Learn, Flow and Grow
What is GBS? Global Business Services (GBS) are providing ample opportunities… just teasing! The GBS I will be speaking of today is Group B. Streptoccus, also referred to as Group. B. Strep or Baby Strep. GBS is a bacterium that may come and go in …
Written birth plans can be controversial in the Obstetrics world! This simple post will help you evaluate if a birth plan will be a support to you in the labor and delivery process. And, if so, as a Labor and Delivery nurse, I will show …
As a good friend and Labor and Delivery Nurse, I get asked some ooey gooey, awkward questions! The sort that only come out in the all safe zones; like the girl’s nights outs or the baby showers… at least once grandma has left right? These questions can make you blush, but what is even worse is not knowing! So step right in my all safe, no shame zone and I will be your BFF Labor and Delivery Nurse and answer your questions to the best of my ability!
Lo and Behold… the most common question, and what a fun topic… POOP! The grade school students’ favorite naughty word that gets written on desks and bathroom walls. Pooping, defecating, having a bowel movement, going number two; whatever you want to call it is absolutely normal and VERY COMMON during labor and especially during the pushing part. Unfortunately, I do not have a hard statistic to tell you just how likely it is for you to have a bowel movement while in labor (I don’t personally count). Although, this statistic would be of little of assistance anyway. What you should know is this- it is nothing to be embarrassed about! I understand growing up, you were taught manners to be lady like and pooping in front of others hopefully did not make that list. But, I can’t think of anything that contains more woman power then creating, growing, and giving birth to a new precious little human being!
When it is time to push, we will tell you to bear down like you are having a bowel movement and we mean it! We don’t want you to hold back, but to push harder then you have ever pushed before! And if a bowel movement comes out, we will discretely clean it up and not even bat an eye. We are not even phased! Okay, I take that back. We are phased, we are excited! We know baby is coming down and you are making progress!
My goal here is to help you feel as comfortable and calm as possible during your labor process because this helps labor to progress. If you are ever feeling anxious or fearful this may slow down the labor process. If you are stressing over having a bowel movement in front of someone in particular, maybe you should rethink having this person in the labor room with you.
Now, if my attempt to convince you not to worry about having a bowel movement while pushing your baby out has just not reached you, try to use the bathroom frequently while you are in early labor. Some women may request an enema during the first stage of labor to save themselves an embarrassing moment of having a bowel movement later in the labor process. The World Health Organization (WHO) recently published a study that showed higher infection rates seen in women who received an enema during early labor compared to those who did not. Thus, the use of enemas in labor are discouraged. (Reveiz, Gaitán, & Cuervo, 2013)
If you are having a scheduled c-section, check with your physician prior to arrival. But, if you are planning on having a vaginal delivery, this is your personal decision. If you were to ask me, after a day of work in labor and delivery, to reflect back and remember if my patients were cleanly shaved or as hairy as a gorilla, I honest to goodness would not remember! We have more important things to reflect upon and remember then how much hair you have there. Some hospitals around the world used to shave the women’s perineum (your private area down yonder) upon arrival to the labor and delivery unit to prevent infection. The newest research published by WHO states, “There is insufficient evidence to recommend perineal shaving for women on admission in labour” (Basevi & Lavender, 2014). In other words, save yourself the difficulty of reaching over that big belly and possibly having a red, itchy, irritated area! That is, unless it is your personal habit to keep your perineum shaved or trimmed and it helps you to feel at ease, then that is totally fine.
Unless specified by your health care provider, intercourse is safe for you and your growing baby throughout the whole pregnancy. Some reasons your provider may prescribe “No sex”, is if you have a high risk pregnancy. This includes, a history of premature labor or birth, history of a miscarriage, if your water has broken, also known as spontaneous premature rupture of membranes (SPROM). This would also include unexplained vaginal bleeding or abnormal discharge, an abnormal placenta, an incompetent cervix (a cervix that is abnormally thin or prematurely dilated), or if you or your partner have any sexually transmitted infections, intercourse is discouraged. (American Pregnancy Association, 2013)
Your body will be going through specific changes throughout your pregnancy that may change your attitude towards sexual behavior. Some of these specific changes include weight gain, hormonal changes, fatigue, breast tenderness, and an increase of blood flow to the pelvic area. Make sure to listen to your body and be open with your significant other to make adjustments so you may both enjoy the experience. If you want to increase your sex drive, squeeze a nap into your regular schedule as well as stay physically active.
