Spoke to the Dr at my 32 week appointment this week. Explained the pains I was having. He is sending me in for an ultrasound to make sure the baby is ok, checking the weight and position etc. He is also checking me for kidney stones and a kidney infection. But I was searching the net and came across - Pelvic Pain (Symphysis Pubis Dysfunction) (see blow), this fits sooo much of the pain and discomfort I am having.
Sigh more tests woohoo. I am getting to old for this.
My weigh in this week was 253.50, 1 pound since my last visit which was 3 weeks ago. Other than that the baby's heart beat is nice and strong, so are her darn kicks and punches. lol.
I also had a new thrombosed external hemorrhoid show up a few days ago, and after being out today with my daughter for a Dr.s appointment I come home and go to the ladies room to find myself bleeding. Of course my first reaction was OMG the baby. Turns out I was walking around so much and the baby is giving me sooooooo much pressure down there that it popped. HOLY CRAP talk about hurt.
So I am waiting for a call tomorrow for a date for the ultrasound. If not it will be 10:30am on Wednesday morning. We will get to find out how big the baby is etc. :D
I am getting excited, I just want to hold my baby girl and her big sister wants her to come too. She keeps asking me when we visit the baby Dr if we are bringing home Paige yet. :( I said soon sweetheart soon.
Thursday, February 11, 2010
Pelvic Pain (Symphysis Pubis Dysfunction)
Pelvic Pain (Symphysis Pubis Dysfunction) Please read the whole article it is quite big and so I just posted the Intro, Symptoms and Causes.
Introduction
One problem that many pregnant women complain about is pubic pain. Yet doctors and midwives often dismiss this pain as either 'inconsequential', 'unfixable', or 'just one of those pregnancy discomforts that have to be endured'. Occasionally, some uninformed doctors have even erroneously told women that such pubic pain means that they would need an elective cesarean section in order not to permanently damage that area during birth, or as a result of prior damage to the area.
Yet none of this is true. Pubic pain in pregnancy is certainly not 'inconsequential'; Kmom knows from experience that it can be very difficult to deal with. Although many doctors and midwives do not know what causes it or how to fix it, many women are able to get improvement or relief with chiropractic treatment or osteopathic manipulation. It is not something that you 'just have to live with'. And although extra care should be taken during labor and birth in order to prevent trauma, it absolutely does NOT mean that you 'have' to have a cesarean!
This purpose of this FAQ is to discuss what causes pelvic/pubic pain, what some of the symptoms are, possible causes, hints for coping with pubic pain, how to prevent further trauma during birth, what kinds of treatments are available, and women's experiences with these treatments.
Anatomy and Structure
Your pelvis is a kind of a circular bone that goes all around and almost meets in the middle in front. The two sides do not quite touch; there is a small gap between them connected by fibrocartilaginous tissue reinforced by several ligaments. This area is called the Pubic Symphysis. This is important for helping your pubic bone to move freely, stabilizing the pelvis while allowing a good range of motion. [An illustration of the pelvis can be found at http://omie.med.jhmi.edu/weblec/templatev1/lec11.html.]
The Pubic Symphysis and the Sacro-Iliac joints (in the back of the pelvis) are especially important during pregnancy, as their flexibility allows the bones to move freely and to expand to help a baby fit through more easily during birth. In fact, the pregnancy hormones relaxin and progesterone help the ligaments of your body to loosen and be even MORE flexible than before, so that there is plenty of 'give' and lots of room for the baby to slip right through.
Because of these hormones, it is normal for there to be some extra looseness and pelvic pressure in pregnancy. This is good---it means your body is getting ready for birth! It's loosening up to give you maximum space and flexibility, and to help make things easy for you and your baby.
However, in some women, either because of excessive levels of hormones, extra sensitivity to hormones, or a pelvis that is out of alignment, this area is extra lax or there is extra pressure on the joint. In 1870, Snelling described this condition: "The affection appears to consist of a relaxation of the pelvic articulations, becoming apparent suddenly after parturition, or gradually during pregnancy; and permitting of a degree of mobility of the pelvic bones which effectually hinders locomotion, and gives rise to the most peculiar, distressing and alarming sensations."
Simply put, significant pubic pain is caused by the pelvic girdle area not working they way it should, probably because of hormones, misalignment of the pelvis, or an interaction of the two.
Although not every provider has a name for this condition, it is most commonly called Symphysis Pubis Dysfunction (or SPD), especially in Britain. Other names for it include:
* pubic shear (osteopathic term)
* symphyseal separation
* pubic symphysis separation
* separated symphysis
* pelvic girdle relaxation of pregnancy
* pelvic joint syndrome.
Diastasis Symphysis Pubis (DSP) is the name for the problem in its most severe form (where the pubic symphysis actually separates severely or tears). For ease of use, in this FAQ the 'milder' form will be referred to as SPD.
Symptoms
The symptoms of SPD vary from person to person, but almost all women who have it experience substantial pubic pain. Tenderness and pain down low in the front is common, but often this pain feels as if it's inside. The pubic area is generally very tender to the touch; many moms find it painful when the doctor or midwife pushes down on the pubic bone while measuring the uterus (fundal height).
Any activity that involves lifting one leg at a time or parting the legs tends to be particularly painful. Lifting the leg to put on clothes, getting out of a car, bending over, sitting down or getting up, walking up stairs, standing on one leg, lifting heavy objects, and walking in general tend to be difficult at times. Many women report that moving or turning over in bed is especially excruciating. One woman wrote, "There were days that I didn't think I was going to be able to get out of bed and actually had to roll out of bed and onto the floor to be able to do so!" [See her story below.]
Many movements become difficult when the pubic symphysis area is affected. Although the greatest pain is associated with movements of lifting one leg or parting the legs, some women experience a 'freezing', where they get up out of bed and find it hard to get their bodies moving right away--the hip bone seems stuck in place and won't move at first. Or they describe having to wait for it to 'pop into place' before being able to walk. The range of hip movement is usually affected, and abduction of the hips especially painful.
Many women also report sciatica (pain that shoots down the buttocks and leg) when pubic pain is present. SPD can also also be associated with bladder dysfunction, especially when going from lying down (or squatting) to a standing position. Some women also feel a 'clicking' when they walk or shift just 'so', or lots of pressure down low near the pubic area.
