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Smokering's Long List of Unsolicited Childbirth Advice

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#1 ·
OK, so this is the email I sent my friend. She did appreciate it, despite the length and goriness! Some of it's NZ-specific, I'm afraid, in terms of hospital policies and such.

For context: she's Emma, her husband's Sam, first baby, birthing in the hospital, and she had false labour one night a week or so ago.

Smokering's Extensive List of Unsolicited Childbirth Advice

Early Labour: You've experienced a bit of this already. Basically, it's pretty similar to period cramps. So do whatever you do for those - bath (not if your waters have broken), shower, hot wheatie bag, Panadol (not Nurofen or anything, sadly), back massage. And distraction. The longer you can labour at home with your mind on other things, the better. I watched Blackadder in early labour with Miles! Don't waste all your energy mowing the lawn or anything, but try not to think about it (I know, easier said than done!) Sleep if you can. Denial is your friend. :p

Once you get to the hospital, you'll have a lot less to distract you; which is why staying home is good. But you can even take a laptop with DVDs, or an iPod with music (or Hypnobabies tracks!) to the hospital if you want to, in case things slow down and you want distraction. But generally, by the time you go to the hospital you won't be able to concentrate on much else anyway.

If you have raspberry leaf tea on hand, early labour's a good time to chug down a big batch of it. It's supposed to shorten labour and make contractions more efficient.

DO stay hydrated. I didn't with Rowan - didn't feel like drinking - and got really exhausted, which slowed down labour, which only perked up again when I got some IV fluids. But IV fluids are no fun. Don't drink tons of plain water, it'll put your electrolytes out of whack. Sports drinks and coconut water are good if you can stomach them; ginger beer will either make you feel better or worse!

Like I said, take snacks. You might not want them, but it might keep Sam going so he doesn't have to leave your side to forage for food! Also, take along prunes/prune juice or dried apricots or something. You do NOT want to be constipated after giving birth. You really don't.

Take fluffy socks as well. Some people get cold during labour. Or really hot. :p And take a hairtie, because having hair in your face during labour might feel like the most annoying thing on the planet. Also, pack the camera! And massage oil.

You might find yourself vomiting or diarrheal during early labour. It's just your system clearing itself out.

Later on in labour: For me the most valuable thing I learned between births #1 and #2 was not to suffer through contractions, or let them passively happen to me, but to actively welcome them in a 'Bring it on, let's get this thing moving!' sense. This doesn't happen naturally; they hurt, so you want them to stop and go away. But the only way out is through, and they'll hurt a LOT less if you relax into them instead of tensing up and fighting them. It takes practice (Hypnobabies helps with that, especially the 'relax' cue).

I used mantras to tell myself during labour, cheesy as it sounds. Things like "That contraction's over and I never have to do it again", or "This next contraction brings me one step closer to meeting my baby", or "I did the last one and I can do the next one." I actually wrote them out - I considered writing them in pen on my arm! And they helped. It made me feel proactive rather than victimised, if that makes sense.

Tension works against contractions. Even though they're called 'contractions', which sounds tense, and the uterus itself does tense up, the whole point is to relax (dilate) your cervix, so tensing up defeats the purpose of the contractions. So it's important to be as loose and relaxed as possible during contractions to let them be the most efficient (and least painful) they can be. Think about getting a cramp in your leg - tensing up further doesn't help, you have to consciously relax and loosen up the tense muscle to fix it.

The easiest way to do this is to keep other parts of your body loose. It's hard to go 'OK, I'm loosening my cervix now', because what does that even feel like? But you can consciously loosen your jaw - drop it open like you're trying to pop your ears, say 'Aaaahhhh' or moan in low tones or sing if you want to. You can consciously loosen your wrists by flapping them. You can loosen your hips by swaying and rotating them like slow-motion bellydancing. You can loosen your shoulders by dropping them and getting Sam to massage them. And if you loosen the rest of your body, your cervix will loosen too. (Ina May Gaskin is really good on this - it's in the second half of her Guide to Childbirth). You might look and/or sound like a bit of a nutter, but that's fine. :p

Also, a really good way to keep loose is to laugh. If you can find humour in labour, that's great!

You might find you feel more comfortable labouring in a small, darkish, private space - like on the toilet with the lights off. That's a very normal, mammal-y response to labour. Make sure you don't have doctors poking their heads into your room every ten seconds - most midwives are good about preventing that.

