By Brent N. Davidson, M.D.

Congratulations on the upcoming birth of your baby. It’s an exciting time and you probably have a lot on your mind anticipating the arrival of your new baby. It’s also a time that presents an opportunity to do something extraordinary for your baby and your family – the opportunity to preserve your newborn’s cord blood stem cells.

Currently, the stem cells in your baby’s cord blood can be used in the treatment of over 70 chronic or life-threatening diseases. Diseases like Leukemia and other cancers, genetic and blood diseases, and a range of immune system deficiencies. Plus, researchers are now looking to cord blood for answers to heart disease, stroke, diabetes and muscular dystrophy.

You only get one chance to preserve your baby’s cord blood. That’s why it’s critical to select a high quality cord blood company. Here are key questions to ask before selecting a cord blood company:

1. Is the company accredited by The American Association of Blood Banks (AABB)?

   Make sure the cord blood banking company you are considering is fully accredited by the American Association of Blood Banks (AABB) specifically for the processing of cord blood stem cells. The AABB is the only accreditation that ensures high standards of quality for the processing and storage of your baby’s cord blood.

   Some banks are fee-paying members of the AABB, but that’s not the same as being fully accredited. To be accredited, the cord blood banking company must have its laboratory and administrative procedures reviewed, inspected and validated regularly and their procedures must be compliant with the guidelines established by AABB for cord blood processing.

   It’s even better if the cord blood banking company you select is recognized by AABB as having procedures that represent exceptional and novel practices in the industry.

2. How experienced is the cord blood banking company and do they guarantee their product?

   You should ask the company you’re considering how many cord blood units they have stored, and whether they have facilitated any successful transplants.

   You should be cautious of a company that has a high number of cord blood units collected and stored, but has never or rarely used a unit for transplant. It could mean transplant physicians have rejected their cord blood – a warning flag that the company’s procedures are not thorough.

   Best of all is if the company offers a quality product guarantee. This ensures the fact that you are dealing with a quality-conscious company dedicated to providing the highest quality processing and cryopreservation of your baby’s cord blood.

3. Is the company financially stable?

   Cord blood banking is a costly industry. Some companies have gone out of business and parents actually have lost their cord blood units. Assessing a company’s long-term financial future is difficult, however there are a few critical questions you should ask. The first is, what the company would do with your cord blood if they were to go out of business. Be sure the company you are considering has a reasonable plan to accommodate customers, such as a formal written agreement with another medical facility where they would take over the management of the cord blood units.

   You should also ask how long the company has been preserving cord blood. In addition, you should find out if the company is a division of larger corporation, and whether there are academic affiliations, research collaborations and equity partnerships with major biotechnology companies. This would provide proof that the company is committed to researching and developing further applications for cord blood stem cell therapy and will most likely be around for the long term.

4. Does their service include bedside pick up by a Private Medical Courier and do they employ state-of-the-art tracking technology to ensure timely delivery?

   Look for a company that handles the logistics and uses a private medical courier to ensure the quickest, highest quality pick-up and delivery of your baby’s cord blood. The company should arrange to pick up your baby’s cord blood from your bedside in the hospital and transport it to the laboratory 24-hours a day, any day of the week, weekend or holiday. The company should manage all courier and transportation logistics, including accurate tracking of sample handling, and should be committed to transporting the cord blood unit to the laboratory within 24 hours of the baby’s birth to ensure maximum viability.

   The three areas proven to increase and maintain cell viability are timing, pressure and temperature regulation, all of which are controlled by the use of a private medical courier. This ensures the cord blood unit is kept at the proper temperature and pressure during transport and ensures the cord blood unit it delivered to the laboratory within 24 hours. With a private medical courier, your child’s cord blood gets to the lab quickly and safely while avoiding the potentially damaging temperature swings and pressure changes that happen with standard package carriers. This maximizes the number of cells that can be used in a transplant should you ever need them.

5. How does the company collect and store your child’s cord blood?

   Look for a company that uses the Gravity Bag Collection method (vs. Syringe method). The Gravity Bag is the collection method most preferred by doctors and it is designed to collect the greatest volume of cord blood. It’s the industry standard method used by the majority of blood banks and similar to the methods used by the American Red Cross and the National Institutes of Health. It is important to collect as much cord blood as possible, as results show that larger samples produce more viable stem cells. The Gravity Bag method allows for the most cord blood to flow into the bag. In addition, the closed tube/bag system eliminates exposure to airborne bacteria and greatly reduces likelihood of contamination during collection. Be sure the company you are looking at provides a sterile collection protocol to allow for collections to be performed during C-sections and emergency births.

