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The Birth & the Hospital

Your big day is finally here! With so much to do and so little time to do them, we’ve put together some helpful checklists, must-haves and quintessential essentials to make your trip to and from the hospital as smooth as possible.


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5 Truths about Labor You May Not Have Heard

Hee-hee-hee…huh? You’ve seen the birth class video and practiced your breathing, but there are still some things about labor that might surprise you (in a good sort of way). Moms deliver the real deal.

1. The best patient advocate is you. "The person administering my epidural just wasn’t getting it right," recalls mom of one Elizabeth Deveney-Frazier of Cohasset, Massachusetts. "I could feel the needle, feel the pressure—all the things they say you aren’t supposed to feel. I spoke up and requested someone else. You can’t worry about being that patient when it’s your well being and your baby’s."

2. You can’t control your baby’s arrival, so relax! "I had this long list of things to get done right up to my due date, and I had it in my mind that I would finish," recalls Marie Alfonso, a mom of one in Brooklyn, New York. "Then my water broke during a staff meeting, which wasn’t part of the plan!" Try to have tasks finished up well before your due date. The more well-rested you are when you go into labor, the better.

3. Labor: the toughest job you’ll ever...sleep through. Contrary to what you may have seen in the movies, labor isn’t all agony, all the time. "After my epidural, I had a completely pain-free labor," says Marina Daly, a mom of one from Tampa, Florida. "The entire process was 10 hours long and I spent it napping and watching the Food Network. The nurses actually had to wake me up when it was time to push."

4. You can always change your mind—and meds. "Both my mother and mother-in-law told me natural childbirth was a beautiful thing, so I gave it a try," says Lorra Brown, a mom of two from Ringwood, New Jersey. "At first I worked through the pain with breathing and relaxation techniques, but hours later, I went for the epidural."

5. Bonding can happen anytime. "After I had a c-section, I couldn’t hold my baby right off and was worried I’d missed my chance to connect with him," says Lynn Whitlock, a mother of two from Minneapolis, Minnesota. "A few hours later the nurses brought him to me, and there was that click. The delay didn’t matter—it was still a great moment."


Packing For The Hospital: What To Take

Don’t leave home without these little essentials that can make a big difference.

I’m glad I remembered to bring:
"Magazines," says Tia Secor, a mom of one in Salt Lake City, Utah. "I was induced but was in labor for 14 hours, most of it with an epidural. The reading material was great to have in between visits from family members."
I wish I’d remembered to bring: "A hair elastic. I didn't pack anything to keep the hair out of my face during labor, which is funny because I keep hair clips and elastics everywhere at home. Must have been pregnancy brain!"

I’m glad I remembered to bring: "My fluffy bathrobe," says Tracey Blackman, a mom of one in Hartford, Connecticut. "Being in my own robe at the hospital was comforting. And it was nice to look decent with family popping in and taking pictures."
I wish I’d remembered to bring: "Slippers. The hospital socks they give you with the little nubby things are so scratchy, they twist all around on your feet, and are just blah!"

I’m glad I remembered to bring: "My pedicured toes!" says Lisa Bedford, a mom of two in Phoenix, Arizona. "With my first, I’d look at my toes while I was pushing and thinking, ‘Wow, I hope no one notices my feet.’"
I wish I’d remembered to bring: "Dried fruit, a tasty way to get my digestive system to start moving again."

I’m glad I remembered to bring:
"Extremely large underwear. Huge!" says Stephanie Callaway-Sifuentes, a mom of one in Dallas, Texas. "After you give birth you have to wear a gigantic pad, and the hospital’s mesh undies aren’t that fabulous."

I wish I’d remembered to bring: "A sleeping mask, or even a scarf to wrap over my eyes. They tell you to rest once you have the epidural, but all the flashing lights and activity keep you awake."

I’m glad I remembered to bring:
"Wet wipes," says Lauren Mackiel Gory, a mom of two in Little Falls, New Jersey. "I was very sensitive after giving birth, and wipes were way better than toilet paper."

I wish I’d remembered to bring: "My favorite lotion. The hospital soaps and sheets are on the rough side and it can get chilly, both of which dry skin."


I’m glad I remembered to bring: "A pair of comfy pants to go home in," says Desiree Wolfe, a mom of one in Las Vegas, Nevada. "You’re larger than you think you’ll be when you leave the hospital, but I felt fine in soft, elastic-waist pants."

I wish I'd remembered to bring: "An iPod. It would have been a way to deflect family who dropped by to chitchat. I love them, but it was like, Look, I’m in labor here!"


Mom-Approved Hospital Bag Checklist


What to Pack for Dad


Hospital Games


What's in your birth bag?

