curl up into a ball of anguish, but that's what having a fantastic labor coach is for! Mark was so positive and attentive, I was almost surprised he'd never done this before. He didn't even have the help of the nurses . . . they weren't too involved with much of anything. Looking back I am still undecided as to if I ever want to deliver in a hospital again.  The home birth option is looking more and more awesome to me, but that still is a bit scary.

So I woke up at two o'clock in the morning on Saturday with what felt like a stomachache. After trying to sleep for a while, I began to realize that this stomachache was coming and going . . . with those braxton-hicks contractions. I felt so excited and terrified, there's nothing like that feeling of oh-my-gosh-this-is-really-happening?  You can't wait for that baby to get here, but on the other hand you realize that yes, there will definitely be some pain involved. I knew Mark would need to clean the Olive Garden windows that morning (one of his many odd-jobs) and so I didn't want to wake him up if this wasn't real. So I lied there for a while, just waiting to see if they got stronger. They never did, but I timed them and although they were all over the place, sometimes they were as close as two minutes apart. So I woke him up! Mark was thrilled, and didn't say a thing about his BYU game later that day. :) So I told him when contractions started, and he timed them. We did this for about two hours until we both fell asleep. We woke up at about six thirty . . .. what??? I was so confused, I should not have been able to fall asleep if this was real labor! So despite his worries, I sent Mark off to clean windows and spent all morning counting contractions. And all afternoon (while watching the BYU game). And all evening. We went on several walks, which definitely made them closer together and stronger, but then they would calm down once I lied back down.

Finally I started bleeding. Bloody show? It's supposed to be natural when it's real labor, but all my books said that it's just mucus tinged pink, and there was definitely more blood than just a "tinge". So I worried. Mark wasn't as worried, he was very reassuring and sweet . . . but I kept worrying. Finally we layed down to try to go to sleep at about 11 that night, and I  couldn't sleep ... I was very worried.  (And also sick of waiting around, not knowing what was going on.)  So we decided to go to the hospital just to get checked. I knew I wasn't going to have the baby quite yet, but I wanted to make sure my placenta hadn't detached or anything crazy like that. So we grabbed my suitcase "just in case", and drove over.

It was so so so busy there. Apparently the next closest hospital decided not to admit Medi-Cal patients, and so this one was over-crowded. I told them I only wanted to be checked, and they warned me that if I left and tried to come back that they probably wouldn't have any space for me. That was a chance I was willing to take; I had done all sorts of reading and studying and knew what I wanted my birthing experience to be like, and it definitely included being at home as long as I possibly could!

So they took me into the last available laboring room and there told me I was dialated to a three and that they were a little concerned about the baby's heart rate, and wanted to keep me strapped to these machines for about another hour so they could monitor him. I was a little frustrated, being strapped to a bed was absolutely the LAST thing I wanted to do while laboring. But I kept telling myself it would only be for an hour and then I could go back to the comforts of my own home! I wasn't concerned about the heart rate, everyone had told me it was very normal for a baby's heart rate to drop a bit with contractions.  (And of course those opinions were more valid than the nurse's.  ??  But having worked in a facility with patients -- my anorexic girls -- I know that nurses have to be ultra-aware of every bad scenario for liability reasons too.  That was what I kept thinking about at this point, and it was bothering me.)

The nurse who was helping us was very sweet, but I felt like she was kind of confused. They were obviously very busy;we heard two babies being born while waiting. But she finally came in and said that they really felt like it would be best if I just stayed. I understood that the hospital was now liable for us, and that it was ridiculously busy and we might not be able to ever get back in, but I wanted to cry. This was not going according to my plan. She told me I could shift positions a bit, but that I couldn't leave the bed and needed to keep the monitors strapped to me. I kept telling myself it was for the good of the baby, but I also didn't trust the old equipment they had me hooked up to. So the following hours consisted of Mark and I laying there watching t.v., left alone unless I moved, which of course made the monitors not work, so a nurse would come rushing in and adjust it. Mark fell asleep at one point, and my contractions were reeeeeaally starting to hurt. I remembered reading that sitting on a backwards chair and leaning forward really took some pressure off, and though I couldn't get to a chair, I thought I might try it on the bed. Well that attempt ended in four nurses running in, turning on all the lights, startling poor Mark half to death, and a stern chastisement informing me that they thought the baby had gone into cardiac arrest. They adjusted everything and left, and I started to cry. Not what I had planned on.

