Showing posts with label Birth. Show all posts
Showing posts with label Birth. Show all posts
Saturday, May 7, 2011
Bishop's Score - Induction
http://www.birth.com.au/Induced-labour/Readiness-for-labour-ripe-cervix-Bishop-point-system?p=1
Friday, April 29, 2011
Great "Nuchal Cord" post about how normal they are (1 in 3)
http://midwifethinking.com/2010/07/29/nuchal-cords/
Wednesday, April 27, 2011
Friday, March 25, 2011
GD Link
http://www.ivillage.com/gestational-diabetes-common-sense-approach/6-a-129188?p=1
A great link regarding GD.
A great link regarding GD.
Tuesday, February 15, 2011
Waiting for birth or inducing found equally effective for women with IUGR
ORIGINAL POST CAN BE FOUND HERE:
http://www.eurekalert.org/pub_releases/2010-02/sfmm-wfb011510.php
CHICAGO, Ill. (February 4, 2010) — In a study to be presented today at the Society for Maternal-Fetal Medicine's (SMFM) annual meeting, The Pregnancy Meeting ™, in Chicago, researchers will unveil findings that show that waiting for birth is as effective as inducing labor in cases of intrauterine growth restriction (IUGR).
Intrauterine growth restriction means that the fetus is substantially smaller than normal. The condition affects about 10% of pregnant women.
At birth the babies are more likely to have low blood sugar, trouble maintaining their body temperature, and an abnormally high red blood cell count. They're also prone to jaundice, infections, and Cerebral Palsy. Later in life growth restricted babies may be prone to executive and behavioral disorders, obesity, heart disease, type II diabetes, and high blood pressure.
Because of lack of evidence, obstetricians follow two main policies for pregnancies with suspected fetal growth restriction at term. Some doctors may induce labor out of concern for complications, while others will await spontaneous delivery to prevent higher operative delivery rates. Researchers in the obstetric research consortium in the Netherlands conducted a randomized controlled trial of 650 women in 52 hospitals to compare both strategies.
Pregnant women with a singleton pregnancy suspected of IUGR beyond 36 weeks of gestation were randomly allocated to either induction of labor or expectant monitoring using a web-based allocation system. Median birth weight was significantly lower in the induction group; 2420 grams, vs. 2560 grams in the group that waited. Adverse neonatal outcomes occurred at similar rates in both groups (difference of 0.9 %). The results show that waiting is an equally effective strategy to inducing labor.
"We now have an evidence based reason to individualize care and to allow women to do what they are most comfortable with when deciding whether to induce labor or wait, although long term outcomes have to be awaited" said Dr. Kim Boers the study's author from Leiden University Medical Center in the Netherlands.
http://www.eurekalert.org/pub_releases/2010-02/sfmm-wfb011510.php
CHICAGO, Ill. (February 4, 2010) — In a study to be presented today at the Society for Maternal-Fetal Medicine's (SMFM) annual meeting, The Pregnancy Meeting ™, in Chicago, researchers will unveil findings that show that waiting for birth is as effective as inducing labor in cases of intrauterine growth restriction (IUGR).
Intrauterine growth restriction means that the fetus is substantially smaller than normal. The condition affects about 10% of pregnant women.
At birth the babies are more likely to have low blood sugar, trouble maintaining their body temperature, and an abnormally high red blood cell count. They're also prone to jaundice, infections, and Cerebral Palsy. Later in life growth restricted babies may be prone to executive and behavioral disorders, obesity, heart disease, type II diabetes, and high blood pressure.
Because of lack of evidence, obstetricians follow two main policies for pregnancies with suspected fetal growth restriction at term. Some doctors may induce labor out of concern for complications, while others will await spontaneous delivery to prevent higher operative delivery rates. Researchers in the obstetric research consortium in the Netherlands conducted a randomized controlled trial of 650 women in 52 hospitals to compare both strategies.
Pregnant women with a singleton pregnancy suspected of IUGR beyond 36 weeks of gestation were randomly allocated to either induction of labor or expectant monitoring using a web-based allocation system. Median birth weight was significantly lower in the induction group; 2420 grams, vs. 2560 grams in the group that waited. Adverse neonatal outcomes occurred at similar rates in both groups (difference of 0.9 %). The results show that waiting is an equally effective strategy to inducing labor.