You'll probably find you lose all sense of time in labour. It's good not to watch the clock, but you might find it helpful for Sam to put an alarm on his phone reminding you every hour to have a drink (and take a cal/mag tablet if you want to). Don't worry about how long labour seems to be taking; you might find out later it has very little relationship to the actual passage of time anyway! With Rowan I felt like I was in labour for days and pushing for five minutes - in reality, labour was a lot shorter and pushing was a lot longer than I realised. You can go into quite a surreal headspace. That's OK.

Massage on your lower back can be really good for pain relief. Another thing that often, weirdly, works is called 'chunging' or 'shaking the apples' - get Sam or the midwife to firmly shake your bottom and hips during a contraction. It helps keep you loose and kind of distracts from the pain (you know how you shake your hand vigorously when you hurt it?); I think because the spinal cord can't process too much info at once.

Listen to your body about hunger. You probably won't feel like eating, but then again you might. Ice chips can be good too. Be prepared to feel hot and cold - you might want a searing hot wheatie bag on your lower back for pain relief, and a cold wet cloth on your forehead at the same time. Sam's job is to be prepared to offer either of these things at a moment's notice. :) Sipping through a straw often feels better than drinking normally, and someone else can hold the cup if you're in a weird position.

If there's no reason to believe the baby's in distress, ask the midwife to monitor you intermittently with a handheld Doppler instead of strapping you down for 30-minutes-at-a-time tracings, which don't allow you to move around. You can even get Dopplers that work underwater if you're in the tub. She can hold the wand to your tummy while you sway or kneel or do whatever you want.

It's up to you whether you want to avoid internal checks. Personally I hate them - I find them really painful and they make me tense up. Some people like to know how far along they are, though. That's fine, just remember it's not predictive - you can be 3 cm dilated and give birth ten minutes later, or 9 cm and be in labour for another five hours! Labour doesn't necessarily progress at an even pace. Plus, especially if your waters have broken, internal checks can just be a potential way to introduce infection. I'm planning to refuse them unless there's a good medical reason for one; not saying you should, but it's something to think about/research.

Transition: This is the end of the contraction stage. It's where things get really intense and you feel shaky and often start feeling out of control and 'I can't do this any more'ish. You'll probably recognise it after the fact. :p It means you're close. It might pay to warn Sam about this stage in advance, so if you get angry at him or wildly upset he won't freak out.

Some women actually have a 'safeword' for labour. They want the freedom to moan things like "I can't do it, I want the epidural!" without actually being offered one; so their husband knows it's only if they say the safeword (something random like 'aeroplane') that they really mean it and want the anaesthetist called in. It can be a handy strategy for fix-it type husbands who aren't good at soothingly saying "I know, you're doing great".

At this point, or even much earlier, you might abandon all sense of modesty and strip naked. The midwife has seen far worse.

Pushing: Pushing's not as alien a sensation as you might think: it basically feels like you're going to poop the baby out. Seriously, you will expect the baby to come out your bottom. This is normal. :p

Most women have a strong 'foetal ejection reflex', aka the urge to push. It's incredibly intense and irresistible - the best way I've heard it described is 'throwing down' - like 'throwing up', but in the other direction! So don't worry about knowing how to push - it'll happen.

The important thing is to give your tissues time to stretch, to avoid tearing. The best way to do this is to avoid 'purple pushing' - the kind of "OK, push while I count to 10" coached pushing they do in movies. (Again, NZ midwives are pretty good about this, so if they ask you to do it it's probably for a good, the-baby-needs-to-come-out-now reason.) Don't try to push, just go with it when your body does. And if it's happening too fast, pant through it a bit to make the pushes weaker. It's called 'breathing the baby out' - you want it to be born a little bit at a time, even slipping back a bit between pushes, like a tide coming in. That way your tissues will stretch and thin gradually.

I also really recommend pushing in an upright position, if you can. Kneeling, standing (supported), even hands-and-knees. Remember your pelvis isn't a single bone, it's four bones joined together by stretchy ligaments that get looser during pregnancy, so you can alter their diameter a lot depending on what position you're in. Being in an upright-ish position gives you 30% more pelvic space, which is really handy! There are times they may need you to give birth in a certain position depending on the baby's position, but aim for upright if you can. And in fact, a lot of mothers find that during the pushing stage they instinctively want to be upright.

