FIRST TIME MOMMIES? FEAR NOT AND BE PREPARED

By TinTin Monsanto

PART 2

This time I will tackle the day labor and delivery. This is the day wherein the couple becomes more anxious, especially for the first timers.

YOU KNOW YOUR BODY

Labor can be tricky at times, and may result in false alarm. There are certain signs and symptoms of labor. Apparently, some will advise to call the hospital for any uncertainties, but it is best to just go to the hospital of your choice. Even if you call, medical staff will still advise you to come. Since they cannot assess nor check your dilation over the phone.

Labor may start anytime. In the beginning, contraction may initially not be painful. It is often described as tightening, or like having menstrual cramps. For those who don’t experience menstrual cramps, or dysmenorrhea, it’s described as heavy lower abdominal pain or discomfort that makes movement very uncomfortable. Although some pregnant women experience more back pains. As the labor progresses, the tightening or cramps will already be perceived as pain, and will become stronger over time; and most of the time radiating to the back.

Along with the cramps and contraction pains, there might be small blood stains known as the “show”. Hence, there is nothing to be afraid of, since this is a normal event. The show may indicate the opening of the cervix. Sometimes, it may also occur after a doctor/nurse did a vaginal examination to monitor cervical opening/dilation.

The ruptured bag of water: Inside the womb, the fetus is inside a sac. Amniotic fluid is the liquid within the membrane that serves as protection for the babies. It could either burst naturally by itself, or it may need to be ruptured by doctors, to help in the progress of labor. Once it ruptures, it will sometimes leak on and off, which is commonly mistaken as urine. But, most of the time, it will continuously flow, especially during body movements. It is important to take note of the color, whether it is clear or greenish. This is also one of the reasons why some doctors need to rupture the bag of water, especially for post-term. It will not only help in the progress of labor, but they will also be able to assess whether the fetus has already passed motion inside, or if there is any presence of infection. Wherein, doctors may order antibiotics, if the bag of water has already ruptured for 12 hours, and hasn't been delivered to serve as prophylaxis.

Be mindful of the fetal movements. As pregnancy reaches 20 weeks of gestation, the fetal movement known as kicks can be felt. It gives a wonderful feeling for the couple. As the pregnancy progresses, most fetuses can be very active at night, while some in the morning. If the fetal movement is less than what the baby used to do, or less than 10 kicks within 30 minutes, you can lie on your side, drink a glass of cold water, eat light food, and let your baby listen to fast track music. These actions can stimulate the baby to wake up. However, if there’s still no change, go to your hospital of choice for fetal monitoring. Fetal monitoring will assess your baby’s heartbeat and movement as well. This is to prevent any chances of stillbirth. There are many causes of stillbirth, and it is usually sudden, and sometimes unknown. Tracking fetal movement is the way to know if the baby is well or not.

LISTEN AND COOPERATE

It is normal for the couple to be nervous, and it’s understandable that lots of questions are running through their minds. Breathe and calm down. As you reach the hospital, listen and follow the instructions of the medical staff first. They will tell you what to do. Let them do their task first, and they will explain to you what is going on, and what is to be done. You can ask questions, and ask for further explanation, especially before every procedure, if needed. It is your right to ask, to know and they will respect your decision regarding any procedure. However, you must also be aware that all procedures, whether done or not, have their own risks for the baby. You must also be mindful and responsible for your decision regarding certain matters. Medical staff may ask you to sign waivers/consents.

When procedures are ongoing, be more cooperative. Do not scowl nor show any arrogant attitude. It won’t help you at all, and will only lengthen your agony. Remember, you are in the hospital. You are going to give birth. d You’re not in a party, socializing. It is not only stressful for the couple, but also to the medical practitioners as well. Both mother’s and the baby’s lives are in the hands of the medical practitioners. It is better to cooperate and show them a good attitude and gratitude. No matter what happens, they will do their best to let you deliver safely.

If there is anything that is not clear regarding instructions or explanations, do not hesitate to ask. But please ask nicely. This is to prevent any misunderstandings or miscommunications on both parties and medical treatments can be done.

REMEMBER THESE VIRTUES

“No Pain, No Gain”

Labor pains are to the highest degree. As you go along with the labor, the pain will become stronger and stronger, until it becomes excruciating. Do not compare. People have different tolerance to pain. Medical practitioners will ask your pain score ranging from 1 to 10, every now and then. Some cannot describe it. For that, you can ask for the pain scale picture. 0 - no pain

1 - Tightening or cramps

5 - Painful but still manageable

10 - Excruciating

People have different ways of coping with the pain, depending on their tolerance.