Many women with SPD also report very strong round ligament pain (pulling or tearing feelings in the abdomen when rolling over, moving suddenly, sneezing, coughing, getting up, etc.). Some chiropractors feel that round ligament pain can be an early symptom of SPD problems, and indicate the need for adjustments. Other providers consider round ligament pain normal, part of the body adjusting to the growing uterus. If experienced with pubic and/or low back pain, it probably is associated with the SPD.
Onset of Pain and Duration
Pubic pain often comes on early in pregnancy, even as early as 12 weeks. One mother reports that she had it at 17 weeks. She says:
When I woke up [from my nap] I could hardly move. It took me forever to walk into the next room. Felt like my hips/pelvis were glued together or something. Already this baby feels sooo heavy inside me, like lots of pressure. I've gained 4 lbs. so far, what's the deal? At night when I wake up to go to the bathroom, sometimes I can't move my legs/hips at all, and sometimes things have to 'pop' back into place. I think, what if there is a fire and I died 'cuz I'm too slow!...I thought this problem in my 1st pregnancy was from gaining so much/swelling and it got worse and worse and stayed till over 3 months postpartum."
Indeed, although pubic pain often does go away after pregnancy, many women find that it sticks around afterward, usually diminished but still present. If treatment to resolve any underlying causes is not done, long-term pain usually sticks around. Anecdotally, this often seems to be associated with long-term low back pain or reduced flexibility in the hips. Even worse, if the mother is mishandled during the birth, the pubic symphysis can separate even more or be permanently damaged. This is called Diastasis Symphysis Pubis (diastasis means gap or separation).
Summary
To summarize, SPD is the mild form of this problem. Its symptoms often include one or more of the following:
* pubic pain
* pubic tenderness to the touch; having the fundal height measured may be uncomfortable
* lower back pain, especially in the sacro-iliac area
* difficulty/pain rolling over in bed
* difficulty/pain with stairs, getting in and out of cars, sitting down or getting up, putting on clothes, bending, lifting, standing on one foot, lifting heavy objects, etc.
* sciatica (pain in buttocks and down the leg)
* "clicking" in the pelvis when walking
* waddling gait
* difficulty getting started walking, especially after sleep
* feeling like hip is out of place or has to pop into place before walking
* bladder dysfunction (temporary incontinence at change in position)
* knee pain or pain in other areas can sometimes also be a side-effect of pelvis problems
* some chiropractors feel that round ligament pain (sharp tearing or pulling sensations in the abdomen) can be related to SPD
Cause
No one knows why SPD occurs for sure, or why it happens in some women and not in others. Some ethnic groups report a high incidence, especially Scandinavian women and perhaps Black women. Other risk factors may include having lots of kids, having had large babies, pre-existing problems with this joint, past pelvic or back pain, or past trauma (car accident, obstetric trauma, etc.) that may have damaged the pelvic girdle area. It also seems logical that women who have broken or injured their pelvis in the past would probably be prone to this problem.
Some sources view SPD simply as a result of pregnancy hormones. As noted, the pregnancy hormones relaxin and progesterone tend to loosen the ligaments of the body in preparation for birth. One theory is that some women have high levels of hormones before pregnancy, and then additional pregnancy hormones cause excessive relaxation of ligaments, especially in the pelvis.
Another theory is that some women manufacture excessive levels of relaxin during pregnancy, causing pelvic laxity. However, although still popular, this theory seems to have been disproven by recent research. Another theory is that women whose joints are especially flexible before pregnancy may be more susceptible to the effect of hormones, or that some women's bodies are just more affected by hormones than others. Traditional medical sources tend to view the problem of pelvic/pubic pain (when they acknowledge it at all) as simply a hormone problem.
A different theory holds that the problem is structural instead, and usually results from a misalignment of the pelvis. In this view, if the pelvis gets out of alignment, the bones don't line up correctly in front, and this puts a lot of extra pressure on that pubic symphysis cartilage. If the two sides are not aligned, it restricts full range of motion, pulling on the connecting pubic symphysis, and making it quite painful. The more out of alignment it is, the more painful this area becomes. It also tends to affect the back, especially in the sacroiliac area, since the pelvis and back are interconnected and work as a unit. And since many areas are affected by back problems, pain can also extend to other areas too.
Kmom's personal opinion is that this condition is probably primarily a problem of misalignment, although hormone levels and sensitivity to hormones may also play a role. In her opinion, the first line of SPD treatment should probably address the possibility of misalignment. Others may not agree. But whatever the cause, SPD is certainly annoying and painful to deal with, and Kmom knows this from personal experience!
Introduction
One problem that many pregnant women complain about is pubic pain. Yet doctors and midwives often dismiss this pain as either 'inconsequential', 'unfixable', or 'just one of those pregnancy discomforts that have to be endured'. Occasionally, some uninformed doctors have even erroneously told women that such pubic pain means that they would need an elective cesarean section in order not to permanently damage that area during birth, or as a result of prior damage to the area.
Yet none of this is true. Pubic pain in pregnancy is certainly not 'inconsequential'; Kmom knows from experience that it can be very difficult to deal with. Although many doctors and midwives do not know what causes it or how to fix it, many women are able to get improvement or relief with chiropractic treatment or osteopathic manipulation. It is not something that you 'just have to live with'. And although extra care should be taken during labor and birth in order to prevent trauma, it absolutely does NOT mean that you 'have' to have a cesarean!
This purpose of this FAQ is to discuss what causes pelvic/pubic pain, what some of the symptoms are, possible causes, hints for coping with pubic pain, how to prevent further trauma during birth, what kinds of treatments are available, and women's experiences with these treatments.
Anatomy and Structure
Your pelvis is a kind of a circular bone that goes all around and almost meets in the middle in front. The two sides do not quite touch; there is a small gap between them connected by fibrocartilaginous tissue reinforced by several ligaments. This area is called the Pubic Symphysis. This is important for helping your pubic bone to move freely, stabilizing the pelvis while allowing a good range of motion. [An illustration of the pelvis can be found at http://omie.med.jhmi.edu/weblec/templatev1/lec11.html.]
The Pubic Symphysis and the Sacro-Iliac joints (in the back of the pelvis) are especially important during pregnancy, as their flexibility allows the bones to move freely and to expand to help a baby fit through more easily during birth. In fact, the pregnancy hormones relaxin and progesterone help the ligaments of your body to loosen and be even MORE flexible than before, so that there is plenty of 'give' and lots of room for the baby to slip right through.