   Look at how the company stores the cord blood after processing. Look for a company that cryopreserves the processed cord blood in multi-compartment, transplant-ready Cryobags. Cryobags allow for higher cell recovery rates and a higher cell viability rate compared to other storage methods like Cryovials. While storage in Cryovials is less expensive for cord blood companies, it does not maximize the value of the stem cells for families. The superiority of the Cryobags allow for higher cell recovery and higher viability than Cryovials.

   Additionally, the company should store a small amount of processed cord blood in aliquots – a small compartment of cord blood designed for pre-transplantation testing. The benefit is that the testing can be done without disturbing the primary compartments. With the Cryovial method, an entire vial must be thawed and used to perform this necessary pre-transplantation testing procedure.

6. Does the company have a Medical Scientific Advisory Board (MSAB) made up of notable authorities in the field of cord blood stem cell preservation and transplantation?

   The company you are considering should have a Medical Scientific Advisory Board (MSAB) made up of thought leaders in the field of stem cell transplantation and cord blood preservation. Ask how the company uses their MSAB. They should meet regularly to set quality standards within the company and thereby help to maintain the highest and most advanced level of service available.

7. Is the company committed to research for future applications of cord blood?

   Look for a company that actively participates and invests in research and development of cord blood stem cell therapies. If a cord blood company is committed to research, it’s a good indication that the company is also committed to the future, which means they are more likely to have financial stability. Another potential benefit — any medical breakthroughs developed by their R&D division will have been conducted using their own processing and cryopreservation methodology. In other words, you may be in a better position to benefit from their discoveries by using their processing techniques as opposed to methods used by other cord blood companies.

By Cami Nettekoven

There are numerous benefits of a Birth Doula. Studies have shown that having a Doula may greatly reduce the percentages of medical intervention. The relationship between Doula and the family is one of respect and comfort. The relationship starts during pregnancy, where the trust is formed. Information is gathered, education is obtained during these early meetings. During labor the Doula is an advocate or liaison for the family. The purpose of the Doula is to support the woman’s ability to give birth.

The Doula is available to educate the family so they may explore their options for their birth experience. This may be in the form of finding the appropriate childbirth class, learning techniques, writing a birth plan, or many other things. Every woman needs and deserves individualized care based on their circumstances and preferences. The Doula respects the desires and decisions of the family by being trustworthy, available, consistent, ethical and honest. It is important to allow the family to express concerns and expectations without judgment. She may expel myths with providing accurate, non-biased information. The information is to empower the family, strengthening them in their awareness and rights. Sometimes assistance is needed in providing questions to ask of the care provider.

A Doula supplies the knowledge of laboring techniques to accommodate the mother. These techniques can speed the length of labor and reduce the rate of medical intervention procedures. The techniques include: laboring and birthing positions, non-medical pain reduction methods, massage, aromatherapy, relaxation and focusing techniques along with emotional comfort and support.

The Doula acknowledges birth as a sacred moment that belongs to the family. She provides continuous support through labor and early post partum. She is the advocate for the family, equipping them with the tools they need to succeed in a joyous birth experience. She respects the privacy of the family. She in no way replaces the father or birth partner’s role, but enhances it. By making suggestions in comfort techniques, and allowing the partner to take a break. Many fathers and partners are eager to help in the support of the mother; however some may need a little guidance. The father’s presence and commitment of love and support is invaluable to the mother. A Doula’s knowledge can help a father or partner to relax and enjoy the experience more fully. The Doula compliments the birth process, by working along side with the family and care providers. A Doula seeks to protect a positive and memorable birthing experience for the entire family. It is most important that the family can be comfortable with the Doula of choice. They should feel free to discuss their fears, hopes, and desires with the Doula.

Doulas do not provide the mother with any clinical care, so they do not replace the doctor or midwife. A Doula’s expertise is in the physiology of labor and birthing by providing comfort measures to the mother. Doula’s have proven to make a favorable impact on the childbirth experience.

Having a Doula accessible after delivery is also beneficial. She may help the family to process the birthing experience. She will facilitate bonding with the baby, as well as initiating breastfeeding. Many breastfeeding moms need a little assistance in getting the baby latched on for the first time. Some gentle suggestions from the Doula can help get breastfeeding get off to a wonderful start.

