Ask the OB/GYN…

The Home-Waterbirth of Colin Shane…

Welcome to my birth story, 2.75 years in the making. Thanks for tuning in. Quick note before we get started: As mothers, we find ourselves apologizing for feeling good about/being proud of our birth experiences, because of those sanctiBirthers that have gone before us, rubbing their natural birth experiences in others faces and being generally gross about it. Ain’t nobody got time for that BS. I’m sharing because I want others to know that I’m not a hero (we don’t need another hero), and I’m not “brave”. And unlike most, I feel very comfortable in hospitals. In fact, I was raised in them :-). This was just a choice that worked well for me, and I was very lucky to have people who supported me on this journey.

Sunday, May 27th 2012. The day before Memorial Day and the 75th anniversary of the opening of the Golden Gate Bridge. My un-due date was May 31st ish, and I’m funny about numbers. Having a baby on a Thursday seemed weird to me. Plus it had been hot that week, and if I’m being honest, I was kind of over it. This was going to be my first time actually experiencing “labor” due to the botched 4-day-induction sans epidural that was my first birth… D.r.a.m.a. that it was, it taught me that even I – world’s biggest whiner – could handle a homebirth avec OB/GYN + inflatable tub. We were all set. My mom (aforementioned OB) had flown in from Ohio about two weeks prior to aid in and facilitate this blessed event, and she was getting impatient. There were talks of breaking my water if it didn’t happen in the coming week because she had to get back to work, etc. I told her to back off and give me a couple more days, which she kindly agreed to… Provided that she and her uncle Tom the Preist could leave to watch the GGB festivites/fireworks.

I’d been meditating + evening primrose oiling and finally decided I felt something like irregular contractions that day, so naturally I downloaded “iContraction” & started live-tweeting/timing the waves. She checked me and I was about 3cm. I also was craving Zachray’s Pizza, so we sent out for it, and about 90min later, it was in my tummy. The day carried on without incedent, however my poor mom saw her GGB Anniversary window waning, and I could see the disappointment in her eyes as I told her that the dream may have to die. Alas, babies happen all the time in her line of work, and this was a once in a life time event. I plied her with the promise of making me miso soup and helping me rearrange the livingroom. by 9pm, we’d all felt a little cheated, so we sent the older one to bed, and promised to wake him up if anything got exciting… Also, I was still 3cm.

Note to those of you who’ve not yet had children and are wondering what early labor feels like: if you’ve grown up having painful periods, you’re halfway there. At midnight, I felt the overwhelming need to both vomit and diarreah at the same time. And because throwing up is the worst thing EVER, the only silver-lining here was that when this happens to your body, it means you’re really in labor. (p.s, I couldn’t eat Zachary’s Pizza for a good 6 months after this).

I drew a bath in a desperate attempt to self-soothe. At this point, I had not woken anyone else up, and because I was still thinking of others, I knew it wasn’t really time yet. As I began to drain the bathtub, mom whisper-shouts “shhhhhhh, don’t wake everyone up” from the living room. Rude. About an hour later, I could give a shit about anyone else’s comfort, and took up steady residence on the toilet… rocking myself as the waves came and went and came again… As I made my way to the kitchen, my then-husband whispered to me “let me know when things really get started, and let me know when you want me to do some of that stuff that we worked on”. Ummm… So like in the HypnoBirthing 2hr refresher session, I’m preeeeetty sure I was clear on the fact that when you’re in proper labor, you’re unable to communicate with those around you. My attempt to glare at him scathingly was likely perceived as indifference, and then I promptly fell to my hands and knees. If I could have rolled my eyes, I would have. Mom takes a look at this, and calmly says, “OK! Fill the tub!”… I flew into the thing, seeing this giant kiddy pool as my only saving grace. Turns out, I was fully in transition and my adreneline surge had already begun, thus making me feel like I was freezing cold. I demanded ex-husband make the water “hotter!”, however as I surfaced from my swandive, mom admonished all of us saying that babies cannot come out in scalding hot water. It was 4am. My girlfriend Lynne was eagerly awaiting her call-to-action, so when she asked if she should “come now or in an hour”, it was all I could do to muster a breathy, “now”. 6 minutes later, she was there, in my kitchen, supporting my entire body weight as mom began feeling for the baby’s head. We woke up Kyle, and he could barely contain his excitement. We got the in-laws set up with a live Skype feed so they could be a part of it all too. Uncle Tom the Preist was so peacefully observent, I often forget he was even there, negotiating with Jesus and whatnot. Contractions were on top of each other… And then. They just stopped. The tiny break was exactly what I needed (thank you, water). Side note, I only said “shit” and “this is hard” once. Which, if you know me personally, is huge.

