By Bonnie Cox
In my years as a Labor and Delivery nurse I have found that there are many facts, question or answers that are not given to patients when they go to see their physician for their monthly or weekly checkups. They therefore go to such places such as Yahoo answers or forums seeking answers rather than asking the physician partly because their physician maybe too busy to take the time to answer their questions., or the patient believes their question to be to silly to ask. This is never the case
Some of the questions I have found asked is:
1. How do I know if I am pregnant?
My answer to this is wait until you are 2 weeks late with your period and then either go to your physician or get an over the counter pregnancy test and if it is positive make an appointment to see your physician. Many people want to know the next day after having unprotected sex and that is too soon to tell. Waiting is hard but in the long run it will cost you less to wait.
2. How do I know if I'm in Labor?
If it is close to your due date, and you start having contractions, always drink several glasses of water, lay on your side and if the contractions go away then you will know that you are not in labor. If the contractions continue and are consistent, no more than 5 minutes a part and are hard as your forehead then that is when you know you are in labor. You always want to give your labor time to work, since once you get to the hospital, you will get IV fluids and nothing to eat until after your baby is born. If it is your first baby then it could take longer than if you have had multiple births. Always remember to call your doctor if in doubt or call the hospital you are going to and talk to a nurse. It's always better to be safe than sorry.
3. What do I do if my water breaks?
Go directly to the hospital. Sometimes once the water breaks your baby can come quickly, sometimes if you wait to long to deliver the baby can get an infection. If you are not sure than go anyway and be checked. Again it's always better to go and be checked and it be nothing than not to go and it be something.
4. Why am I having contractions when it's not my due date?
Many times it's because you are not drinking enough fluid. It's essential that you drink at least 8 glasses of water a day. Coke and tea are not good for you or the baby although it's OK to have an occasional glass of either but mostly water should be your main drink until you have your baby. Sometimes you start having braxton-hicks contractions which is getting you ready for the "real" thing but you would be well into your pregnancy before this happens. If you are just a few months then you should call your physician or go to the hospital. Also if you were to start bleeding in the early stages of pregnancy then you would call your physician or go straight to the hospital.
5. What do I do when I go into labor?
Once you are assured you are in labor and if you have been contracting for several hours and the contractions are no more than 5 minutes apart and hard as your forehead, then go directly to the hospital. Sometimes even though your contractions are close together and hard, you may not have started to dilate yet and you may be told to walk. Walking helps the dilation process. This should be done even before you start labor as it will help when the time comes.
6. Is it alright to have sex when pregnant?
Unless your physician tells you different then having intercourse is perfectly alright. Sometimes having intercourse right around your due date will help induce labor but your cervix has to be "ripe" and ready and then intercourse will help. Always ask your physician when in doubt.
7. When and what happens when a patient is induced?
When a pregnant woman goes over her due date 2 weeks she is considered overdue and her physician may opt to induce her so that she will deliver her baby before the baby gets to big. There are various reasons why a woman maybe late, there is no real answer since every woman is different. If a patient insists on being induced because she is "tired" of being pregnant, her physician may give it a try if she is far enough along and the baby is mature enough to be delivered. A word of caution about being induced. If the cervix is not ready, if a patients has not started to efface or dilate then there is nothing that is going to make the baby come before everything is ready. I have seen women come into the hospital to be induced only to have it fail and be sent home. Until nature takes its' course then it's a waiting game and patience is required. If induced the mother is given a IV fluids with a drug called Pitocin mixed with the fluid. This is given slowly, using an IV machine and turned up about every 15-30 minutes. As long as the baby is fine then the Pitocin will continue to be turned up until delivery. After delivery the mother is given a couple of bags of IV fluids with Pitocin so that her uterus will contract and keep her from bleeding. This is done in any kind of delivery.
8. Why do some women have to have C-sections and what is to be expected?
If a baby is breech it is safer to deliver a baby by C-section then vaginally. Sometimes the physician is able to turn then baby and a vaginal delivery can be done but if it fails then a C-section is in order for the safety of the baby. Another reason is if a women becomes preeclamptic and her blood pressure gets very high, she swells and/or has blurred eyesight then a C-section is needed for a safe delivery and so the mother will be safe as well. Preelampsia can turn in to Eclampsia which is very serious and also other things can happen from being Eclamptic which can in the end cause death to the mother and/ or baby. The mother can also have seizures from this problem. If a C-section is required, the mother will have an IV and be given medication to try and lower her blood pressure, usually Magnesium Sulfate. If this does not work, then a C-section will be done as an emergency procedure. The mother may be given an epidural or be put to sleep depending or the situation. A C-section is nothing to be afraid of as so many think.
