Doula hired! (A few more questions for you...)

[ourbabygirl]

Thanks to everyone for your advice to go ahead and get a doula, even though it's late in the game (I'm almost 38 weeks)! I set up 4 interviews last week but was really happy with the second person I interviewed, so I hired her and met with her again yesterday. :thumbsup:

Anyhow, I still have a few questions for those of you who've gone through this before...

1. WARNING, (possible) TMI:

Today I noticed that I'm more sore 'down there,' almost like I'm swollen and kind of 'sticking' to my underwear. I'll mention it at my dr. appt. tomorrow, but I was wondering if any of you experienced this, too (I probably did a bit with my daughter, but don't remember). It just kind of stings and feels like something's caught in a zipper or on the sticky part of the pad or something. Anything I can do about it?

2. If you had an unmedicated labor & delivery, how tempted were you to ask for an epidural (or something else)? I had an epidural with my daughter, and while I really don't want to resort to it this time, I'm worried I'll give in to the pain right away (though I'm sure my doula will help me through it, as I didn't have any extra support last time).

3. How much do the different 'positions' actually help during labor? I honestly can't even imagine myself being willing to squat on a birthing ball or walk around, lift my legs, etc. when I'm in so much pain. It just seems like moving around in different positions is the last thing I'll want to do, even though I know it will help me get closer to seeing my baby. Were there certain things you were willing and able to do, and certain things you refused to do because they would have been too painful?

4. I need to come up with an image and a phrase to help me focus (or at least distract myself somewhat from the pain during labor); any suggestions on a phrase? My doula suggested something with the "oooh" sound to help open up my cervix and bring the baby down. I'm at a loss for ideas...

5. How did you prepare yourself again for the lack of sleep? Last time I could just stay in bed when DD was a newborn and sleep when she slept, but this time she's a toddler and I have more responsibilities. :) Any tips on getting through those first few months?

6. Final question: Did you ever really feel 'ready' for the baby to come? I guess I'll feel that way if I go past my due date again, but part of me still feels like I'll never be ready and I need to slow down time to get everything done and ready for the craziness that my life will turn into.

Thanks for your help!

[brittone2]

I'm off to bed shortly, but wanted to say yes, moving helps. A lot, IME. My only times of strong discomfort with my labor with DS1 was when I was in bed getting EFM strips done intermittently. Doula played the bad guy role and got the nurse to hook me up so I could be on all 4s, kneeling, etc. Actually being *in* bed...yikes. Way uncomfy. Walking and moving-no problem. I did some tailor sitting, kneeling/all 4s, swaying holding onto DH's neck, sitting on the ball (did a lot of that while laboring at home before DD was born. Sat on the ball and listened to my hypnobirthing/hypnobabies CDs), etc.

There's truly an anatomical basis for some of those positions helping baby descend. For example, hands and knees can be great for back labor.

Penny Simkin is a PT that does a lot of childbirth stuff and she has good info on positions for labor:
http://transitiontoparenthood.com/ttp/parented/pain/positions.htm

eta: I used active labor positions with all of my kids. I am way more comfy moving than being still. Like, exponentially more comfortable.
I can also honestly say I never wished for the epidural. Maybe in transition with DS1, but with him I had a lot of rectal pressure right at the end that I did not have with the other two kids. 95% of that labor was totally, totally manageable. With the other two kids I don't think it even crossed my mind. I had a great support team and I really like labor, as crazy as that is.

[MoJo]

1. no idea

2. not at all . . . and I had a very good epidural with my first. Didn't even consider it for my second.

3. Hands and knees helped me a lot in early labor. After that, laying on my side as relaxed as possible was best. I was laboring on my own, so there was no refusal. . . I just did what felt right.

4. I focused on "opening" and the image of a flower blooming.

5. I don't think you can prepare much. If the toddler naps, you should too. I tried getting my husband to take the "late shift" so I could go to bed earlier, since he was awake anyway. It never worked for me, (he wouldn't do it) but you could ask. The main thing is remember that it's temporary.