"We now have an evidence based reason to individualize care and to allow women to do what they are most comfortable with when deciding whether to induce labor or wait, although long term outcomes have to be awaited" said Dr. Kim Boers the study's author from Leiden University Medical Center in the Netherlands.
Friday, July 2, 2010
Tuesday, June 29, 2010
Induction - Fake & Natural
In regard to sleep... can you perhaps have a hot bath before bed and take some panadol to ease your back pain? Maybe schedule a massage to see if some of the tension can be released?
Syntocin generally makes labour more difficult so you may be getting baby out a few days earlier but it may mean you have a much more difficult labour. You've probably heard of the Cascade of Intervention... if you can avoid stepping on this slippery slope then this is the way to go.
I would try some less invasive induction methods first. Contact the hospital and explain how you are feeling and ask if you can come in for a stretch and sweep. The midwife will do a vaginal exam and try to stretch your cervix apart a little, while also pushing your membranes off the cervix. This is often enough to get things going.
You could also try a few acupuncture sessions... if your body is ready then this may kick start your labour.
Sex is another thing that can encourage labour. Semen contains prostiglandins which ripen your cervix, sometimes this is all that's needed to start the chain reaction of hormones which happens in labour.
Syntocin generally makes labour more difficult so you may be getting baby out a few days earlier but it may mean you have a much more difficult labour. You've probably heard of the Cascade of Intervention... if you can avoid stepping on this slippery slope then this is the way to go.
I would try some less invasive induction methods first. Contact the hospital and explain how you are feeling and ask if you can come in for a stretch and sweep. The midwife will do a vaginal exam and try to stretch your cervix apart a little, while also pushing your membranes off the cervix. This is often enough to get things going.
You could also try a few acupuncture sessions... if your body is ready then this may kick start your labour.
Sex is another thing that can encourage labour. Semen contains prostiglandins which ripen your cervix, sometimes this is all that's needed to start the chain reaction of hormones which happens in labour.
Monday, June 28, 2010
C Section
In theatre, before they hook you up to the machines, take your arms out of the gown, much easier for skin to skin contact when you meet your little one.
YOU CAN STILL BREASTFEED EVEN IF YOU HAVE A C-SECT
A pad stuck inside the front of your undies against the scar is soothing
it really hurts to cough, sneeze and laugh just after - brace your incision before doing these
You may have bad wind pain for the first little while after the op
Pear juice is brilliant for softening up and bringing on the first Bowel Movement
Ask for Lactulose for the constipation, most hospitals will carry it. Forget Metamucil, or Fibrogel, you need the hard stuff (esp, with the Endone). Otherwise just send hubby down to the pharmacy to get some. Let the midwives know that you are planning on taking it.
Suppositories for pain and constipation relief
If you are having problems with your bowels, definitely ask for something
You should get up and walk around as soon as you can, though you may feel like you're going to rip in half the first few minutes or meters. The more mobile you can comfortably be, the better you will feel.
Increased blood flow helps move the anaesthetic and speeds healing. Also go to physio classes if offered to get some tips on movement and safe exercising in the first few weeks, yes you are allowed to exercise but carefully so that your wound is not in any danger.
Laying on your side to begin with can pull on the scar and feel horrible
Arnica is good for promoting healing - particularly if you bruise
It's easier to manage the pain if you stay on top of it with the pain meds. Don't be a 'hero', it's harder to "catch up" on pain relief.
Endone.
Tramadol
Fentanyl
Morphine
Panadeine Forte
Nurofen
Panadol
Expect to be pretty out of it for at least half a day, if not 24 hours due to the drugs.
This is the main pain relief post caesar after they withdraw the morphine. Along with Voltaren, Tramadol and Panadeine Forte. They may try to pull you off the Endone after a couple of days. If you find the pain too much, demand the Endone. I guarantee your OB has it written up and will back you up on taking it. The midwives are getting you ready to go home without it. Some OB's will script it to you for going home, some only Panadeine Forte. Either way, insist on whatever it takes to be pain free while you are in hospital, even if they try and talk you out of it, or look down on you. You will have plenty of time to feel the pain at home.
keep track of your medication timings if they are busy so you should always know when something is due and take it as soon as you can
'birth stripe'
Mum had to go to recovery and because baby was early he had to go to SCN so mum only saw him for a few minutes for the first 24hrs which mum wasn't aware was going to happen.
they have to PUSH that baby out if you're not going to
you feel tugging, pulling and pressure on your belly and chest area as they are getting that baby out. Be prepared for it. It's the weirdest feeling. Doesn't hurt but just feels odd
A flat, firm bed is better than a squishy soft one and if you can raise it a little it will be easier to get in and out of bed and minimise your scar stretching.
