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Ask a Labor Nurse: Trish Answers Viewers Questions | 112
Episode 11210th May 2024 • The Birth Experience with Labor Nurse Mama • Trish Ware, RN
00:00:00 00:36:11

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Trish: [:

Quick note, this podcast is for educational purposes only and does not replace your medical advice. Check out our full disclaimer at the bottom of the show notes. 


, which part of labor is the [:

That is the most dangerous part of labor. Hi, can I ask if it's normal to experience frequent Braxton Hicks in six months of pregnancy. I love the terms, is it normal? Because we have such a wide range, a vast range of normal. But yes, it is normal to an extent. But here's what I would tell you guys to do. 


are just basically practice [:

It is the most powerful muscle in the world. Sorry to all my gym bros who go and work out all the time. Uterus has got you beat. Your uterus will do these practice Braxton Hicks and it's these. Like little squeezes in the middle. The thing about Braxton Hicks is they're usually just in the tummy. They don't go down to your legs. 


They don't radiate to your back. They're only in the middle of the uterus and they're like, Hey, I'm practicing and getting ready. Now, if you find yourself having a lot of Braxton Hicks, my very first thought is you're not drinking enough fluid. So what we recommend to our students and our members inside of the membership is increase your fluids and maybe do some like liquid IV or coconut water, or if you have to, something that has a lot of preservative, which is like Powerade or Gatorade. 


me to have too much amniotic [:

So, sometimes it can be a sign of some sort of like kidney issue with baby. Usually it isn't, but it can be. So unless you are actually diagnosed as polyhydramios, which is a lot of amniotic fluid, you shouldn't have too many side effects. The one thing that we worry about when you have polyhydramios is it's putting too much pressure on that uterus. 


, and I [:

So there's actually three medications. They're not all vaccines. Only one of them are. But I want you to know, I think your name is L, that you get to make the decisions on how you navigate the newborn medications. Typically, within the first day, we're going to do them all. They've all got different ranges of when we do them or want to do them, should I say, because you get to decide. 


So the first one is the vitamin K shot. The vitamin K shot is needed or not needed. It's your choice. Some cultures do not do it. They avoid it. It's again, it's your choice. The vitamin K is given because that's better than needed, right? Given. Because. Babies do not they cannot clot the way that we can. 


than a baby who had a nice, [:

However, if you don't do the vitamin K, I would definitely say if you're making choices like a circumcision, do not do that until day seven. I think they start, I think they start and I might be wrong because I'm lacking sleep right now, but I think around day eight, nine is when they start producing their own sleep. 


clotting factors. So a lot of cultures they don't do circumcisions until then. They don't do any kind of things until then to prevent. The next thing that we do is the urethromycin eye ointment. It's a little tube of ointment. We squirt it in the baby's eyes. I always say if you're going to do it, tell your labor nurse you do not want it until after those first precious hours because part of what I taught last night is that the baby is using all of their senses to acclimate. 


s or so. So we want the baby [:

And we don't want to miss that, right? We don't want your baby to miss that. I always, when, once my mom's deliver, I always dim the lights so that the baby's eyes will pop open because they're in this newborn alert stage, this awake alert stage. So avoid the erythromycin. It is given because back in the early 1900s All of these babies were going blind and it was linked to gonorrhea and chlamydia. 


So if you have been tested for sexually transmitted diseases, if you don't have any kind of funky infection and GBS does not count, even though some people will argue with me, that's okay. I don't care. Then you really don't need it. If you have a committed partner or you're not having sex at all since the last time you were tested, or we know that you don't have one. 


t necessary, but again, it's [:

The third medication that we give your newborn is the hepatitis V vaccine. It's the first of a series and they like to start it in the hospital. I personally did not do that in the hospital for my own babies. I did a very long drawn out schedule, which y'all know, I don't talk about this online cause I'm sure I just messed up and I'm going to get a lot of hate DMS, but that's okay. 


us. It is not a coincidence [:

So, I was wondering if it's okay to get my hair colored. So there is mixed opinions about this. If you're going to get your hair colored, there are toxins in it. So I would avoid doing it during the first five weeks. However, there are some really healthy natural hair products that you can color your hair. 