A Doula strengthens the mother’s ability to birth in a way that stimulates her natural power within. It is important to give the mother confidence in herself and her body. By having a Doula it can help the family get off to a very good start.

About the Author
Cami Nettekoven: Is a trained and certified birth Doula through DONA International. She works in the Greater Kansas City Metro area for home, hospital or birth center births. She is also trained by the Kansas City Missouri Health Department as a Breastfeeding Counselor with Nutritional Services. Cami has 6 children and has 9 years of personal breastfeeding experience. All of her pregnancies have been high-risk, with pre-term labor and delivery, gestational diabetes, and a baby with abnormalities. It is her privilege as a Doula is to help families understand the nature of the birth process and to empower them with the tools to make pregnancy, childbirth, and their life beyond an experience of fulfillment and joy. Her web site is www.kansascitydoula.com.

When you first find out you are pregnant, you may immediately start envisioning the perfect labor and child birth. You will be at home, your water will break, contractions will start, you will show up at the hospital, have a quick labor and delivery, and then your baby will be born! However, most of the time, this image of “perfect” labor is not the reality.

Quite often, a woman will have to face the possibility, or reality, of an induction to get her labor started and to deliver her baby. Inductions can be a welcome relief to some women, while others dread them. Inductions are performed for various reasons. Sometimes they are performed because of a problem in the pregnancy. Other times, factors may include the size of the baby, or because the woman is past the 40 week mark of pregnancy and labor has not started on its own. Inductions can also be done if a woman’s water has broken, but she has not started having contractions, or she was having contractions and they stopped.

There are many ways your doctor or midwife may attempt an induction if it is needed at the end of your pregnancy. If your cervix is not dilating and effacing on its’ own your provider may choose to insert a pill called cervidil that has a drug in it called prostaglandin. Prostaglandin is one of the natural chemicals that your body produces that plays a part in the ripening of your cervix.

If your cervix is already ripe, or after you have had the cervidil and it has done its’ job, your doctor or midwife might choose to go ahead and break your water. Many times just the breaking of your water will make contractions start and labor progress on its’ own, without any further medical intervention.

If breaking your water does not work, then the doctor may begin administering the synthetic form of the hormone that your body naturally makes, oxytocin, which is called pitocin. Pitocin generally will start labor contractions, however it can cause labor to be very painful. Most people who are administered pitocin end up needing pain medication during labor, in order to get through labor. For the women who want to go natural, with no pain meds, pitocin is normally not something that they want to have to help induce labor.

Induction is not a necessity in all labors, and many women who are lucky will get their picture perfect labor and delivery. It is always best however to know and research all the possibilities ahead of time so that when the time does come, if you have problems getting labor started, you will know all your options.

by Lee-Anne Robert

After 42 weeks of pregnancy, two days of undergoing inducement and physical stress on the baby, my daughter was delivered via an emergency C-section. Oh, it was music to my ears when my gynecologist arrived in my hospital room at 4:30 a.m. and told me they were going to do an emergency C-section. I must have been in shock or delirious! However, after going through a traumatic two days, I had had enough and I wanted to meet this precious baby who lived inside of me for 9+ months. The time came and I was wheeled to the operating room, and what a blessed event it was to see my sweet new baby girl!

I wasn’t prepared for the aftermath of a C-Section but I am so grateful that I had a great family who were there for me and helped me every step of the way.

1. Plan ahead. No one can predict whether or not you’ll need an emergency c-section. So prepare yourself with information.
2. Try not to be upset if you are told you have to undergo a C-section to deliver your baby. I know that many new parents are less than thrilled at the prospect and have anticipated a natural delivery. Plenty of women feel put down and feel less like a woman because they did not deliver their baby through the hard work of labour. I know it is emotionally hard. Truly, the main concern is you and your baby’s health and that is more important than how you delivered your baby.
3. Expect a brief hospital stay. My daughter and I were in the hospital for four days after the birth. If you require assistance at any time in caring for you or your baby, are uncomfortable due to the pain, or have any questions, do not be afraid to ask for help. There were times when I was too proud to press the buzzer to ask for assistance. But, believe me, their assistance is very much required, especially with the care of your newborn baby.
4. When the time comes and the nurses and/or doctors tell you to walk around, do try. It may be difficult but do try to do a little walking if and when possible. It helps to alleviate the stomach gases that are very much a part of the discomfort you feel after a C-section.
5. The day arrives when you and your newborn can finally go home. Enlist support! Ensure that you have family, friends or loved ones to assist you and, once again, do not be afraid to ask for help. Do not try to be supermom! I was fortunate to have a supportive family at home and could not imagine going through the recovery without them. It will take you 6 weeks to fully recuperate from a C-section, afterall, it is major surgery.
6. Do not pick up heavy items. Remember, you have just had surgery and your incision is in the healing process.
7. Ensure that you eat healthy and drink lots of water. This is important to ensure that your digestive systems returns to normal. Plenty of rest is vital for recuperation. Enjoy this period of relaxation because you have many years of motherhood to go!
8. Enjoy this special time with your new baby!