9. Do I have to have an enema when I go to the hospital to have my baby?
Not Always. Sometimes it depends on the doctor, sometimes it depends on the patient. Many years ago the doctors always ordered enemas but today most doctors do not. Some patients request one especially if they have eaten in recent hours before going into labor. It is embarrassing for some it they defecate while pushing the baby out so therefore they prefer and enema prior to going into hard labor. This is usually done upon admission. Some physicians are of the old school and therefore it is in their orders for their patients to have an enema. Should a C-section be required it is better not to have anything on the stomach because a patient can aspirate during surgery. So it just depends on the patient, the physician and the situation as to whether an enema is given.
10. My advice for the husband/significant other when spouse is in labor.
Do not wear any rings or ties. Unless you want your ring to be dug into your fingers while your wife/significant other is pushing then don't wear them. If you do not want to be choked to death then don't wear ties as many woman don't realize how strong they are when pushing and will grab said tie without thinking. Do not take pictures of your spouse while she laboring unless she agrees as she may make you eat the camera before the baby is born. Be patient and don't take offense to anything she may say as she will tell you she is sorry later. If you can't stand the sight of blood then don't be in the room when the baby is born but just remember you will miss the most precious sight in your life if you miss the birth of your child.
11. Do I really need to have an epidural or any kind of pain medication?
My advice is not to be in pain if you don't have to. An epidural is safe and you can enjoy your labor much more if you are not feeling all of the pain. Most doctors will not allow epidurals until you are at least 3 centimeters dilated. You may be a little uncomfortable having it put in but it's worth while in the long run. Some patients opt for IV medications but these can affect the baby so an epidural is much safer. Some women think that feeling the pain is the brave thing to do and if that is their choice that is fine but I see no reason for anyone to be in pain. Having an epidural is better than suffering.
12. Do I have to breast feed my baby?
No one has to breast feed. Breast milk is good for the baby and if you have the patience to do it then I suggest mom to try. There is no harm though in not breast feeding. My babies were not breast fed and they were always healthy and had no problems from not being breast fed. It's whatever the mother chooses to do. Breast or bottle is fine.
13. Should I have my baby circumcised if it's a boy?
My advice is yes. I say this because as they grow into adulthood, they must keep themselves very clean or they can cause their partners to have infections. The foreskin must be pulled back and cleaned thoroughly or there will be infections. There is nothing wrong with not being circumcised as long they are taught as they are growing up to keep themselves clean.
14. What happens when I am admitted to the hospital and I'm in labor?
Expect to have several vials of blood drawn, and IV fluids started. If you are in a natural pattern of labor then you won't be given anything to help but if your labor is not consistent then as in an induction a drug call Pitocin will be added to your bag of fluids to help you along. You will be hooked up to a monitor that has attachments placed on your abdomen so that your babys' heart rate can be monitored as well as your contractions. You will see you nurse do a lot of charting as your labor progresses. Depending on your doctor, you may or may not be given an enema and it also depends on how far dilated your are. Some physicians also like for the vaginal area to be shaved or partially shaved. Some do not require this at all. If you have requested an epidural then when you are at least 3 centimeters dilated then you can have the epidural. If you prefer not to have an epidural then hopefully you have had classes to teach you how to breathe and what to expect. When you have an epidural you are asked to sit up on the side of the bed, leaning forward over the food tray with a pillow to help support you. You will be asked to bow your back out like a mad cat and to remain very still but to tell the anesthesiologist when you are having a contraction so he/she can allow you time to breath through it before he/she starts to stick you and proceed. Always tell them when you are starting a contraction so they will know when to stop doing what they are doing. If they are really good at their job then they should explain everything to you as they are doing it. It takes a few minutes to get this done and the longer you can be still the quicker they can get it done. Your nurse should be right there with you for support. When it gets time for you to deliver which means you are fully dilated to 10 centimeters, and your babys' head is right at the vaginal opening, then your nurse will put your legs up in stirrups, wash your vaginal area with betadine solution (unless you are allergic), call your physician and have all the instruments ready so when the physician arrives all he/ she has to do is deliver your baby.
Sometimes a patient has to an episiotomy which requires cutting the vaginal opening a little larger to allow the baby to deliver. The physician will then stitch that area up. There will be much massaging your abdomen also called the fundus to keep you from bleeding to much and also so the placenta will deliver. A nurse will take your baby to a warmer and make sure all is OK and give you the baby to hold and bond. If you are breast feeding then if you feel like it then you can go ahead an attempt to breast feed. Don't be disappointed if your baby does not take to the breast the first time. Remember your baby has just had a traumatic experience from being in a nice warm womb to coming into a cold world. So be patient as sometimes this takes time and much patience. Once you have delivered and your bleeding is under control and you have urinated on your own then you will be taken to a post partum unit for the rest of your recovery.
As a last word, always remember any question is just a phone call away. Don't hesitate to call your physician or a nurse at the hospital in Labor in Delivery for ANY question no matter how trivial you may think it is. Always carry a list of any medications you are on and anything you are allergic too whether it be food, medicines or latex.
My experience as a Labor and Delivery Nurse.
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