So talk to your hairstylist and maybe even consider doing it yourself right now temporarily with a more natural hair product. But again, do your, research and make a decision that's best for you. Can you feel if baby turns to a head down position? So. If it's happening slowly in the, in a natural process of how it's supposed to go, typically, no, you may feel the result of it because suddenly you can breathe a little better, but you have to pee all the time and you feel a lot of pressure on your vagina on your pelvis. 


ment when it happens, around [:

At the end of my pregnancy, my babies, they have enough room to go wherever they want. So I feel them all the time. We are answering pregnancy and postpartum questions. I also have a 10 month old, so I thought perhaps it's because the pregnancies are close together. I thought that might be a factor. It very well could be because your uterus knows exactly what it's doing. 


And like my midwife says, the more babies you have, the more stretched out it is. Like a rubber band, you know how you have a hair bow and you keep using it and keep using it and finally it's just too stretched out? That's what she said to me. I don't think that was very nice though. So apparently I have a very stretched out rubber band of the uterus from having so many pregnancies. 


ice? I would say do the mile [:

I really hesitate to tell you too many positions because it's very important that you learn how to use your pelvis. So we teach you guys before labor starts how to open up the at the inlet. That's really important because the real crux of labor of a good, flowing easy, calm labor is that baby getting down into the pelvis, that, that's the magic of it all. 


We all think, oh my gosh, how far dilated I am. That's really not the magical part. The dilation won't happen if the baby's not putting pressure on your cervix. So we want to teach you, and this is why we created this guide, which you can get it for 7 on its own. It's not as powerful as if you have the classes because I teach you the rationale and we help assist you. 


But [:

If you don't know what station is, station is where the baby is inside of your pelvis or outside of your pelvis. Okay, is it possible my partner is experiencing Braxton Hicks contractions when she feels like she needs to poop but doesn't? She's 39 weeks today. Two things, two things I want to say, yes, 100%, 100%. 


nna be in the room family or [:

How to navigate these kind of things as well. So more than likely, she could be having early labor. I want to say that as well, but Braxton Hicks do get stronger towards the end of pregnancy. And what's probably happening is those Braxton Hicks are pushing the baby down and the baby might be putting pressure on her rectum and her colon. 


Tell her to hydrate. Any advice for fast labors? First was four hours total. Midwife says this one is likely to be faster. Your midwife is probably 100 percent correct. Fast labors are, it's funny. Everybody's like, I wish my labor was faster. But too fast of labor can also be a little bit traumatizing. 


red and ready. And you might [:

We recommend when your contractions are less than five minutes apart, each one lasting for 60 to 90 seconds. for one hour for our second time moms. Our first time moms, we have a totally different rule. It's less than four minutes apart for each one lasting 60 to 90 seconds for two hours. So if you are a second time mom, you go by the 5 1 1. 


But for someone like, I think your name is Jade, for someone like Jade, who has very fast labors, which I do too, if I go in spontaneously, then you might want to head in a little sooner. Maybe when your contractions start to really declare themselves, maybe they're less than 10 minutes apart for an hour, or your instinct, your gut tells you. 


start feeling the baby down [:

Can the newborn gaze happen when in epidural or C section, do you think? Yes, it absolutely can. But again, this is why I have my mamas in their birth plan put in to minimize interruptions, minimize outside talk. You don't need the team talking about. their weekend plans or anything like that. You want that room to be quiet and centered on that baby because again, another one of their senses is their hearing. 


the lights in the OR. I had [:

Until they were every four. I'm guessing you didn't deliver. Maybe you did, I could be wrong. The difference with real contractions and what we tell our moms is they will declare themselves. So I said every four, but I also said lasting 60 to 90 seconds. So if you're having these little putsy poo, I call them putsy poo, that's the official term, you'll find that in labor and delivery books. 