Cue Video… there is very minimal editing done here (iMovie hates me), so we can go ahead and call this real-time. So, without further ado, I give you the last 5+ minutes of labor:

Thanks so much for watching and reading along, y’all. I’m so grateful for the support of my team, and even more grateful for having this second baby during the iPhone generation. I listened to that HypnoBirthing app every. single. night. and felt truly prepared in a way that never happened the first time. I suppose the moral of the story here is that I’m not special for having gone through this. And while I do wish it was a thing, NO, “birthing” is not my Superpower… You too can do this! If you’re interested in learning more about how the HypnoBirthing techniques can help you through labor, stay tuned. We’re gonna be doing a Q&A on the subject over at Ask the OB/GYN in the next couple days. NEXT UP: Placenta Encapsulation! (Eww… but yes. do it.) Stay tuned for post/video…


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Q&A Thursday… {submitted anonymously}

Had a great question come in to Ask the OB/GYN today… Here goes!

New Mom to 8wk old asks:
“I had second degree tearing from an over eager doctor during delivery, and stitches. My vagina has never felt right since – still sore, occasional bleeding, and it doesn’t feel like the skin healed together right. Latest is that there’s some extra skin on the exterior; doctor called it a skin “tag” from the stitches, which she removed without pain. Yesterday I discovered it appears it may have grown back – or maybe she never fully removed it to begin with – and I also see what looks like a growth just on the interior, barely coming out, maybe a centimeter. The skin is red and raw but not really painful. In doing some googling it seems like it may be a granuloma or maybe even some sort of prolapse. Am afraid of the removal and equally afraid my vagina is becoming a monster and i can never have sex again. Advice?”

So… you had an episiotomy (sorry, about that) or you tore when that big head came out, or a hand next to the head shot out to give a “high 5” to the new world (it happens)
The tissue of the vagina and perineum (the skin outside between the vagina and the anus) is very stretchable, but with a fast delivery, some genetic differences in tissue, and age, you can tear even with the most attentive birth attendant and caring perineal massage with oils, etc.
The vaginal repair (it’s mucous membrane inside) is very forgiving and there is little scaring with the repair. The sutures are dissolvable and don’t need to be removed. By 6w visit you cannot tell if there was a vaginal tear. The skin outside is different and it can scar if the edges are not stitched together just right. You can get a “stitch granuloma” like you mentioned-which is a reaction of the tissue to the suture material and it does look beefy red and can bleed easily. (The sutures, again, are dissolvable and RARELY need to be removed.) Or a tissue scar band can form just at the outside of the vagina at the lower edge.
It is likely NOT a prolapse (although after a delivery the vaginal walls between the bladder above and the rectum below, are a little more relaxed than before having a baby.)
Your vagina is NOT A MONSTER, although historically in medieval times it was though that the vagina had teeth (don’t we wish in some situations), which engendered fear of that “black hole” that bleeds and brings forth new life. Pretty damn scary.
However, it is my job to empower women to KNOW their bodies. SO good that you looked and know what’s going on. Sometimes the tissue needs to be removed, often it will go away with a little massage. I tell women to massage with lavender essential oil in a little coconut oil and massage with your thumb. This and continued sexual intimacy (with a mild lubricant, no additives-avocado or coconut oil is a little messier, but way better for your vagina) will help break down the scar tissue and make the area more pliable. Lubricants after having a baby, esp if you are breastfeeding and your estrogen levels are low (more estrogen, more natural vaginal moisture) make intimacy a lot more comfortable. Hang in there, mama!

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Ask the OB/GYN… a live Q&A

Many Apologies! Our live feed had some technical difficulties, so we went analog. We’ve pulled together some highlights from our evening for you to enjoy! Check back next month for another live sesh. In the meantime, please feel free to send us questions (we can post anonymously if you prefer) via our Facebook page.