Placenta: Once the baby's out, the placental (third) stage comes next. Pushing it out is generally a breeze compared to pushing out the baby, because it's squooshy and doesn't have bones, so don't worry too much about that! You can manage the third stage with a shot of Syntocinon or wait for the placenta to come by itself. Because this is your first baby, the afterpains probably won't be too dire either (lucky you!)

You can ask to have your placenta wrapped and frozen to take home, if you want to plant it under a tree or whatever. Otherwise they'll chuck it out after inspecting it autopsy-style (which I find fascinating; if you find it gross, don't look!)

Postpartum Grossness: Sorry, this gets a bit graphic. :p

For the first few days of bleeding, wear two pads. (They provide 'em for free at the hospital and birth centre.) And don't be surprised if you pass some scary-looking chunks of dark purplish... stuff. You can save them to show your midwife if they're huge and you're worried, but they're probably just chunks of uterine lining. Can be unexpected and disconcerting, but not painful.

You might notice afterpains or gushes of bleeding when the baby nurses. That's because it's all hormonally linked, and it's a Good Thing.

Like I said, you do NOT want to be constipated after giving birth. Prune juice, magnesium, whatever you gotta do.

If you have any tears or even 'skid marks' (tiny microtears), going to the bathroom can feel really raw and stingy and painful. Best thing is to pour warm water over yourself to dilute the urine - some people take a small jug or something to the birthing centre for the purpose.

If you had a long pushing stage you might look horrifically, scarily swollen down there. Don't panic, it's temporary!

Day 3 postpartum is one to watch out for. You have massive hormonal shifts, your milk (sometimes) comes in, and you tend to get the 'three-day blues'. Weepiness and the like. It's not fun, but it IS generally temporary. Make sure you're taking zinc and fish oil and vitamin D and all those mood-supporting things. And do as much skin-to-skin bonding with the baby as possible - Sam too. Releases oxytocin all round and helps with breastfeeding and temperature regulation and all that jazz.

Some women feel really energised after birth. I was not one of them. :p Even if you are, though, don't overdo it. Pretend to be a languishing Victorian matron for a good month or six weeks after birth. Overdoing it can massively increase your bleeding and/or make you faint (ask me how I know!)

I recommend looking up belly-binding. It's really good for after birth when your tummy feels empty and floppy and weird; it kind of keeps everything in place, and can help your uterus shrink back to size quickly as well as helping you get your shape back. There are different ways you can do it, from official (expensive) postpartum girdles to strips of fabric wound round and round your tummy. I did it both times and will definitely do it again.

The Baby: Swaddling is amazing. The baby's been cramped up for several weeks, and is used to moving its limbs in water. Being able to move them freely in air is a huge shock to its system, and tends to make the baby panic. Being firmly swaddled makes the baby feel like it's back in the womb, which it will find comforting. So don't be afraid to snug it up good and tight! The nurses/midwife will show you how if you need help.

Whitish vernix all over the baby is normal - good for the baby's skin, actually. So's blood and gore. You can wipe off any really revolting crusty bits without giving the baby a full-on bath, which it's best to avoid for a few days so the vernix can all be absorbed. Also, fair warning, the cord stump is gross. Sorry.

DO use disposables (free, provided by the hospital/birthing centre) for the first few days until the meconium passes. And do make Sam change the first few nappies so he can't go all "No, you're the expert, I don't know how!" on you later. :p (Plus, you might not want to get out of bed!)

DON'T let anyone tell you you're holding the baby too much. It's been in constant contact with you for nine months; cuddling it is the best thing you can do!

Also, don't feel guilty if you don't have the 'right' feelings when the baby's born. You don't have to fall in love at first sight. If your first thought is just "Wow, I'm glad labour's over!" that's fine; if you don't think your baby's the most beautiful thing to grace the planet, that's fine; if you find yourself thinking "Well, that was fun, can I give the baby back now and go home and resume normal life?", that's TOTALLY NORMAL. Honestly, I've talked to tons of women about this and for everyone who's gazed into her newborn's eyes and felt an overwhelming rush of love, there's someone else who gazed into her newborn's eyes and thought "Man, I could really go for a curry about now", or even "Crikey, this thing looks like an alien."

