Thursday, May 26, 2011

Bradley Class #3

First of all as promised before I have a picture of the building the class is being held every week.
 Its such a pretty building

This is the room where class is held. Well its one side of the room. Its a lot bigger than that. This class was about pregnancy.  A warning to the reader: This is going to be a long post. No apologies just informing you in case you are looking for a light read, this post is not that. This week was our presentations where we got to teach each other about our topics. There was a lot of information shared. But first we did some other activities. We started class with a back pack full of items, each which represented the changes in a women's body during pregnancy. Here is what was in the backpack:

Sugar- Baby and Uterus, baby average of 8lbs and uterus 2lbs 
Flour- Fluid in maternal tissue, 4lbs
Rice- Placenta is 1-2 lbs
Water Bottle- Amniotic Fluid 2lbs
Can of Spaghetti Sauce- Maternal blood, 4lbs
Oil-  Nutrient storage and maternal fat, 7lbs
Soy Milk- Maternal tissue of the breast, 5lbs

Rachel then invited each dad to put the backpack on at any time during the class and do any of the activities they normally would to see how each mother might be feeling. It was a nice sympathy exercise. Sean had some trouble sitting down and getting up. Even for a big strong man like my Sean having a prego belly put off his balance. Here is Sean all prego-like

Isn't he just so darn cute :) I know I'm not that big but I sure do feel it!

 We then each got to give baby updates and news. Sean and I discussed our hospital tour and about how Mr. Noah is moving so very much lately. I love hearing all the stories about the other parents and their cute little babies growing and how they are each preparing for the arrival.

Then we went over our weekly relaxation technique. The couple for this week explained how massage can be great for relaxing the mother during labor. We were asked to talk as a couple about what feels good for the mother and what type of massage would be effective in encouraging deep relaxation. I loved this week’s technique. Each mother is different so the types of techniques used in order to help her relax are going to be different. Sean and I decided the progressive relaxation one we learned last week is definitely not for us but massage is an absolute yes!

Next we did our presentations. One couple couldn’t make it to this class so there were 5 topics covered besides our own. After the presentation we all discussed the topic and gave our own knowledge, insight and opinion on them. I feel so educated after that class and I’m excited to do some of my own research on the topics as well. I’ll just do an outline of the presentation topics. We tried to stay unbiased for each topic so we were asked to give the definition, benefits, risks and controversies surrounding the practice.

First of all did you know that the epidural isn’t just a needle poked into your spine? Its actually a catheter. I wasn’t even aware of that. Turns out most women, even expecting mothers planning on getting the epidural don’t know that.  They put the needle in first and then insert a tube that stays in your back in case they need to give you more drugs. Epidural is actually just the name of the procedure, there is no drug named epidural. Many different drugs go into the catheter after the epidural is performed. Most doctors can’t even tell you exactly what is used.The epidural is named for where it is place in the back.

Definition- Epidural anesthesia is regional anesthesia that blocks pain in a particular region of the body. The goal of an epidural is to provide analgesia, or pain relief, rather than complete anesthesia, which is total lack of feeling. Epidurals block the nerve impulses from the lower spinal segments resulting in decreased sensation in the lower half of the body. Epidural medications are often delivered in combination with opioids or narcotics
·         When other types of coping mechanisms are not helping any longer, an epidural may be what you need to move through exhaustion, irritability, and fatigue. An epidural may allow you to rest, relax, get focused and give you the strength to move forward as an active participant in your birth experience.
·         If you deliver by cesarean, an epidural anesthesia will allow you to stay awake and also provide effective pain relief during recovery
·         Relieving the discomfort of childbirth can help some woman have a more positive birth experience
So basically the benefits of an epidural are for the mother to be comfortable and make birth easier on them. As said above if other coping mechanisms are not working it is a good option for mothers that can’t relax. To each her own. Please don't get me wrong. No chastisement or judgement to those who did, or are planning on getting one. I'm just really happy with my decision not to. 
·         Epidurals may cause your blood pressure to suddenly drop. For this reason your blood pressure will be routinely checked to make sure there is adequate blood flow to your baby. If this happens you may need to be treated with IV fluids, medications, and oxygen
·         You may experience a severe headache caused by leakage of spinal fluid. Less than 1% of women experience this side effect from epidural use. If symptoms persist, a special procedure called a “blood patch”, an injection of your blood into the epidural space, can be done to relieve the headache
·         After your epidural is placed, you will need to alternate from lying on one side to the other in bed and have continuous monitoring for changes in fetal heart rate. Lying in one position can sometimes cause labor to slow down or stop
·         You may experience the following side effects: shivering, ringing of the ears, backache, soreness where the needle is inserted, nausea, or difficulty urinating
·         You may find that your epidural makes pushing more difficult and additional interventions such as Pitocin, forceps, vacuum extraction or cesarean may become necessary
·         For a few hours after birth the lower half of your body may feel numb which will require you to walk with assistance
·         In rare instances, permanent nerve damage may result in the area where the catheter was inserted.
·         Though research is somewhat ambiguous, most studies suggest some babies will have trouble "latching on" which can lead to breastfeeding difficulties.
·         Other studies suggest that the baby may experience respiratory depression, fetal malpositioning; and an increase in fetal heart rate variability, which may increase the need for forceps, vacuum, cesarean deliveries and episiotomies.
IV’s, No food or Drink by Mouth
I didn’t really take many notes on this topic because it is kind of self explanatory. Many women receive iv’s during labor because food and drink are forbidden during labor. The reason behind this practice is that some women throw up during pregnancy and its easier to monitor what she is receiving by iv. Basically its easier for the nurses and hospital staff. I don’t want to have an iv if I don’t have to.