When prepping for the hospital, some people tend to pack like they're moving to another country. Other people might only bring along their husbands. Either of those extremes is probably not the best idea, so, with that in mind, here are a couple of checklists you might enjoy. Take a look — there might be something we've thought of that could be useful for your big trip.

So — what do you want in your Birth Bag?

The basics: you've probably already thought of these, but...

  • Admission forms/papers
  • Baby name book
  • Camera and/or video camera
  • Film and tapes
  • Cash
  • Phone/phone card
  • Charger for your phone (don't forget this one)
  • Gift for a sibling
  • Health insurance card
  • Pregnancy/birth reference book
  • Birth plan (if you have one)

Additional items to consider for labor:

  • Birth ball
  • Facecloth from home (maybe with a distinct color or pattern, so it doesn't wind up in the hospital laundry)
  • Hot water bottle
  • Lollipops and hard candy (for dry mouth)
  • Lotion and/or powder (for massage)
  • Massage/aromatherapy oils
  • Tennis balls (for back massage)
  • Watch or stopwatch (with a second hand for timing contractions)

Additional items to consider for the comforts of home:

  • Books/magazines
  • Small cooler with drinks and snacks
  • CD/audio player
  • CDs
  • Extra pillow (maybe with a colored pillowcase, so it doesn't get into hospital laundry)

Additional items to consider for your partner:

  • Change of clothes
  • Snacks
  • Reading material

Additional items to consider for after the baby arrives:

  • Address book
  • Baby book
  • Thank you cards/notes
  • Large bag to bring home gifts and hospital supplies
  • Phone number list

Additional items to consider for clothing:

  • Bathrobe
  • Loose, comfortable outfits
  • Nightgown
  • Nursing bras
  • Nursing pads
  • Slippers
  • Thick socks
  • Underwear

Additional items to consider for personal care:

  • Barrettes/hairbands (ponytail holder)
  • Body soap
  • Brush/comb
  • Contact lens case/lens supplies
  • Dental floss
  • Deodorant
  • Earplugs
  • Eyeshade
  • Facial soap
  • Glasses
  • Lip balm/ChapStick
  • Lotion
  • Makeup/cosmetics
  • Maxi-pads
  • Mouthwash/breath mints
  • Prescription medications you're taking
  • Shampoo/conditioner
  • Toothbrush/toothpaste

Additional items to consider for the baby:

  • Approved car seat
  • Diapers for the trip home
  • Going-home outfit
  • Hat/cap
  • Receiving blankets


Cervical Dilation From 1 10: Are You Ready for Delivery?

hospital bed

By Jeanne Sager, Cafe Mom

When you're pregnant, a whole new part of the English language opens up. Suddenly you're obsessed with placentas, trimesters, and sussing out whether you should go with a sonogram or an amniocentesis to determine baby's gender. And then you hit the ninth month of your pregnancy, and a new term pops up: cervical dilation.

It refers to the opening of the cervix, the part of the body that separates the uterus from the vagina, and according to Dr. Robert Atlas, an OB/GYN at Mercy Medical Center in Maryland, dilating is part of the body's way of getting ready for delivery.

"As you get closer to term, the body knows to start contracting and opening of the cervix begins," he explains.

Moms have the option of whether or not they allow their practitioner to check whether or not you're dilating -- a process done by putting the hand up the vagina and feeling the cervix to determine whether it has begun to open.

If you allow it, your doctor or midwife will describe a dilated cervix with a series of numbers.

But what do those numbers mean? Dr. Atlas breaks dilation down -- from 0 to 10 centimeters:

O -- Your cervix is closed. This is how it will stay for most of your pregnancy as the cervix separates the uterus from the vaginal opening and protects the baby from infection, Dr. Atlas explains.

1 centimeter dilated -- Start packing that hospital bag, you're on your way to labor land! Doctors measure dilation in centimeters, and 1 centimeter is a "good sign," says Dr. Atlas. It means your body is getting ready for delivery. It doesn't, however, mean that you're going to deliver immediately.

A mom can walk around for weeks at 1 centimeter dilated, Dr. Atlas says, or she can go from 0 centimeters dilated to having a baby in a day. "Every patient is different," he explains. "And if this your first pregnancy, it takes longer to go through the early stages of labor."

Up to 5 centimeters with contractions -- Put contractions and dilation under 5 centimeters together, and you've got what's called "latent labor" or "early labor." That means your uterus is readying for delivery, but again, Dr. Atlas says, when you'll deliver really depends.

He relates the story of one mom who began contracting every 3 minutes when she was just 33 weeks pregnant. She continued like that for weeks before actually giving birth!