If you have these little putsy poo contractions that are like not lasting, you know, maybe they're lasting 20 seconds, 30 seconds, but they're not lasting 60 to 90 seconds. Those are not real contractions. Those are Braxton Hicks and Braxton Hicks will go away. Real labor contractions. They stick around until that baby comes out because that's their entire job. 


of education and advice for [:

You need to know the options so that you can navigate that process because you can make decisions along the induction process. You can make decisions like one of my team members who was a student at the time who told her doctor what she wanted and they changed the whole plan for what Ashley wanted. 


You get to navigate those decisions. You're going to be made to feel that you don't have all the rights that you think you should have, but you need to know what you can say yes and no to. We have a, another little motto. We say you can refuse anything, but should you? You don't ever want to refuse or accept anything without knowledge. 


e the choices on what sounds [:

Active labor is usually past five centimeters. Sometimes there's some exceptions in the rule, but that's why you need to be educated. Number four, remember that it's slow and steady. A lot of women during inductions will end up agreeing to a c section because they're just stinking over it. But if you tell yourself, this could be a two or three day process, you won't think, Oh my God, I'm going in this morning. 


I'm having a baby tonight. Cause that probably won't happen, especially with the first baby. So if you go in there with the expectation, this is going to be slow and steady. And I'm not going to have the baby today, probably in a couple days, and you're not setting yourself up for disappointment. You're going to have a much better induction. 


ital unmedicated inductions. [:

It sounds like you have more than likely a yeast infection, but it could be something more, but you need to have that checked out. You need to get that checked out. I would also consider starting to do some probiotics, maybe drink some make sure you're increasing your fluids. Doctors worries baby is big and won't have enough room to move. 


Thoughts on that. I think it's mostly more often than not bull. is not actually true. Big baby is misdiagnosed all the time. Ultrasounds are not accurate. Even palpating your abdomen is not always accurate. They say that ultrasounds are off by one to two pounds, and I can't tell you how many cesareans I've done. 


ivery and the baby comes out [:

Having a C section for big baby alone. Now, if you have other diagnoses along with it, it makes it a little more complicated. For my GDM patient or students and my moms who are diagnosed as bigger baby we usually navigate that by not being induced. Is lower back pain common and normal after labor? Oh, again, is it normal? 


We say this all the time as women when we're pregnant and post delivery. Is this normal? Is that normal? This is why we give all of our birth class students 30 days in our mama membership. Because you think, Oh my gosh, I'm pregnant. And I'm, some of you guys don't educate yourself at all. Shame, shame, shame. 


think I took a birth class. [:

You just had a human come through all those bones. Yes, your lower back can hurt, but depending on your own situation, there's some exercises you can do. There's some things you can do to relieve that back pain, some stretches. I wouldn't do anything hardcore. I did not take the glucose test beverage. 


would never say you're wrong [:

And Is there power in knowing if you're gestational diabetic? Yes, for sure. So if you refuse that test, I would be checking your blood sugars just to make sure. Because there can be so many complications from undiagnosed and untreated gestational diabetes that we don't want to happen. So I would say you need to know, but you don't have to drink the drink to find out. 


Postpartum hemorrhage is one [:

So we don't want to take that lightly. Potosin after delivery. I'm not some kind of person who's don't do anything. You don't have to add anything. Interventions aren't all bad. No, I'm a labor and delivery nurse. I believe in interventions when they're necessary. Now, if I went in to have a baby, I am very high risk for a postpartum hemorrhage because I've had a butt ton of babies. 


