Posts Tagged ‘childbirth education’

Know Your Score – Before an Induction

Wednesday, March 23rd, 2011

Knowing your Bishop’s score prior to agreeing to an induction when not medically necessary or setting the stage for a medically necessary induction can make a great difference in expectations, additional interventions and understanding for the process as a whole.  Knowing your score can help you determine the type of induction or whether or not to be induced at all.
Your score is based on a vaginal exam that takes into consideration the areas listed in the chart below.


Dilation, Effacement, Consistency and Position all have to do with your cervix. Station is telling where the presenting part of baby is in relation to the ischial spines. (sitz bones).

Are you a good candidate for induction based on your score? Do you need a ripener? Are you a VBAC mother?  What other factors are working in your favor or against success?
Induction is not an easy or guaranteed process. You can see the criteria toward success is telling even without discussing the additional risks leading to additional interventions, medications and/or cesarean.

Additional links and information on induction can be found in this previous post https://prepforbirth.com/2009/08/12/preparing-for-labor-induction/.

Say What? Getting a handle on birthy terminology.

Wednesday, February 16th, 2011

So often I am in conversation and forget that everyone does not eat, drink and sleep birth related information like my peers and I do.

I have put together a list of useful terms and definitions to take the “What?” out of navigating the host of terms surrounding pregnancy and birth.

  • AROM – Artificial Rupture of Membranes – using a finger or tool to open the amniotic sac to to allow the fluid to release.
  • 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.
  • Bloody Show – Mucous and blood mixed together as dilation and effacement occurs.  Starts off as blood tinged mucous and becomes heavier as labor progresses.
  • Braxton-Hicks – Practice contractions that do not dilate or efface the cervix often felt at the top of the uterus versus the bottom.
  • CBAC – Cesarean Birth After Cesarean – This is a repeat cesarean after a woman desires and tries to have a vaginal birth after cesarean.
  • 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.
  • Cesarean – Baby born via a surgical incision made through the abdomen into the uterus.
  • 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.
  • 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.
  • Effacement – The thinning of the cervix which occurs before and while it dilates.
  • Endorphins– Any of a group of peptide hormones that bind to opiate receptors and are found mainly in the brain. Endorphins reduce the sensation of pain and affect emotions.
  • 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.
  • 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).
  • ERCS – Elective Repeat Cesarean
  • 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.
  • 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.
  • Fourth Stage – First hours after placenta is delivered.
  • Fundus –  Top of the uterus. During labor contractions the fundus thickens and gets more firm as the strength of contractions increase and dilation increases.
  • HBAC – Home Birth After Cesarean
  • 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.
  • Induction – To attempt to artificially start labor usually by pitocin, artificial rupture of membranes with or without cervical ripening (Cytotec, Cervadil, Prepadil or Foley Catheter).
  • Intervention – Anything that does not exist in a spontaneously, naturally occuring labor and delivery that is done.
  • 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”).
  • 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.
  • 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.
  • 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
  • Mucous plug – The mucous that blocks off the non-dilated and non-ripened cervix for protection.
  • Natural Birth – Labor and vaginal delivery free from intervention except for intermittent fetal monitoring. In the hospital only a saline lock and intermittent monitoring. Can also mean no monitoring.
  • Obstetrician – Is the surgical specialty dealing with the care of women and their children during pregnancy, childbirth and the immediate post birth time.
  • 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.
  • 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.
  • 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.
  • Perineum – The area between the anus and the vulva (the labial opening to the vagina).
  • Pitocin (oxytocin injection, USP) is a sterile, clear, colorless aqueous solution of synthetic oxytocin, for intravenous infusion or intramuscular injection.
  • 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.
  • PROM – Premature Rupture of Membranes – when the amniotic fluids releases before labor starts.
  • 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.
  • RCS – Repeat Cesarean
  • ROM – Rupture of Membranes
  • 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.
  • Second Stage – Pushing phase after cervix is completely dilated to delivery of baby.
  • SROM – Spontaneous Rupture of Membranes during labor.
  • Stripping membranes –  Pressing the amniotic sac away from the inside of the cervix.
  • Third Stage – Delivery of baby to delivery of placenta.
  • UBAC – Unattended Birth After Cesarean
  • Umbilical cord – The cord that transports blood, oxygen and nutrients to the baby from the placenta.
  • Uterus -The muscular organ in which a fertilized egg implants and matures through pregnancy. During menstruation, the uterus sheds the inner lining.
  • Vagina – A muscular canal between the uterus and the outside of the body. Also known as the birth canal.
  • Vaginal Birth – Baby born vaginally with or without medication and intervention.
  • VBAC – Vaginal Birth After Cesarean
  • WBAC – Water Birth After Cesarean