Because of these hormones, it is normal for there to be some extra looseness and pelvic pressure in pregnancy. This is good---it means your body is getting ready for birth! It's loosening up to give you maximum space and flexibility, and to help make things easy for you and your baby.
However, in some women, either because of excessive levels of hormones, extra sensitivity to hormones, or a pelvis that is out of alignment, this area is extra lax or there is extra pressure on the joint. In 1870, Snelling described this condition: "The affection appears to consist of a relaxation of the pelvic articulations, becoming apparent suddenly after parturition, or gradually during pregnancy; and permitting of a degree of mobility of the pelvic bones which effectually hinders locomotion, and gives rise to the most peculiar, distressing and alarming sensations."
Simply put, significant pubic pain is caused by the pelvic girdle area not working they way it should, probably because of hormones, misalignment of the pelvis, or an interaction of the two.
Although not every provider has a name for this condition, it is most commonly called Symphysis Pubis Dysfunction (or SPD), especially in Britain. Other names for it include:
* pubic shear (osteopathic term)
* symphyseal separation
* pubic symphysis separation
* separated symphysis
* pelvic girdle relaxation of pregnancy
* pelvic joint syndrome.
Diastasis Symphysis Pubis (DSP) is the name for the problem in its most severe form (where the pubic symphysis actually separates severely or tears). For ease of use, in this FAQ the 'milder' form will be referred to as SPD.
Symptoms
The symptoms of SPD vary from person to person, but almost all women who have it experience substantial pubic pain. Tenderness and pain down low in the front is common, but often this pain feels as if it's inside. The pubic area is generally very tender to the touch; many moms find it painful when the doctor or midwife pushes down on the pubic bone while measuring the uterus (fundal height).
Any activity that involves lifting one leg at a time or parting the legs tends to be particularly painful. Lifting the leg to put on clothes, getting out of a car, bending over, sitting down or getting up, walking up stairs, standing on one leg, lifting heavy objects, and walking in general tend to be difficult at times. Many women report that moving or turning over in bed is especially excruciating. One woman wrote, "There were days that I didn't think I was going to be able to get out of bed and actually had to roll out of bed and onto the floor to be able to do so!" [See her story below.]
Many movements become difficult when the pubic symphysis area is affected. Although the greatest pain is associated with movements of lifting one leg or parting the legs, some women experience a 'freezing', where they get up out of bed and find it hard to get their bodies moving right away--the hip bone seems stuck in place and won't move at first. Or they describe having to wait for it to 'pop into place' before being able to walk. The range of hip movement is usually affected, and abduction of the hips especially painful.
Many women also report sciatica (pain that shoots down the buttocks and leg) when pubic pain is present. SPD can also also be associated with bladder dysfunction, especially when going from lying down (or squatting) to a standing position. Some women also feel a 'clicking' when they walk or shift just 'so', or lots of pressure down low near the pubic area.
Many women with SPD also report very strong round ligament pain (pulling or tearing feelings in the abdomen when rolling over, moving suddenly, sneezing, coughing, getting up, etc.). Some chiropractors feel that round ligament pain can be an early symptom of SPD problems, and indicate the need for adjustments. Other providers consider round ligament pain normal, part of the body adjusting to the growing uterus. If experienced with pubic and/or low back pain, it probably is associated with the SPD.
Onset of Pain and Duration
Pubic pain often comes on early in pregnancy, even as early as 12 weeks. One mother reports that she had it at 17 weeks. She says:
When I woke up [from my nap] I could hardly move. It took me forever to walk into the next room. Felt like my hips/pelvis were glued together or something. Already this baby feels sooo heavy inside me, like lots of pressure. I've gained 4 lbs. so far, what's the deal? At night when I wake up to go to the bathroom, sometimes I can't move my legs/hips at all, and sometimes things have to 'pop' back into place. I think, what if there is a fire and I died 'cuz I'm too slow!...I thought this problem in my 1st pregnancy was from gaining so much/swelling and it got worse and worse and stayed till over 3 months postpartum."
Indeed, although pubic pain often does go away after pregnancy, many women find that it sticks around afterward, usually diminished but still present. If treatment to resolve any underlying causes is not done, long-term pain usually sticks around. Anecdotally, this often seems to be associated with long-term low back pain or reduced flexibility in the hips. Even worse, if the mother is mishandled during the birth, the pubic symphysis can separate even more or be permanently damaged. This is called Diastasis Symphysis Pubis (diastasis means gap or separation).
Summary
To summarize, SPD is the mild form of this problem. Its symptoms often include one or more of the following:
* pubic pain
* pubic tenderness to the touch; having the fundal height measured may be uncomfortable
* lower back pain, especially in the sacro-iliac area
* difficulty/pain rolling over in bed
* difficulty/pain with stairs, getting in and out of cars, sitting down or getting up, putting on clothes, bending, lifting, standing on one foot, lifting heavy objects, etc.
* sciatica (pain in buttocks and down the leg)
* "clicking" in the pelvis when walking
* waddling gait
* difficulty getting started walking, especially after sleep
* feeling like hip is out of place or has to pop into place before walking
* bladder dysfunction (temporary incontinence at change in position)
* knee pain or pain in other areas can sometimes also be a side-effect of pelvis problems
* some chiropractors feel that round ligament pain (sharp tearing or pulling sensations in the abdomen) can be related to SPD
Cause
No one knows why SPD occurs for sure, or why it happens in some women and not in others. Some ethnic groups report a high incidence, especially Scandinavian women and perhaps Black women. Other risk factors may include having lots of kids, having had large babies, pre-existing problems with this joint, past pelvic or back pain, or past trauma (car accident, obstetric trauma, etc.) that may have damaged the pelvic girdle area. It also seems logical that women who have broken or injured their pelvis in the past would probably be prone to this problem.
Some sources view SPD simply as a result of pregnancy hormones. As noted, the pregnancy hormones relaxin and progesterone tend to loosen the ligaments of the body in preparation for birth. One theory is that some women have high levels of hormones before pregnancy, and then additional pregnancy hormones cause excessive relaxation of ligaments, especially in the pelvis.