On average, your breasts will enlarge a total of 25%-50%, thus your breasts may be very sore! (Beckmann, 2010) You could steal the lines from the museum sign, “Observe with your eyes and not your hands.” If you are too uncomfortable or sensitive, encourage your significant other to explore other parts of your body. You may also want to try more comfortable sex positions with your growing belly such as side to side or with you on top. (American Pregnancy Association, 2013)
Have most things taken on a new scent since you have been pregnant? Take comfort in this, your sense of smell is heightened during pregnancy. But please take caution, as normal vaginal discharge during pregnancy has a mild smell. This is called leukorrhea, leukorrhea’s normal characteristics are thin, white, and milky. See your doctor if your vaginal discharge ever becomes green, yellow, or stronger in scent than your normal pregnancy discharge. Also take note if you become itchy and red down there. These symptoms can be caused by a vaginal infection. The most common vaginal infection during pregnancy is a yeast infection (candidiasis) but these symptoms may also be caused by something else such as a sexually transmitted infection (STI). But please, never try to diagnose and treat yourself. See your Provider!
*If you are uncomfortable from the normal increase in vaginal discharge use a panty liner. DO NOT use tampons or douche while pregnant as this can introduce infection. (American Pregnancy Association, 2014).
The female body is absolutely incredible as it changes to house a little growing baby. Incredible as it is, some changes may not be so glamorous as you probably have realized by now. I like to believe that these transformations help us to become more humble to prepare us for a life-changing event.
During pregnancy, the hormone progesterone increases and thus slows down the movement of the intestinal tract up to 30% longer than normal. This increased duration allows for a greater amount of time for your body to absorb nutrients and is the reason for the increased amounts of gas. This gas is released by burping (belching) or farting (flatulence).
There are some ways to help, such as chewing your food slowly and thoroughly. “Most gas is caused by bacteria in the large intestine working to break down food that was not digested thoroughly by enzymes in the stomach.” (American Pregnancy, 2014) Constipation is also related to gas, thus make sure you stay active and drink plenty of water. American Pregnancy Association also gives advice to decrease gas by avoiding carbohydrate drinks, fatty fried foods, artificial sweetners, and avoid drinking with a straw or wearing tight clothing around the waist. (American Pregnancy, 2014).
There are multiple reasons why you may have painful pressure down. Genital engorgement is one of the main reasons and is due to the increased blood flow to your pelvic area. 10% of pregnant women develop vulvar varicosities, usually with their second pregnancy. These are varicose veins in your private area caused by the increase in estrogen and progesterone. These may cause a feeling of heaviness, itching (pruritus), painful intercourse (dyspareunia), and discomfort with exercising, walking, or standing for long periods of time. (Van Cleef, 2011)
When someone has varicose veins in their legs, they are encouraged to wear compression socks to aid in the pain. Oddly, the vulva is a more difficult area to support compared to a leg and there is no such thing as a vulva sock;). But, there have been support belts made especially for vulvar varicosities that wrap around the crotch, funny looking, but helpful! If you want to try a less expensive method, you may create your own support with a thick cold compress pressed up against your vulva to give support and relief. Also, try changing positions often, elevating your hips when sitting down, and try swimming for exercise. The good news is that these usually resolve within six weeks after delivery of the baby. (Murry, 2013)
Varicosities can also also appear in the anal/rectum area known as hemorrhoids. Hemorrhoids are unfortunately very common in pregnancy and appear most frequently in the third trimester. (American Pregnancy, 2014) Hemorrhoids can be visible (external) but also hidden inside (internal). These little monsters are caused from constipation and an increase in pelvic pressure due to the extra blood flow and growing uterus. (Beckmann, 2010) To prevent hemorrhoids, drink plenty of water throughout the day, keep a diet high in fiber, and stay active. You may want to keep a stash of prune juice in your fridge. Also, when you feel the urge to use the restroom, try to go right away and do not strain while having a bowel movement.
If you are already experiencing itchiness, discomfort, or bleeding from hemorrhoids, try taking a “sitz bath”. After drying off, use local preparations such as witch hazel or tucks pads to reduce the swelling or bleeding. Your bottom may tell you not to sit for long periods of time; listen to it! If you are itchy down there, try using some dry or wet baking soda on the area.
Tip to the wise: Ask your health care provider ANY question you have! They know what is best for you and can help you in the best way. Remember, they have heard many questions and although you may think your question may be embarrassing, they have probably heard it many times before!