Celebrating the Birth of Our New Location

Wednesday, December 22nd, 2010

DATE: January 15, 2011

TIME: 10am-2pm

LOCATION: 6180 Lehman Drive, Suite 103, Colorado Springs, CO 80918

WHO’S INVITED:  Mothers and families, birth professionals, related professionals, friends, media and anyone interested in learning more about what Preparing For Birth has to offer the expecting woman and her family!

What To Expect: Food, conversation, door prizes and an all around good time!

If you are interested in donating a door prize or bringing in your mompreneur/birth biz related marketing materials,  please contact Desirre for details at desirre@prepforbirth.com or at 719-331-1292.

Download the Open House Flyer.

Why Childbirth Education?

Monday, November 22nd, 2010

I sit here and ponder Why childbirth education is important?. I am an educator because I think it can be a vital piece to the preparation puzzle prior to welcoming a baby.  I use the word “can” versus “is” due to the fact that all educational offerings are not created equally.

It is known that only a percentage of expecting mothers attend a childbirth class series. Perhaps they believe the staff will explain everything when they get to the hospital, they really have a deep trust in the process and are reading up on everything, or since they are having a home birth that additional education is unneeded. Whatever the reason, women are not getting the foundational information that can be incredibly helpful toward confidence, ability, decision making and mothering far beyond the birth itself.

A good childbirth class series (or rather perinatal class) is well worth the monetary and time investment for most first time mothers and can benefit those who have already birthed.  My post on choosing a childbirth class is a good jumping off point to figuring out what type of course suits the individual expecting mother (her partner or labor support).

A class series worth the time and effort will be comprehensive in nature, not just covering labor and birth. What does that look like? A class that covers midway third trimester pregnancy through 4-8 weeks postpartum. It is content that is deep and is applicable to real life.

A sample of course content:

  • Pregnancy Basics
  • Common Terminology
  • Normal Physiologic Changes and “helps”
  • Exercise
  • Nutrition
  • Prenatal Testing
  • Birth Plans
  • Informed Consent
  • Communication and Self-Advocacy Skill Building
  • Overview of spontaneous Labor and Birth
  • Labor milestones with Comfort and Positioning Strategies
  • Overview of all Options in Labor, Birth and Postpartum
  • Labor Partner Role
  • Immediate Postpartum
  • Navigating first weeks Postpartum
  • Overview of Infant Feeding and Norms
  • Bonding
  • Medications and Interventions
  • Cesarean and VBAC
  • Unexpected Events
  • Role-playing Scenarios
  • Relaxation and Visualization Practice
  • Local/Online Resources

How the educator reaches her class is fundamental to the learning process and take away of participants.  I encourage women to interview the potential educator. Finding the right fit in a class is no different that in provider, doula or birth location.

Even if a woman knows she wants an epidural, TAKING A GOOD CLASS is vital because she will be having a natural birth the epidural is on board and her Plan B could very well be a natural birth. Being prepared will only serve her well in the fluid process known as labor and delivery.

Gaining knowledge that will help a woman to partner with her provider, address her own needs fully and help her to define her own birth philosophy gives her a leg up on being responsible and in charge in her own health care and even outcomes.

