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Childbirth

QuestionAnswer
How many stages of labor are there? three
What is the first stage of labor? Dilation
What is the second stage of labor? Pushing/baby delivery
What is the third stage of labor? Placenta delivery
What are dilation and contractions like in active labor? 5-7cm dilated, contractions more than a minute long, every 2-3 minutes
Things doula can do/say during active labor Short sentences only. "Give me 20 mins and you will find your way. I will help you." "We're going to try something. Tell me if you don't like it."
Things doula can do/say during transition Offer straw for water between contractions Keep her moving as much as possible Explain things are going well Time to get to 5cm is NOT equal to time to get to 10cm
What does an epidural include and why? epidural line (for pain) IV (hydration for BP) BP cuff catheter (no bladder control) fetal monitor (FSE, fetal scalp monitor) IUPC (inner uteral pressure catheter)
How long does it take for feeling to return after epidural is stopped? 45 mins
What is prodromal labor? consistent labor signs with no progression for ~10 hours
What medication can be used for temporary relief during prodromal labor? morphine
What is augmentation? artificially speeding up labor
What are two methods of augmentation/induction? Pitocin Prostaglandin (Cervadil or Citotec)
What is the reason induction can be difficult physically? It's active labor contractions on an early labor cervix
What does the acronym BRAIN stand for in response to a proposed intervention? Benefits? Risks? Alternatives? Instinct/gut feeling. Next (what happens next). Nothing (what happens if we do nothing for now?)
What are some things to say to mom during hard times? "I know this is hard, but let's do this together one at a time." "What do you need?" Soft, Open, Down "One contraction at a time. That one is gone." "There are two ways to do this. Fighting or acceptance."
Comfort measures for back labor Rub sacrum Have her lean over ball or bed Have her on hands/knees
Comfort measures for epidural Keep her calm/relaxed Keep her company Ask how she is/what feeling Rub legs
What is an epidural crash? Baby's heartrate drops into 60s about 15 mins after epidural placement
What are three steps to addressing concerns around childbirth? 1. Ask open ended questions (eg, tell me how it's going, tell me what you've heard about X) 2. Acknowledge concerns and validate feelings (eg, tell me more about) 3. Educate with things that target her concerns
True or false: directed pushing is normal True. It is normal for women with an epidural
What to do if mom is getting violent/rough in contractions? "Let's put that energy into getting baby here" Give her a towel to twist
How should a doula respond to a suspicion about an incoming intervention, for example, episiotomy, in the birth plant? "You might want to tell your MD about your episiotomy preferences."
True or false: baby's heartrate accelerating during contractions is always bad. False. Accelerated heartrate during contractions is expected.
What is the cause of getting to 10cm and needing a C section? Baby position (not mom's ability)
What can a mom say instead of, "Can I try XXX?" "Are there any risks if I try XXX?"
What can the doula say instead of "I think XXX would be better."? "Is there any reason we can't try XXX?"
True or false: prolapsed cord is life or death situation True. Mom should put butt in the air to take weight off the cord.
When baby is taken after an hour of skin to skin, what can the doula do? Go get everyone some cran-OJ!
Around what time does the doula leave after birth? About 1.5 hours; once baby is latched for second feeding
In a C section, what should the doula do in the OR? Stand behind the partner; don't touch anything
In a C section, if doula is not allowed in, what can a doula do? Ask to gown up so doula can enter to be with mom when partner leaves with baby
How long does baby blues last? 14 days after birth
How long does PPD last? weeks or months after birth
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