Below is a compilation of common terms and acronyms that women often will come across during pregnancy, labor, and delivery. Check back as more will be added from time to time.
AROM – Artificial Rupture of Membranes – using a finger or tool to open the amniotic sac to to allow the fluid to release.
PROM – Premature Rupture of Membranes – when the amniotic fluids releases before labor starts.
SROM – Spontaneous Rupture of Membranes during labor.
ROM – Rupture of Membranes
Miso – Misoprostol is the pharmacological name for Cytotec a drug used for cervical ripening and induction though a controversial, off and against label used ulcer Medication
VBAC – Vaginal Birth After Cesarean
HBAC – Home Birth After Cesarean
WBAC – Water Birth After Cesarean
UBAC – Unattended Birth After Cesarean
CBAC – Cesarean Birth After Cesarean – This is a repeat cesarean after a woman desires and tries to have a vaginal birth after cesarean.
ERCS – Elective Repeat Cesarean
RCS – Repeat Cesarean
Natural Birth – Labor and vaginal delivery free from intervention except for intermittent fetal monitoring. In the hospital only a saline lock and intermittent monitoring.
Vaginal Birth – Baby born vaginally with or without medication and intervention.
First Stage – Early, Active, and Transition. This encompasses the effacement to 100%, dilation to 10 centimeters/complete, position movement of cervix from posterior to forward as contractions begin while staying longer, strong and closer together prior to pushing and delivery.
Second Stage – Pushing phase after cervix is completely dilated to delivery of baby.
Third Stage – Delivery of baby to delivery of placenta.
Fourth Stage – First hours after placenta is delivered.
Oxytocin – A hormone made in the brain that plays a role in childbirth and lactation by causing muscles to contract in the uterus (womb) and the mammary glands in the breast. It also plays a role in bonding with mate, child, and socially.
Pitocin (oxytocin injection, USP) is a sterile, clear, colorless aqueous solution of synthetic oxytocin, for intravenous infusion or intramuscular injection.
Prostaglandin – Any of a group of hormone like fatty acids found throughout the body, esp. in semen, that affect blood pressure, metabolism, body temperature, and other important body processes such as cervical ripening.
Uterus -The muscular organ in which a fertilized egg implants and matures through pregnancy. During menstruation, the uterus sheds the inner lining.
Cervix -The lower portion of the uterus that provides an opening between the uterus and the vagina. Also known as the neck of the uterus that softens, effaces, dilates and changes position during labor.
Vagina – A muscular canal between the uterus and the outside of the body. Also known as the birth canal.
Perineum – The area between the anus and the vulva (the labial opening to the vagina).
Pelvis -The basin like cavity formed by the ring of bones of the pelvic girdle in the posterior part of the trunk in many vertebrates: in humans, it is formed by the ilium, ischium, pubis, coccyx, and sacrum, supporting the spinal column and resting upon the legs.
Pelvic Floor Muscles -The sphincter mechanism of the lower urinary tract, the upper and lower vaginal supports, and the internal and external anal sphincters. It is a network of muscles, ligaments, and other tissues that hold up the pelvic organs. Includes bladder, rectum, vagina and uterus.
Fundus - Top of the uterus. During labor contractions the fundus thickens and gets more firm as the strength of contractions increase and dilation increases.
Placenta -The organ that develops during pregnancy that transports nutrients to the fetus and waste away from the fetus. The placenta is attached to the uterus and is connected to the fetus by the umbilical cord.
Umbilical cord – The cord that transports blood, oxygen and nutrients to the baby from the placenta.
Bloody Show – Mucous and blood mixed together as dilation and effacement occurs. Starts off as blood tinged mucous and becomes heavier as labor progresses.
Stripping membranes - Pressing the amniotic sac away from the inside of the cervix.
Mucous plug - The mucous that blocks off the non-dilated and non-ripened cervix for protection.
Lochia – Post birth bleeding that though a wound site from the placenta detaching from the uterine wall, it mimics a heavy and long menstrual period.
Cesarean – Baby born via a surgical incision made through the abdomen into the uterus.
Obstetrician – Is the surgical specialty dealing with the care of women and their children during pregnancy, childbirth and the immediate post birth time.
Midwife – Is a person usually a woman who is trained to assist women during pregnancy, during childbirth, and postpartum as well as the newborn post birth. There are many types of midwives – some work in the home, at birth centers or in the hospital.