Even if you want to transfer after a day or two to the nice double bed, resist. You need the poles, bars etc attached to the single to help you get in and out of bed.
Rest as much as you can. Even with elective which is heaps easier than emergency you have a lot to recover from, and deal with when you get home, so don't waste your rest time in hospital. Move around, absolutely, keep active, but also gets heaps of rest.
They take you into recovery straight after the operation - so you will be separated from baby for an hour or so.
Not necessarily. I held my DD2 during my short time in recovery and she had her first breastfeed at that time
You won't be able to sit up to feed (your legs won't work for a little while) and you may need help to swap baby from one side to the other
Note that they won't take out your IV line till you pass urine at least once after they take out the catheter. So be prepared to be asked a lot about that. Wind and bowel movements may hurt at first, right inside like period pain. The first Bowel Movement may be like diarrhoea, that is probably a side effect of the anaesthetic. You might need a mild laxative to get things really moving, like Nulax or Metamucil, nothing serious though.
they clean/shave you down there while you don't have movement in your legs.
not allowed to drive for 6 weeks
Also most people don't realise how low the scar is- most of it can be covered by hair
The scar can be numb
Swollen Feet - short walks with the baby and lots of water to drink.
The Fixomull also helped "protect" my scar
suggest having a back up person in case your DP falls through
recommend keeping the original "sticky" paper tape on the scar until it fell off, then to re-apply a paper tape over the length of the scar until 6 weeks
knee high compression stockings
If you hold a pillow to you wound when you have to laugh/cough/move, it will hurt less.
Don't pack anything to wear that is going to be tight across the scar line.
Bio oil can help after the inital healing to make the surrounding skin feel more soothed.
have lots of pillows to help you feed as it's not good to hold the weight of the baby while sitting / slouching in the hospital bed!
if you're a side/tummy sleeper, you may have a lot of trouble sleeping
i wasn't prepared for the fact that i couldn't reach him for the first day when he cried and couldn't change nappy.
bike shorts great to wear - kept me feeling "in place".
have some degas tablets packed as your bowels will slow down and trapped wind is PAINFUL
extremely itchy face with a c-sect poss due to morphine or Epi? Tablet to help?
fluid retention
that the epidural and painkillers (ie. tremadol) DOES cross over through breastmilk
the fine print on the disclaimer about risks to next pregnancies.
Drink, drink and drink some more, drink for Australia while they have the catheter in and you don't need to get up to the toilet
the hospital staff don't know the way you want it done if you don't tell them.
You need to have a catheter
after catheter came out - it took nearly two weeks to get back the sensation back properly when urinating, I still had control, but it just felt like a waterfall and i could not tell when I was empty
request a wheelchair to see bubs if needed
intense shivers
sensitivity to Adrenalin
tell the Anethetist this and they give me a lower does adrenalin injection - apparently they put it in to help the anesthetic spread around the body quicker???
shoulder tip pain - referred pain from gas under the diaphragm obtained during surgery plus the position I was in.
a drain put into my scar and the next morning after the catheter came out they pulled that out and I can tell you I almost hit the roof. So if you have that make sure you tell them to take it nice and slow like I did second time around and it was much better.
ask for stitches and NOT Staples
you may not feel comfortable using the 'cradle hold' for breastfeeding in the first week or so due to pain & swelling. Instead you have to use the 'football hold'
Yoga pants are the most comfortable thing to wear
abdominal binder for afterwards, I felt I could do more 'everyday things' without worrying about injury.
Buy Emla patches to put on your hands where the canula will go in, pain relief.
Do ask them to wait the first bath until you are there though, if it's something important to you. You might not be able to do it, but nice to see it happening.
anti clotting injections, if lager or prone.
take maternity pads
take some peppermint tea with me. I would make one up everytime the tea lady came and it helped SO much with the wind pain.
ask for a tubigrip - a big wide elastic band to wear around your abdomen. After carrying twins I had an abdominal separation and that plus the c/s scar made it feel like I would split in half when I moved. I lived in the tubigrip for several weeks and it really helped my core strength.