So Mark suddenly became super-dad and rubbed my head and my feet and my back. We decided to play cards, and since I didn't feel like I could focus enough for Slap Jack, we settled on War. So we played for a good half hour with random breaks as the contractions came. They still weren't regular, but they definitely were beginning to hurt. Then of course a nurse came running in saying she couldn't read me very well in this position, and so I layed back down. And the contractions got worse. Mark tickled my back and got the life squeezed out of his hand as I rocked my knee back and forth, breathing as deeply as I possibly could, which seemed to help. The breathing almost made it feel like I was pushing the contractions downward, so they didn't feel like they were choking me so much.

Finally at five thirty the nurse came in to check me. I was exhausted. I hadn't slept in almost two days, and I was already getting shaky. I was thinking this kid better come soon, because I was worried I would be too tired to push him out! The nurse informed me I was at about a six, and still had a good six or seven hours to go. She asked me if I wanted anything, and I told her about my fear of being too tired to push. She told me she could give me a little bit of something to take the edge off, that it would wear off soon and that she could keep it small so what little bit did get to the baby would be through his system and out of there by the time I had to push. That sounded good to me. She gave me half of a dose of nubane, and it knocked me out. I think I forgot to mention that I am really sensitive to medications.

I slept for two hours, and started to come out of it as the morning shift came on and Mark started to tickle my back again. But I felt like I had been run over by a truck. Like I had taken nyquil or something, and just couldn't focus on anything. The contractions started to bring me back, but between them I would drift off to sleep. The new nurse told me I was at an eight and to move from side to side as the contractions came on, because the baby's heart rate was still an issue. She turned up the monitor really loud, and so the next couple hours were spent listening to that heart rate slow down as my pain went up, and Mark helped me rock from side to side until we found a position that the baby "liked". Gads, I that part feels like a hazy nightmare. I hated feeling so groggy, and really depended on Mark to tell me what to do. Plus there is nothing so horrible as hearing that heart rate get slower and slower . . . . and then miraculously pick back up as I moved. The nurse gave me an oxygen mask to help the baby, which at first I hated and it make my mouth taste horrid, but the couple times it fell off I found myself gasping for air, so I suppose it was worth it.

Eventually the pain of the contractions brought me out of it, and boy could I feel them! Contractions have such a distinct feeling . . . it's really hard to describe. My sister-in-law calls it a menstral cramp on steroids, which is fairly accurate. But that still doesn't quite do it. Anyway, despite how much it hurt, it was still doable.  It just happens, whether or not you think you can do it.

At that point some nurses came in and told us they couldn't find some of my paperwork.  I had been routinely tested for an infection that often comes on at the end of pregancy, and they couldn't find the test results.  Well, I knew very well that I had had no infection of any kind, and told them so.  They said sorry, they needed the paperwork.  So they would just go ahead and give me a whole bunch of antibiotics.  I was quite annoyed that they couldn't find a stupid piece of paper, and already feeling guilty that I had used some narcotic that probably had my little infant feeling quite loopy even still -- and maybe causing allergies, who knew??  The drama in my brain was having a hay-day.  But the intense contractions quite impaired my ability to argue, and even though Mark attempted a bit, they hooked me up to a bunch of antibiotics anyway, and off they went.

The nurse had also told us to call her when I felt the urge to push, which kind of made me nervous because I had no idea what that felt like and worried I wouldn't call her in enough time. But those fears were unfounded, because there is no mistaking that feeling. It's like you have to take the biggest dump of your life! And then you find that pushing actually helps the contractions to not hurt so much, maybe because you're actually doing something, working with it, instead of just trying to take it. 