Another theory is that some women manufacture excessive levels of relaxin during pregnancy, causing pelvic laxity. However, although still popular, this theory seems to have been disproven by recent research. Another theory is that women whose joints are especially flexible before pregnancy may be more susceptible to the effect of hormones, or that some women's bodies are just more affected by hormones than others. Traditional medical sources tend to view the problem of pelvic/pubic pain (when they acknowledge it at all) as simply a hormone problem.
A different theory holds that the problem is structural instead, and usually results from a misalignment of the pelvis. In this view, if the pelvis gets out of alignment, the bones don't line up correctly in front, and this puts a lot of extra pressure on that pubic symphysis cartilage. If the two sides are not aligned, it restricts full range of motion, pulling on the connecting pubic symphysis, and making it quite painful. The more out of alignment it is, the more painful this area becomes. It also tends to affect the back, especially in the sacroiliac area, since the pelvis and back are interconnected and work as a unit. And since many areas are affected by back problems, pain can also extend to other areas too.
Kmom's personal opinion is that this condition is probably primarily a problem of misalignment, although hormone levels and sensitivity to hormones may also play a role. In her opinion, the first line of SPD treatment should probably address the possibility of misalignment. Others may not agree. But whatever the cause, SPD is certainly annoying and painful to deal with, and Kmom knows this from personal experience!
Monday, February 1, 2010
Due Date Rant
So on January 5th, 2o1o we had an Ultrasound to look at the baby and see how she is doing. At that time we were told the baby weighed in at approx. 1903 grams.
For those of you who do not know math you multiply that by 2.2 pounds to get the weight in pounds. So for those who want the quick answer our daughter is weighing in at approx. 4 pounds 2 ounces.
With that being said this I think goes to prove that I am actually 35 weeks not 31 weeks like the first ultrasound had guesstimated.
So hopefully in the next 4 weeks we will have a baby. I am actually thinking on trying Castrol Oil to see if it will help induce the pregnancy. If it does I would be so happy :D At this point in time I believe the baby would be healthy enough to survive.
When we had the first ultrasound done the tech asked me how far along I was I said approx. 12 weeks. After the ultrasound was done she claimed I was 8 weeks not 12 weeks. With the baby weighing in as much as she did on January 5th, I believe my dates were correct which would put me at 35 weeks not 31 weeks like the ultrasound say I am to be.
Sigh so here is hopefully to a speedy February :D so we can get this show on the road. :D
For those of you who do not know math you multiply that by 2.2 pounds to get the weight in pounds. So for those who want the quick answer our daughter is weighing in at approx. 4 pounds 2 ounces.
With that being said this I think goes to prove that I am actually 35 weeks not 31 weeks like the first ultrasound had guesstimated.
So hopefully in the next 4 weeks we will have a baby. I am actually thinking on trying Castrol Oil to see if it will help induce the pregnancy. If it does I would be so happy :D At this point in time I believe the baby would be healthy enough to survive.
When we had the first ultrasound done the tech asked me how far along I was I said approx. 12 weeks. After the ultrasound was done she claimed I was 8 weeks not 12 weeks. With the baby weighing in as much as she did on January 5th, I believe my dates were correct which would put me at 35 weeks not 31 weeks like the ultrasound say I am to be.
Sigh so here is hopefully to a speedy February :D so we can get this show on the road. :D
Thrombosed External Hemorrhoid
These things are extremely painful. OMG. I have read that most women would rather be in labor than to have these. Even the smallest thrombosed hemorrhoid can lead to extreme pain. On Thursday the 28th of January I had a clot removed from one that was the size of a grape. But the nurse practitioner missed the other clot so it is still there just not as painful but still uncomfortable.
On February 1st, I decided to walk back up and see if they could do anything because it has been really awkward and feels like I am walking around with a stool in my pants, when I am not. But I also noticed I have a smaller one, about 2mm that is it and it was more painful than the one that was the size of a grape.
So I had that one removed and was told I am doing the right thing using the Anusol HC Ointment, Sitz Baths, Tucks Pads and Witchhazel, warm baths,laying on my left side to allow the circulation to get better which will decrease the swelling and eventually make it go away. I was also told that because I am pregnant it may not go away until after the baby is born. SIGH.
Anyways that is my rant, below is what Thrombosed External Hemorrhoids are.
What Thrombosed Hemorrhoid Look and Feel Like
Veins in the anus or outside of the rectum can start to swell and become external when they protrude outward from these areas. When blood flow becomes restricted in these veins, the vessels tend to split, causing pools of blood to form and clot under the skin. When this happens, you get a thrombosed hemorrhoid.
Thrombosed hemorrhoids are easy to spot and felt. They can be either hard or soft to the touch. Referred to as a skin tag, these lumps feel like small masses of skin. Thrombosed hemorrhoids also appear to be blue in color. This is because the veins are strangled under the skin and there is no regular blood flow through them. Upon being irritated, they can also turn red.
While they are not considered dangerous, thrombosed hemorrhoids do cause considerable pain and swelling because they affect the nerve endings located in the anal skin. Bleeding is not common but it can occur if the blood clot oozes or receives friction.
Possible Causes
Common causes of thrombosed hemorrhoids include sitting for long periods of time, straining too much during a bowel movement, lifting weights, and giving birth.
Treatment of Thrombosed Hemorrhoids
It is possible for blood clots to break up and be re-absorbed by your body. This can happen over a four to six week period. However, if a thrombosed hemorrhoid grows and creates more pain or there is considerable swelling, it may be necessary to have surgery.
Removing a blood clot can be done at a doctor's office or as an outpatient procedure. Under no circumstances should a blood clot be removed at home as it can lead to severe bleeding and trauma.
The doctor has a number of procedures to choose from when extracting a blood clot. Once quick and easy choice is to make a cut above the clot so it can be squeezed out. However, the probability of blood clots reforming and additional pain remains greater with this procedure. While more intrusive, a full hemorrhoidectomy removes the clot and the blood vessels, leading to better cure results. Both procedures use local anesthesia to numb the area that needs to be cut.
It is recommended that thrombosed hemorrhoids surgery be done within the first three days of symptoms. After that period of time, the level of hemeroids symptom relief may not be as significant and there could be more recovery time required. There is also the possibility that the thrombosed hemorrhoids will go away without treatment.