Ask for help to start expressing. Nobody mentioned it to me for the first 24hrs so my girls in NICU had formula. I was so angry they hadn't helped me when I obviously couldn't get up to the expressing room myself.
If you get horrendous oedema, one option is lymphatic drainage massage
I lost what looked like my lungs - huge huge big (i'm talking the size of your hand) chunks of clotted blood. I was scared and called the nurses - I though I was going to die! - the nurse then explained that it was totally normal due to the fact that I had been laying on my back since the day before and all of the excess blood had clotted inside - also happens in vaginal birth.
Ensure its not really hurting when they remove the staples as may be sign of bruising and therefore not ready to be removed!
I wish I was told that having a c-section after c-section can limit how many children you can have
Your milk can take an extra day to come in after a c/s
it doesn't matter how the babies get into the world just as long as you and they are safe
(http://www.essentialbaby.com.au/forums/index.php?showtopic=756988&hl=gown)
"What don't they tell you about caesars? "
YOU CAN STILL BREASTFEED EVEN IF YOU HAVE A C-SECT
A pad stuck inside the front of your undies against the scar is soothing
it really hurts to cough, sneeze and laugh just after - brace your incision before doing these
You may have bad wind pain for the first little while after the op
Pear juice is brilliant for softening up and bringing on the first Bowel Movement
Ask for Lactulose for the constipation, most hospitals will carry it. Forget Metamucil, or Fibrogel, you need the hard stuff (esp, with the Endone). Otherwise just send hubby down to the pharmacy to get some. Let the midwives know that you are planning on taking it.
Suppositories for pain and constipation relief
If you are having problems with your bowels, definitely ask for something
You should get up and walk around as soon as you can, though you may feel like you're going to rip in half the first few minutes or meters. The more mobile you can comfortably be, the better you will feel.
Increased blood flow helps move the anaesthetic and speeds healing. Also go to physio classes if offered to get some tips on movement and safe exercising in the first few weeks, yes you are allowed to exercise but carefully so that your wound is not in any danger.
Laying on your side to begin with can pull on the scar and feel horrible
Arnica is good for promoting healing - particularly if you bruise
It's easier to manage the pain if you stay on top of it with the pain meds. Don't be a 'hero', it's harder to "catch up" on pain relief.
Endone.
Tramadol
Fentanyl
Morphine
Panadeine Forte
Nurofen
Panadol
Expect to be pretty out of it for at least half a day, if not 24 hours due to the drugs.
This is the main pain relief post caesar after they withdraw the morphine. Along with Voltaren, Tramadol and Panadeine Forte. They may try to pull you off the Endone after a couple of days. If you find the pain too much, demand the Endone. I guarantee your OB has it written up and will back you up on taking it. The midwives are getting you ready to go home without it. Some OB's will script it to you for going home, some only Panadeine Forte. Either way, insist on whatever it takes to be pain free while you are in hospital, even if they try and talk you out of it, or look down on you. You will have plenty of time to feel the pain at home.
keep track of your medication timings if they are busy so you should always know when something is due and take it as soon as you can
'birth stripe'
Mum had to go to recovery and because baby was early he had to go to SCN so mum only saw him for a few minutes for the first 24hrs which mum wasn't aware was going to happen.
they have to PUSH that baby out if you're not going to
you feel tugging, pulling and pressure on your belly and chest area as they are getting that baby out. Be prepared for it. It's the weirdest feeling. Doesn't hurt but just feels odd
A flat, firm bed is better than a squishy soft one and if you can raise it a little it will be easier to get in and out of bed and minimise your scar stretching.
Even if you want to transfer after a day or two to the nice double bed, resist. You need the poles, bars etc attached to the single to help you get in and out of bed.
Rest as much as you can. Even with elective which is heaps easier than emergency you have a lot to recover from, and deal with when you get home, so don't waste your rest time in hospital. Move around, absolutely, keep active, but also gets heaps of rest.
They take you into recovery straight after the operation - so you will be separated from baby for an hour or so.