So we called her, and she didn't come. Two contractions went by with no sign of the nurse, and I did not know what to do! Mark ran out into the hall and found someone, and still another contraction went by until she came. Busy busy hospital. So then the pushing began! Mark helped me grab my knees and the nurse kept shoving around down below, which HURT. I was getting very upset with her. I don't know if she could tell or what, she didn't say much and ended up just standing by the machine for a while. Pushing entailed Mark counting to ten while I acted like I was basically trying to poo, taking a deep breath and doing it again and again until the contraction ended. After about forty-five minutes, the nurse told me to stop. STOP??? She had to be joking . . . I could not fight that urge to push! She said the baby's head was crowning and the doctor wasn't there yet. GAAAAH!!! And so I had a minor freak-out as they told me to just breath, and Mark jumped right in with the "hee-hee-hee" breathing to help guide me. I attempted to do that but I think I was crying too . . . finally, after two contractions like that Dr. Vouis ran in, threw on some scrubs and numbed the perineal area. They told me to push again, and Mark started getting so excited and saying "Allie Allie I see him! He has black curly hair, he's coming he's coming!" And then they told me to push again, push push as hard as you can Mamita!! I feel my face turn purple and in the back of my mind wonder if eyes can explode, and then all of a sudden . . . WHOOSH! It feels like all my guts have fallen out of me, Mark is thrilled and the doctor looks startled, and then suddenly there he is, this bloody, lanky little man lying on my stomach . . . suddenly there are three or four nurses in the room -- where did they come from? -- and everyone is hovering, sucking my guts out of the baby's nose and mouth, Mark is kissing me and shaking -- or is it me? -- and whispering, "Oh he's perfect, Allie you did so good, so good. . ." and then the nurses are saying, "Daddy come cut the cord!" And I think, oh my word this is real . . . that is my son.

Then Mark heads with the nurse into another corner of the room and I watch as they clean him up and check him out. Then another nurse starts kneading my stomach and there are a couple more contractions, but they are nothing compared to anything before, and I hardly noticed them. Turns out the doctor had been in the process of an episiotomy when Mac came flying out, he informed me he had not been expecting him to come all in one push, and therefore I tore like crazy. The repairs took a little longer than I wanted them to, but nothing really matters much at that point, because MacAlister was here, he was healthy, and we are a family!"

eating and drinking

During labor, nearly all hospitals restrict eating and drinking.  It stems from a procedure that is rarely used today, and is quite unnecessary.  Eating and drinking (juice, particularly) will boost your energy and aid you physically, and oftentimes emotionally as well.  Talk to your doctor to see if this will be a possibility.

I just read a really great article about it, and here is the first paragraph to tantalize your tastebuds ...

"The traditional practice of restricting food and fluids during labour does not provide any benefits, finds a new review co-authored by a Queen's University Associate Professor."

Read the rest of the article here.

some definitions

pain·ful  [peyn-fuhl] 

–adjective

1. affected with, causing, or characterized by pain: a painful wound; a painful night; a painful memory.

2. laborious; exacting; difficult: a painful life.

3. Archaic . painstaking; careful.

 

in·tense   /ɪnˈtɛns/ Show Spelled[in-tens] 

–adjective

1. existing or occurring in a high or extreme degree: intense heat.

2. acute, strong, or vehement, as sensations, feelings, or emotions: intense anger.

3. of an extreme kind; very great, as in strength, keenness, severity, or the like: an intense gale.

4. having a characteristic quality in a high degree: The intense sunlight was blinding.

5. strenuous or earnest, as activity, exertion, diligence, or thought: an intense life.

6. exhibiting a high degree of some quality or action.

7. having or showing great strength, strong feeling, or tension, as a person, the face, or language.

8. susceptible to strong emotion; emotional: an intense person.

9. (of color) very deep: intense red.

We've all heard that "Pain is mandatory.  Suffering is optional."  Lately, I heard a new one.  A gal was telling me how she had been so worried that the pain would worsen to the point that she would just loose it; but she said that ended up not being the case at all for her.  She told me it didn't become more painful, just more intense.  There is a difference, and as labor is as much, if not more mental than physical, I think it's important to understand the difference. I highlighted my favorite parts.  Hope it helps you. 

(Used this online dictionary)