So yes, I'm going to accept it. But what I was telling the mamas I think last night. is that there's options. You don't have to get the whole bag. You can just get an injection in your leg, which is just the Pitocin. So you're not getting all that extra fluid on board because all that extra fluid is, it can cause some issues. 


is. It's actually after the [:

Most doctors. Now, there are some schools of doctors that do it waiting for the placenta. But typically, a mom who has just delivered, had her, delivered her placenta, we're going to give you a bolus of 500 mLs. of a fluid which includes 10 units of Pitocin. So, like I was saying, you can do that in an injection form, so you're just getting the Pitocin and not the fluids. 


But like I was just saying before, we do this to prevent a postpartum hemorrhage or to stop one. Can the vitamin K be given while the baby is on me or do they have to take the baby somewhere? How long should we wait for them to give them? Everything just about that we do to the baby, assessments, shots, blood draws, can be done on top of you. 


ycin, The heel prick, you do [:

That really helps, especially if baby's breastfeeding. So if baby's blood sugar has to be drawn, Or, we have to do blood draw on baby, have them laying, rest here, and legs hanging off of you. When the legs are hanging, it helps with that blood draw. All right, let's see, had suction and episiotomy with first delivery, will I need them again with my second? 


or will it be easier? So more than likely you will not. The path has been paved, if you get my drift. So when she says suction, she means the vacuum to help baby be delivered. 39 weeks, over seven pound baby, first time, don't want to get induced, recommendation, say no. If you are healthy and baby is healthy, you can wait for labor. 


ou can say no if you're both [:

I'm four centimeters dilated so far. And haven't had constant contractions. Is this normal? Absolutely. I have so many, I have a student right now who's 7 centimeters and not in labor. Can you imagine? This is the second time this has happened to her. She is a repeat offender with me. And she's got us on our toes right now. 


I need to check her labor bat signal because she just went to the doctor again. Again, so you guys know, this is why I do what I do. For this mom, who's 4 centimeters and not knowing what the heck to think, and I'm sure doctor's office is not giving her a lot of things except for, if this happens, come in. 


xam, but typically it's very.[:

hard to cause a miscarriage or a loss. So she really needs to sit down if she's having any kind of like thoughts that maybe someone caused it. She needs to sit down with her provider. How to get my husband interested in this information before birth. He doesn't seem to care much. Have him come to, if you join my classes, have your partner come to the hangouts on Wednesday and we will get them interested. 


We will talk about How powerful it is for them to understand what is happening inside of you and around you because during labor, your only job is to labor. Their job is to advocate for what you already made decisions on, so they need to understand. So if you say, I don't want to a FSE, they need to know what is an FSE and why is it normally used and is this an appropriate time to use one? 


s a labor nurse, and in some [:

Is the glucose test mandatory? It's not mandatory. I'm sorry. However, it's wise to know if you're gestational diabetic. You want to know. But you don't have to do the test the way they're saying. That's something we teach our girls too. There's other ways to do it, even if they're telling you. I had gestational diabetes with baby number one. 


What are the chances baby number two? I've lost 50 pounds since having my first baby. Sammy, actually, you may not, and not just because of the weight loss, some of my moms have not had it the second time around because they know how to eat smarter and to, they know their bodies. So you may not be diagnosed with it this time around. 


r outside of an epidural? So [:

Some hospitals offer the nitrous oxide. Some women love it, some women hate it. It doesn't take away all the pain like a good epidural can. I say good because they don't always work. The other option is IV narcotics. However, if you've had a baby before, we're only going to give it to you till six centimeters. 


And if you've never had a baby, maybe seven centimeters. However, IV narcotics only take the edge off. They don't take the pain away and they usually only work the first dose. They just make you feel loop to do. They don't really help with labor pain. Bad. Ball doesn't help. What do I do? So there's some different things that you can do. 


oor work with a pelvic floor [:

I just did a live on Instagram with my followers over there and we were talking about, is it normal? Probably the thing that you're going to ask the most during pregnancy and the first two years after baby is it normal? This is why I give, if you guys join my birth classes, my full birth program, you get 30 days free on my membership. 