Doula – Is an assistant who provides various forms of non-medical and non-midwifery support (physical and emotional) in the childbirth process. Based on a particular doula’s training and background, the doula may offer support during prenatal care, during childbirth and/or during the postpartum period. A birth doula provides support during labor. A labor doula may attend a home birth or might attend the laboring at home and continue while in transport and then complete supporting the birth at a hospital or a birth center. A postpartum doula typically begins providing care in the home after the birth. Such care might include cooking for the mother, breastfeeding support, newborn care assistance, errands, light housekeeping, etc. Such care is provided from the day after the birth, providing services through the first six weeks postpartum. In some cases, doula care can last several months or even to a year postpartum – especially in cases when mothers are suffering from postpartum depression, children with special needs require longer care, or there are multiple infants.
Birth Center – Free standing location usually run by one or more certified nurse midwife. True birth centers are almost always independently run. They are not overseen by a hospital or in a hospital. May be near a hospital. Often set-up like a home birth space and epidurals or other pain medications are not available. Hospital “birth centers” are labor and delivery floors not birth centers in the true sense of the term.
Intervention – Anything that does not exist in a naturally occuring labor and delivery that is done.
Saline Lock/Buffalo Cap/ Hep Lock – Is the apparatus that the IV line hooks into. It is silicone tubing that is lightweight with a plastic needle that stays under the skin to allow easy vein access.
Foley – A foley catheter is used to release the bladder if a woman unable to urinate due to an epidural, post surgery, or with a swollen urethra post birth. It can also be used for successful cervical ripening in lieu of cytotec.
Induction – To attempt to artificially start labor usually by pitocin, artificial rupture of membranes with or without cervical ripening (Cytotec or Foley Catheter).
Epidural - A medical method of giving pain relief during labor. A catheter is inserted through the lower back into a space near the spinal cord. Anesthesia is given through this catheter, and results in decreased sensation from the abdomen to the feet.
Contraction – Tightening and loosening of your uterus. Productive contractions are often felt at the bottom of the uterus, start out like period cramps and progressively grow stronger, longer in length, and closer together.
Braxton-Hicks – Practice contractions that do not dilate or efface the cervix often felt at the top of the uterus versus the bottom.
Episiotomy – A surgical procedure to widen the outlet of the birth canal to facilitate delivery of the baby and avoid a jagged rip of the perineum. (Natural abrading or tearing is preferred and episiotomies are not evidence-based to be used except under specific circumstances).
Ina May’s Sphincter Law -Tapping into the concept that if one sphincter is open and relaxed, the others will also open, relax and be able to handle, quite adequately, the task at hand. This also includes the aspect of birth requiring privacy, sacredness, and honor as well so a woman feels safe, unwatched and supported.
Kegel Exercises – Named after Dr. Arnold Kegel, consists of contracting and relaxing the muscles that form part of the pelvic floor (sometimes called the “Kegel muscles”).
Here is the radio interview I did with Debbie Hull of the Whole Mother Radio show. We talked about the current percentage of cesareans, VBAC availability, where to obtain support, ways to prevent an unnecessary cesarean and much more!
This is a slight re-do from a popular blog post from early 2008. The information is vital and pertinent to the near 1.5 million women (based on previous CDC data) who will have a cesarean surgery this year.
Having a cesarean section will almost always get you a baby. Generally there is much more to it and anyone could bargain for or anticipate even in the best of recoveries.
Let me count the ways in no particular order:
A scar that in no way makes a bikini look better. Sometimes described as a shelf or a pouch.
The feeling of failure, guilt or less than deserving of motherhood.
The struggle of living with the huge dichotomy of loving your baby and perhaps hating the birth.
Higher probability of losing your ability to have more children either through physiologic secondary infertility, pregnancy complications, self-induced secondary infertility, hysterectomy or lack of sexual intimacy in relationship.
Higher probability of difficulty in breastfeeding.
Postpartum depression or PTSD, especially in an unwanted cesarean.
The feeling of failure as a wife or partner.
Having others discount your feelings and needs. After all you “just” had a baby. Really you just had MAJOR surgery, perhaps by coercion, a true medical indication, or completely from interventions and medications.
Living with the idea that you failed to pass induction, you failed to push out your baby, you failed because _________ (fill in the blank).
Obtaining your records to find what you were told and what was written are different. Could your trusted care provider have lied and cheated you?
Simply finding out that no one told you and you didn’t think it would happen to you. That being induced, getting the epidural, allowing AROM, not getting out of bed, etc. is why you had the cesarean. Is maternal ignorance and fear enough to quell what you feel and make it okay?
How can you trust yourself as a mother when you ignored your maternal intuition and kept saying yes, because the nurse, midwife or doctor told you to?
The way your marriage or partnership takes a turn toward hell or in the least a divided place.
