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Planning For The Unexpected: C-Sections

9/17/2020

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First, let me be clear that there is NO ROOM for us to shame or guilt anyone about C-Sections. Birth is birth. However your baby enters the world, I’m here to support!

Okay, let’s dive into the good stuff.

What is a C-Section?
A cesarean or c-section is a surgical delivery of a newborn through a series of 7 incisions through the abdomen and uterus.

C-sections can be a life saving surgery and sometimes the safest delivery method, but for low-risk pregnancies, c-sections actually pose greater risks to maternal health and life. Most pregnant people rightfully want to avoid them. The US levels for c-section are currently too high (about 32% of all births).

Did you know Doulas decrease the risk of cesarean by 39%?

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Pros

  • When valid reasons are present, c-sections can save lives - for both pregnant person and baby.

  • Can be scheduled in advance

Cons
  • Longer hospital stay
  • Urinary incontinence
  • Issues with incision and muscle healing
  • Placenta issues in future pregnancies
  • Hemorrhaging, need for hysterectomy, infection, blood clot
  • Risks associated with pain medications (epidural or general anesthesia for emergencies)

The 615 Doula Co Approach
With all my clients, we sit down together and create a c-section plan in case that becomes the route for your baby to be born. Even with a c-section, you have options, and I am here to help you understand those options and feel confident in the plan that we’ve established.


Sources // CDC, Evidence Based Birth, ACOG

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What To Know About Epidurals

9/17/2020

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Oh the controversial topic of Epidurals... Often, our views on such topics are predetermined due to stories we've heard from family or friends. It's so important that YOU decide what is best for YOUR experience. No matter what you decide, please know that you are strong and capable!

Let’s dive into some epidural basics.

What is an epidural?
An epidural works to significantly reduce pain during labor and delivery, though a sense of intense pressure is often still present. An epidural is a nerve block delivered through a small, flexible tube (catheter) that is inserted into the spine at the small of the back. They are used for both vaginal and c-section deliveries. When given an epidural, a pump is also placed at the bedside so the mother can choose to push the button to receive a controlled boost. Some epidurals are lighter doses and you may still be able to lift your legs while in the bed. With a higher dose epidural you may not be able to move your legs. Your upper body is not affected.  You are awake and alert. It takes about 10-15 minutes to take effect and sometimes things have to be adjusted.

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Pros

  • Provides pain relief
  • Safer for baby than medication given through IV
  • Can allow for rest during labor
  • Can assist in relaxing the pelvic floor (though this isn’t typically a goal)

Cons

  • Lengthens labor by an hour on average
  • Loss of sensation to push  
  • More likely to need forceps or vacuum delivery which increases risk of more severe vaginal tears
  • More likely to need pitocin to help labor progress
  • The medication transfers to the baby, so babies tend to be a bit more sleepy which can lead to a short delay in baby latching for breastfeeding. The medication is also present in breastmilk.
  • Cords - requires urinary catheter, constant fetal heart monitoring, IV, oxygen sensor on finger, blood pressure cuff on arm
  • Limited Movement - confined to bed, so positioning is more limited up to a few hours after birth (though I have some tricks 😉)

  • Needle Insertion - pain and having to stay still in sitting position
  • More people in your room

Side Effects

  • Drop in mother’s blood pressure is not uncommon and dizziness and nausea can result.  This can lead to a drop in baby’s heart rate and oxygen levels.  An additional medicine usually quickly remedies this.  

  • Itchiness or nausea from opioids 
  • Infection
  • Headaches lasting a few days - can sometimes be remedied through a procedure, this is a more rare side effect, affecting about 1 in 100
  • Nerve damage pain

The Unintended
IV’s are given with epidurals. IV fluids can cause retained water weight in the mother and baby. If the breast is swollen from fluids, this can impact the baby’s ability to latch for breastfeeding.  IV fluids also can slightly increase a baby's weight, so when they naturally lose that water weight, it may inflate how much weight a baby has truly lost and cause some anxiety in mothers and pediatricians.
The 615 Doula Co Approach
Doula support is correlated with fewer requests for pain medication, however, I proudly support women that are planning for either option! As your doula, I will be right by your side as you and your family make this tough choice.


Sources // Evidence Based Birth, DONA, National Library of Medicine, Stanford Study

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Changing Your Perceptions of Birth with Affirmations

8/27/2019

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We grow up hearing birth stories and so many of them are not positive.  The moment you tell someone you are pregnant, they share a birth story. These stories shape our view of birth, often negatively.  A big part of preparing for birth is redefining perceptions. Affirmations are one tool we can use to reset our perceptions around birth.   

Most of us use affirmations in our daily life, though not always intentionally or positively.  We often say or think negative or limiting thoughts, especially about birth. For instance, “I’m sure something is going to go wrong.”; “We don’t know what we are doing.”; “I’ll probably end up with a c-section.” etc.  

The goal of setting intentional, positive affirmations is to reinforce your vision for your birth and mitigate negative thoughts.  They are part of the internal work we can do to prepare for a powerful birth.  They are an opportunity to build your internal connections and show yourself (and your baby) loving support.  

Affirmations do not guarantee that you will have a specific type of birth, but they are helpful in shifting mindsets to ones of empowerment and love, instead of fear. 


Steps:
  1. Identify your doubts and fears about birth.  These are often the thoughts or statements you say repeatedly.  Doubts often surface in your hesitations when speaking with others about your plans for birth (like that co-worker or family member).  Common fears are about the safety of you and baby, doubts about the ability of your body, your baby’s body, or if you can birth without an epidural, etc. 
  2. Explore some sample affirmations and see which ones resonate with what you want to be true.  Sample affirmations are below.   
  3. Create a few personalized affirmations.  Flip the negative thoughts into a handful of positive affirmations, maybe 3-5.  Consider looping in your baby, by including “we” language.  
  4. Refine affirmations that include words with negative connotations.  Restate them with positive language, for example, “I will not be afraid” could be restated as, “I am brave.”
  5. Write them.  You may choose to type them or write them.  Save them to your phone, computer, or even get creative and print or write on cards or beautiful paper.  
  6. Incorporate a routine for reading your new affirmations.  You can place them on your bedside table to read before bed and when you wake.  Some find time at mealtimes or when you check social media. Read them whenever negative thoughts or feelings creep into your mind.  Connect with your baby and partner by reading them aloud or having your partner read them to y’all.  


Sample Affirmations:
  • I was born to do this. - Joan of Arc
  • All is well, we are both safe, all is well, we are both loved by Life. - Louise Hay
  • I may feel strong waves of labor, but I move through it.  I don’t avoid it. The only way to be done with it is to walk through it.  I accept it as part of the process. It gives me you.  
  • This doesn’t have to be hard.  I just have to accept it and let it happen.  
  • I feel the love around us.  We are loved. We are safe. All is well.  
  • We got this!
  • I am a strong and capable woman.  
  • We are strong.
  • I am willing to experience all of my feelings.
  • My body knows what to do.  My baby’s body knows what to do.  
  • My baby will be born at the perfect time.​

Longing for other strategies to prepare mentally for birth? That's what I am here for.

Book your FREE Consultation to learn more about doula support and the unique care I bring to Nashville births.
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    Meet Nicki

    Hi, I'm Nicki! I am a Nashville based Doula and founder of 615 Doula Co! My favorite part of working as a Doula is supporting families through the life transitions of pregnancy, birth, and postpartum life.

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