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Ask an Expert
MAY TOPIC: Childbirth
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Cindy Lintel, RN
Creator of the BG Birth & Breastfeeding Gown
OUR EXPERT:

Cindy Lintel is the owner of BG&Co and creator of the patented BG Birth & Breastfeeding Gown. She has been a nurse for over 30 years and has worked as a Lamaze instructor and a gynecological surgical assistant. She has assisted with both the physical and emotional aspects of prenatal care, birth and breastfeeding, helping guide thousands of moms-to-be and their partners as they prepare for their growing family.

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For women worried about going into labor and the pain associated with contractions and transitional labor - especially for those who may have additional issues, such as an anxiety disorder, claustrophobia, or perhaps someone on the autism spectrum who may not be able to handle pain as well - what should she know about epidurals and the labor process? As a nurse, how could you help a patient like this through the process? ~ Anita Lesko, RN (Florida)
 
Everyone is worried. I had been birthing babies for eight years before I had my first...and I was scared to death! Until you experience this incredible event for yourself, you really don't know how it's going to go.
 
For everyone getting ready to start a family, as well as those who have special circumstances, here's some advice:
  • An Epidural is not the only answer. It is a wonderful tool, but there are other options.
  • Check out your support group. Surround yourself and your partner with those who say, know, and understand what you and your partner want for your birth experience.  
  • Stay away from negative energy. Do not listen to the horror stories. Some women love to make it seem as though they nearly gave their life for their child. If you want a positive experience, surround yourself with those who will reinforce the positive - listen to their positive birth stories.
  •  Get educated. There are so many class styles to choose from. The more you know about the labor process, the better off you will be. There are three basic keys to success in labor...knowledge about the physical process, breathing and relaxation techniques. These techniques need to be practiced, so sign up for class early. Your class will be 4 or 5 weeks long, so make sure you have plenty of time. If you are uncomfortable attending a public class, there are plenty of educators who will come to your own home to teach you privately.*
  • Another option: Hire a “doula.” A “doula” (a.k.a. birth companion or birth coach) is a support person who will educate you, get to know and understand who you and your partner are, and support both of you every step of the way through your labor and birth. The doula will also make sure everyone is adjusting to the new family after the birth. 
  • Despite all that you've done, you may still need an epidural – and that's okay! Just know that with an Epidural comes a lot of medical equipment - IV, catheter, continuous fetal monitoring, etc. You can't eat or drink and no more walking. But the good news is the epidural is highly effective in reducing the pain, and sometimes you need that to help get you to fully dilated.  
  • Finally, do your best to prepare in advance, surround yourself with positive and supportive people and trust that your body really can birth your baby.

*For more information on types of childbirth preparation:

LAMAZE
HypnoBirthing International: The Mongan Method
HypnoBabies Childbirth Hypnosis
The International Childbirth Education Association (ICEA)

Who is (and is not) an ideal candidate for VBAC (vaginal delivery after C-section)? My birth plan did not work out as planned. I pushed for 3 1/2 hours before finally calling it and having a C-section. Any advice on preparing and accepting when the birth plan doesn't go as planned? ~ Nancy DeVault (Florida)

Even after attending over 6000 births, no two births were ever alike. Generally speaking, it's hard to say who the ideal candidate is. I believe you have to take a look at the whole picture and include your caregivers. Here's a few thoughts to consider:
  • Check out your OB's track record. Ask what her C-S rate is.
  • What is the general C-S rate of the hospital where you'll be delivering? It is not just the doctor's responsibility. The doctors rely on the nurses to manage your labor and keep them informed of your progress.  
  • What is your OB's and the hospital’s VBAC success rate? Is this a procedure that is fully embraced by the hospital and staff? Understanding the statistics speaks volumes.  
  • Does your doctor talk to you with confidence and encourage a VBAC?
  • Walking is vital to help labor progress. Will you be able to walk in labor, or will you be monitored continuously and have to stay in bed? 
  • Will you have a midwife or a doula available to help manage your labor and advocate for you?

Wouldn't it be great if all labors went according to plan? As you’ve learned, you can never tell exactly what is going to happen during labor. Be open to changes. Sometimes things happen in labor and you need interventions you hadn’t planned on (such as an IV, etc.). It's better to be flexible. I truly believe that having a doula as an advocate - an instant educator - is a far better tool than a birth plan.
I hoped to donate cord blood on my first delivery. I delivered on a weekend, and the hospital told me that the department that handles cord blood donation doesn't operate on weekends. I was super disappointed that just because I gave birth on a Saturday, I was out of luck. Are hospitals improving the process to make cord blood donation easier? ~ Nancy DeVault (Florida)

I have attended countless births where parents request cord blood sampling. The parents contact a cord blood bank in advance and bring the kit with them for the birth. The parents need to let the staff know they are doing an umbilical cord blood sampling when they arrive at the hospital with the kit. Whether it is a weekend or holiday, cord blood sampling is performed. This is not a hospital policy decision. The sample is very easily collected at the time of birth. The parent notifies the blood bank that the sample is ready for pick up. A courier is then sent to the hospital to pick up the cord blood donation.

I would review where the breakdown occurred. 
 
For more information:

Parents Guide to Cord Blood Foundation
Donating Umbilical Cord Blood to a Public Bank (HRSA)

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