·         If mom has a medical condition that requires her to be on an iv then it can be helpful
·         The American Society of Anesthesiologists thinks it’s best to stick to clear liquids and eat no food to avoid maternal complications.

·         Imbalance of electrolytes, drop-off in blood sugar levels producing ketones which can cross into fetal circulation causing fetal blood to become more acidic (acidosis) which is a symptom of fetal distress. Increased perception of pain when hungry and/or thirsty.
·         Hunger, thirst, discomfort, dehydration sometimes resulting in fever, exhaustion leading to fewer or less effective contractions
·         Prolonged labor due to exhaustion, less contractions.

Forceps & Vacuums
When forceps were invented in the 1500’s they were a break through in how babies were being born. Its kind of a crazy story how forceps were invented. Back in the day having a living baby produced after labor was rare. The OB forceps was invented by the eldest son of the Chamberlen family of surgeons. The Camberlen’s were French Huguenots working in Paris before they immigrated to England. The instrument was kept secret for 150 years by the Chamberlen family. The forceps were used most notably in hard and difficult childbirths. The forceps avoided infant death more successfully than previous approaches involving hooks and other instruments. In the interest of secrecy, the forceps were carried into the birthing room in a lined box and would only be used once everyone was out of the room and the mother blindfolded.

Definition- An instrument that resembles a pair of tongs and can be used in surgery for grabbing, maneuvering, or removing various things within or from the body. They can be used to assist the delivery of a baby.
·         Avoidance of C-sections
·         Reduction of delivery time
·         If the baby is facing the wrong way, use of forceps can maneuver the baby the correct way

·         Possibility of bruising, deformation, nerve damage, skull fractures, and cervical cord injury
·         High risk of having to get an episiotomy
Fetal Monitoring
This one is one I wasn’t that interested in. They kind of made it seem like it was bad. I disagree with this. I see nothing wrong with fetal monitoring. The only thing I want to make sure of is that I have the wireless monitor so that I can be free to walk around and not be restricted by wires. The risks that were presented was that it can slow birth because sometimes nurses or even the father can be preoccupied with watching the monitor instead of giving the mother the attention she needs.

This is another one I didn’t take many notes on. But here are the ones I got.

            Definition-  Surgical removal of the foreskin on the penis

·  Decreased incidence of urinary tract infections.
·  Lower incidence of sexually-transmitted diseases and may reduce HIV transmission.
·  Lower the risk for cancer of the cervix in sexual partners.
decrease the risk for cancer of the penis
·         Easier to clean and take care of

·         Its said that circumcision can affect breastfeeding, sleep, and even maternal bonding.
·         Studies have also indicated that men who are circumcised have a lower pain threshold and suffer from Post Traumatic Stress Disorder symptoms.

I don’t really think that it affects the bonding or makes men have lower pain thresholds but everyone gets to make their own decisions. Sean and I have both decided that we are for circumcision. It is a health issue.

Then Sean and I got to do our presentation.

Induction with Cervadil or Cytotec

Definition-  Artificial start of labor. When labor does not naturally start on its own and vaginal delivery needs to happen soon, labor may be started artificially.

Cytotec is a pill taken by mouth or placed in the vagina (using a smaller dose). It is a medicine currently approved for treating ulcers. Using it for cervical ripening is a widely accepted but unlabeled use.  (also an abortion drug, can cause uterine rupture)
Cervidil Gel can be inserted as a suppository into your vagina. It can also be given as a gel that is gently squirted into the opening of the cervix  

·         Your water has broken, but you're not having contractions.
·         There's an infection in your uterus.
·         Your baby has stopped growing at the expected pace.
·         There's not enough amniotic fluid surrounding the baby.
·         Your placenta has begun to deteriorate.
·         You have a medical condition that may put you or your baby at risk 


·         Inducing labor too early may result in a premature birth, which poses risks for the baby including difficulty breathing, yellowing of the skin and whites of the eyes (jaundice), and other problems. Even inductions close to term may cause these problems
·         The medication used to induce labor may provoke too many contractions, which can diminish your baby's oxygen supply and lower your baby's heart rate
·         Increases the risk of infection for both mother and baby
·         By definition, induction promotes delivery before your body is ready for labor which may lead to poor labor progress and the need for a C-section
·         An increased risk of uterine rupture if you've had a prior C-section. Uterine rupture is a rare but serious complication in which the uterus tears open along the scar line from a prior C-section. An emergency C-section is needed to prevent life-threatening complications 

Some women request labor induction for convenience or to avoid causing a sudden disruption at home or work Induction of labor is a medical procedure and like all medical procedures, it should be restricted to medical indications. Convenience based inductions should not be allowed. The benefit is trivial and the risk is large.

See I told you this post was super super long
But for those of you who made it though that whole thing: I hope you found it as informative as Sean and I did. We just soaked all that material up. We learned a lot we had no idea about. In class 8 we will go over more of the unexpected situations like emergency birth or cesarean sections and how we can be prepared for them. We all want a natural birth but we do realize that things happen out of our control sometimes and we need to be prepared to accept medical intervention if it is absolutely needed for the baby or mom’s safety.
So after the presentations we had a yummy snack and mingled. Then we watched a 20 minute video of the stages of pregnancy then class was dismissed. 

With each class I feel more empowered to have the natural birth experience I want. Sean says he feels more confident about his responsibility to coach me through the labor and delivery. We were talking on the way home about our birth plan and the things we expect to happen and how we felt about each topic that was discussed in class. I feel so confident in Sean’s ability to keep me calm, relaxed, and strong through my labor. He is so kind and gentle and knows me perfectly. I know he is going to be there right by my side the whole time kissing my forehead telling me I can do it. That thought is so comforting.

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