[Baby musings]: Labor and birth


Everything I write about is my opinion and is based on my (very limited) experience with giving birth to one child at a particular hospital in MA. I was fortunate to have an uncomplicated pregnancy and delivery which pretty much went like I planned. Below are the things I found useful, with the most useful ones marked with a star .

Preparing for labor and birth

Figure out what kind of birth you want and do your research. Every birth is different and sometimes things don't go according to plan. I still think though that's it helpful to figure out what kind of experience you want. Labor does not have to be the most painful thing you have ever done - it wasn’t for me (and I didn’t have an epidural). Nor am I some kind of masochist or a person with a high pain threshold. When choosing your care provider, take into account what you want during labor (unless you have a medical reason, i.e., you are having a high-risk pregnancy and need to stick with a particular doctor/hospital) - we were with the midwives at Mt. Auburn and it was absolutely the right choice for us since they were very supportive of our decision to have a natural birth (which to me means unmedicated, i.e., no epidural). I was also able to go almost 2 weeks past my due date without being induced, which was in big part due to the midwives' approach to childbirth. The Midwives at Mt. Auburn take the approach of planning for the "normal case" but having the support structure around in-case something goes wrong, as opposed to the more "medical" approach of expecting things to go wrong. Hospitals also differ on their support of natural childbirth - choose the one where you will have the support of the staff (in our case Mt. Auburn Hospital was great). If you choose to go with a natural childbirth (which is so much better for the mother and the baby), take a natural childbirth class. We took hypnobirthing classes, which was instrumental in our ability to have a natural birth, but there are other natural childbirth classes that are not hypnobirthing, which, I hear, can be just as useful.

Classes we took in preparation to having a baby and their usefulness:

Hypnobirthing - extremely helpful in preparation of having a natural birth. (Don't let the name put you off --- my husband thinks it is very unfortunately named.)  If you are interested in hypnobirthing, check out the website. We took a semi-private hypnobirthing class with Shay Pokress but many hospitals teach their own hypnobirthing classes (we found Shay after it turned out that the hypnobirthing class at Mt. Auburn was full). The main idea in hypnobirthing is that if you know what your body is going through during labor and birth (which is a natural thing, and not some kind of medical event), you can prevent yourself from entering the fear-tension-pain cycle that is so common in labor and you can have your baby without (much) pain. You also practice relaxation throughout pregnancy so you can call upon it when your labor starts. The relaxation technique was actually very helpful during pregnancy (for me and for my husband), during labor and after L was born. Some people manage to go "into the zone" and go through labor without feeling pain. While I never quite get there, I did have my baby without an epidural (and without wishing I had one) and was as a whole very happy with the birth I had. I also want to add that giving birth was the more empowering experience I've ever had in my life.

Happiest Baby and Infant Care Essentialsat Mt. Auburn - very helpful for when the baby is here. It goes over the 5 Ss principles from theThe Happiest Baby on the Blockbook and DVD. If you don’t take the class (where they also go a bit over the other basics of baby care - like bathing and taking temperature, although the focus is on the 5 Ss soothing techniques), read the book and/or watch the DVD. It’s a must as it will help you survive. I’m serious. The idea is that babies would have stayed on the inside longer if they could, but because they "have" to be born at 9 months gestation (or their heads would be too big to fit through the birth canal), the first 3 months of their lives are really "the 4th trimester". The book then focuses on 5 techniques to help baby feel like he is still in the womb (the "5s") and how to perform them:

  • Swaddling
  • Side/stomach position
  • Swinging
  • Shushing
  • Sucking

I highly recommend the class (or, if you can't make it to one, the book/DVD). In general, it is helpful to take a class that is preparing you for your first days/weeks/months with the baby. There is a lot of focus on the childbirth and while it's very helpful to be prepared for it, at the end of the day your labor will only last some number of hours - and then you will be left with the baby and it's very important to know what to do. Hint: changing diapers is not the hardest thing (although that's something you stress about before the baby is here), that you will figure out in no time. It's how to soothe the baby and how to feed him/her that is the most challenging, in my experience, and if you can learn something about that, that can be very helpful.

Breastfeeding class at Mt. Auburn- we took it 3 months before the baby was born and I don’t think it was that useful. They showed some videos of what is a good latch and we practiced a few nursing positions and learned that there is a “football hold”, but other than that, I think it was hard to learn anything without an actual baby. At the hospital they held a free breastfeeding class every morning that we didn’t go to, but that could have been more useful. If you don’t go to a breastfeeding class, learn as much as you can about breastfeeding BEFORE you have a baby. I wished I read books on breastfeeding and tips on increasing your milk supply while still pregnant since you certainly don’t have time/mental capacity to read anything immediately after you have the baby when you can benefit from this information.