6. Not really

[SnuggleBuggles]

1. Yeast infection? Could just be normal pregnancy swelling as there are so many more fluids in you now.

2. Never. My reasons for not wanting one held the whole of it. I didn't want the cascade of interventions the whole time. I also really and truly kept thinking if I made it that far I could certainly make it farther- why not? The hardest part is usually transition and the "I can't do it anymore! sentiment is common. But, that almost always means you are almost done! With ds2 I had about 5-10 minutes where I really didn't think I could do it but I wouldn't have chosen meds and they wouldn't have done a bit of good anyway! What was great was for both births my birth team (doula, dh and CNM with ds1 and just CNM and dh with ds2) were super reassuring . They told me I could do it- that I was, in fact, doing it! Just hearing that made a world of difference. Darned right I was doing it. I could do it!

3. Ds1 was posterior so there was no way that being in bed would be comfortable. My body cried out for me to change positions, like hands and knees, so I listened to it. If you listen to your body it will help you get in positions that feel better and will help the birthing process. With ds2 I spent most of my time tailor sitting on the bed or in the tub. During transition I walked and knelt, squatted- the works- b/c I wanted to find a position that was comfortable. Listen to your body. And read over pp's Simkin info!!

4. Maaaaa, ahhhhh, ohhhhh- those were the toning patterns that my yoga instructor taught me and I found them very helpful with ds2. Are they necessary? No. If they don't feel good to you in labor then don't worry. But, in the depth of labor they felt great for me. I focused on really taking long, deep breaths and really pacing out those patterns. High pitched, tight, panting type stuff in labor or "ow, ow, ow!!" just isn't helpful.

5. The goo thing about having another child already is that you have seen the light at the end of the tunnel. So, you aren't just taking people's word for it that it gets better and doesn't go on forever. You have been there, done that and you survived once! You can do it again! :)

6. So, both of my boys were past 41w. I was under time pressure with both if I wanted to avoid interventions. But, I still didn't feel ready with ds1. With ds2, I was fine and dandy till one day (maybe 10d past EDD?) and I asked to have an appointment to come in for membrane sweeping. The day before I had no desire for it! I finally hit the ready part. :)

GL!!!!!
Beth

[Momof3Labs]

1. Who knows

2. Had an epidural with DS1. With DS2, I did fine through 8 hours of labor and begged for an epidural at the very end - that's how they knew I was in transition, lol. The doula talked me through it and I'm so, so glad that she did.

3. About 1,010%. Moving isn't painful; moving relieves the pressure and helps you find a position that is more comfortable. I was so much more comfortable sitting on the ball leaning over the foot of the bed through my contractions - sure, they were still uncomfortable, but not painful like they are when you are laying on your back in bed. Keep in mind, too, that the pain isn't nonstop for the most part. You get breaks between contractions.

4. Music helped me focus. Enya, to be exact. I recall that DH had loaded a bunch of CDs, and Abba came on during a contraction. It was then that I realized how much it was helping to lose myself in Enya, and I ordered him to put Enya back on immediately, lol.

[AnnieW625]

1. sounds like a yeast infection. I had one at the very end of my pregnancy with DD2.

2. I ended up with an epidural with DD1 because my water was broken and my labor stalled so I had to have pitocin, and penicilin for strep b. I didn't get the epidural until an hour before I started pushing so I know I went through the toughest stages of labor un medicated. Transition that time lasted for a good hour plus. Not initially what I had planned but it made the birthing so much more tolerable. With DD2 I did not have an epidural. I had a really short transition, about 15 minutes, plus I didn't need pitocin, or penicilin.

3. Moving helped me a lot with DD1, but I was fairly comfortable with DD2 so I didn't need to move nearly as much.

4. Knowing the end was near both times helped me focus. Knowing I would be happy helped me too.

5. I didn't really prepare for the lack of sleep although I knew it was going to happen. I just went with the flow. With DD2 I was better about sleeping when she slept because at first because of reflux she wasn't a great sleeper at night.