Alternative Treatments to Consider
Outside of surgery, there are a number of alternative treatments that can bring relief from thrombosed hemorrhoids. These treatments include warm baths and creams to alleviate the inflammation and pain. Dietary changes, including the addition of fiber sources, can solve constipation and soften stools. One of many natural treatments now available, Venapro uses pure botanical and herbal extracts known to soothe and heal. This effective alternative improves venous circulation while calming inflamed areas with absolutely no side effects.
How to Choose a Thrombosed Hemorrhoids Treatment
The level of pain you experience will help you determine the right thrombosed hemorrhoids treatment for you. For example, if the pain prohibits your common daily activities, such as walking, working, sleeping or exercising, surgery is probably the solution. However, minor pain that seems to dissipate might indicate that your thrombosed hemorrhoid is going away on its own and should be left alone or treated with a natural alternative like Venapro.
On February 1st, I decided to walk back up and see if they could do anything because it has been really awkward and feels like I am walking around with a stool in my pants, when I am not. But I also noticed I have a smaller one, about 2mm that is it and it was more painful than the one that was the size of a grape.
So I had that one removed and was told I am doing the right thing using the Anusol HC Ointment, Sitz Baths, Tucks Pads and Witchhazel, warm baths,laying on my left side to allow the circulation to get better which will decrease the swelling and eventually make it go away. I was also told that because I am pregnant it may not go away until after the baby is born. SIGH.
Anyways that is my rant, below is what Thrombosed External Hemorrhoids are.
What Thrombosed Hemorrhoid Look and Feel Like
Veins in the anus or outside of the rectum can start to swell and become external when they protrude outward from these areas. When blood flow becomes restricted in these veins, the vessels tend to split, causing pools of blood to form and clot under the skin. When this happens, you get a thrombosed hemorrhoid.
Thrombosed hemorrhoids are easy to spot and felt. They can be either hard or soft to the touch. Referred to as a skin tag, these lumps feel like small masses of skin. Thrombosed hemorrhoids also appear to be blue in color. This is because the veins are strangled under the skin and there is no regular blood flow through them. Upon being irritated, they can also turn red.
While they are not considered dangerous, thrombosed hemorrhoids do cause considerable pain and swelling because they affect the nerve endings located in the anal skin. Bleeding is not common but it can occur if the blood clot oozes or receives friction.
Possible Causes
Common causes of thrombosed hemorrhoids include sitting for long periods of time, straining too much during a bowel movement, lifting weights, and giving birth.
Treatment of Thrombosed Hemorrhoids
It is possible for blood clots to break up and be re-absorbed by your body. This can happen over a four to six week period. However, if a thrombosed hemorrhoid grows and creates more pain or there is considerable swelling, it may be necessary to have surgery.
Removing a blood clot can be done at a doctor's office or as an outpatient procedure. Under no circumstances should a blood clot be removed at home as it can lead to severe bleeding and trauma.
The doctor has a number of procedures to choose from when extracting a blood clot. Once quick and easy choice is to make a cut above the clot so it can be squeezed out. However, the probability of blood clots reforming and additional pain remains greater with this procedure. While more intrusive, a full hemorrhoidectomy removes the clot and the blood vessels, leading to better cure results. Both procedures use local anesthesia to numb the area that needs to be cut.
It is recommended that thrombosed hemorrhoids surgery be done within the first three days of symptoms. After that period of time, the level of hemeroids symptom relief may not be as significant and there could be more recovery time required. There is also the possibility that the thrombosed hemorrhoids will go away without treatment.
Alternative Treatments to Consider
Outside of surgery, there are a number of alternative treatments that can bring relief from thrombosed hemorrhoids. These treatments include warm baths and creams to alleviate the inflammation and pain. Dietary changes, including the addition of fiber sources, can solve constipation and soften stools. One of many natural treatments now available, Venapro uses pure botanical and herbal extracts known to soothe and heal. This effective alternative improves venous circulation while calming inflamed areas with absolutely no side effects.
How to Choose a Thrombosed Hemorrhoids Treatment
The level of pain you experience will help you determine the right thrombosed hemorrhoids treatment for you. For example, if the pain prohibits your common daily activities, such as walking, working, sleeping or exercising, surgery is probably the solution. However, minor pain that seems to dissipate might indicate that your thrombosed hemorrhoid is going away on its own and should be left alone or treated with a natural alternative like Venapro.
Wednesday, January 27, 2010
Signs of labor
Is there any way to predict when I'm going to go into labor?
Not really. Experts don't fully understand what triggers the onset of labor, and there's no way to predict exactly when it will start.
Your body actually starts preparing for labor up to a month before you give birth. You may be blissfully unaware of what's going on — or you may begin to notice new symptoms as your due date draws near. Here are some things that may happen in the weeks or days before labor starts:
Your baby "drops."
If this is your first pregnancy, you may feel what's known as "lightening" a few weeks before labor starts. You might detect a heaviness in your pelvis as this happens and notice less pressure just below your ribcage, making it easier to catch your breath.
You note more Braxton Hicks contractions.
More frequent and intense Braxton Hicks contractions can signal pre-labor, during which your cervix ripens (see below) and the stage is set for true labor. Some women experience a crampy, menstrual-like feeling during this time.
Sometimes, as true labor draws near, Braxton Hicks contractions become relatively painful and strike as often as every ten to 20 minutes, making you wonder whether true labor has started. But if the contractions don't get longer, stronger, and closer together and cause your cervix to dilate progressively, then what you're feeling is probably so-called false labor.
Your cervix starts to ripen.
In the days and weeks before delivery, Braxton Hicks contractions may do the preliminary work of softening, thinning, and perhaps opening your cervix a bit. (If you've given birth before, your cervix is more likely to dilate a centimeter or two before labor starts, but keep in mind that even being 40 weeks pregnant with your first baby and 1 centimeter dilated is no guarantee that labor is imminent.)
When you're at or near your due date, your practitioner may do a vaginal exam during your prenatal visit to see whether your cervix has started to change.
You pass your mucus plug or notice "bloody show."
You may pass your mucus plug — the small amount of thickened mucus that has sealed your cervical canal during the last nine months — if your cervix begins to dilate as you get close to labor.
The plug may come out in a lump or as increased vaginal discharge over the course of several days. The mucus may be tinged with brown, pink, or red blood, which is why it's referred to as "bloody show." Having sex or a vaginal exam can also disturb your mucus plug and cause you to see some blood-tinged discharge, even when labor isn't going to start in the next few days.