References:
American Pregnancy Association. (Updated 07/2014). Gas During Pregnancy. Retrieved from: http://americanpregnancy.org/pregnancy-health/gas-during-pregnancy/
American Pregnancy Association. (Updated 03/2014). Hemorrhoids During Pregnancy. Retrieved from: http://americanpregnancy.org/pregnancy-health/hemorrhoids-during-pregnancy/
American Pregnancy Association. (Reviewed 01/2013). Sex During Pregnancy. Retrieved from: http://americanpregnancy.org/pregnancy-health/sex-and-pregnancy/
American Pregnancy Association. (Updated 03/2014). Vaginal Discharge During Pregnancy. Retrieved from: http://americanpregnancy.org/pregnancy-health/vaginal-discharge-during-pregnancy/
Basevi V, Lavender T. Routine perineal shaving on admission in labour. Cochrane Database of Systematic Review 2014, Issue 11. Art. No.: CD001236. DOI: 10.1002/14651858.CD001236.pub2.
Beckmann, C. (2010). Obstetrics and gynecology (6th ed.). Baltimore, MD: Lippincott Williams & Wilkins.
Murry, Mary M. (2013). Vulvar varicosities: I have varicose veins where? Retrieved from: http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-blog/vulvar-varicosities/bgp-20055755
Reveiz L, Gaitán HG, Cuervo LG. Enemas during labour. Cochrane Database of Systematic Review 2013, Issue 7. Art. No.: CD000330. DOI: 10.1002/14651858.CD000330.pub4.
Van Cleef, Jean-Francois. (2011). Treatment of Vulvar and Perineal Varicose Veins. Retrieved from: http://www.phlebolymphology.org/treatment-of-vulvar-and-perineal-varicose-veins/
Congratulations! YOU are going to be a DAD! Nervous, excited, panicked? One of my many favorite parts of my job is to observe the interactions between the Daddy-to-be and the Mommy-to-be during this intense, life altering moment. As you can imagine, it’s somewhat entertaining and …
Dear Pregnant Smoker, First of all, my heart goes out to you. You probably already know the health risks associated with smoking, let alone to your unborn child. I do not know your exact circumstances but I do know just how addictive this habit is …
Although referred to as “morning sickness” in pregnancy, nausea and vomiting is common any time of the day. Nausea and vomiting is believed to be caused by hormones during pregnancy, and in most women, subsides about half way through the pregnancy (there is light at the end of the tunnel). Unfortunately, there is no complete cure for morning sickness, but there has been research done that shows taking a prenatal vitamin regularly at the time of conception decreases the chances of having severe morning sickness. But, even sometimes when you were faithful at taking your prenatal vitamin you may find yourself to still be nauseated during your pregnancy. Here are some tips and tricks that may help you or a friend to feel a little better!
Click here to download my Pregnancy Nausea Relief poem!
Mild morning sickness can be miserable but does not cause harm to the baby. But, if you or your friend is unable to keep any fluids or food down and begin to loose weight, contact your OBGYN. The Provider will first need to rule out that it is in fact morning sickness and not some kind of bug or virus. He or she may suggest a Vitamin B6 and if that doesn’t work Doxylamine (Unisom SleepTabs) an over the counter sleep aid, might be added as well. If the nausea and vomiting still persist, other pharmaceutical such as Zofran may be prescribed if needed. Intravenous (IV) fluids may also be prescribed to keep you hydrated if unable to keep any fluids down.
*Check with your Provider before taking any herbal supplements or trying any new treatment
Click here for the Free Print Out Card!
Please share bellow with what has helped you with your morning sickness!
References:
The American College of Obstetricians and Gynecologists. (October 2012). Morning Sickness. Frequently Asked Questions. Retrieved from: https://www.acog.org/-/media/For-Patients/faq126.pdf?dmc=1&ts=20150204T0946466919
Video created by my dear friend from West End Creative Group, see more of their beautiful videos at westendcreativegroup.com. Schedule with them and use the code westendbabies for a 10% discount! My heart sympathizes when I see my laboring patient’s eyes swell with disappointment and …
What is the Cervix? Cervix in Latin means neck (English Dictionary, 2008). Anatomically, picture the cervix being the neck of the uterus. You can also think of the cervix as the protection gate that keeps your baby inside the uterus until ready for birth. Where …
One of the least expensive ways to protect your unborn Baby but one of the most effective. Folic acid, a B vitamin that aids our body in making new cells- A must take vitamin for all sexually active woman. Just 3-4 dollars at your local grocery store for a healthier babe.