The good news is contractions at this stage are typically mild to moderate (think Braxton Hicks), and your body is doing something. Typically your cervix is not only opening but softening and lengthening, making it easier for baby to make the trip from your uterus to your vagina and out into the world.

5 to 6 centimeters -- The doctor will see you now! This is the point when "active labor" begins, and typically your dilation will be much quicker after you hit the 5 to 6 centimeter point. Contractions will also likely pick up and become more painful as the cervix works its way toward full opening.

10 centimeters -- Considered fully open, this is the point when moms are considered "ready to push" by OB/GYNs. You may also hear your practitioner say you're "fully effaced," which means the cervix has also elongated to let baby out into the world.

At the end of the day, dilation numbers are good for Moms to know, but Dr. Atlas warns mothers not to get too caught up on finding out how dilated they are or aren't.

"You may have lots of contracting and not dilate. You may NOT have a lot of contractions and be dilating," he says. "Certainly people can go from closed to delivery in a short amount of time!"

Did you start dilating well before delivery? How long did it take?


How to Have a Successful Vaginal Birth After a CSection

By Nicole Fabian-Weber, Cafe Mom

For decades, pregnant women lived by the principle that once they gave birth via cesarean, that's how all subsequent deliveries had to be. This school of thought was due to the restrictions the American College of Obstetricians and Gynecologists (ACOG) put on the practice in the '90s, which caused many hospitals to refuse natural labors for women who already underwent C-sections. But, thankfully, in 2010, the ACOG became more lax with its restrictions, giving women more opportunities to attempt vaginal births after C-section, or VBACs.

There are many reasons pregnant women find VBACs to be an attractive option. With vaginal births, there are shorter hospital stays, quicker recoveries, and less blood loss involved in the delivery process. And the good news? According to the American Pregnancy Association, about 90 percent of women who have undergone cesarean deliveries are candidates for VBACs, and in most studies, roughly 3 to 4 out of 5 women who have previously undergone cesarean birth can successfully give birth vaginally.

Thinking of attempting a VBAC? Here are 5 ways to put the odds in your favor.

Monitor your weight. Many patients end up with a C-section because they gained more than the recommended amount of weight during pregnancy (between 25 to 35 pounds) and had bigger babies. The bigger the baby, the higher risk for a C-section. Exercising and being mindful of what you eat can allow for a smaller baby and a higher chance for a vaginal delivery. Daniel Roshan, MD, a maternal fetal medicine specialist in New York City with a high VBAC success rate, suggests running and swimming for his pregnant patients attempting VBACs. "This allows for a stronger body, better abdominal muscle tone, and pushing power," he notes. "It also decreases the risk of developing gestational diabetes, which leads to bigger babies."

Try evening primrose oil. It's important you talk to your doctor before taking any supplements, but Dr. Roshan gives his patients evening primrose oil starting at 34 weeks. "This makes the cervix much softer and more amenable to dilation when the labor starts," he says. "Many patients have C-sections because their cervix does not dilate."

Avoid inducing labor. "Using medication to induce labor (Pitocin) increases the risk of uterine rupture, and the best is to avoid it or use it very carefully," states Dr. Roshan. "Induction is not a natural process. The uterus, pelvis, and baby are not ready for labor, and this by itself increases the risk of cesarean. If there is no clear need to induce, it is best is to wait for spontaneous labor, which allows the baby to be in a better position, and the body is more ready for giving birth."

Wait between pregnancies. Many doctors will recommend you avoid getting pregnant for 18 months after a C-section to increase the odds of a successful VBAC. The reason? The interval between pregnancies can help the uterus to heal, and the scar of the C-section will be stronger, so the likelihood of it separating during pregnancy or labor is decreased. "Twelve to 18 months is recommended in between pregnancies for VBAC patients," suggests Dr. Roshan. "Unless the patient is of an age where she might not be able to get pregnant easily, then a shorter interval is allowed. However, the recommendation is to do a repeat C-section in such a case."

Choose your caregiver wisely. After you've made the decision to try to have a VBAC, you should do your homework. Typically, midwives have lower rates of cesarean sections (though you may want to seek out a midwife who delivers at a hospital in the case that you do need a C-section). If you're not comfortable giving birth with a midwife, look for a doctor/hospital with a low cesarean section/high VBAC rate, and be sure to discuss your intentions with your practitioner before you go into labor. You want someone who is up on the latest studies; preferably who doesn't view VBACs as "high risk"; and of course, who is on the same page as you.

What are you doing to prepare for your delivery?