Preparing for a childbirth with a midwife class at Mt. Auburn- we didn’t actually take this one, we were planning on taking it but then the scheduling didn’t work out. It was for the best though because they do spend time in the class talking about epidurals etc. and we didn’t actually want to hear about it. If you choose to go the natural route, focus on that (and you can always read about epidurals in a book).

Other useful things we did in preparation for birth and labor that I highly recommend:

Hire a birth doula. They are expensive, but absolutely worth it. A doula will meet with you and talk to you about your pain management preferences, the plan for your birth, and she will help you achieve the goals you set for your birth. Our doulaJulie Carew was also a certified lactation counselor and she helped me tremendously with breastfeeding (immediately after birth, and afterwards via email and phone when I was having trouble). She was provided a lot of support in general after the baby was born - I turned to her with questions about sleep, weight gain/lack thereof etc.

Tour the birth center at the hospital you will be giving birth in. It helps you to familiarize yourself with the place you will spend (potentially a lot of) time.

Pick the clothes to wear to the hospital. If you plan to labor at home, prepare the clothes you will wear to the hospital so that they are ready when you ready to head out of the door. When it was time to head to the hospital, I was glad I had everything ready because I was in no state to pick clothes from the closet. I ended up laboring in the clothes I was in (i.e., not in the hospital clothes). Good choice of clothes was: a long stretchy skirt and a tank top.

Have a birth plan. It will help you to think through things beforehand and have them written down so you don’t have to make rushed decisions in the hospital. For example, we decided to decline giving thebaby eye ointment after birthafter researching what causes the infection that the ointment was trying to prevent and realizing our baby was in no risk for it. If we had not thought about it beforehand, we would have agreed to it (or not asked that it is not done - since sometimes they don’t even ask you if you want certain things done or not). Similarly we asked that they don’t bathe the baby for at least 24 hours. We also asked for a delayed cord clamping. There are the choices that are easier done before you have the baby and not when you are recovering from labor. Keep the birth plan concise and to under a page or so if you want people in the hospital to actually read it. We reviewed our birth plan with our midwife and actually took a bunch of stuff off of it, because certain things were already standard at the hospital (like not doing episiotomy routinely etc).

Get a birth ball (big exercise ball to sit on) - it’s great for labor and it’s very useful once you have the baby to bounce on it (babies like bouncing and it’s one of the soothing techniques, plus it’s much easier to bounce on the ball than to rock the baby while walking around half asleep). Also, if your baby hates the car seat (like ours did in the beginning) it’s very handy to bounce the baby strapped in car seat on the ball (rest the car seat on the ball and bounce) while your partner finishes up packing the car. An alternative technique is swinging the baby in the (infant) car seat, but that is very tiring since the car seat is kind of heavy.

Get a pedicure :). Doctors/nurses appreciate it. Plus it will make you feel good. Also, if you go past your due date it is told to cause labor to start. I didn’t test this theory, but I know people who swear by it :).

Postpartum care for the mom

Get these before you have the baby to have on hand when you get home from the hospital. My husband ended up going for a CVS run the night we got home from the hospital, which wasn’t ideal.

Big (huge) padsfor when you will bleed. These would NOT be usual regular pads for the period. Get the biggest pads they have in the store.

Stool softener

Witch hazel pads

(optional) Iron pills (you might not need these, but I lost enough blood to be monitored for anemia so I had to take these)

Fenugreek(for boosting your milk supply). I would take it 3 times a day starting day 4 or 5. We would get these at Whole Foods.

Packing for the hospital

Pack snacksfor the hospital - we packed a bunch we were going to use for labor, but ended up eating them afterwards since by the time we got to the hospital I was already in transition and could care less about food. Good choices are: nuts, dried fruit, power bars.

Pack clothes to wearfor heading home from the hospital - something comfy, along the same lines as the clothes you wore on the way to the hospital: a long stretchy skirt (maternity one would work great) and a tank top. I gave birth in May, so it was reasonably warm, you might want something warmer if you are due in the colder months.I ended up not wearing the clothes I packed to wear at the hospital. You will be bleeding (for a while) and will not actually want to wear your underwear and pjs. Plus you will be sore, so putting pants on is not that appealing either. The hospital gowns are not glamorous but they are easy to put on and to nurse in. Your partner will need something to wear during your two days at the hospital, though, while you hang out in hospital attire.

Pack an outfit for the baby to leave the hospital in. While in the hospital, the baby will wear the outfit they give the baby (a hat and a long sleeved shirt is what we got in May) and will be tightly wrapped in a swaddling blanket (keep in mind that after you leave the hospital you will not be able to swaddle the baby in this swaddling blanket - only nurses are capable of it :).

At the hospital after giving birth

Try to restas much as possible. Babies sleep a lot when there are a day old. It’s normal. Use this time to sleep (as much as you can). I was high on endorphins after giving birth and wanted to text everyone the great news. Pace yourself and try to get some sleep.