It is widely known that Folic acid supplements taken regularly during conception and pregnancy decreases the chances of infants having major neural tube defects including anencephaly (baby is born without parts of the brain and skull) and spina bifida (a defect in the baby’s spine). Centers for Disease Control (CDC) encourages women to take 400mcg of folic acid daily, starting at least one month before getting pregnant.
In addition to this, a recent Norwegian study published that folic acid in early pregnancy does even more than thought before. In 2011 The Journal of The Medical American Medical Association (JAMA) supported this by stating that the maternal use of folic acid in early pregnancy is associated with a reduced risk of severe language delay in children at age 3 years.
The evidence:
The study included 38,954 children testing their language abilities at age three. The children were set in four different groups showing the percentage of children considered to have a severe language delay (only able to speak one word or unintelligible utterances). The groups and percentage of children within these groups considered to have a severe language delay are displayed bellow.
Group one: children whose mothers took no dietary supplements during 4 weeks before to 8 weeks after conception, .9% had a severe language delay
Group two: children whose mother regularly took dietary supplements but no folic acid during 4 weeks before to 8 weeks after conception, .9% had a severe language delay
Group three: children whose mother’s only took folic acid during 4 weeks before to 8 weeks after conception, .4% had a severe language delay
Group four: children who took folic acid in combination with other supplements during 4 weeks before to 8 weeks after conception, .4% had a severe language delay
Conclusions to draw: Make sure your prenatal vitamin includes at least 400mcg of folic acid and it is taken regularly!
References
Centers For Disease Control and Prevention. (2012, January 13). Facts About Folic Acid. Retrieved from: http://www.cdc.gov/ncbddd/folicacid/about.html
C, Magnus P, Schjølberg S, et al. Folic Acid Supplements in Pregnancy and Severe Language Delay in Children. JAMA.2011;306(14):1566-1573. doi:10.1001/jama.2011.1433.
Download PDF checklist shown in the picture here: Check List of What To Bring to The Hospital Momma’s Hospital List Picture ID and insurance card These will be taken at registration. Any medications you are currently taking or a list Sometimes you are allowed to take …
It is your right to know the effects and side effects of the medications offered to you When I go to the car mechanic I am lost and frustrated in their car mechanic lingo. Healthcare lingo is also a different language… our tools and procedures …
The complaints I hear the most about from the significant other is the pregnant woman’s draining emotions… that with the new increase in appetite causing the significant other to gain “sympathy weight”. I like to believe that the dramatized emotions are there to help the to be mom and to be dad deepen and grow in their relationship in preparation of the stresses that come when adding a new member to their family. Take advantage of this uncomfortable time by learning healthier ways to communicate and problem solve, try to look at it as a challenge and not hopeless situation.
Feeling a loss of control of emotions creates new emotions in of itself, it’s a good idea to remind yourself that these emotions are due to the hormones your body is creating to keep baby in a healthy environment! It is also important to recognize these emotions are also influenced by external circumstances, some that you may control. These include the amount of sleep and rest you obtain, the foods you decide to eat, the people you surround yourself with, and the amount of extra responsibilities you accept. Keeping good physical care of your self and looking to the people you love for support helps to keep your emotions stable.
It is normal for a pregnant or postpartum woman to feel impatient, irritable, or just feel like crying. These emotions generally come and go quickly, this may be referred to as the baby blues. When a pregnant or postpartum woman has feelings of being guilty or worthless, or hopeless without relief, or has uncontrollable crying spells, lack of interest in the baby, or thoughts of harming the baby or themselves they need to seek medical attention right away. This is referred to as “perinatal mood and anxiety disorders” or if after birth “postpartum depression”. These are real conditions that need to be treated.
A tip: I encourage my patients to make and write a post delivery plan. This includes 10 things that they may do to help better their mood. For example, a walk outside, listening to a special playlist, a trip to target, a smoothie, a nap, painting your nails, etc. This plan also needs to have five written names of people you feel you can trust and rely on as well as their phone numbers. It also includes your doctor’s telephone number and hospital’s phone number. If you ever experience these symptoms you may know exactly who to call to keep yourself and baby protected.
References:
Moran E. D., Kallam G. B., (2013). In A new beginning: your personal guide to postpartum care. Arlington, TX: Customized Communications, Inc.
NCT (2012). Emotions during pregnancy. Retrieved from: http://www.nct.org.uk/pregnancy/emotions-during-pregnancy
You might hear many people say, “You will absolutely know when you are in labor”. Well what defines labor? Labor is when the cervix is becoming thinner (effacement) and opens (dilates) due to the uterus contracting at regular intervals. Signs that you are approaching labor …