Image: Getty Images


5 Myths and Realities About Epidurals

replace coffee pregnant

By Michele Zipp, Cafe Mom

Almost from the second you're pregnant, one of your biggest questions is: How is this baby going to get out of me?! Of course, you know the answer, but what you're really worried about is the pain of childbirth. After all, a newborn's head is usually bigger than the size of a grapefruit.

One of the most common ways of dealing with pain the delivery room is the epidural -- at least 60 percent of American moms are choosing this form of pain management. Lots of them joke about it after: "The epidural was my best friend!" But deciding whether or not it's for you is a big decision. Many moms struggle with the idea that getting an epidural makes them a "wimp" (it doesn't), and more importantly they want to know whether getting an epidural is safe for them -- and their baby.

There are a lot of common myths about epidurals, and here, we address them, and give you the facts you need to help make your decision.

We asked Paloma Toledo, M.D., Obstetric physician anesthesiologist and Assistant Professor of Anesthesiology at Northwestern University Feinberg School of Medicine, to address the most common misconceptions about epidurals during labor. Here, the facts you need.

Myth 1: Epidurals can cause permanent back pain or paralysis in the mother.
Serious complications from an epidural, including paralysis, are extremely rare. Some women have discomfort in the lower back (where the catheter was inserted) for a few hours or days after the epidural, but it doesn't last.    

Myth 2: Epidurals can harm the baby.
Fact: In Dr. Toledo's study, published last year in the International Journal of Obstetric Anesthesia, women expressed concern that an epidural could cause cerebral palsy or be harmful to the baby -- no evidence or research corroborates these concerns. Additionally, the amount of medication that reaches the baby from the epidural is so small it doesn't cause harm.    

More From The Stir: Everything You've Ever Wanted to Know About Epidurals But Were Afraid to Ask

Myth 3: Epidurals can slow down labor -- or increase the risk of having a C-section.
Fact: There is no credible evidence that an epidural slows down labor or increases your risk of having a c-section. If a woman has a C-section, other factors usually are at play. In fact, there is evidence that epidurals can speed the first stage of labor for some women.  

Myth 4: An epidural interferes with the birth experience.
Some women express fear that their legs will be numb and they won't be able to walk, feel a contraction or push properly. In fact, your legs should not be so numb that you do not feel them. You may be able to walk after an epidural, depending on the hospital's policy; however, walking generally is not recommended immediately after the epidural is placed. Epidural procedures have improved significantly in the last 20 years, and you'll receive enough medication to relieve the pain without taking away your ability to move. Furthermore, the epidural medications will not cause you to be groggy or tired. In other words, you'll be able to feel contractions -- they just won't hurt -- and you'll be able to push effectively.    

More from The Stir: 8 Natural Ways Women Can Manage Pain During Labor

Myth 5: There's a limited window of time when you can get an epidural.
Fact: You can get an epidural any time you are in labor -- in the beginning, the middle or even toward the end.     

There are many ways to have the best birth, and that answer is unique to each woman and baby being born. The key is to do your research and prepare yourself with knowledge so you have options. If an epidural isn't for you, there are many other ways to manage pain during labor and delivery. And once you're holding that bundle of joy in your arms, you'll forget all about the pain anyway -- or so they say.

Are you considering an epidural? What's your biggest concern? (If you've had one, please share your experience.)

Image: Getty Images


14 Questions to Ask About CSections

C-sections patient

By Nicole Fabian-Weber, CafeMom

Whether you're going into your birth already knowing you're having a C-section or you have every intention of having a vaginal birth, it's smart to talk to your doctor about what to expect in the event that you do have to have a cesearan, being that about 32 percent of all deliveries today are via C-section (and not all are planned). You may not think so now, but there is a chance that you will wind up on an operating table the day you welcome your beautiful baby into this world. One 15-minute discussion can prevent you from winding up in a position where you feel completely helpless, overwhelmed, and in the dark as to what's happening to you.

Here, some questions to consider asking your doctor before you give birth.

  1. Who can be in the operating room with me? Planning on having your husband, doula, BFF, and a professional photog with you when you give birth? That might not be possible if you're having a c-section. Hospital policies vary, but more than two people are almost never permitted in the OR. "Typically, most places only allow one person in the operating room, some maybe allow two, usually a husband and a doula," says Daniel Roshan, M.D., an OBGYN specializing in high-risk pregnancies in New York City. If having more than one person in the room with you during surgery is important, discuss it with your doctor as soon as possible.

