Pregnancy can be one of the happiest times of your life but with it can also come an overwhelming array of questions and concerns about what to expect. When it comes to parenting advice, let’s face it, there’s a ton of information available, but often it’s hard to discern what information is accurate or not. South Shore Hospital’s new Healthy Pregnancy and Parenting blog has been created by a trusted community of expert colleagues from our maternity team as well as other experts throughout our system of care. The main goal of the blog is to disseminate accurate, useful information focused on healthy pregnancy and parenting to the community at large.
The interactive platform of the blog allows readers to engage with our team of experts as well as other readers on a variety of pregnancy and parenting-related topics.
Nitrous Oxide has been used as a method of pain relief since post-World War II in Europe and most recently, the United States. Many people are most familiar with its use in the dentist office—often referred to as “laughing gas.” On the television program, Call the Midwife, Gas and Air (Nitrous Oxide) was introduced in one of the episodes as a method of pain relief for women in labor.
What is Nitrous Oxide?
Nitrous oxide is a mixture of nitrous and oxygen (50/50 blend). It is self-administered through a machine that delivers just the right amount at any point in labor.
How can the use of Nitrous Oxide help me during labor?
As a pain relief during labor, Nitrous Oxide delivers a number of benefits including no limit as to how long you choose to use it during labor. Benefits include:
Ability to use it in the labor tub
Ability to delay the use of an epidural (if needed)
Minimal to no effect on the infant
Wears off quickly
It doesn’t impede the natural process of labor
Minimal side effects to the mother
So why isn’t everyone using Nitrous?
Pain relief in labor is such a personal choice. There are many things that can affect how a woman perceives pain in labor such as length of labor, pain tolerance, position of the baby or if you are having an induction of labor.
Nitrous Oxide will be an option coming soon to South Shore Hospital. If the use of this method of pain relief is something that you may be interested in, be sure to ask your provider if you are a candidate.
“Sit up straight, shoulders back!”, the common mantra of many mothers, is not so easy to follow when you’re expecting. Normal changes in your pregnant body can affect prenatal posture in challenging ways. When the breasts and belly expand during pregnancy, the shoulders pull forward leading to a hunched and strained upper back. In addition, the curve in the lower spine becomes more pronounced as your center of gravity adjusts to compensate for the extra weight in the front of the body. Consequently, the muscles and ligaments in the lower back become shorter, tighter and weaker, potentially leading to discomfort and even sciatica. Poor posture in pregnancy can also interfere with your baby getting into the most optimal position for birth. Furthermore, you may experience balance issues due to the shift in your center of gravity.
Sounds unattractive and unpleasant, right? Never fear – you can manage these changes with prenatal yoga. Yoga positions involve stretching, strengthening, balance and relaxation - the perfect remedy for the musculo-skeletal mayhem that arises in pregnancy. Add to that the benefits of meeting a community of women involved in the same life event and you’ve got a full package of physical fitness and peer support. A prenatal yoga class with an experienced and qualified instructor will include a variety of safe positions and movements, such as shoulder rolls, chest openers, pelvic tilts, forward bends, and lunges. Modifications of certain yoga poses will be suggested depending on your gestational age, yoga experience, level of flexibility, and any conditions that could affect your performance or require alternative options. In a prenatal yoga class, participants do not engage in positions that involve lying directly on one’s belly and are instructed to avoid lying on one’s back for an extended period.
The American College of Obstetrics & Gynecology recommends a minimum of 30 minutes of prenatal exercise per day. In addition to prenatal yoga, other safe exercise options include walking, swimming and stationary biking. Remember to hydrate well during any fitness activity and call your doctor or midwife if you experience bleeding, cramps or shortness of breath with exercise. Group prenatal yoga classes offer a chance to meet other women; however, if a class is not possible, consider using a DVD at home. You may even be able to sign one out for free at your local library.
Prenatal yoga can offer you many potential benefits, including increased energy, relief of constipation and leg cramps, improved mood, increased stamina, better sleep, control of gestational diabetes, increased endurance during labor, and an easier postpartum recovery. So don’t delay on your “namaste”. Start practicing yoga today and you’ll feel like heaven.
To learn more, check out these video segments on yoga positions for the upperback & shoulders and yoga positions for the lower back.
I have been attending women at birth for decades. It has always seemed natural to me to just put the baby up on mom’s chest or abdomen first. I would then dry and cover the baby with a warm blanket. Women seemed to want to just reach down and bring the baby up to their chest.
Today, we call this practice skin to skin care and we encourage it at all births, even Cesarean births. The baby is placed chest to chest on Mom with her baby’s face turned to one side. Research has shown that skin to skin contact between Mom and baby at birth helps to stabilize the baby’s breathing, body temperature and blood sugar levels. It offers a familiar environment in which the baby recognizes mom’s heartbeat, voice, and smell to make an easier transition to life outside the womb. It provides a calm place; it is soothing and babies cry less when on mom. The skin to skin contact helps the baby smell mom’s milk and this in turn helps initiate breastfeeding.
It has been 19 years since the birth of my daughter, yet I still recall the feeling of that warm wet baby born into my arms and placed on my abdomen, dried and covered with a warm blanket. It is a memory imprinted in my brain as my most joyous moment ever. Still attached to by her cord, she began to open her eyes and look at me, began to know me and I her. I will carry the memory forever and am so grateful for the midwife who gently and lovingly placed my baby on me.