Your water breaks.
When the fluid-filled amniotic sac surrounding your baby ruptures, fluid leaks from your vagina. And whether it comes out in a large gush or a small trickle, you should call your doctor or midwife.
Most women start having regular contractions before their water breaks, but in some cases, the water breaks first. When this happens, labor usually follows soon. If you don't start having contractions on your own within a certain amount of time, you'll need to be induced, since your baby's more likely to get an infection without the amniotic sac's protection against germs.
How can I tell whether my labor has actually started?
It's often not possible to pinpoint exactly when "true" labor begins because early labor contractions might start out feeling like the Braxton Hicks contractions you may have been noticing for weeks.
It's likely that labor is under way, however, when your contractions become increasingly longer, stronger, and closer together. They may be as far apart as every ten minutes or so in the beginning, but they won't stop or ease up no matter what you do. And in time, they'll become more painful and closer together.
In some cases, though, the onset of strong, regular contractions comes with little or no warning. It's different for every woman and with every pregnancy.
When should I call my doctor or midwife?
Toward the end of your pregnancy, your practitioner should give you a clear set of guidelines for when to let her know that you're having contractions and at what point she'll want you to go to the hospital or birth center.
These instructions will depend on your individual situation — whether you have pregnancy complications or are otherwise considered high-risk, whether this is your first baby, and practical matters like how far you live from the hospital or birth center — as well as on your caregiver's personal preference (some prefer an early heads-up).
If your pregnancy is uncomplicated, she'll probably have you wait to come in until you've been having contractions that last for about a minute each, coming every five minutes for about an hour. (You time a contraction from the beginning of one to the beginning of the next one.) As a rule, if you're high-risk, she'll want to hear from you earlier in labor.
Don't be afraid to call if the signs aren't clear but you think the time may have come. Doctors and midwives are used to getting calls from women who aren't sure whether they're in labor and need guidance. It's part of their job.
And the truth is, your caregiver can tell a lot by the sound of your voice, so verbal communication helps. She'll want to know how close together your contractions are, how long each one lasts, how strong they are (she'll note whether you can talk through a contraction), and any other symptoms you may have.
Finally, whether or not your pregnancy has been problem-free up to now, and whether or not you think you might be in labor, be sure to call your caregiver right away (and if you can't reach her, head for the hospital) in the following situations:
• Your water breaks or you suspect that you're leaking amniotic fluid. Tell your practitioner if it's yellow, brown, or greenish, because this signals the presence of meconium, your baby's first stool, which is sometimes a sign of fetal stress. It's also important to let her know if the fluid looks bloody.
• You notice that your baby is less active.
• You have vaginal bleeding (unless it's just bloody show — mucus with a spot or streak of blood), constant severe abdominal pain, or fever.
• You start having contractions before 37 weeks or any other signs of preterm labor.
• You have severe or persistent headaches, vision changes, intense pain or tenderness in your upper abdomen, abnormal swelling, or any other symptoms of preeclampsia.
Some women assume that various symptoms are just part and parcel of being pregnant, while others worry that every new symptom spells trouble. Knowing which pregnancy symptoms you should never ignore can help you decide when to call your caregiver.
That said, every pregnancy is different and no list can cover all situations, so if you're not sure whether a symptom is serious, or if you just don't feel like yourself or are uneasy, trust your instincts and call your healthcare provider. If there's a problem, you'll get help. If nothing's wrong, you'll be reassured.
Not really. Experts don't fully understand what triggers the onset of labor, and there's no way to predict exactly when it will start.
Your body actually starts preparing for labor up to a month before you give birth. You may be blissfully unaware of what's going on — or you may begin to notice new symptoms as your due date draws near. Here are some things that may happen in the weeks or days before labor starts:
Your baby "drops."
If this is your first pregnancy, you may feel what's known as "lightening" a few weeks before labor starts. You might detect a heaviness in your pelvis as this happens and notice less pressure just below your ribcage, making it easier to catch your breath.
You note more Braxton Hicks contractions.
More frequent and intense Braxton Hicks contractions can signal pre-labor, during which your cervix ripens (see below) and the stage is set for true labor. Some women experience a crampy, menstrual-like feeling during this time.
Sometimes, as true labor draws near, Braxton Hicks contractions become relatively painful and strike as often as every ten to 20 minutes, making you wonder whether true labor has started. But if the contractions don't get longer, stronger, and closer together and cause your cervix to dilate progressively, then what you're feeling is probably so-called false labor.
Your cervix starts to ripen.
In the days and weeks before delivery, Braxton Hicks contractions may do the preliminary work of softening, thinning, and perhaps opening your cervix a bit. (If you've given birth before, your cervix is more likely to dilate a centimeter or two before labor starts, but keep in mind that even being 40 weeks pregnant with your first baby and 1 centimeter dilated is no guarantee that labor is imminent.)
When you're at or near your due date, your practitioner may do a vaginal exam during your prenatal visit to see whether your cervix has started to change.
You pass your mucus plug or notice "bloody show."
You may pass your mucus plug — the small amount of thickened mucus that has sealed your cervical canal during the last nine months — if your cervix begins to dilate as you get close to labor.
The plug may come out in a lump or as increased vaginal discharge over the course of several days. The mucus may be tinged with brown, pink, or red blood, which is why it's referred to as "bloody show." Having sex or a vaginal exam can also disturb your mucus plug and cause you to see some blood-tinged discharge, even when labor isn't going to start in the next few days.
Your water breaks.
When the fluid-filled amniotic sac surrounding your baby ruptures, fluid leaks from your vagina. And whether it comes out in a large gush or a small trickle, you should call your doctor or midwife.
Most women start having regular contractions before their water breaks, but in some cases, the water breaks first. When this happens, labor usually follows soon. If you don't start having contractions on your own within a certain amount of time, you'll need to be induced, since your baby's more likely to get an infection without the amniotic sac's protection against germs.
How can I tell whether my labor has actually started?
It's often not possible to pinpoint exactly when "true" labor begins because early labor contractions might start out feeling like the Braxton Hicks contractions you may have been noticing for weeks.