Oh yeah, that's another thing; you might be starving after labour. If you give birth at the hospital at an awkward between-meals time, that's where your snacks will come in really handy. Or ring me up and I'll bring you a pizza or burger or whatever you want, day or night. :)

Do feel free to limit visitors though, both at the hospital/birthing centre and after you go home. You can make a "No visits unless you bring food" rule, or a "No visits with small children" rule, or a "No visits in the afternoon when I'm napping" rule. Get Sam or your mum to enforce it. And if you have visitors, make them get their own cups of tea and for goodness' sake don't bake them biscuits!

Also, exploit the birth centre resources. They have on-call staff who will be happy to come into your room at 2AM to show you how to swaddle the baby, or help you diagnose why it's crying, or show you how to burp it or dress it or whatever. They have lactation consultants. You may as well get all the help you can while you're there. And they tend to be really nice and gushy about babies, which is kind of cool. :) They'll be like "Ooh, you need help dressing the baby? Fun!" Goes with the vocation, I guess!
 
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#2 ·
Smokering- I love this list! I completely agree that denial is your friend in early labor. When I was in labor with DD, I kept trying to convince myself that it wasn't really labor. I even finished the last 2.5 hours of my shift. Then I went home, told DH that I *might* be in labor, and that I was going to get a snack, and try to go to bed and get some rest. I was able to sort of doze between contractions. I think that not jumping right into "This is it! I need to start using my hypnobirthing techniques and get the labor music going!" helped me not get burnt out with labor earlier on, and possibly even helped labor along, especially since I was on my feet walking for the last 2.5 hours of my shift, which were the first 2.5 hours of labor.

I also completely agree with the "bring it on!" attitude with contractions. With DS, I think I was too focused on trying to make the contractions pain free, and I really feel that it stalled my labor. With DD, I focused on each contraction opening my cervix. I loved the mantra "I welcome this contraction; I welcome my baby."

Oh, and I totally didn't care about modesty, and was nude for both births. I think having a hospital gown on would really get to me by transition, and I would probably rip it off and shock the hospital staff. Good thing I have them at home.

The section on postpartum grossness is great, too! With my first, I was completely unprepared for the postpartum issues, and wish someone would've more prepared me for them, but no one likes to talk about them.
 
#3 ·
The section on postpartum grossness is great, too! With my first, I was completely unprepared for the postpartum issues, and wish someone would've more prepared me for them, but no one likes to talk about them.
I know, right?! I gleaned a few things from MDC before I had my first baby, but I was still quite unprepared for the ickyness of it all. It's not just like having a regular period. I can see why no-one talks about it, because it is pretty gross, but... some information's worth having, you know? :p
 
#4 ·
I appreciated this SO much, glad Fyerfly asked :) I've done a ton of research but especially the after birth section, no one wants to talk about it! My own mother just insists my body will "never be the same" and it's "Disgusting after" without any more information. The only time people talk about labor is if they had a really horrific birth, I've heard about so many 3rd and 4th degree tears and post-partum hemorrhaging. Then the pendulum swings in my natural parenting group there are many mother's who swear natural childbirth didn't hurt.

Thanks for sharing.
 
#5 ·
Here are icky details about my postpartum experiences- With DS, I had a small tear which MW rated as "first, maybe second degree." She gave me the option of having it stitched or not. I opted not. Partially because I'd been through a really rough labor, and couldn't stand the thought of something else being done down there. Also I hadn't thought to ask beforehand if she would use numbing shots or something in the case of stitching, and felt like after doing a 31 hour natural childbirth, it would look weak to ask. Which is a really dumb reason, but was there in my mind, nonetheless. I wish I would've gotten it stitched. Sex was very, very painful in that area for several months afterwards, and I think I would've felt better in a matter of weeks had I had it stitched. With DD, I didn't even have a skid mark. This was partially due to her being my second but I like to think that the perineal massage helped, too. Sex was completely comfortable again within 6-8 weeks.

Also, hemorrhoids. For some reason I just assumed I wouldn't get these, but I did. And I had no idea what to do about them the first time around. Using a perineal spray bottle after using the bathroom, and using wet wipes to gently cleanse around any bulging tissues is much, much better than toilet paper. Also, going in and re-cleansing the area when it starts to sting, as it usually seems to sting when there is a small amount of leakage that is sitting on the sensitive tissues, which will really hurt the longer you let it sit there. (Until the hemorrhoids shrink back down, you will occasionally have a little bit of leakage.) Also getting your finger wet with cold water and gently pushing the hemorrhoids back inside after a BM pushes them out can be a great help with the pain too. Keep your stools soft with stool softeners to decrease the likeliness of hard stools. Hard stools passing by hemorrhoids will cause you to use your natural childbirth coping techniques again, because it hurts, and can tear the hemorrhoidal tissue, which is painful and will bleed.