6. I was ready both times. I was 37 w/5 d with DD1, and 38 w/6d with DD2.

6.

[daisymommy]

Sounds like the beginning of a prolapse to me (where the inside vaginal muscles bulge out under pressure, or it can be your bladder or rectal muscles from inside bulging out as well). It happens, but for the majority of women it will all go back fine after you have the baby. I would mention it at your check-up, as the only worrisome thing would be if it were a uterine or cervical prolapse.

I had an epidural with my first after 24 hours of labor, and come to find out I was at 9cm. and would have given birth within a very short amount of time. But I didn't know that. They did the epi, and THEN checked my immediately afterwards--how dumb. I was so mad. If someone had of just helped me through that last cm. I could have started pushing and skipped the epi.

With baby #2 I cried out for one when I was already pushing ;) It obviously would have been too late then anyway. But up until he was crowning, I had no desire at all for one. The pain just wasn't bad enough, totally bearable and manageable.
FWIW--I spent 2 full hours (out of 3) bouncing and swaying my hips round and round on the birthing ball to help baby descend. It felt so good!

With baby #3, never wanted one at all.

I agree 100% with the others: moving is the only thing that makes a natural delivery possible. If you're lying still, the pain will be intolerable. A doula will help you remember to move, and which positions are best for which type of pain (for example back pain).

My "happy place" in life and when I'm stressed is the ocean. I brought a beautiful picture of the ocean and used that to look at when I was in transition, and imagine myself there. That was baby #1.
With #2, it all went so fast I didn't need it.
With #3 I imagined a beautiful flower blooming & opening (it sounds so cheesy, I know ;)). And I was repeating to myself "ooooooopen, oooooopen" in my mind. And I swear I could feel my cervix opening wide open when I did that. Letting your jaw drop down, and those low moaning Ohhhhhh sounds will open up your body.

Try to get your toddler to still take a nap, then you can get at least 1 decent nap each day. If they won't, can you baby proof their room really well, and put a gate up with some toys, so you can at least lay down and close your eyes for awhile? I would also baby proof our living room, put up a gate, put in Baby Einstein, and let my toddler watch that while I took a cat nap on the couch. I wasn't really "out" but resting.

Yes, please slow down NOW and rest up for the big event!

Good luck!

[bostonsmama]

Our doula/birth instructor told us to moan or groan an "Ooooooooooouuut" or "Ooooooopen" when in the painful throws of transition b/c you can't yet push, but baby is making enormous head-way opening up/dialating that last lip of cervix. It's both a visualization technique as well as an anatomical one b/c keeping your lower jaw relaxed allows the muscles of the uterus to relax/not tense up. She even has a technique for breathing during transition contractions that includes a micro one-second push at the peak of those contractions as it keeps baby's head right against the cervix and won't cause the swelling that early pushing on a cervix that isn't fully dialated does. She also said that deep inhales work contrary to the down-and-out during transition breathing. Let the air naturally refill your lungs, then collapse your body around/over your abdomen and exhale long and fully. She has our birth partner guide us with the cue: "Inhale--hold it--ooooouuuut" until the peak (you'll see it on EFM) where we get the cue "inhale--hold it--tiny push--out all the way." This only works when you're like 9-9.5cm dialated in transition. Don't do it during active labor (4-7cm). Anyways, your doula will be a great help to you. You need to have it solidified in your mind why YOU want to avoid an epidural in order for there to be good motivation. No one can make decisions for you--and please don't beat yourself up if you end up with one. I'm trying to take that mindset. :)

You're gonna do great. Can't help w/ the rest.

[daisymommy]

You need to have it solidified in your mind why YOU want to avoid an epidural in order for there to be good motivation.