I survived my first C-section and 18 months after the birth of my daughter, I gave birth to a healthy baby boy via a scheduled C-section. The second C-section was easier. I am grateful to have two healthy children who are the joy of my life, irregardless of how I delivered them.

About The Author
Lee-Anne Robert, proud mother of two healthy young children and owner of Cuddles ‘n Gifts,
Copyright 2004 info@cuddlesngifts.net

There are three main phases and stages of labor that you will hear referred to quite often when it comes time to deliver your baby. However, there is no reason to wait until you are in labor to learn about these phases and stages, what they involve, and what you should be doing during each one. The first stage consists of three phases, and the remaining two stages have just one phase each.

Stage One – Labor

Latent Phase
This first phase of the first stage of labor is called the latent phase, but can also be referred to as early labor, or just simply the first stage of labor. During this phase. your cervix will start dilating and you will be having contractions, and they are normally not painful and you are able to move around, talk, laugh and function through them as normal.

Some women, who want a more natural labor and delivery (and who choose to refrain from using pain relief), will choose to stay home during this first stage of labor where they are more comfortable and surrounded by familiar things. As long as their water has not broken, they may choose to take baths or showers, light candles, play music, or just sit and talk to their partner while they time contractions.

This phase of labor can last on average 8 hours, although it can also last much longer, or end much sooner. Your contractions will come between 5 and 20 minutes apart and generally last about 30-45 seconds. You should not be in a lot of pain during this first phase, or too uncomfortable. This phase ends about the time a woman reaches 3 centimeters dilated, which is when the contractions become more frequent and more intense.

Active Phase
This second phase of the first stage of labor results in your cervix dialating from 4-7 centimeters, and during this phase, your contractions will normally come between 2-5 minutes apart, and last up to a minute in duration. You will also start to feel much more discomfort and possibly more pain as the contractions become more intense as they help to push the baby down through your cervix. If they have not ruptured yet, this phase is the most common time for your membranes to finally rupture. The active phase can last an average of 3-4 hours, but can go on longer, or end sooner, depending on your body and your labor.

Transition Phase
The third and last phase of the first stage of labor results in your cervix dilating between 8 and 10 centimeters, and is the phase where your pain will be at its worst. During this time your contractions will seem to be coming one right on top of the other, and may last up to two minutes each in duration. During this stage the contractions are pushing your baby further down through the cervix, allowing his head to enter the vagina to prepare for birth. This stage normally lasts between 10 minutes and an hour.

Stage Two – The Birth of Your Baby
Stage two is the pushing of the baby out of your uterus through your vagina. Most women will find that they have a second round of strength as they begin pushing their baby. The contractions normally slow down giving a woman more time to catch her breath in between contractions. This stage can end relatively quickly, or can take several hours, depending on the position and size of the baby.

Stage Three – Delivery of the Placenta
This last stage of labor occurs after your baby has been born and normally lasts for a relatively short time. After the baby is born, the placenta should naturally detach from the uterine wall, following the baby out of the birth canal. The doctor will check the placenta for tears or problems that could lead to your uterus not contracting properly after the baby is born. It is important that your uterus contracts properly so that it can slow your bleeding and heal the area where the placenta was attached.

By Danielle GoodnightFor today’s mother, methods for natural birth include so much more than Lamaze class! The Lamaze method of natural child birth is probably the most recognized name in methods for giving birth, but mothers-to-be wishing to prepare for a natural birth have so many programs to choose from. To find a great child birth class or teacher, you may have to look beyond the standard hospital class.