The vast scope of what a solid class series can offer an expecting mother (her partner or support person) is incredibly valuable and can not be understated. A class that provides for encouragement, comfort, safety, respect, connection, structure, evidence-based information and real life application can plant seeds and prosper skills that will carry a woman well into her mothering years. These skills are for life, not just for labor and birth. I am stunned often by how birthing knowledge carries me in daily ability with my own family.

Here’s to happy and deep learning!

Choosing Your Childbirth Class

Sunday, November 21st, 2010

Being a childbirth (perinatal) educator is a position that affords great opportunity to positively influence women in the childbearing year and far beyond.  It is also a great responsibility that ought include: self-assessment, continuing education, evidence-based curriculum, the ability inform with discernment and the willingness not to teach a good patient course.

With all of this in mind, it is important that pregnant women choose their childbirth class wisely. There is not any one-size-fits-all class.

How does one go about choosing a childbirth class? I encourage you to go about choosing a class series in the same way you would choose a provider or birth location. Do some investigating and even interview the educator.

Off to a good search:

  • Get referrals from women who have had or wanted the type of birth you are desiring.
  • Check out your local birth groups and get referrals.
  • Ask your provider for a referral.
  • Do a web search for classes in your area. You may be surprised that there are many offerings method and philosophy based outside and within the hospital setting.
  • If thinking about a hospital sponsored course, find out if it is a comprehensive series or a what happens to women once they get to our hospital class? This is otherwise known as a good patient class.
  • Check out the course website then call or email the instructor to get a feel for her style and philosophy. Even a hospital based educator should be able to call you back or email you.

Before registering for a class series:

  • How long is the series? A minimum of 12 hours is needed to be a comprehensive series. At least 2 different class sessions over two different weeks, but  preferably a minimum of 4 class sessions. You may find classes up to 12 sessions. Be wary of condensed one or two day classes as there is not enough time to process information and retain it well. It IS worth the investment of time.
  • When is the class? Day of week and time of day needs to fit into your lifestyle. Again, I encourage your investment over a period of time versus a one-day class.
  • Where is the class held? Classes may be held in like-minded businesses, in home, care provider office or hospital.
  • What organization is the instructor trained and certified with? Though certification is not required, it can be very important the training and background an educator has.  Check out the organization to make sure you agree with it.
  • What does the instructor’s experience involve?
  • What is the instructor’s philosophy and style?
  • What is the cost of the course? Classes can cost anywhere from free through a hospital to a few hundred dollars. It really can be a wide range. Find your comfort level. Though expect to invest in a good class. Free or low cost for everyone is often not comprehensive in nature.
  • What is the course content? A comprehensive class should include a variety of topics, such as, pregnancy basics,  common terminology, normal physiologic changes, exercise, nutrition, prenatal testing, birth plans, informed consent, communication skill building, overview of spontaneous labor and birth, labor milestones with comfort and position strategies, overview of all options in labor and birth, labor partner role,  immediate postpartum, navigating first weeks postpartum, overview of infant feeding, infant norms, medications and interventions, cesarean, unexpected events, role-playing scenarios, relaxation practice and local/online resources. It is usual to expect homework on top of class time as well.
  • What are the birth outcome statistics for class participants? It may be difficult though to get true data whether a philosophy-based or method-based class.
  • What is expected of me as a class participant?
  • What do I need to bring?
  • Who may come with me?
  • Is there a lending library?

I hope you find this list helpful and are able to find the just right fit. I look forward to your feedback.

Announcing New Addition to the PFB Team

Saturday, April 3rd, 2010

I am very excited to announce the addition of  Lori Welch, BS, CCCE to the Preparing For Birth teaching team. She is a CAPPA Certified Childbirth Educator and also Lamaze trained. She has experienced both hospital and home births herself.  She has a deep calling for assisting others in their pregnancy, birth and early parenting journeys.

Beginning in May 2010, she will begin teaching and overseeing the bulk of  PFB group classes.

Class registration will remain the same. Her contact information will be lori@prepforbirth.com.

I look forward to working alongside her and expanding the available offerings for birthing families.