I totally agree. I had read so much on natural childbirth, and why to avoid an epidural, and I held all that in my mind when I was in pain. It really helped to tell myself "I do NOT want drugs going into my baby's system!"
I remember how good I felt right after DD was born, feeling that her little body had been kept clean of anything. It was all worth it.

*Note: there were countless other reasons I didn't want an epi, that was just the one that stood out in my own mind during labor. Everyone has their own reasons to hold on to.

[ewpmsw]

2. If you had an unmedicated labor & delivery, how tempted were you to ask for an epidural (or something else)? I had an epidural with my first DC and really wanted to have an unmedicated birth the second time. That was one of the biggest reasons we chose to have a doula. After a really long labor, that almost went out the window. I was sure I'd have an epidural when we got to the hospital. Having the doula's support during labor helped me wait to go to the hospital until it really was time (went too early last time) and I didn't have long to labor once we arrived. (Unmedicated birth.)

3. How much do the different 'positions' actually help during labor? Being able to labor in different positions really helped me get through the discomfort of labor. The doula was great about suggesting different positions and coaching me on breathing and comfort measures. Before this baby, I didn't really buy that a lot of that stuff would help when I was in pain, but it did help me to focus on laboring and moving the baby down and out rather than on the discomfort.

4. I need to come up with an image and a phrase to help me focus (or at least distract myself somewhat from the pain during labor); any suggestions on a phrase? My doula suggested something with the "oooh" sound to help open up my cervix and bring the baby down. I'm at a loss for ideas... The "ooohhh" really worked for me when I was moving into active labor and while pushing. I imagined the baby moving down with each contraction and kept telling myself, "This is moving my baby down and out. Down and out. Down and out..."

5. How did you prepare yourself again for the lack of sleep? Last time I could just stay in bed when DD was a newborn and sleep when she slept, but this time she's a toddler and I have more responsibilities. :) Any tips on getting through those first few months? I only have the 1st month under my belt, so can't offer much advice on this one, except to take it easy, let people help you, ask for help when you need/want it and try to get some time to yourself, if only a minute here and there. I have a toddler and some health issues, so we have a postpartum doula three mornings a week (for 8 weeks). She cares for our toddler and infant and does some light housework while I sleep. She was the doula who assisted at DD's birth.

6. Final question: Did you ever really feel 'ready' for the baby to come? Not the first time. This second time, I was SO ready. It's probably different for everyone. I thought that the mind-body connection thing everyone talks about meant that once I decided I was ready, my body would kick things into gear and baby would arrive soon after. It didn't work that way.

Best of luck to you, mama, and congrats.

[Uno-Mom]

#3 - YES! You know what helped me the most? Finally sitting down on the cold tile floor with my husband pushing on my back. Somehow the sensation of the cold tile on my legs made me focus differently. Oh...and using the birth ball was great. Especially bouncing and swaying on it.

#4 - funny story (in hindsigth).
My labor was ALL back labor which totally sucked! And it was emotionally hard for me because I couldn't feel a connection between my contractions and the birth process. Ahead of time I prepared myself to feel contractions in the logical place! KWIM?

So about 15 hours in, I realized what I needed. I ordered our doula to start saying over and over again: "back equals cervix ... back equals cervix...back equals cervix" when the contractions hit. Silly as it was, it made a difference. And, it made her and me laugh a little, which I badly needed. I really hope you don't need to borrow my mantra...

[american_mama]

In terms of moving during labor, think of it like when you are stiff after sitting in one position a long time, or waking up kind of stiff. You just know what parts of your body you want to move to stretch out, or at least you know what to try. Being in labor is like that... you'll think, "Lemme just sway, just hold on to DH and sway.." You'll try it and know if you're feeling better or not. It DOES help to learn about different positions beforehand, to open your mind up to what often works and to normalize it all. Real labor (not Hollywood labor), especially natural labor, is unfamiliar to most of us, which is why reading about childbirth, thinking, viewing movies, and talking to people all help.