The secret to a satisfying and pleasant natural childbirth experience is preparation. When giving birth, many mothers seek drug relief for childbirth pain because they believe that natural birth means painful birth. What some women fail to realize and what most doctors won’t tell their patients is that when giving birth, women can reduce and control the discomforts of labor with natural techniques and methods that don’t involve drugs which may interfere with the natural process of labor and lead to multiple interventions. A childbirth class taught by an independent instructor is the best place to learn about the natural process of birth and the techniques and methods that will empower you in your journey through pregnancy and childbirth.

Second to Lamaze, the Bradley Method is probably the most recognized name in natural child birth. The Bradley Method is known as “husband coached childbirth”. It is likely that you can find a Bradley certified instructor in your area. Birthing From Within is a best selling book on natural childbirth that emphasizes self-knowledge, information and personal preparation rather than a specific method for natural childbirth. Birthing From Within classes are quickly gaining in popularity. Independent childbirth educators are certified by a variety of excellent organizations including Birth Works, ALACE, CAPPA, DONA and ICEA. Many childbirth educators are also doulas and are certified by the same organizations.

Another alternative in childbirth education is to use a self study program. Many parents-to-be like the camaraderie and shared experience of going through a class with other couples, but self study is a valid option for many. Using hypnosis for childbirth is a natural method that lends itself well to self study. Hynobabies, HypBirth and HypnoBirthing all offer self study programs. Mothers can also find hypnotherapists and/or doulas in their area who are certified in various childbirth hypnosis methods.

Any article on natural child birth would be incomplete without mentioning water birth. Water, sometimes referred to as “nature’s epidural” is a wonderful way to relieve the discomforts of labor. Many women labor and birth their babies under water. If water birth is an idea that appeals to you, find a doula or midwife who is comfortable and familiar with water birth. Waterbirth International is the best source for information and waterbirthing supplies.

Natural childbirth is a wonderful, safe and satisfying experience for mothers, babies and families. With adequate preparation and supportive labor assistance you will go through childbirth armed with knowledge and empowered to make the right choices for your birth, no matter what the circumstances. Most women who prepare for a natural childbirth, even if it becomes prudent to utilize certain medial interventions, are happy with their decision to be informed and educated about this most life transforming and life fulfilling event that we call birth.

About the Author
Danielle Goodnight is the mother of three boys. She has experienced childbirth differently every time, from the standard obstetrician attended medical model of birth, to a c-section, to a home birth with a midwife. She shares her natural mothering and attachment parenting experiences at http://www.mommythink.com/, a website for mamas with sharp minds, independent spirits and loving hearts.

Once you hit the last month of pregnancy you should have almost all of the supplies and furniture you need for your baby. If you are having a nursery, you probably have it already decorated and set up. But don’t forget the other things you’ll need for going and coming home from the hospital!

Hospital Bag for You
By the time you hit 37 weeks you should make sure that you have your hospital bag packed and ready to go. You may even want to have it in the trunk of your car. Every labor is different and since you do not know if you will go into labor at home, in the middle of the night, or while you are out of the house, you want to be prepared ahead of time. You won’t want to go into labor and not have time to pack a bag or take anything with you to the hospital. Things you might want to include in your bag are:

• Pajamas/lounging outfit for after the baby is born, if you don’t want to be stuck in the hospital gown
• Music for during and after labor
• Camera/video camera to record the birth and get your first pictures of baby
• Snacks for during labor for you and your labor partner
• Maxi-pads to go home in (the hospital will supply what you need while there)
• Clothes to go home in
• Any medicine you are on, including your prenatal vitamins
• Birth Plan
• Phone cards to call family and friends long distance if cell phones are not allowed in your room
• List of numbers of who to call after the baby comes

Hospital Bag for Your Baby
You also want to make sure that you have a bag packed for your baby, or that you pack some stuff for your baby in your hospital bag. Some things you may want to include are:

• Going home outfit
• Gowns for baby while in hospital
• Special baby blanket
• Cloth diapers if you choose
• Diapers/Wipes (hospital will supply some but it is always good to have extras!)
• Diaper rash cream
• Scratch mitts for babies hands

Other Last Minute Things to Do
If it is possible, get as much sleep as you can in the last weeks before your baby arrives. Chances are you won’t get much sleep after your baby is in your arms. Make your lists of who to call and when to call them. Double check your birth plan and go over it with your doctor or midwife.

Some women are concerned about how they will look “down there” while giving birth. If you choose, go in for a bikini wax and trim a couple of weeks before your due date. Shaving at this point in pregnancy is probably not possible, so have a professional help you.