So you have access to me and doulas and other professionals so that we can help you navigate those things. At 24 weeks of pregnancy, it's very normal to begin to feel an increased amount of pressure. And at some point you're going to think your vagina is falling out. I have a lot of pressure down there, but not labor pressure, can barely move legs a certain way. 


weeks, four [:

Very normal. Our body is just not its normal self, but as long as you're not having consistent, more than six consistent contractions per hour, I think you're fine. And one thing I would tell you for those achy muscles is to overhydrate yourself. So drink a lot of fluids, maybe do some liquid IV or some coconut water. 


Coconut water is like so disgusting to me. but it's also really powerful. Some of y'all love it. Contraction like cramps at 25 weeks. Again, the most common cause is dehydration. So chug some coconut water. If you're having more than six per hour, you need to be seen. Can I choose how I'm induced? Yes. Yes, you can. 


o work on taking care of our [:

including your birth. So you don't need to start a hit routine or anything like that. But if I were you, I would make some small daily changes that helps yourself get healthy again. But I wouldn't use that as a reason to discourage yourself from having another baby. If you want to get pregnant, girl, get pregnant, but then take care of your body. 


Is there anything that doctors will try or suggest that you feel is unnecessary for baby after delivery? Here's the thing that doctors won't want you to do is to decide for yourself. They want you to do what's standard. And so the most powerful thing you can do is educate yourself. Educate yourself so that you know what you can and cannot say no to, and that's pretty much everything. 


me and my baby or is it not? [:

Don't let me choose it. Don't let your doctor choose it. You choose it. This is your little person, and you have every right to make every decision for that baby. 38 weeks, my doc says, induced at 39. I'm not high risk, no issues, my natural First of all, if you are fine, and baby is fine, and you have no medical indication for induction, I would say hell to the no. 


That's ridiculous. I would not agree to that. Especially if you don't want it. Now, if you want it, I'll support you and help you, but I wouldn't do it just because they say to do it. They'll try to get you to do it because guess what? They have more control over it if you're induced. God forbid you go in labor at the middle of the night and they have to leave their bed. 


s down there. It gets really [:

It's very normal. 41 weeks on Saturday. Just moved to Texas from Cali. No one will induce. So they don't want to induce you. Do I have to get epidural or meds for labor or can I go natural? Absolutely, you can go natural and get it if you need it. That's totally a question. Yes, don't rush baby unless, here's the thing, everybody jokes that I'm crunchy with a side of medical. 


accept me. There's a couple [:

Number one, I would not worry about him measuring. They're always wrong. Almost always wrong. Just show up to the hospital, girl. Just go to the hospital and tell them you think you're in labor. I know you don't think that. Go to the hospital, tell them you think you're in labor you just moved, you don't have an OB, and you need help, and they're not going to send you home. 


more than likely. The resident OB will probably induce you. That's just what you're getting from me. Now, what I would recommend you do is you join the birth process, start your labor bat signal, and let us help get your cervix ready before you do that. =. I'm pregnant with my second and on blood thinners. I was the same with baby number six. Due to PE with my first, how can it affect labor? So more than likely what they're going to want to do, is they're going to want to take you off of Lovenox around 36 weeks, put you on heparin. They're going to stop the heparin and want to induce you at 39 weeks. And you can always navigate those choices with your provider. 


wonderful. Oh, thank you so [:

And so for me, it's not unusual for me to have 70 over 40. For someone else, that could be detrimentally low. So it's really important to know what your average is. And if it drops from that, then it needs to be looked at. 


Hey there. I hope you enjoyed this live q and a with me. These are some questions that my followers on both Instagram and TikTok had for me. If you don't follow me on Instagram or TikTok, go do so. we have over 500,000 followers on all the social media accounts. It's such an honor. And we love answering your questions. 


ast. I hope you enjoyed this [:

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