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Let's Talk Babies!

Labor and Delivery

I came across this article yesterday regarding an ethical dilemma that researchers are finding themselves in surrounding the use of left over blood from newborn screening tests.  At question is whether or not researchers should be allowed to use the blood samples left over from newborn screenings as a research tool without written consent from the parents.  Currently, most states allow these blood samples to be banked and used in research.  All the identifying information is stripped from the sample and there is no real way for the information gleaned from the research to be traced back to the original person.  However, parents are up in arms about this and have taken the issue before the courts in several states, arguing that it violates their child’s privacy and puts their child’s genetic information out there for anyone to find.  Courts in several states, including Texas and Michigan, have agreed with the parents and forced millions of leftover samples to be thrown out and have developed a consent form so that parents have the option to opt-out if they do not wish to have their child’s sample stored and used for future research.

Although I see the point the parents are making about the privacy concerns, I think the benefits of this program far outweigh the risks, especially since the there is no identifying information attached to the samples once it is banked.  Newborn screening tests are vital for identifying potentially life threatening illnesses and conditions.  Through these screening tests doctors are able to identify illnesses and treat them right away in order to save a life, when before these screening tests were routinely done the child would likely have died.  My fear, and the fear of many, is that this current uproar will result in parents opting out of getting the screenings done all together and will result in too many babies leaving the hospital with potentially life threatening illnesses and conditions.  Also, the additional research done on the left over samples is essential to developing new screening tests, learn more about the illnesses and conditions we currently screen for and identify new conditions and illnesses that need to be added to the screening.  Our babies lives depend on this research.

I think what states, doctors and researchers need to do is to educate the public on the importance of these screening tests and the importance of the additional research being done on the left over samples.  Probably every state will need to develop a consent form and give parents the option to opt-out of the program as some parents just won’t be comfortable knowing their child’s left over blood sample is being used. However, I think most parents, if comfortable in the knowledge that their child’s information is stripped from the sample before it leaves the hospital, will opt-in to the banking program and researchers will be able to continue the research that allows for groundbreaking, life saving discoveries.

What are your thoughts on this topic?  Do you think it okay to use the left over samples for research?  Do you think there should be a consent form developed?   Would you opt in or out if given the choice?

As you approach the end of your pregnancy you’ll probably begin feeling a bit anxious about getting the “show on the road”. By the time the eighth month of your pregnancy rolls around you may feel like you’ve been pregnant your whole life. Waiting for the “big day” can be hard. You’re ready to meet this little person you’ve been carrying around inside of you for almost nine months, and you’re probably more than a little sick of being pregnant.

Late pregnancy can be difficult and uncomfortable for a lot of women. The baby is taking up a lot of space in there and weighing pretty heavy on those poor lower back and pelvic floor muscles. Many of the pains of late pregnancy are often mistaken for early signs of labor. It may be a little bit of wishful thinking, but it can sometimes be hard to tell the difference between a common late pregnancy symptom and early labor.

Here are a few common late pregnancy symptoms that are often mistaken for early signs of labor.

  • Increased pressure (and sometimes pain) in the pelvic area. As the baby moves down or drops the pressure and pain you feel may increase. This can happen as early as several weeks before labor begins.
  • Braxton Hicks contractions. These contractions have been going on since very early on in your pregnancy. The farther along you are the more you will feel them. Sometimes they even hurt.
  • A change in your appetite. As the baby begins to take up more and more space in there your stomach has less room to expand and you may find you are eating much less now.
  • Nausea. Some women experience this towards the end of their pregnancies due to changes in hormones, pressure on the stomach and intestines, or changes in their diet.
  • Increase in vaginal discharge. Some women pass their mucus plug as early as several weeks before actual labor begins.

If you have any questions about something you are experiencing be sure to call your doctor. It is always better to run it by him or her to be safe. Early signs of actual labor include; rupturing of your membranes (water breaking), contractions that increase in severity and frequency, and bloody show or spotting.

Don’t worry labor will begin sooner or later for you. Although it may feel like the baby will just live in there forever, he or she will make an appearence soon.

We all know how important it is to choose the right doctor or midwife for our pregnancy care, but choosing the right hospital to deliver in may have just as big, or bigger, an impact on the quality of your birth experience and your chance for complications during delivery.  A new study released by HealthGrades found that women who gave birth at top-rated hospitals had significantly fewer complications during both vaginal and cesarean deliveries.

Study Findings:

  • Women having a vaginal delivery in a top-rated hospital were 51% less likely to have complications versus women having a vaginal delivery in a poorly-rated hospital.
  • Women having a cesarean delivery in a top-rated hospital were 76% less likely to have complications than women having a cesarean delivery in a poorly-rated hospital.