Try to get away for a quiet weekend just you and your partner before the baby comes. This last chance for quiet time and bonding will be appreciated in the months after your baby arrives and you find that you have very little time alone, or with each other. If you have other kids, arrange with a family member or friend to keep them for a night or a weekend.

Get a facial, get your nails done, or other things that help you relax and are just for you. Once your baby arrives it will be difficult to find time to pamper yourself, so be sure to pamper yourself while you still can.

These last weeks of pregnancy will be tiring as well as joyful. It is important that you try to relax and enjoy the last minutes of your pregnancy and your baby’s movements before you enter a whole new phase of your life.

by Christine Ramos

Not much else changes your life in so many ways as having a child does. Pregnancy and childbirth are life altering events for women and their involved partners. Many women enter their birthing facility as a private and reserved individual only to succumb later to the throes of labor and literally let it all hang out.

Having a baby can tell a woman a lot about herself that she previously did not know. Like the strength of her endurance, the magnificence of her body, and yes, the fact that there exists an occasion where she will not give a hoot who sees her in the most private of body positions. I strongly encourage pregnant women to embrace this truly magical time, a time when their own soul allows the entrance of another into this world. The following is a list of the five things I advise every expectant couple to know.

1. Understand what is happening.
Pregnancy is a time when you should be educating herself on the many wondrous changes your body and that of your unborn baby undergoes. You and your partner should learn about the course of childbirth, what birthing choices are available to you, and what to expect in both a normal delivery and one that requires medical intervention. Know what can be expected for your particular prenatal health status and draw up a birthing plan based on your educated wishes. But please remember, a birth plan is a list of wishes for your birthing experience. Changes in your, or your baby’s, health status may necessitate having an entirely different birth than what you initially wanted, and being prepared will put you in a position to better cope. Sign up for childbirth preparation courses and tour the birthing facility before the big day approaches.

2. Learn various options available for pain management.
Epidurals, though very common, are not without risks. Low blood pressure, slowing of your baby’s heart rate, back pain, severe headache, and seizures are all associated with administration of epidural anesthesia. The inability to recognize the natural urge to push your baby out is also a side effect of it. Water birthing is a marvelous birthing option which has been shown to be as effective as an epidural for pain control. Acupuncture, Reiki, and even hypnosis can also assist in obtaining effective pain management. Research these wonderful options, you owe it to yourself and your baby.

3. Avoid becoming submissive.
I strongly urge expectant parents to take an active role in their birth experience while discouraging submissiveness. So many times I have seen couples surrender their experience to the authority of their well-meaning, but very occupied, physician. What you need to know is that you must work to make the birthing experience your own.

No matter how caring the physician is she has a ton of other responsibilities she must be mindful of while attending to your birth. Many of the procedures she orders are routine and quite possibly can be negotiated in terms of your vision for your individual birthing experience. Say for example, you prefer to not have intravenous fluids during birth because you desire to walk about unencumbered by an I.V. pole.

Intravenous fluids are often routinely ordered, not so much because the birthing woman is at risk for dehydration, but to ensure easy access for medication administration via I.V. route should the need arise. Your physician may agree to only having intravenous access by the use of a saline-lock, an I.V. catheter inserted and taped to your arm but not hooked up to the tubing and bags. If the course of the pregnancy has been uncomplicated there is no reason why laboring couples cannot experience the birth of their child without medical intrusion.

4. Consider a Midwife.
Certified midwives are skilled and competent clinicians who advocate non-intervention in the normal processes of pregnancy and childbirth. These caring practitioners encourage active participation of their patients and their families as well as providing education, emotional, and social support throughout the childbearing experience. Always working with a physician as a back up measure in the event of an obstetrical emergency, the certified midwife is a safe, highly satisfying alternative to an M.D. for normal pregnancies.

5. Consider expert support during labor.
Doulas and labor support specialists, like myself, are also a very nice option for the birthing woman. We are certified professionals who work to improve the normal progress of your labor. We provide emotional support and use various comfort measures such as positioning, massage, and effective relaxation techniques during this momentous time. Having this type of assistance for pregnant women has been proven to reduce the need of medical intervention. Ask anyone who’s had a doula during their birthing experience and more than likely you’ll hear raves.