I did ask about an epidural for my first birth, but my nurse helped me focus on here-and-now things I could do and I did not think about an epidural again - hard to believe now, but true. My sister had four natural births and asked for an epidural with her third; not sure why she didn't get one. So it happens regardless of the number of births, jsut as it also happens that you are entirely living in the moment and an epidural doesn't even cross your mind. If I was thinking about an epidural a lot in labor, trying to resist, I am sure I would just end up getting one. And that might not be bad - if I was thinking about it constantly, maybe getting one would have been the right thing.

[citymama]

Congrats on the doula hire. Between that and being at 38 weeks, you're almost there!

Anyhow, I still have a few questions for those of you who've gone through this before...

1. Swollen feeling: with DD2, I had a yeast infection at 38 weeks. You definitely want to treat it if it is one. But as PPs have said, there is so much more fluid retention and production that you just feel quite "engorged" if that's the right word.

2. If you had an unmedicated labor & delivery, how tempted were you to ask for an epidural (or something else)?
I had an epidural (under duress!) at 6cm with DD1 even though I really didn't want to. That was the beginning of my interventions, resulting in a c/s. In my case, I was 100% sure this time I did.not.want.an.epidural and you know what? I did not want an epidural - not at ANY point in the labor or delivery. The thought didn't even cross my mind. I can't explain it, but I was so focused on working thru the labor pain to get to the outcome I desired, that the idea of numbing it never occurred to me. And in my case, with DD1s birth I literally felt so numbed by the whole process that I wanted to feel and um, dare I say, enjoy, the birth of my second and most likely last baby.


3. How much do the different 'positions' actually help during labor?
Again, with DD2, I felt the whole labor and birth to be so much more organic - I moved when I needed to, I stood when I needed to, etc etc. My doula and DH were with me every second of it, and mostly just provided support or counter pressure under my direction or the doula's direction. Funnily, with DD1, I spent most of the labor in the shower. With DD2, I had no desire to do that, but I did squat over the toilet a bunch!

4. I need to come up with an image and a phrase to help me focus
Again, this is one of those things I might have thought of ahead of time but I was so focused on the moment that everything flew out of my head. I had brought focusing images, music, etc, but I didn't even think about them. I was in my zone in my own body and head and no advance prep really came into play - other than my body's memory of the first labor.

5. How did you prepare yourself again for the lack of sleep?
Sleep when the baby sleeps - a famous old adage that is absolutely true! I think I did that more the second time and allowed myself to rest, than I did the first time. DH took time off and my mom stayed with us - a huge help. If you haven't already got friends volunteering to bring meals, sign them up now! ETA: a huge difference with DD2 was we coslept - had her in our bed, which helped sooo much with the sleep. DD1 was in our room, but in a crib, and the getting up and turning on the light etc woke me up more, whereas with DD2, I just had her beside me and didnt need to get up or turn on lights, so stayed drowsy or even slept while she was nursing.

6. Final question: Did you ever really feel 'ready' for the baby to come?
With DD1 - she was almost 2 weeks late, and I was uber prepared for her arrival, so yes, I was ready! With DD2, I felt like a headless chicken and totally unprepared. I had a false alarm a couple of days before I actually went into labor, and those last 2 days I did everything I could do ready myself. It is def harder to feel prepared the second time around. And truthfully, we didn't have the car seat installed or co-sleeper set up before DD2's arrival, but you know what? We got it done before she needed to use them. It works out.

All the best to you in the home stretch!

[Tanya]

1. Well, I am swollen down there. I have a little discharge I guess, but I don't have the stinging or sticking feeling. I'm definitely swollen. I don't recall having that feeling with my previous two pregnancies, but maybe I did towards the end? I've had it for quite awhile this time, BUT I'm pregnant with twins. I had it early on when we went on vacation and I sat in the car for too long. Now I just pretty much always have it. I asked the OB about it a couple weeks ago (29.5 weeks) and he just said it's normal since I have so many more fluids in my body plus I was already carrying around 6 pounds of babies. He suggested a maternity belt, so you might try that for the swelling. I'd check with the doc about a yeast infection, etc. too though.