5:14pm Meg Asks: About peeing our pants… We’ve all been there sister. Thanks for being brave. Check out the vid for the Q&A:

5:23pm Stacie Asks:“My boyfriend says I need to curtail my exercise regimen now that I’m pregnant (14 weeks). Is he an a-hole or no?”
DR. DIANNE: Well, he may or may not be an a-hole but he’s wrong about no exercise. Now you have to remember, that our bodies are very versatile and when we are pregnant we can be very fit-but you should never start something new from scratch when you’re pregnant if your body is not already used to it. i.e.., don’t think you are going to run a 10k everyday starting at 20w.
You won’t hurt your baby but your joints will complain a lot. My best advice is that if you are used to doing aerobic exercises, continue them and LISTEN TO YOUR BODY. Drink PLENTY OF FLUIDS, dehydration is bad and can lead to premature contractions and worse muscle pain and slower recovery (just like when you’re not pregnant)
Being fit is great for you and keeping your muscles toned and your aerobic capacity up will help you during labor and delivery. Use a belly support as your pregnancy advances and a good sports support bra for greater comfort.

5:48pm AB Asks: “I have a 9 month old that I am still breastfeeding. I just found out I am pregnant. Can I continue to breastfeed? Can it cause a miscarriage?”
DR. DIANNE: No, breastfeeding does NOT cause miscarriage. It does however, use up a lot of calories. You will need to make sure your nutrition is good (as you should whenever you breastfeed) and even better when you’re pregnant. If you have morning sickness this may be difficult but good fluid intake is the most important thing in the beginning. Your milk supply may change with the advancing pregnancy as the demands on your body increase, and your baby may note a change in the milk (this is similar to changes noted in breastfeeding moms who have their periods regularly – yes many women menstruate regularly while exclusively breastfeeding- hence you are asking this question :-). Premature labor is also a question often asked-with nipple stimulation and let down, oxytocin is released. This can cause some uterine irritability, but rarely leads to labor. If you are at risk for premature labor, or have painful contractions with breastfeeding in your late second or early third trimester, you should be evaluated to make sure these contractions are not leading to labor. Otherwise continuing to breastfeed is your choice dependent upon your comfort level (breast tenderness) and your breastfeeding baby’s acceptance of the new “taste” of the milk and of course your supply.

(submitted via Facebook) Chelsey Asks: “I was diagnosed with symphasis pubic dysfunction with my first pregnancy and now I am 37 and a half weeks pregnant with my second baby. Let’s just say it is 100 times worse this go around. The pain at times is totally unbearable. For the past week especially Most afternoon/nights im unable to walk. I have been seeing a chiropractor and physical therapist for the majority of my pregnancy and they have encouraged me to talk to my doctors about getting induced because my pain levels are pretty high. I was induced at 39 weeks with my first and it went relatively smoothly, but so far when I have asked about it this time the doctors don’t seem on board with inducing me again since the baby is healthy and it’s just me that’s having the issues (I guess their csection rate is too high or something because of inductions). They were perfectly fine with prescribing me with Percocet though for the pain to get me until Dday though. Which I don’t know how I feel about that. I guess my question is the pain I am in and the stress brought on by the pain could that be bad for the baby? Also what’s yours thoughts on the Percocet? I am absolutely miserable…”
DR. DIANNE: Symphysis pubic dysfunction and diastasis symphysis pubis are 2 similar conditions that are almost always painful and debilitating to pregnant women. It results from a separation or a loosening of the bones that join at the “pubic bone”. There is a ligament in the center that allows some movement and of course allows some relaxation during the delivery of the baby’s head. In some women, this separation is greater, leading to the pain. The body makes a hormone called “relaxin” that helps all of the joints (ligaments) relax during pregnancy. This ultimately allows the pelvis to relax during delivery. The extreme conditions are tough to treat and often a practitioner will resort to narcotic pain relief as a last resort. Percocet is safe in pregnancy but of course few moms-to-be want to be using medication during pregnancy. Physical therapy, stretching, belly binders (pelvic support bands) all can help with the symptoms but the ultimate relief comes with delivery. there is no perfect answer but strengthening the core muscles helps the support of the pelvis (a lot of muscles insert at that point in the pelvis, so the stronger they are, the less movement of the pubic ligament.) Exercise in water can help relieve the weight on the bone and allow you to stretch with less pain. As for early delivery, I know you would feel better, but there are risks of early delivery before 39w. Even though we think a baby is fully mature at 37w, some babies just don’t do as well at that gestation and can have breathing problems that can lead to a prolonged hospital stay in the neonatal intensive care unit.Too many women in the past have been induced for convenience or discomfort ( and unfortunately physician convenience) and there is a lot of data showing this is a bad practice. Keep comfortable however you can and at 39w, revisit the question of induction. Good luck and hoping for a healthy baby and smooth birth experience for you.

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