When you have the opportunity to choose which hospital you will deliver in, choose wisely.  Do your research.  Talk to your doctor, other moms, and research the hospitals in your area.  Choosing the right hospital can greatly improve your overall childbirth experience and minimize your chances of suffering complications.

Some useful online resources for research hospitals in the United States:

When labor starts and you begin feeling those early contractions many of us grab for the stop watch and a piece of paper so we can begin timing those contractions.  By the end of pregnancy we are so ready to see our little darling babies that we want to see that pattern develop on our contraction logs.  This whole pregnancy process has been leading up to this moment.

Keeping track of your contractions is important for a couple of reasons.  Knowing how far apart your contractions are and how long they are lasting helps you gauge how your labor is progressing.  Timing your contractions will help you determine when it is time to call the doctor and head to the hospital.

To help time your contractions many online tools have been developed.  Here are a few good contraction timers.  Each creates a log for you so you can see how far apart your contractions are, how long they are lasting, etc.  When you call your doctor he or she will want to know this information to help determine if you should head to the hospital or not so be sure you have it handy.

When I went into labor I used the traditional stop watch and piece of paper.  I wish I had thought to look for these tools before hand.  I definitely would have used an online contraction timer instead.

Labor is often a little unnerving to think about for most new moms.  It is hard to comprehend what your body and mind will go through during that time.  No matter how many books you read, how many childbirth preparation classes you take, or how many stories you hear from other mothers you will never know for sure what will happen until it does.  Each woman handles their labor differently.

Knowing what to expect at each stage of labor can help you know if you are really in labor, what you need to do to prepare yourself (as best as possible) for each stage, and what questions to ask your prenatal caregiver.  Below you will find a little information about each stage of labor.  Be sure to ask your doctor if you have any questions or concerns.

Before Labor Begins:

  • You can expect to notice an increase in the amount of Braxton Hicks (practice contractions) you are having.
  • You may also notice a burst of energy, often called nesting.
  • You may notice you are sleeping less and when you do sleep you are in a much lighter sleep.
  • Your doctor may tell you that your cervix is softening or even beginning to dilate a little.

Stage 1 – Early Phase:

  • Contractions will begin.  Typically they are any where from 5 to 20 minutes apart and last approximately 30-60 seconds.  You will notice a regular pattern to your contractions and they will become stronger, longer, and closer together over time.
  • You may have some bloody show.
  • You may notice an dull low back ache.
  • Many women experience an increased frequency of bowel movements.
  • You cervix will dilate from 1-4 centimeters during this stage.
  • Some women experience their water breaking during this stage (it does not always happen though).

Stage 1 – Active Phase:

  • Your cervix will dilate from 4-7 centimeters during this stage of labor.
  • You will notice contraction that are more intense and coming more frequently.  Typically contractions will last between 40-80 seconds and will be coming every 2-4 minutes.
  • If your water has not already broken you may notice it ruptures during this stage (but not always).

Stage 1 – Transition Phase:

  • Your cervix will dilate from 7-10 centimeters during this stage.
  • Your contractions will be much more intense.  Typically they will last between 60-90 seconds every 2-3 minutes (sometimes more frequently).
  • You may begin to get the urge to push.
  • Some women experience nausea, vomiting, hiccups and cramps during this stage.
  • Some women begin to shake uncontrollably during this stage since your body is working so hard during the contractions.
  • You may notice that you are becoming drowsy.  Rest between contractions if you can.

Stage 2:

  • Your cervix is completely dilated.
  • You will experience contractions every 2-5 minutes and they will typically last 60 seconds or more.  They are often less intense during this stage than they were during the transition phase.
  • The baby will begin to descend through the birth canal.
  • You will have a strong urge to push.  Your doctor or midwife and the nurses will help you through the pushing.
  • You will experience a burning sensation as the baby’s head crowns.
  • This stage ends with the delivery of the baby.

Stage 3:

  • You will experience mild contractions.  After the intensity of the contractions you have been feeling up to this point you may hardly notice these ones.
  • You will be asked to push again to deliver the placenta.
  • If there was any tearing or you had an episiotomy your doctor will stitch you up at this time.

Stage 4:

  • This is the recovery stage.  You will experience mild cramping/contraction pain as your uterus begins to return to its previous size.
  • Many women experience shaking as your muscles recover from the intensity of childbirth.
  • You may experience difficulty urinating at first.
  • There will be pain and discomfort in your perineal area.

Talk to your doctor about when you should him or her and when you should head to the hospital.  If you are worried about any stage of labor and what you should expect be sure to discuss those questions and concerns with your doctor.