Living with dread when a hungry hand sweeps over your scar. Being sexual can be extremely difficult physically and emotionally.
Having great fear of becoming pregnant again.
Having great fear of going for a VBAC and ending up in the OR at the end.
Not being understood and having others say to your face how lucky you are that you got to take the easy way out.
Pain.
Difficulty moving, walking, getting up, rolling over, coughing, laughing, tending to personal cleaning…. You get the idea. It is surgery.
Though not every woman will experience what is on the list, many do. For all of these – there a stories layered and interwoven for too many women.
Every thirty seconds a woman is surgically having her baby delivered. Light her a candle. Offer her a meal. Let her speak. Listen to her intently. Don’t judge her. Send her to ICAN. http://www.ican-online.org/.
I have been invited to share with you an intimate and challenging (and graphic) journey of a mother from an unexpected primary cesarean, physician decided repeat cesarean and a home water birth after those two cesareans.
Before you watch it, take a deep breath and have an open mind. A box of tissues may be in order as well.
Watch how a baby is delivered in a cesarean birth and see the dramatic difference of what both the mother and baby experience in a home water birth after cesarean.
Thank you Alex for allowing me to share your story! Many blessings to you and yours.
For more information on cesarean recovery, support, prevention and VBAC information go to www.ican-online.org.
There are many reasons why a woman chooses to birth in the hospital. Women have the right to choose where and with whom she will birth regardless of what another would choose.
Women need the tools to navigate the hospital setting. She and her baby ARE unique. They are human beings. Laboring women are often placed under one-size-fits-all standing orders and protocols. Because of this, pregnant women need to be very careful regarding the books read, the types of birthing shows viewed, the care provider chosen and the childbirth class taken prior to entering the hospital to birth.
Here are some tips for a truly healthier and safer experience:
Take the hospital tour – ask lots of questions – induction rate, induction medications and/or procedures routinely used, average cesarean rate for first time moms, VBAC rate, pitocin use rate, epidural rate, use of non-medical pain relief, natural childbirth rate, IV use versus saline lock, percentage of moms who utilize doulas, is pain management highly suggested to every laboring mom, monitoring norms, availability of tub or shower for labor, standard protocol on eating and drinking in labor, use of non-supine pushing positions, mobility in labor, are the labor and delivery nurses open to anything goes in labor, what is protocol on immediate postpartum baby care, is there a lactation staff available….
Read the pre-admit paperwork. If you are not sure what it says, ask a paralegal or lawyer to look at it. Be certain that you agree with what you are signing.
Do not sign epidural or cesarean consent form at pre-registration. You want to be fully consented during true decision making time. Be sure though to be familiar with benefits, risks and consequences of everything ahead of time.
Take a non-hospital childbirth class or independently run class within the hospital.
Only agree to induction for a true medical reason - (suspected big baby, pre-pre-eclampsia, being tired of pregnancy, care provider going on vacation, relative will be in town, being past your “due date”, just because you can – are not medical reasons)
When induction is necessary – choose a foley catheter to ripen the cervix over misoprostol (cytotec, miso, or the little pill) and if labor establishes upon cervical ripening – decline pitocin or ask to keep it very low over a longer period of time.
Keep your “water” (amniotic sac) intact until it breaks on its own. This can keep infection probability much lower, lessen risk of cord prolapse, and lessen the discomfort of contractions among many other things.
As long as a mom and baby are low-risk – wait until well into active labor to arrive at the hospital – contractions 3 minutes apart and lasting a minute or more. Shortening the time in the labor and delivery room usually keeps interventions and medications to a minimum.
Any birth and immediate postpartum preferences need to be discussed PRIOR to labor with your care provider. A concise birth preference plan can be given to the nurse upon arrival.
In the event a cesarean is necessary (hopefully not created by interventions and medications in labor), discuss with your care provider prior to labor what you would like to have occur (partner in OR, no separation of baby from mom, pictures taken, etc. – for a complete list, please email me).
Make postpartum baby care decisions prior to arriving at the hospital. You do not need to have a pediatrician or family practitioner picked out ahead, as the floor doctor will oversee your baby’s care. If you are unsure of what you want, it is always acceptable to delay any immunization, vitamin K injection, eye ointment, etc. until you have the opportunity to investigate further. As a parent you have the right to say yes or no to anything.
The key thing to remember is that as a consumer, you are paying your care provider for a service, for the hospital staff to attend you respectfully, and for the use of the room you are renting. You do have rights. Protocols and practices are not laws. You can say yes or no to anything or everything.
As a woman you are making parenting decisions throughout labor, delivery and early postpartum that should be respected, honored and can have lasting consequences. There is no do-over.
