Lamaze Magazine 2009

Celebration Birth (see “Position Statement,” page 14). Try not to hold your breath for extended periods. and follow your body’s cues, pushing when you feel the urge. Warm compresses or oil on your perineum may help ease pain. cEsarEan Birth What: major surgery that allows the baby to be removed via incisions into the abdomen and uterus. Why: When there is an urgent threat to the life of the mother or the baby, a cesarean can be a life-saving intervention. examples include a mother hemorrhaging or a baby not getting enough oxygen. But most cesareans are not emergencies. Some non-emergency reasons are prolonged labor (“failure to progress”), a baby in a breech or transverse position, and changes in the baby’s heart rate. lower your risk: Cesarean rates in the United States have reached an all-time high of almost 32 percent, and the World Health organization is urging healthcare providers to decrease that number. lower your risk by choosing a health-care provider and place of birth with a low cesarean rate. Skilled, continuous labor support is also vital. research has shown that the presence of a doula can lower the chance of having a cesarean. Finally, be actively involved in all decision making before and during labor, and ask if each medical intervention or pain-relief option increases the risk of cesarean birth. Some hospitals or health-care providers will not allow a woman to have a vaginal birth after she has had a cesarean (VBaC). But the american academy of Family Physicians has a policy to expand VBaCs, so research your options. | online: Read more at lamaze.org/magazine. clamping the cord Another important factor to discuss with your health-care provider before labor begins: when to clamp the umbilical cord. Increasingly, women and their health-care providers are choosing to delay clamping the cord until it stops pulsing. The baby will continue to receive oxygenated blood as she transitions to breathing on her own. In addition, by delaying clamping, some research shows, the baby receives her full blood volume and optimal iron stores. The placenta also will be more readily expelled. the muscle beneath it, between the vagina and the anus, during the pushing stage. Why: If there is fetal distress, an episiotomy may shorten the pushing stage by 5 to 15 minutes so the baby can be born faster. It is often required if the baby needs to be assisted, rotated with forceps or a vacuum extractor, or if her shoulders aren’t able to rotate and pass through the pelvis. episiotomy should not be done routinely; it is largely unnecessary and carries risks to the mother, such as pain, infection and blood loss. lower your risk: recent studies have shown that the routine use of episiotomy does not benefit the mother or newborn. Also, not only does it increase postpartum pain but it weakens the pelvic floor, contributing to long-term problems. make it known before labor begins that you’d like to avoid having an episiotomy unless absolutely necessary. During late pregnancy, continue Kegel exercises to strengthen and elasticize your pelvic floor. This will decrease your need for an episiotomy and lessen the chance of tearing naturally. Choose labor positions, like squatting, that help speed the process What: a surgical cut to the perinium and EPisiotoMY Making the Best of a cesarean photo: n. auBrier/agefotostock If it turns out that you do need to have a cesarean birth, know that it is possible to keep the experience “birth-like.” Below are some questions to ask your care provider. If possible, bring these issues up prior to your due date, and make sure your partner is also aware of your wishes. | Can you have more than one support person with you? Often the father may want to be with the baby during newborn exams. A second support person can stay by your side, offering support. | If you choose, can the drape be lowered after the incision is made so you can see your baby being born? | Can your arms not be restrained so that, after the birth, you will have a free hand to touch your baby? | Can you nurse your baby while the incision is being repaired? | Can you choose the music that is being played in the operating room? | Can conversations be limited to only those directly related to the birth? | Can the baby and your support person stay with you in the recovery area? lamaze maGazINe 2009 22 lamaze.orG http://www.lamaze.org/magazine http://www.lamaze.org

Table of Contents Feed for the Digital Edition of Lamaze Magazine 2009

Lamaze Magazine 2009 Contents Essential Lamaze for Pregnancy Making Connections Body Beautiful Birth Day, Your Way Mother Knows Best Essential Lamaze for Birth Supporting Cast Labor Day Position Statement Comfort Zone Intervention Intelligence The Waiting Game Essential Lamaze for Parenting Nursing School Reality Check Sleep Tight Unforgettable

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