Not necessarily. I held my DD2 during my short time in recovery and she had her first breastfeed at that time
You won't be able to sit up to feed (your legs won't work for a little while) and you may need help to swap baby from one side to the other
Note that they won't take out your IV line till you pass urine at least once after they take out the catheter. So be prepared to be asked a lot about that. Wind and bowel movements may hurt at first, right inside like period pain. The first Bowel Movement may be like diarrhoea, that is probably a side effect of the anaesthetic. You might need a mild laxative to get things really moving, like Nulax or Metamucil, nothing serious though.
they clean/shave you down there while you don't have movement in your legs.
not allowed to drive for 6 weeks
Also most people don't realise how low the scar is- most of it can be covered by hair
The scar can be numb
Swollen Feet - short walks with the baby and lots of water to drink.
The Fixomull also helped "protect" my scar
suggest having a back up person in case your DP falls through
recommend keeping the original "sticky" paper tape on the scar until it fell off, then to re-apply a paper tape over the length of the scar until 6 weeks
knee high compression stockings
If you hold a pillow to you wound when you have to laugh/cough/move, it will hurt less.
Don't pack anything to wear that is going to be tight across the scar line.
Bio oil can help after the inital healing to make the surrounding skin feel more soothed.
have lots of pillows to help you feed as it's not good to hold the weight of the baby while sitting / slouching in the hospital bed!
if you're a side/tummy sleeper, you may have a lot of trouble sleeping
i wasn't prepared for the fact that i couldn't reach him for the first day when he cried and couldn't change nappy.
bike shorts great to wear - kept me feeling "in place".
have some degas tablets packed as your bowels will slow down and trapped wind is PAINFUL
extremely itchy face with a c-sect poss due to morphine or Epi? Tablet to help?
fluid retention
that the epidural and painkillers (ie. tremadol) DOES cross over through breastmilk
the fine print on the disclaimer about risks to next pregnancies.
Drink, drink and drink some more, drink for Australia while they have the catheter in and you don't need to get up to the toilet
the hospital staff don't know the way you want it done if you don't tell them.
You need to have a catheter
after catheter came out - it took nearly two weeks to get back the sensation back properly when urinating, I still had control, but it just felt like a waterfall and i could not tell when I was empty
request a wheelchair to see bubs if needed
intense shivers
sensitivity to Adrenalin
tell the Anethetist this and they give me a lower does adrenalin injection - apparently they put it in to help the anesthetic spread around the body quicker???
shoulder tip pain - referred pain from gas under the diaphragm obtained during surgery plus the position I was in.
a drain put into my scar and the next morning after the catheter came out they pulled that out and I can tell you I almost hit the roof. So if you have that make sure you tell them to take it nice and slow like I did second time around and it was much better.
ask for stitches and NOT Staples
you may not feel comfortable using the 'cradle hold' for breastfeeding in the first week or so due to pain & swelling. Instead you have to use the 'football hold'
Yoga pants are the most comfortable thing to wear
abdominal binder for afterwards, I felt I could do more 'everyday things' without worrying about injury.
Buy Emla patches to put on your hands where the canula will go in, pain relief.
Do ask them to wait the first bath until you are there though, if it's something important to you. You might not be able to do it, but nice to see it happening.
anti clotting injections, if lager or prone.
take maternity pads
take some peppermint tea with me. I would make one up everytime the tea lady came and it helped SO much with the wind pain.
ask for a tubigrip - a big wide elastic band to wear around your abdomen. After carrying twins I had an abdominal separation and that plus the c/s scar made it feel like I would split in half when I moved. I lived in the tubigrip for several weeks and it really helped my core strength.
Ask for help to start expressing. Nobody mentioned it to me for the first 24hrs so my girls in NICU had formula. I was so angry they hadn't helped me when I obviously couldn't get up to the expressing room myself.
If you get horrendous oedema, one option is lymphatic drainage massage
I lost what looked like my lungs - huge huge big (i'm talking the size of your hand) chunks of clotted blood. I was scared and called the nurses - I though I was going to die! - the nurse then explained that it was totally normal due to the fact that I had been laying on my back since the day before and all of the excess blood had clotted inside - also happens in vaginal birth.
Ensure its not really hurting when they remove the staples as may be sign of bruising and therefore not ready to be removed!
I wish I was told that having a c-section after c-section can limit how many children you can have
Your milk can take an extra day to come in after a c/s
it doesn't matter how the babies get into the world just as long as you and they are safe
(http://www.essentialbaby.com.au/forums/index.php?showtopic=756988&hl=gown)
"What don't they tell you about caesars? "
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