I didn't think the bleeding was too bad, compared to those 2 things. Hopefully it wasn't TMI, but when discussing how to deal with postpartum issues, I think the typical problem is not having enough info, so there you go.
 
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#6 ·
@Smokering thanks for sharing - great read!!! Along with the graphic-ness (which I didn't even find particularly graphic...but I'm pretty earthy and down with gross stuff - DH too - I bet he's going to be fascinated by the cord stump, that's my prediction), there is your usual humor - I thought my favorite line was: "Pretend to be a languishing Victorian matron..." but then you hit me with "Crikey, this thing looks like an alien." I'm still chuckling. Mostly because I can totally imagine that happening.

Glad you mentioned the dark purplish chunks - might be weird but I'm super intrigued at the thought of seeing what the uterine lining looked like, aside from just normal menses stuff (read: it looks like blood, FyerFly). I guess the one thing I'm still unsure of is how much is too much (bleeding or whatever)?? I guess I'll just know?
@MnMtm nope, not TMI here :) thanks for sharing your experience with the tear/stitching - of course hoping that won't be an issue, but if it is, our doula already told us that our midwife is apparently amazing at stitching, and I know she'd use topical lidocane (I have it sitting right here next to me, to take with me to my 36w appt on monday). And the hemorrhoids....I can pretty much guarantee I'll be dealing with that, since I've already had them the last few weeks. Not painful, though, just hard to feel really clean. I've stashed perennial irrigation bottles in both our bathrooms (I find them easy/nice to use in the shower, actually), and tucks pads have been pretty awesome too.
 
#7 ·
Glad you mentioned the dark purplish chunks - might be weird but I'm super intrigued at the thought of seeing what the uterine lining looked like, aside from just normal menses stuff (read: it looks like blood, FyerFly). I guess the one thing I'm still unsure of is how much is too much (bleeding or whatever)?? I guess I'll just know?
The uterine lining thing is pretty interesting, in an icky kind of way. The best way I can think of describing it is flattish chunks of liver crossed with jelly. Thicker than you might expect. I was chatting to a friend about it the other day (as you do!) and it turned out we both thought, at the time, that we were passing chunks of retained placenta or something. (Which of course is possible, and you should save any really huge or horrific-looking bits to show the midwife if you're worried, but she will have inspected the placenta for missing bits after the birth, so it's probably just... chunks.)

I'm not sure about hard-and-fast rules for bleeding after birth (in terms of pads-per-hour or whatever)... I think my MW asked me how many I was going through, last time? They're generally pretty good about watching you to make sure you don't look pale and faint, and they'll probably palpate your stomach to make sure your uterus is shrinking nicely, not 'boggy'. Again, it's an 'ask if you're worried' thing.
 
#9 ·
So interesting, it seems to be a repeating question in my natural parenting group of how long post-partum bleeding is "supposed" to last and given everyone's answers I really think it varies so extremely between women and even pregnancies there isn't really an average time.

I think MnMtm suggested in another thread just switching to wipes altogether instead of TP and I found when I did about 4 weeks ago bathroom trips have been MUCH more pleasant. No hemorrhoids yet. *knockonwood*
 
#10 ·
I finally got around to reading this and enjoyed it.

I have a tip for back labor! I leaned over on my bed and pressed my butt against the wall. It felt SO nice. And made me laugh as I felt like I was a cat getting my butt scratched or something.

I agree completely with the bonding stuff. I was super duper exhausted after having my first that I was just relieved the whole thing was over. I had been up for 26 hours after running on 3 hours of sleep. I do not recommend that at all! I was too excited to sleep when my water broke though and just never got another chance.

Besides my first baby, I'm definitely one of those energized by birth. I probably do not take it nearly as easy as I should. It's all too exciting!

One thing I like to warn people about is to be prepared for extreme thirst everytime the baby latches on. I am rarely hungry in the days after giving birth, but so, so thirsty.

Oh! And don't be too surprised or disappointed if you poop yourself while pushing. It happens.

And finally, I am contracting just reading about all of this! Babies are coming soon!
 
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