Skin to skin care can be done anytime, not just at birth. If for some reason, you are unable to do skin to skin at birth, you may do it as soon as you are able. Dad’s can do skin to skin too. Ask your nurse to show you how. It is such a precious way for you and your baby to bond.
Author: Abraham (Nick) Morse, MD, MBA Boston Urogyn
Pregnancy can be a joyful and a stressful time all at once! The ability of a woman’s body to adapt to the incredible demands of a growing baby is breathtaking. However, particularly as the end of pregnancy approaches, the ability of the body to adapt can still be overwhelming. Did you know that urinary and bowel incontinence are both surprisingly common as the end of pregnancy approaches? These experiences may not be ones that all pregnant women are willing to share with their family or friends but it is important to know that if you are experiencing problems with bowel or bladder control you are not alone.
Reports from all over the world on this topic documents that on average 30 to 40 percent of women in the third trimester experience at least occasional urinary incontinence and anywhere from 5 to 10 percent experience occasional leakage of stool. For the vast majority of these women (who have a lot of other things to pay attention to) these leakage episodes were rated as a minor bother, but for a small percentage (less than 10 percentage) the problem was described as significantly disruptive to their quality of life.
Does the problem go away after delivery? As you would expect, the answer is: sometimes. But there will be more discussion about that in a separate post.
One thing that you can do to help improve the health of your pelvic floor and reduce the impact of bladder and bowel leakage is to do your pelvic floor exercises (Kegels) daily during pregnancy. If you don’t know how to do these key pelvic floor muscle contractions, or you are not sure whether you are doing them correctly ask your obstetric provider to check and see how you are doing.
If problems with bowel or bladder control are becoming significantly disruptive, then don’t hesitate to ask your obstetric provider for support and suggestions. Even though some interventions would not be appropriate during pregnancy, there are still ways of helping with the problem. Your obstetrician or midwife may consider referring you to a urogynecologist-a specialist in female pelvic floor problems such as urinary and bowel incontinence.
Sneezing, a mild cough and a runny nose…sounds like a benign cold, right? Maybe so, but if severe, violent coughing occurs after 1-2 weeks it is important to rule out whooping cough, named for the characteristic “whoop” sound that may occur during a coughing fit. Whooping cough, or pertussis, is a highly contagious disease that’s especially concerning when it strikes vulnerable populations, especially babies and young children. The U.S. gained the upper hand on pertussis after a vaccine was introduced in the 1940’s; however, just before the turn of the century we began to see a persistent rise in rates of this dangerous disease. Why? Investigators are not completely sure, but the increase in whooping cough cases may be related to the introduction of a new pertussis vaccine in the 1980’s—an overall safer version when compared to the previous vaccine, but perhaps somewhat less effective.
What we do know is this: Complications of pertussis include pneumonia and seizures. About half of infants who get pertussis are hospitalized, and 1-2 in 100 hospitalized infants die. What’s more, symptoms are not always so obvious, especially in babies. The cough may be subtle or not even be present; instead, some infants experience apnea or concerning pauses in breathing. For these reasons the CDC developed new guidelines over the last couple of years to help protect families:
For Pregnant Women
All pregnant women should get one dose of the pertussis booster, or Tdap, during the third trimester of each pregnancy to allow transfer of maternal pertussis antibodies to the newborn. These antibodies will provide protection until the infant is vaccinated with 5 doses of DTaP (pertussis vaccine) at 2, 4 and 6 months, at 15 through 18 months, and again at 4 through 6 years.
For Preteens and Teens
Vaccine protection for pertussis, tetanus, and diphtheria can decrease with time which is why the booster vaccine (Tdap) is given to preteens at age 11 or 12 years. Teens and young adults that didn't receive Tdap as a preteen should get one dose when they visit their health care provider.
Adults 19 years of age and older who didn't get Tdap as a preteen or teen should get one dose of Tdap. Family members, close friends and caregivers that are not up-to-date with their age appropriate vaccine (DTaP or Tdap) should be vaccinatedat least two weeks before coming into close contact with a new infant.
Non-vaccinated children are 8 times more likely to get pertussis. Take charge of your family’s collective health by keeping up-to-date with each family member’s vaccine schedule and encouraging others to do the same. Vaccines are the most effective tool available to prevent the spread of pertussis as well as many other diseases. Let’s each do our share to protect each other!
A question I often hear from pregnant women and their partners is, “Do I need to take childbirth preparation classes?”
I believe that all women and partners will benefit from becoming educated about normal labor and birth. Myths are dispelled and women learn about what to expect. The "knowing what to expect”, actually reduces the fear of the unknown and empowers women for the process.
Taking childbirth classes does not mean that you have to have an un-medicated labor. On the contrary, you still have the option of many types of pain relief and are more fully informed about the options. Thirty years ago, all women having a first baby took classes. I taught those classes and recall watching pregnant women grow in knowledge and confidence as they approached the greatest physical and emotional event of their lives.
One patient recently said to me, “I don’t need to prepare for labor.” That’s like saying, “I am going to run the Boston marathon but I do not need to prepare.” Before running a marathon, you would look over the course, work out a bit ahead of time, set up support systems and get prepared. That is exactly what classes will do for you.
We see women coming in to labor who are unprepared, uninformed and fearful. Fear increases pain. I have noticed that our Cesarean birth rates have increased over 30 years. It may have something to do with our culture of fear surrounding childbirth rather than the awareness that labor and birth are normal physiologic events. Prepared childbirth classes are a good place to help women start believing in their ability to birth normally. I am so proud that SSH offers childbirth classes. Sign up today!