It's likely that labor is under way, however, when your contractions become increasingly longer, stronger, and closer together. They may be as far apart as every ten minutes or so in the beginning, but they won't stop or ease up no matter what you do. And in time, they'll become more painful and closer together.
In some cases, though, the onset of strong, regular contractions comes with little or no warning. It's different for every woman and with every pregnancy.
When should I call my doctor or midwife?
Toward the end of your pregnancy, your practitioner should give you a clear set of guidelines for when to let her know that you're having contractions and at what point she'll want you to go to the hospital or birth center.
These instructions will depend on your individual situation — whether you have pregnancy complications or are otherwise considered high-risk, whether this is your first baby, and practical matters like how far you live from the hospital or birth center — as well as on your caregiver's personal preference (some prefer an early heads-up).
If your pregnancy is uncomplicated, she'll probably have you wait to come in until you've been having contractions that last for about a minute each, coming every five minutes for about an hour. (You time a contraction from the beginning of one to the beginning of the next one.) As a rule, if you're high-risk, she'll want to hear from you earlier in labor.
Don't be afraid to call if the signs aren't clear but you think the time may have come. Doctors and midwives are used to getting calls from women who aren't sure whether they're in labor and need guidance. It's part of their job.
And the truth is, your caregiver can tell a lot by the sound of your voice, so verbal communication helps. She'll want to know how close together your contractions are, how long each one lasts, how strong they are (she'll note whether you can talk through a contraction), and any other symptoms you may have.
Finally, whether or not your pregnancy has been problem-free up to now, and whether or not you think you might be in labor, be sure to call your caregiver right away (and if you can't reach her, head for the hospital) in the following situations:
• Your water breaks or you suspect that you're leaking amniotic fluid. Tell your practitioner if it's yellow, brown, or greenish, because this signals the presence of meconium, your baby's first stool, which is sometimes a sign of fetal stress. It's also important to let her know if the fluid looks bloody.
• You notice that your baby is less active.
• You have vaginal bleeding (unless it's just bloody show — mucus with a spot or streak of blood), constant severe abdominal pain, or fever.
• You start having contractions before 37 weeks or any other signs of preterm labor.
• You have severe or persistent headaches, vision changes, intense pain or tenderness in your upper abdomen, abnormal swelling, or any other symptoms of preeclampsia.
Some women assume that various symptoms are just part and parcel of being pregnant, while others worry that every new symptom spells trouble. Knowing which pregnancy symptoms you should never ignore can help you decide when to call your caregiver.
That said, every pregnancy is different and no list can cover all situations, so if you're not sure whether a symptom is serious, or if you just don't feel like yourself or are uneasy, trust your instincts and call your healthcare provider. If there's a problem, you'll get help. If nothing's wrong, you'll be reassured.
Braxton Hicks
What are Braxton Hicks contractions?
Braxton Hicks contractions are sporadic uterine contractions that start about 6 weeks into your pregnancy, although you won't be able to feel them that early. You probably won't start to notice them until sometime after mid-pregnancy, if you notice them at all. (Some women don't.) They get their name from John Braxton Hicks, an English doctor who first described them in 1872.
As your pregnancy progresses, Braxton Hicks contractions tend to come somewhat more often, but until you get to your last few weeks, they'll probably remain infrequent, irregular, and essentially painless. Sometimes, though, Braxton Hicks contractions are hard to distinguish from early signs of preterm labor.
Play it safe and don't try to make the diagnosis yourself. If you haven't hit 37 weeks yet and you're having more than four contractions in an hour — or you have any other signs of preterm labor (see below) — call your caregiver immediately.
By the time you're within a couple of weeks of your due date, your contractions may get more intense and more frequent, and they may cause some discomfort. Unlike the earlier painless and sporadic Braxton Hicks contractions, which caused no obvious cervical changes, these contractions may help your cervix "ripen" — gradually soften and thin out (efface) and maybe even dilate a bit. This period is sometimes referred to as pre-labor.
How can I tell the difference between Braxton Hicks and true labor contractions?
In the days or weeks before labor, Braxton Hicks contractions may intermittently become rhythmic, relatively close together, and even painful, possibly fooling you into thinking you're in labor. But unlike true labor, during this so-called false labor the contractions don't grow consistently longer, stronger, and closer together.
What can I do if my Braxton Hicks contractions are making me uncomfortable?
If you're within a few weeks of your due date, try these measures:
• Change your activity or position. Sometimes walking provides relief. At other times, resting eases contractions. (True labor contractions, on the other hand, will persist and progress regardless of what you do.)
• Take a warm bath to help your body relax.
• Try drinking a couple of glasses of water, since these contractions can sometimes be brought on by dehydration.
• Try relaxation exercises or slow, deep breathing. This won't stop the Braxton Hicks contractions, but it may help you cope with the discomfort. (Use this opportunity to practice some of the pain-management strategies you've learned in your childbirth preparation class.)
When should I call my doctor or midwife?
Call your caregiver right away if you haven't reached 37 weeks and your contractions are becoming more frequent, rhythmic, or painful, or if you have any of these possible signs of preterm labor:
• Abdominal pain, menstrual-like cramping, or more than four contractions in an hour (even if they don't hurt)
• Any vaginal bleeding or spotting
• An increase in vaginal discharge or a change in the type of discharge — if it becomes watery, mucusy, or bloody (even if it's only pink or blood-tinged)
• Increased pelvic pressure (a feeling that your baby's pushing down)
• Low back pain, especially if it's a new problem for you
If you're past 37 weeks, there's no need to call your doctor or midwife just for contractions until they last about 60 seconds each and are five minutes apart — unless your caregiver has advised you otherwise.
Braxton Hicks contractions are sporadic uterine contractions that start about 6 weeks into your pregnancy, although you won't be able to feel them that early. You probably won't start to notice them until sometime after mid-pregnancy, if you notice them at all. (Some women don't.) They get their name from John Braxton Hicks, an English doctor who first described them in 1872.
As your pregnancy progresses, Braxton Hicks contractions tend to come somewhat more often, but until you get to your last few weeks, they'll probably remain infrequent, irregular, and essentially painless. Sometimes, though, Braxton Hicks contractions are hard to distinguish from early signs of preterm labor.
Play it safe and don't try to make the diagnosis yourself. If you haven't hit 37 weeks yet and you're having more than four contractions in an hour — or you have any other signs of preterm labor (see below) — call your caregiver immediately.