About The Author
Christine Ramos is a Registered Nurse and Certified Childbirth Educator, with experience in High-Risk Antepartum and Maternal/Child Health. In addition to writing articles Christine offers private maternity services. Her first book, entitled ‘A Journey Into Being. A Guide to Knowing Our Children as Spirit and How to Nurture Their Inner Being’ will be due out in June 2006. She is the mother of 2 boys ages 15 and 12, and a girl age 4. Visit Christine at www.IntuitiveNurturing.com for more information.

You are nine months pregnant. Your belly is huge, you are uncomfortable, you are ready for your baby to come, and voilà! Almost as if you willed it, you feel a contraction. Is this it? Are you in labor? Or is your body just teasing you, letting you hope, just to end up going to bed and trying to get to sleep again that night while you toss and turn?

What is false labor, and how will you know is the difference between the real thing and false labor? False labor can appear in many forms. Many people will feel Braxton Hicks contractions for months, and associate this as false labor. As you get closer to the end of your pregnancy, your BH contractions might come more frequently and intensify, making it very hard to determine if they are the real thing

There are several things you can do to determine if your labor is false or real. Start by timing the contractions. If they are sporadic and do not increase in frequency or intensity, it is likely to be false labor. If you begin to see a pattern in your contractions, however, where they are coming several times an hour on a regular basis, and they are lasting 30-60 seconds each, this might be a sign that labor is on its way.

If you are feeling contractions, there are things you can try to see if they stop. Take a walk, drink a couple tall glasses of water, take a warm shower or bath, or try lying down on your left side for a while. Some of these things may stop the intensity and frequency of the contractions. If they stop, then it is false labor.

If you are not yet 37 weeks pregnant and you are experiencing what you believe is not false labor, you should call your doctor or midwife to see what they suggest you do. If it is after 37 weeks then you are generally considered full term, and unless your provider has mentioned any reason for you to come in early, you will be able to stay home and at least try to relax for as long as you are comfortable.

Most women do have false labor signs several times before the real thing hits. For first time moms it can be exciting and irritating at the same time, involving many trips to the hospital, just to be sent home because the contractions stop. Moms who have been through the joys of labor may generally not be so quick to head to the hospital, but it won’t make the anticipation any less. The thing to remember is that eventually the false labor will turn out to be real labor and your baby will be arrive.

If you are planning on a vaginal birth,whether or not to have an episiotomy is an important decision to consider. While all women know that child birth is painful, the thought of having her vaginal area cut or torn is very frightening. It is best to know all the options available before labor begins, so that your birth plan expresses your specific wishes.

Episiotomies
Are episiotomies necessary? Many women today say no. Episiotomies used to be done routinely during a vaginal child birth by the doctor or midwife as a way to help the woman avoid getting a tear.

There are two main types of episiotomies – the midline and the mediolateral. The midline is when the doctor makes the incision straight down towards the anus, and the mediolateral is an incision made diagonally to help avoid a later tear into the anal area.

Episiotomies are said to have both positive and negative aspects

The benefits can include:

• Faster birth
• Prevention of tearing
• Protection against incontinence
• Protection against pelvic floor relaxation
• Faster rate of healing than tears

The negative aspects can include:

• Infection
• Increased pain
• An increase in 3rd and 4th degree vaginal lacerations (euphemistically called extensions)
• Longer healing times
• Increased discomfort when intercourse is resumed

Many midwives believe that there are better ways to avoid a tear than getting an episiotomy. These might include:

• Good nutrition (healthy skin stretches more easily)
• Kegels (exercise for your pelvic floor muscles)
• Prenatal discussion with your care provider about episiotomy
• Prenatal perineal massage
• A slowed second stage (controlled pushing)
• Warm compresses, perineal massage and support during delivery

Tearing
Many organizations that do not consider episiotomies as necessary believe that it is better for a woman to tear, but is it really? Some make the argument that not every woman will tear, and that those that do may only tear a tiny bit, resulting in only one or two stitches, vs. the 10, 20 or even more needed with an episiotomy. Not every woman will tear during delivery, and so some women may have episiotomies unnecessarily.

There is a negative side to allowing your body to tear naturally as well. Both episiotomies and tears are considered by degrees. The most common is the second degree tear or cut, which extends halfway back to the woman’s anus. The least common, but most painful, is the fourth

Both options today are acceptable in the medical field, and episiotomies are actually done less routinely than they used to be on pregnant women. It is best for a woman to research both options before she goes into labor so that she can choose which one she prefers while writing out her birth plan, and talking to the doctor at delivery.