2. My first was back labor and it was miserable. It was my first time and I was sooooo afraid that if I told the nurse to stop offering pain meds that I might lose the chance of getting them or something...which was stupid. I should have told her to stop offering since it was so annoying. I about gave in to getting *something* when I was going through transition and my midwife convinced me that I was about there and ready to push.
For my second, I ended up with pitocin. Most of my labor was "easy" until transition, but I knew I was in transition and knew I could make it through a relatively short amount of time it takes for that.
I took a natural childbirth class and I visualized what was happening and that really helped me. Instead of fighting the contractions, I worked with them and breathed through them.
Everyone has a different pain tolerance and I'm one of the wimpiest, but I really didn't find it all that bad. I also went through so many shots/needles for infertility that I flat out didn't want a needle put in my back for an epidural and that was pretty good motivation for me.

3. Oh my gosh. I cannot imagine not moving into various positions. I would NOT have made it through back labor if I hadn't gotten on my hands and knees and had dh's thumbs pressed hard into my back. I tried a birthing ball and switching to various positions, but my hands and knees was the only thing that was tolerable. The nurse wanted me to get on my back to check me and I made one attempt and told her she'd have to figure out how to do it while I was on my hands and knees because she would never see me on my back. The midwife ended up having to check me because the nurse couldn't do it that way.
For my second, I walked and tried various positions just to get things moving along. I was in the shower and out. When the pitocin contractions kicked in, I went into whatever position felt better. Once again, I was never on my back. Back was uncomfortable.
Really, when you are in labor, do you really care what others think? I know I was MEAN to my nurse during back labor. I was a much more pleasant person the second time around. I just did what worked for ME.
Anyway, my midwife might have suggested/recommended certain positions, but in the end, I did what felt best to me. For my first one, I labored on my hands and knees for hours and hours, but my midwife suggested getting on my side to push and it took me awhile, but I did get there and that's how I finally pushed my daughter out. For my second, I was already on my hands and knees and my midwife said I could stay that way to push or come up onto my knees or a partial squat, so I did. They never wanted me on my back or tried to really get me to change.

4. I don't know what sounds I made. They were just from instinct. I visualized my uterus how it was a big huge muscle working the baby down. I pictured what it would look like when contracting. Then I kind of visualized a turtleneck and how the baby would work its way through there. So, when I had contractions, I would just picture how it was all working and I wouldn't fight the contraction, I'd work with it. It's hard to explain. I think there's a big part of us that panics at such a strange feeling happening inside of us and we tend to tense up and fight the discomfort of it. It's so much easier to just work with it.

5. Haha! I'm horrible with lack of sleep. Dh helps a lot. He knows when I'm about to lose it and have a breakdown and he knows to just take the baby and walk her. I guess I was somewhat fortunate in that my first daughter was my high-needs baby, so I didn't have another little one to deal with too. My second daughter was "easier" and my first daughter was already in preschool then, so it gave me a little break from having two to deal with. Dh always helped at night as much as he could (since I was breastfeeding)...which should be ummm interesting with twins, I may not get a break. We gave up trying to have our babies sleep elsewhere and just put them in our bed since I'm all about getting as much sleep as possible. Oh, and I'm not a napper. I just never have been, so I never really slept when the babies slept.
At least we know the lack of sleep wont' go on forever.

6. I was much more prepared the last two times than I am now. I'm annoyed that we are still in this house without enough room and I'm just not working at getting things ready. My youngest doesn't want to give up her bed (crib made into toddler bed) and sleep with her sister and I don't want to disrupt what has been working (co-slept until she was over 3). It seems so much harder not knowing when to expect twins too and overwhelming to think about going grocery shopping or taking my 4 year old to preschool or whatever. I thought I would have done more in the 2nd trimester, but we were so busy. Now, I'm in the 3rd trimester and I get tired so much more easily that it's hard to get things done.