Some expectant mothers can tolerate it, without any pain relief, just like in the old days. While some need these pain relievers. Different hospitals offer different types of pain relief, also, depending on the country. It could either be through injection, or gas inhalation. Injection and gas inhalation will only alleviate the pain a little, and help relax the muscles every after contraction. Both the gas inhalation and Pethidine injection will only take away 30 – 40 percent of pain. It means, patients can still feel the pain. It is not painless. An injection on the thigh with Pethidine can make you sleepy, after every pain; while the gas can make you feel dizzy, sleepy or nauseated.

On the other hand, there is one more pain relief that could take away 80 - 90 percent of labor pains, and that is the induction of anesthesia; the epidural. For normal deliveries, epidural anesthesia is the most common choice. It doesn’t only relieve the pain, but will help the patient rest from the pain. Some patients don’t want to have an epidural, due to their previous experiences of side effects and after effects. Also, there is a certain culture that doesn’t prefer to give it to their patients, in which all medical practitioners respect. However, there is no point in suffering a lot, if it is the one that can help you. After all, it is your body; it is you who is feeling the pain. Again, not all have the same body and tolerance. But again, it is your prerogative. I will explain, as we move along to our next virtue.

“Patience is a Virtue”

Labor is sometimes referred to as a waiting game. It is very exhausting and stressful for the couple. Labor, especially for first babies, may take up to 10 hours or more; the reason why patience is very much needed. The couple tends to become impatient and anxious, especially for mommies undergoing induction. Induction of labor is stimulating childbirth, if there is a necessity to do so, and will be according to your doctor’s preference. Different doctors have different ways of treating their patients. Sometimes, when a couple becomes impatient, they tend to transform from being a sheep to a lion. It’s human nature. However, it will not help in the progress of labor. Let me explain. The woman’s cervix is a muscle. It is like a slice of meat as thick as 1.5 inches steak. It needs to be tenderized. Just like the cervix, it needs to be thinned out before it can open and be stretched. There are different ways of doing so, depending on the doctor. Hence, this is why some doctors may recommend their patients to undergo pain relief like an epidural. It is a myth that anesthesia/epidural inhibits the progress of labor. Pain causes our body to be stiff and tense. Therefore, the muscle itself will be as hard as stone that needs to relax in order for it to open. Pain relief, like an epidural will help this to do so. Moreover, pain relief can help the patients rest, prior to the delivery itself. So, you might want to consider it also.

“It’s All Hard Work”

The Doctor or the nurses may check the dilation through vaginal examination every now and then. The cervix must be open to 10cm before a mother can finally bear down the baby. Medical practitioners will never allow a patient to push, if the dilation is 8 to 9 cm, to prevent any cervical tear and profuse bleeding that can be critical. Although for patients who don’t have any pain relief, it is natural for them to push unconsciously, since it can be uncontrollable. It is a must to listen and to follow the instructions on what to do, to prevent any complications.

It will be such a relief for couples to hear, once the cervix dilates to 8 to 9 cm. The anxiety level increases and they will not be able to help but look at the time over and over again. Be patient. The more you look at the time, the more it will feel slower. Once the cervix opens to 10cm that is when all the hard work must be done. This is the reason why proper pain relief is advised. Having a 10 cm dilation doesn’t mean that the baby is coming out. The baby is still at the far end of the tunnel. It needs to bear down in order to reach the other end. This is when mothers need to push. Why does the mother need to be rested or get pain relief prior to pushing? Pushing is like running in a marathon for 3 days straight, and it’s no joke. All efforts and energy go hand in hand during the pushing process. Listen to the medical practitioner's instructions, and she will guide you. For those patients who don’t have anesthesia/pain relief, it’s understandable to scream. However, I advise you, DO NOT SCREAM. Listen to the instructions. It is excruciating, definitely! But babies do not come out of their mouths by screaming. Screaming will not help at all. it will only lengthen your agony.

“Not Everything You Want, You Can Get”/ “It Depends Upon The Situation”

In some countries, birth plans are being practiced. It can either be hypnobirthing (use of meditation), hydrobirth (use of water to alleviate the pain), or some couples may opt for water birth (delivering babies in the tub). All these birth plans aim to deliver as natural as possible.