  2. What kind of anesthesia will I have? You're obviously going to have to let go of the dream of having a drug-free birth. An epidural is the most commonly used medication during a C-section (yes, just like the one most women have during vaginal births), but another option is a spinal block. With an epidural, a catheter is placed in your back and you'll be given medication as needed. A spinal, on the other hand, is a one-time injection that kicks in quickly, but only lasts a few hours. La Leche League suggests opting for an epidural if you have a choice, as it will leave you more lucid post-surgery, and more likely to nurse right away, which can increase breastfeeding success. But if you have a spinal, don't worry, you're not doomed to be a breastfeeding "failure." Discussing your options with your doctor before surgery will help you make the best, and most helpful, decision for your situation.

  3. What are the risks of a C-section? Celebrities who are "too posh to push" may have given the impression that C-sections are a walk in the park, but the fact is, they're major surgery. "It requires anesthesia, and anesthesia of any kind has complications of its own," says Dr. Roshan. It's uncommon, but some women have complained of extreme headaches in the days following an epidural or spinal block. Other risks that come with a C-section may include: blood clots, excessive blood loss, infections, depression.

  4. What are the risks of a C-section to my baby? If your due date wasn't calculated correctly and you have a scheduled C-section, your baby could be delivered early. Premature babies may have more health problems than those delivered full-term. Babies delivered via C-section are more prone to breathing and respiratory problems, and may have lower APGAR scores.

  5. How long will it take? The surgery usually lasts between 45 minutes and an hour, but for a planned C-section, your doctor may want you at the hospital hours before the actual surgery begins. It's good to know how much waiting-around time to plan on, and whether or not you can have anyone with you during that time (your other children, friends, family members, even a "pre-surgery" doula).

  6. Will I be shaved before surgery? Shaving the pubic area is almost always part of the surgery prep before a C-section, because it gives doctors a clean area to make an incision. Ask your doctor what her policy is as early as possible -- the fewer surprises on the day of your surgery, the better. And taking care of the job at home might just feel more comfortable.

  7. Will I be strapped down? Some doctors do strap down their patients' arms, and if yours is one, you'll want to find out ahead of time so you can talk it out if that's not something you're comfortable with.

  8. What's the recovery time? Most C-section patients are released from the hospital after 3 days. This is important to know because if you are going in for a natural birth and end up having an emergency c-section, you might have to line up childcare. Once you get home, recovery time varies. Your doctor will likely limit your activity (usually for around 2 weeks) so you should expect to need help once you get home. If you don't have family or friends who can pitch in, now is a good time to suss out professional caregivers should you have to hire someone. Most women are completely "back to normal" between 6 and 8 weeks.

  9. Can I eat before surgery? Most doctors will tell you not to eat or drink 8 hours prior to a scheduled C-section, as food in the digestive tract could cause complications, or can make you nauseated or even vomit. But you should find out and follow your doctor's pre-surgery eating rules. If you weren't planning on a C-section and ate within 8 hours, it's very unlikely that there will be dire effects, but let your doctor know.

  10. Where will my incision be? Just because your friend has a vertical C-section scar in the middle of her abdomen doesn't mean you will too. There are three types of incisions -- low transverse, which are the most common; classical, which are typically for a quick delivery or pregnancies with complications; and low vertical, which may be used if baby is in an awkward position. Your doctor might not know for sure before surgery, but she may have a better idea which is likely the further along you are in your pregnancy.

  11. How is my wound going to be closed up? Depending on your skin, medical history, and doctor's normal practices, she likely will close your wound up with either dissolvable stitches or staples, which would be removed before you leave the hospital. (Both your skin and uterus will be stitched post-surgery.)

  12. Can I hold my baby in the OR? Because every hospital has its own policies, it's imperative that you discuss this with your doctor as early as possible if you want to hold your baby. Skin-to-skin contact between moms and babies directly following birth has many benefits, including an increased likelihood of breastfeeding success. Barring any complications from surgery, most hospitals will let you hold your baby as soon as you've been stitched up. Note: It might not be a bad idea to reiterate your wishes on the day of surgery.

  13. What will you do to ensure that breastfeeding is as easy as possible for me post-surgery? For a variety of reasons, you might have more difficulty nursing your baby if you had a C-section than if you gave birth vaginally. The key is letting your doctor (and nurses) know that you're committed to breastfeeding. Many hospitals have lactation consultants on staff, as well as breastfeeding classes. Knowing what kind of support team is in place before you give birth can alleviate a lot of stress, should you run into problems trying to breastfeed.

  14. What resources will be available to me at the hospital if I feel depressed post-surgery? Some women report having a "negative birth experience" after they've undergone a C-section (particularly if it wasn't planned). Find out exactly who to ask for at the hospital should you feel depressed after your C-section (there likely will be therapists on staff).

Did you have a C-section? Did anything take you by surprise that you think moms should ask their doctor about first?

Image: Getty Images

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