Augmentation Following Water Breaking

In class, we extensively discuss the spiral of interventions that add risk and may not necessarily improve the outcomes. Although the downward spiral can be started by almost any intervention, the most common steps into the cycle are induction/augmentation or pain medication.

Here is an interesting link about general induction/augmentation procedures particularly when the bag of waters has ruptured, involving patience and risk.

While these are very important topics that should be discussed with your provider before you yourself are in labor, realize that you may have unknowingly either made decisions about your care or limited your choices by your provider (or the provider's group policies). The provider(s) have a certain way of doing things that may or may not be flexible depending on your desires and individual situation. So, the take home message is to choose your provider carefully! Talk to me if you have questions about finding a provider whose practice lines up with your birth philosophy.

IV fluids

Although IV fluids during labor seem nominal and almost as though they could only have pros and no cons, a new study reveals at least one potential down side (multiple studies have been published on the topic however).  The study indicates that there is a positive and proportional correlation between maternal IV fluids, newborn output (pee), and newborn weight loss in the first several days. It appears as though the newborns may be receiving more than enough fluids (in correlation with the amount given to mom) and are self-regulating by urinating more after birth causing an apparently more dramatic weight loss. The problem with this possibility is that the baby may be deemed "failing to thrive" and formula may be introduced. During these critical days of learning to breastfeed for both mom and babe, milk coming in, bonding, and oxytoxin-release which contributes to the involution of the uterus back to normal size, it is important not to interfere with unnecessary formula and bottles. Read more here.

Try a date

source

Here's a news link a study showing how pregnant women consuming date fruit during the last 4 weeks of pregnancy helped their labor and birth outcomes! Amazing. I don't love dates, but I think it would be worth trying for a few weeks to impact my labor and birth positively. And it is just fruit! No side effects or possible harm to the baby! :) Let me know if you try it!

The waiting game

As we learn in class, the average non-induced, first time mom gestates 41 weeks and 1 day, or "8 days past your EDD," in terms of what your doc at a routine OB visit will inform you. That means that a high percentage of women go into labor naturally days to weeks even after this average of "8 days late," which is normal for her and is the exact right timing for when her baby is ready. But it is SOOOOOOOOO hard to wait once you hit that magical EDD. Each passing day seems like an eternity. So you may become very open to suggestion, when the doctor brings up induction and sort of pads the issue with comforts such as your husband/mom/family/etc. can plan accordingly, you will be DONE being pregnant, and it is "safe."

Your baby is worth the wait

We learn in The Bradley Method about the cascade effect of interventions that frequently begins with induction. Each intervention has it's own risks which are compiled with subsequent interventions that may become necessary. We also know that if mom is not feeling supported to continue on, carrying the baby until the baby is ultimately ready, she can be more likely to be induced even if it is for convenience, rather than an actual medical indication.


That is where you coaches come in. I sent a brief list of reminders to the coach of a couple who is currently several days past that elusive EDD and waiting for their bundle of joy to arrive, and I wanted to share the suggestions with you all.

• Stay hydrated. It is your job to bring her water/juice. Use a straw, she'll probably drink more. This is good practice for you as a coach to try to remember during labor!
• Keep well-nourished and well-rested. Ask her to take naps. You never know when labor will begin and how long it will go, but once it starts, these can be a little difficult to maintain.
• Distract her with non-baby stuff while you're waiting for labor to begin. Bring out some old pictures, talk to her about how you met/fell in love, watch a favorite movie.
• Talk about the baby. But if she does want to talk about the baby, discuss the name if you haven't decided. Talk about who you think he/she will look like. What personality traits you hope he/she does or does not have. Read baby books to baby.
• Go on walks. Multiple per day is good. While she needs to get lots of rest, she also needs to be upright, especially on her feet to help bring the baby down.
• Go over a "stress" list. Ask her to answer, "What if anything is weighing on your mind?" Write them down, and address them one by one as to how you are dealing with them together.
• Think welcoming thoughts. Talk to baby. Let her hear you beckon the baby come on down. Remind her of her own psychosomatic connection with her physical body.
• Help her relax physically with massage. Think about all the stuff that you're planning on doing for her in labor and do that stuff now! You maybe able to fine-tune your skills to what she really prefers.
• Make her laugh. You're good at that. She loves to laugh with you. Just commentary about stuff on tv may work. It releases endorphins when she smiles.
• Go over your Bradley book. If she doesn't want to, do it by yourself. You'll refresh your memory by reading the B.E.S.T. pg 93-96 (or highlights on pg 97-98), first stage  pg 74-75, transition/second stage, pg 86-87.
• Check off as much as you can on the list to bring to the hospital and put it in the car. Make sure you know what few key things need to go when it is time.
• Encourage her. Most importantly, tell her how she is doing a great job, already caring for your baby so well. Tell her how she is going to do great, when it is just the right time. And that she doesn't need to worry about when that right time is - the baby knows and her body is capable.