Saturday, October 30, 2010

Prodromal labor - start and stop, start and stop...

A friend and very pregnant mommy, just wrote this post. It's really good.

Red Light, Green Light…A Tale of Prodromal Labor
October 30th, 2010 | Author: Ashley Sparks

I am not a very nice person these days. Just ask my poor husband. I mean, I try to be, but when you feel as though your uterus has declared war on the rest of your body, it’s kinda tough to be Little Miss Sunshine.

There is a term that, unless you have taken natural birth classes (Lamaze doesn’t really count, and we will discuss why another day) or birthed with a midwife, you are probably unfamiliar with. It’s called prodromal labor. Unfortunately, most OB’s and L&D nurses are quick to mislabel this “false labor” or, even worse “failure to progress”. It is neither. First, anyone who has experienced it or seen it will be quick to tell you that there is nothing false about it! Second, progress of some kind is indeed happening, but it just may not be the measurable progress on the timeline that women have somehow been pigeon-holed into as ‘normal’. In reality, ‘normal’ has been narrowed to such a small window that almost no one fits it, which is why we have so many interventions happening. I can show you ten different women with ten entirely different labors and all of them would qualify as normal. We have just forgotten what normal looks like because we no longer give it the opportunity to happen.

Prodromal labor is a funny thing. For some women, this phase of labor may last a day or two. For some particularly lucky women, like me, it may last for weeks.

Basically, your uterus is working hard, and you know it, but the docs may not see the cut-and-dried quantitative results they want to see. During prodromal labor, the types, intensity and regularity of the contractions are widely variable. Some women have what feel like intense Braxton-Hicks contractions with no real pattern for a day or two and then begin “active labor”. Some women have very time-able, regular, labor contractions that will reach regular intervals and then fade apart and die down. This may happen several times over a few days or a few weeks. And, of course, there are many different patterns. Some women will have regular contractions and Braxton-Hicks intermittently between the regular contractions. Some will have one episode lasting several hours and then go into active labor a few days later. Some women will have stop and go episodes for a week or two – or longer. The variations are endless. There are several reasons for this type of labor to happen.

Your baby may not be in great position and your body may be helping baby get into a more favorable position for birth.
Your cervix may be posterior and the contractions may be helping to ease your cervix into a better position.
You may be effacing or “thinning out” which is just as critical as dilation.
You may actually be slowly dilating. I’ve heard of women doing this up to as much as six centimeters!
As you can imagine, this particular type of labor can be very, very draining. It can drain you physically, emotionally, and mentally. Physically, this is the equivalent of lifting a weight every few minutes for hours, days or weeks. After a while, you would get pretty darn tired! Emotionally, you may find yourself getting discouraged, wondering if you will ever really go into labor, and wondering if you will have the stamina to make it through the ‘real thing’. You might feel helpless, frustrated, overwhelmed, angry, impatient, and just generally upset. This is the hardest part for many women. Finally, you may struggle mentally. You may begin over-analyzing every contraction for it’s duration, intensity and frequency. You may begin giving yourself ultimatums, or even doing your best to get labor going by any means necessary. You may start searching the internet for a magical answer to when you will go into labor… I mean, I’ve never done that, but somebody might… ok, I totally have. But the point here is that prodromal labor is very real and very hard to deal with. This is one of the reasons that women often give in to induction, pain relief and even cesareans – because they are just plain exhausted.

Here at the Frazzy house, prodromal labor has kind of been our nemesis of late. My husband has already come home once thinking that this was the real thing and that was two weeks ago! And I’m not even a first time mom! My Bradley teacher has a saying “Labor is a retrospective diagnosis. Once you are holding the baby, you can say ‘yep, that was labor!’” Oh, how true that is!

So, as far as my personal situation, here’s where we are: I am apparently really good at this prodromal labor thing. I have been having the stop and go labor for several weeks now. At one point I was having contractions every 3-4 minutes, over a minute long, for over and hour. Then…it stopped. Just stopped. No slowing down and gradually spacing out. *sigh* Since then I have reached five minutes apart and over a minute long several times, but they keep backing off. Now, I know at one point Baby Bug was decidedly posterior, so I am certain that these episodes have helped her to get into the position she’s in now. I’m sure other things are happening, but since my GBS (Group B Strep) screen came back positive, I am not doing any more exams until I hit active labor. Even then, they will be minimal to reduce the risk of transmission to the baby. (I have another post ready about GBS that I will put up later this week.) So at this point, I am just trusting that my body is doing what it is supposed to be doing and that it’s all for the best. Someone may need to remind me of that if you see a tweet that says something like “I think I might jump off of the roof if I have one more episode of this!” or ”I’m going to choke the next person who asks me if I’ve had the baby!”. Don’t take anything I say personally, I’m just a little on edge. I’ve outlined the reason for that in pretty good detail here. However, I apologize in advance for any ‘tude I throw out there! I promise, it will be over by Thanksgiving at the latest!

Posted in Baby #2, Midwifery, Natural Birth, Pregnancy

Tuesday, October 5, 2010

Home Birth and Midwifery in the News...

There have been several articles in the news lately regarding Birth, Midwives, and Out of Hospital Birth, specifically Home Births.

This year the CDC released a report on births, and they have seen that Homebirths are on the rise.
"The number of Alabama families giving birth
out of hospital without regulated maternity care providers is
increasing faster than the national average." In AL the rise was 18% compared to 3-5% nationally.
Jennifer Block wrote an article about a study (a very poorly done study), that said HB is 3 times deadlier than hospital birth... This is part of what she had in her article...
*The medical community calls home births unsafe, but recent large studies comparing home to hospital show why women with uncomplicated pregnancies would choose the former: They are much more likely to avoid the complications of surgery or tearing, they are more likely to breastfeed, and they are happier.

...Meanwhile, rival journal The Lancet took the study at face value, publishing an editorial under the headline “Home Birth—Proceed with Caution,” with a stern warning: “Women have the right to choose how and where to give birth, but they do not have the right to put their baby at risk.”

“That was really offensive,” said Marjorie Greenfield, M.D., a professor of OB/GYN at Case Western Reserve who submitted a letter to The Lancet along with several other physicians. “But you know, I can understand, because there’s such a deep, deep belief that it is unsafe to have a baby at home. I used to believe that! But when you look at the good studies of home birth, there’s no difference in baby outcomes, and probably improved outcomes for mothers.” Still, she added, “most people I work with think it’s self-indulgent and risky.”

Last week here in Alabama we had families from all over the state gather in 7 cities and we Walked for Midwives, in an effort to help bring awareness to the issue, and to garner support. The Alabama Birth Coalition is trying to help get legislation passed to allow and License Certified Professional Midwives.
Here in our fair city... we caused a stir!

In response to this -
The President of the Alabama Chapter of the American Academy of Pediatrics wrote an article

This was then written in response to the article:
*The president of the Alabama Chapter of the American Academy of Pediatrics displayed his woeful ignorance of birth, midwifery and the current proposed legislation to provide Alabama women with birth options.
I urge people to learn the facts and then educate him on the topic.
This is the official response from the Alabama Birth Coalition to the specific article written by Dr James C. Wiley.
They make sure to explain that ABC is not trying to get licensure for untrained 'lay' midwives, but are seeking recognition and licensure for Highly Trained and skilled Certified Professional Midwives.

Things have certainly been heating up... Now if we can just get the law passed here in Alabama, so many mom's would be so happy, and planning for their births would be so much nicer as well!