Birth plans can be searched anytime on the internet. Couples will copy and paste depending on their preference, then show them to their doctors for approval. All medical practitioners will respect all birth plans. However, not everything written on the plan is applicable, and will depend on the protocol of the institution, even if the doctor agreed. Most especially when it comes to monitoring babies, you must let it be done. It is understandable that you know your body, but medical staff must know how well your baby is doing inside. They can see you, but not your baby. They’re not doing this for you, but for the baby as well. Some plans will be written, and may not ask for any kind of pain relief. If you indicated in your birth plan not to ask for pain relief make sure you already made up your mind what you want and don’t just tell them it’s painful. Medical practitioners will not be able to alleviate the pain no matter how many times you call, stating that it is painful, because they know how excruciating it is. Have to tell them what you want to do to alleviate it l, since it is what you wanted in the first place. Therefore do not throw fit. They are just waiting for you to tell them what you want to be done. Don’t tell them to stop the pain. If you cannot, neither could they. If you cannot handle your body, they can’t either. The only way to stop the pain is to get pain relief or deliver the baby. It is your plan, it is what you wanted, be responsible with your plan and decision.

Let’s face it, if we don’t get what we want, or when the plan doesn’t go as it was supposed to be, we complain a lot. There are couples who complain when their plans are not followed. But please be mindful, that it will still “depend upon the situation”. Medical staff don’t have superpowers, nor do they have the ability to predict things. They will still act accordingly to what they know is needed, for safety and to save lives, regardless of the plans.

Every woman wants to have a normal spontaneous delivery or a natural birth. It is possible, but it is not for everyone. There are cases wherein the caesarean section must be done depending on the patient’s antenatal history. There are times that even supposed deliveries can turn to an emergency caesarean section. Even if patients are already pushing their babies it may still lead to an emergency caesarean section. It is the baby who decides their own date/time of delivery; even the mode of their delivery. They can, for they are the only one who knows what is really going on inside. No one can force your baby to be delivered, unless you opt for a caesarean section for the auspicious cases. Please don’t tell the medical staff to let you deliver at a specific timing for they are not God, nor have the power to do so. Unless heaven will make a miracle.

“Be Afraid of Karma”

Everyone knows what Karma is, and it could either be good or bad. Walking inside the hospital is like walking into a forest. You will never know what lies ahead. You are not going to a party, rather to a place to seek treatment. You may not want to bring your A-list attitude. Medical practitioners may not be Gods, but they are His instruments. The reason why you might still be alive. You are not in your own house solely served by your servants; you are not the only patient being monitored and treated. They are trained to know what cases to prioritize first. If you are being given an instruction, listen and follow. If they said to press the call bell for any assistance, press it. Do not go out and look for any staff for they are nursing other patients. Do not loiter around the corridor and roam like a supervisor, you are not an executive of the institution. Even these simple instructions are necessary to follow. The call bell signals the staff the room that needs assistance that they will attend to, as soon as they finish with the other. Do no loiter, so in case of emergencies, they will not bump you. Give them the necessary space for faster action. These are simple instructions, yet are necessary. Be thankful and grateful. Better leave your socialite or spoiled attitude, unless you are ready to face karma. Karma may not get back to you, but think of your unborn child that they may suffer the least. Mothers who keep insisting what they want, despite all the explanations, may face serious problems. If something happens, their tendency is to blame the medical staff, and sometimes, they will even turn the story upside down to avoid guilt. Unfortunately, this really happens, and it is part of human nature to do so. Remember, all medical treatments/procedures have their own risks. Things may go well at first, but no one knows how things will end. Even smooth sailing labor can turn into an emergency caesarean section. Everything is being done for one major reason; it is to save the lives of both mother and child. No medical staff would want a mother to go under a caesarean section. They know every mother would want to have natural labor, as much as possible. No medical staff will pray for something bad to happen. You are responsible for your own decisions. It’s not a joke when karma does its job. The stress level may be high for the patient; most of it is on all medical staff. Their hearts can literally drop just to save lives. They will not show it, but deep inside, they already called all the Gods and Saints for a miracle, and to fight the karma for you. No need to neither praise them nor hail them. Just be a proper human being. Everything has its reason and price.

This wraps up my blog for mommies-to-be, especially for first-timers. I hope this will help ease your anxieties.