But nothing makes me more upset than hearing the delivery tales of terror from friends and family that come to *support* a laboring woman. Let me explain.

If you’ve ever been pregnant, you’ve heard the horror stories of painful deliveries, epidural mishaps, and awful labor experiences. Some of these stories are solicited, but most of them are shared spontaneously and without provocation. 

Don’t get me wrong. Sharing your bad experiences with your provider and birth center or hospital is essential and can improve future women’s outcomes. Birth trauma is very real, and I strongly encourage women to discuss their experiences with people to help them debrief and recuperate.

But the delivery room of your daughter, sister, friend, or cousin is most definitely NOT the place to recount your experiences.

I’ve heard birth stories of 4th-degree tears while pushing with a patient. I’ve heard about the agonizing back pain after receiving an epidural ten years ago while an anesthesia provider is preparing to insert an epidural catheter. I’ve listened to women drone on and on about being in labor for five days before finally ending up in an emergency c-section while I’m preparing a woman for induction of labor. 

I’ll tell you what I’ve never heard. I’ve never, not even once, listened to a support person talk about a positive birth experience while their friend or family is laboring 10 feet away. It’s as if every birth story has to have some dreadful or terrifying aspect. And like any good fisherman, a woman’s birth story always seems to become more hair-rising and more heinous with every retelling.

What validation do women receive by talking about these experiences while in someone else’s labor space? Is it cleansing for women to discuss their induction, contractions, labor, delivery, and pain while the laboring woman is anxiously experiencing their own birth story? Not to mention the older women recounting how “back when I had my babies…” Believe me when I tell you that obstetrics is continuously evolving and practices that were standard even five years ago are now obsolete. So your birth story from 30 years ago will probably not be relevant or helpful.

If you have the privilege of being a support person for a laboring woman in the future, check your birth story at the door and ask yourself three simple questions:

Is my birth story helpful?

Will the retelling of your experiences enhance or inhibit the labor experience? If someone told you this story while you were in labor, would it have helped or hurt you? While your family member is barely breathing through contractions, will your birth story help her cope with the pain?

Is my birth story hurtful?

Again, if your birth story will in some way demean, demoralize, or hurt in any way, don’t share it in the labor room. Will your birth story cause unnecessary fear? Don’t assume your experience was superior, and don’t tell a woman that her labor or delivery is doomed because of your own personal hurts or trauma.

Is my birth story true?

Have you embellished certain aspects of your birth story to make it seem like you should be receiving some medal of honor for enduring the impossible? Would your partner tell the same birth story if you weren’t around? So many labor and delivery stories are mundane and uneventful, and maybe it is human nature to have some fantastical element included in the birth of your child. But mundane and uneventful deliveries are the very best kind, so please don’t feel the need to recount your “fisherman” birth story at another woman’s delivery.

Lastly, please know that I want to hear all about the funny, good, positive, and crazy experiences you may have had during your pregnancy. Humor truly is the best medicine. 

And you should always confront the healthcare team about concerns or questionable practices. Just maybe leave the birth horror stories for the postpartum room 🙂

This article was contributed by MacArthur Medical Center’s Certified Nurse Midwife Jen Rockhold.

The post When You Shouldn’t Share Your Birth Story With a Pregnant Women appeared first on Medika Life.

One proven way to promote labor progress is to change positions frequently, as in every 20–30 minutes. Frequent position changes and movement during labor can help decrease pain perception, facilitate fetal descent into the pelvis, enhance the birth experience, and promote labor progress.

With all of these advantages, why are so many women laboring in one position for hours at a time? In a word, convenience.

Certain positions allow for continuous fetal heart monitoring making this convenient for nurses, and some women are more comfortable in one position after being in labor for several hours making it convenient for women.

Labor is hard work, but frequent position changes can make the difference between progress and prolonged labor. In addition to promoting movement during labor, intermittent auscultation is a great way to allow women to move frequently and unencumbered during contractions.

The American College of Obstetricians and Gynecologists (ACOG), the American College of Nurse-Midwives (ACNM), and the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) all recommend intermittent fetal heart rate auscultation for low-risk women during labor.

Over 60% of women receive an epidural or spinal during labor, but frequent position changes are still necessary and possible after receiving an epidural.

Most hospitals require continuous fetal monitoring after epidural placement, though this should not interfere with frequent position changes.

Here are five labor positions to promote labor progress, with or without an epidural.

1. Walking or Upright Positions

With current practices to decrease exposure to the coronavirus and other viral illnesses, women cannot walk the halls in most hospital systems. However, women can walk, lunge, and stand in upright positions in their labor rooms.

Walking uses gravity to help the fetus to descend into the pelvis and rotate into position for delivery. Walking and lunging enhances the effectiveness of contractions and can decrease pain perception.

After an epidural, women can sit in an upright position with the bed’s foot lowered to allow the pelvis to open. Note, this position cannot be maintained for longer than 20–30 minutes as it may decrease the effectiveness of the epidural.

2. Peanut Ball

Using the peanut ball during side-lying positions opens the pelvic outlet and encourages fetal descent/rotation within the pelvis. This body shift is especially helpful for babies that are in a persistent occiput posterior position.

Rotate from side-to-side while using the peanut ball to really promote labor progress. Women that receive an epidural should be encouraged to use a peanut ball or other positioning aid during side-lying positions for enhanced labor progress.

3. Squatting

Squatting can decrease pain during contractions, open up the pelvis, and allow the perineal muscles to relax. Squatting can be done on a birthing ball, sitting on the toilet, sitting on the bed, or with the help of a birthing partner.

Leaning forward while squatting enlarges the pelvic outlet and can promote fetal descent. After an epidural, women can sit upright with the bed’s foot slightly lowered and the legs positioned in a natural squatting position.

4. Hands and Knees

The hands and knees position during labor can decrease back pain and can significantly increase the pelvic diameter. Women in the hands and knees or knee-chest position can move freely and adjust their weight for comfort.

This position is similar to squatting and allows birth partners to perform back massages, hip squeezes, and counter-pressure on the lower back. Leaning forward on hands or elbows will enable women to rest in between contractions, which can be ideal during the pushing stage.

The hands and knees position can be modified for women with an epidural, though most women will need help in rotating to this position and maintaining continuous fetal monitoring.

5. Asymmetrical Kneeling

While in hands and knees or in a forward kneeling position, bring one leg up. This movement is similar to using the peanut ball but in an upright position, optimizing contractions’ strength and opening the midplane pelvis.

This position uses gravity and pelvic rotation to enhance labor progression and fetal descent. Asymmetrical kneeling can be done after an epidural with a birth partner or nurse’s assistance to maintain safety.

These positions are safe and effective, though they may not be appropriate for every woman. Discuss labor position options through the shared decision making and be open to suggestions.

Remember, the most important position during labor is one of patience while trusting the process!

The post 5 Labor Positions to Help Your Baby Come Out appeared first on Medika Life.