Limityour visitors. We had one person come visit, and even that was somewhat stressful since I was in the middle of trying to feed the baby which was not going so well.

Limitthe flowers (unless you have people helping you bring them home). Flowers are awesome, but you will want to haul them home with you and you are likely to have a lot of stuff (more than when you got to the hospital since you will have a car seat with the baby).

Use people at the hospital to learn how to take care of your babyas much as you can. Nurses can teach you how to swaddle and bathe the baby (we didn’t give the baby a bath till day 2 and we asked a nurse to show us how its done).

Get help with breastfeeding right away. Don't be afraid or embarrassed to ask for help (repeatedly, if needed). We saw 3 lactation consultants at the hospital because we kept asking for them. In addition to being helpful, they hooked me up with a hospital grade pump to use at the hospital and gave us shields to use and a feeding syringe, which we used to supplement the baby with expressed breastmilk before we started giving him a bottle at home.

Sign up for a follow-up visit with a nurse(if it’s an option). They encouraged us to do it (for which we had to leave the hospital within 48 hours of giving birth) and it was great. We ended up leaving after 47 hours. A nurse came to our house the day after we got out of the hospital to see me and the baby (it was mostly for me though).

Eat! At Mt. Auburn the food is actually good and you can order for your partner too!

Take everything they give you at the hospital home with you(except for sheets :)). Everything they bring into your room they throw away afterwards anyway and you never know how useful it will be. The stuff we took:

· Two waterproof pads they put on the bed. We used it for a few nights to protect the sheets at home on our bed.

· Hospital gown. I used it was a robe for a few days since at the beginning you want to spend as much time skin-to-skin with the baby as possible, so the robe is one of the more convenient things to wear.

· Pink (or whatever color your hospital uses) plastic mugs (I think they hold 1 liter of water) with straw lids. Nursing moms need to hydrate and these mugs are great because they hold a lot of water and they have a straw and a lid. Now we use one during bath time for pouring water on baby's head.

· Pink plastic bin - we used it to wash the bottles and pump parts in. Very useful. Now L uses it as a container to put toys in and take toys out.

· Witch Hazel pads and whatever other medication they give you.

· Spray bottle. We now use it for spraying cloth wipes at the changing table. Take an extra one of these, if you can. I wish I did.

· Mesh underwear. This is the best thing ever, I kid you not! In fact, I regretted not asking for more of these, since I only brought home 2 pairs that were in the room when I left the hospital. Ask for more (they will bring you a stack) and bring them home. You will appreciate just being able to throw these out.

· Pads. At Mt. Auburn in Labor and Delivery they had giant pads which were awesome. For some reason in post-partum, which was full of women bleeding heavily, which is perfectly normal after giving birth, they only had pads more suitable for a regular period then for amount of blood you lose after delivery. I had to use 4 of these at a time (sorry about the TMI). But, you can ask the nurses to get you some of the bigger pads, they will do their best. Regardless, take all the pads they give you, you will use them at home.
The shirt they dress babies in at the hospital. It’s size 12M and was too big for him for a while, but we were eventually able to use it for sleeping when he started sleeping with arms out of the swaddle.

· Baby stuff they bring you for the baby (diapers, wipes, shampoo etc.). Out of the baby stuff we didn’t use again:

· the hat (it fell apart after 1 wash). it was not a real hat anyway, just a tube sewn at the end

· the “snot removal” bulbs (they are way too huge for little baby noses). Plus there was some scary stuff about those snot removal bulbs getting moldy inside since the standard ones only have 1 hole to drain out of (there is a similar concern about bath toys with little holes - like rubber duckies). We useNosefrida The Snotsucker Nasal Aspirator which is awesome for snot removal.

· Baby blankets. They are not big enough to swaddle in (although nurses manage to, somehow), but they are useful receiving blankets for covering surfaces, using as burp cloths etc.

· Any breastfeeding items: pump parts, shields etc. We brought home a feeding syringe and used it to feed the baby in the first few weeks in addition to breastfeeding. The reason for using a syringe was to not get the baby used to the bottle prior to establishing breastfeeding. With the syringe you could squirt milk into baby's mouth little by little and wait for them to swallow. They also set up a Medela Symphony pump for me and gave me a whole bag of supplies which I then used with my Pump In Style Advanced pump (and also with Medela Symphony I rented). If they hook you up with a pump in the hospital, make sure to take ALL the parts with you (minus the pump itself). I ended up forgetting the membranes and the membrane caps inside the pump and had to buy new ones when I rented the Symphony.

One last bit of advice: enjoy the time with your baby and enjoy having people who can help you (and who will appear when you press the button on your bed :). The hardest work starts at home.