By the time you're within a couple of weeks of your due date, your contractions may get more intense and more frequent, and they may cause some discomfort. Unlike the earlier painless and sporadic Braxton Hicks contractions, which caused no obvious cervical changes, these contractions may help your cervix "ripen" — gradually soften and thin out (efface) and maybe even dilate a bit. This period is sometimes referred to as pre-labor.
How can I tell the difference between Braxton Hicks and true labor contractions?
In the days or weeks before labor, Braxton Hicks contractions may intermittently become rhythmic, relatively close together, and even painful, possibly fooling you into thinking you're in labor. But unlike true labor, during this so-called false labor the contractions don't grow consistently longer, stronger, and closer together.
What can I do if my Braxton Hicks contractions are making me uncomfortable?
If you're within a few weeks of your due date, try these measures:
• Change your activity or position. Sometimes walking provides relief. At other times, resting eases contractions. (True labor contractions, on the other hand, will persist and progress regardless of what you do.)
• Take a warm bath to help your body relax.
• Try drinking a couple of glasses of water, since these contractions can sometimes be brought on by dehydration.
• Try relaxation exercises or slow, deep breathing. This won't stop the Braxton Hicks contractions, but it may help you cope with the discomfort. (Use this opportunity to practice some of the pain-management strategies you've learned in your childbirth preparation class.)
When should I call my doctor or midwife?
Call your caregiver right away if you haven't reached 37 weeks and your contractions are becoming more frequent, rhythmic, or painful, or if you have any of these possible signs of preterm labor:
• Abdominal pain, menstrual-like cramping, or more than four contractions in an hour (even if they don't hurt)
• Any vaginal bleeding or spotting
• An increase in vaginal discharge or a change in the type of discharge — if it becomes watery, mucusy, or bloody (even if it's only pink or blood-tinged)
• Increased pelvic pressure (a feeling that your baby's pushing down)
• Low back pain, especially if it's a new problem for you
If you're past 37 weeks, there's no need to call your doctor or midwife just for contractions until they last about 60 seconds each and are five minutes apart — unless your caregiver has advised you otherwise.
A childbirth cheat sheet for dads-to-be
One of the best ways to prepare for childbirth — an eye-opening experience for most of us — is to accompany your wife or partner to a childbirth education class. Almost all hospitals and birth centers hold sessions, and parents are usually given the option of attending two or three short evening sessions or one long daytime session. For me, the class was a great introduction to the big event, still several weeks off for us.
We decided to attend a one-day childbirth preparation class at our hospital (Alta Bates in Berkeley, California) rather than attend an offsite class, where the emphasis is more likely to be on natural childbirth. I'll confess up front that I thought 80 percent of the class would be about breathing exercises. Not quite.
We immediately hit it off with our instructor, Janaki Costello, a certified doula, childbirth educator, and board-certified lactation consultant. Here are the ten key lessons she passed along:
1. Recognize the onset of true labor
Late in their pregnancy, most women will experience false labor — Braxton Hicks contractions that may start out strong but taper off and then stop after a while. Look for these signs, among others, that your wife is experiencing the real deal:
• Her water may break, resulting in a trickle or a gush of fluid. When the amniotic sac (also called the bag of waters) breaks, 80 percent of women will spontaneously go into labor within 12 hours. Keep in mind, though, that contractions usually start before her water breaks.
• Persistent lower back pain, especially if your partner also complains about a crampy, premenstrual feeling.
• Contractions that occur at regular and increasingly shorter intervals and become longer and stronger in intensity.
• She passes the mucus plug, which blocks the cervix. This isn't necessarily a sign that labor is imminent — it could still be several days away — but, at the very least, it indicates that things are moving.
2. Know how to time the contractions
Make sure your watch has a readable second hand, and time your wife's contractions from the beginning of one contraction to the beginning of the next. If they're eight to 10 minutes apart and last 30 to 45 seconds each, your partner is likely in early labor. Your doctor or midwife can help you make the decision over the phone about when to come in. As a general rule-of-thumb, if the contractions are less than five minutes apart, last a minute or more, and continue in that pattern for an hour, you should get to the hospital. But some situations call for getting to the hospital sooner, so be sure to talk to your caregiver ahead of time about what's right for you.
3. Don't get to the hospital too early
Costello hit us over the head with this admonition: Don't head to the hospital the minute your partner goes into labor. If she's dilated to only 1 centimeter, chances are they'll send you home because you have a good ways to go. "Take a walk, go to the mall or a museum, hit the beach, catch a movie — anything to help you take your mind off the contractions," Costello said. "Try not to fixate on the clock. If it happens at night, try to get back to sleep for a few hours." Easier said than done, says my wife.
4. Know what to expect during labor
Forget those TV sitcom images where a woman goes into labor and a baby pops out by the second commercial. It sometimes happens that fast, but only rarely. For most, especially first-time mothers, labor is a journey, not an event. Bottom line: Don't expect this will be over in just a few hours. Every woman's experience is different, but it's helpful to understand that there are three distinct stages of labor:
First stage
The first stage really consists of three phases:
• Early phase. This phase typically lasts up to 14 hours or longer, although it's usually considerably shorter for second and subsequent babies. As labor progresses, the contractions get longer and stronger.
• Active phase. Often this phase lasts up to six or more hours, although it can be a lot shorter. You should be in the hospital or birth center by now or en route. Contractions are much more intense, last about 40 to 60 seconds, and are spaced 3 to 5 minutes apart. Breathing exercises, relaxation techniques, and coaching are all important now. If your partner is having trouble coping or she's not interested in a drug-free labor, this is when she might opt for an epidural or other pain relief.
• Transition phase. This phase can last anywhere from a few minutes to a several hours. It's here that your partner is most likely to swear at you like a truck driver. (Don't take it personally; even women who have coped well up to this point often "lose it" during the transition phase.) Contractions last 60 to 90 seconds and come two or three minutes apart.
Second stage
• Pushing and birth. The second stage can last from minutes to hours — the average is about an hour for a first-time pregnancy (longer if she's had an epidural) — and ends with a moment that's made up in equal parts of relief and breathtaking beauty: the birth of your baby. There's a lot to think about during this phase: Do you want to record the birth on video? Will you want to cut the cord? (Be sure to remind your doctor or midwife if you do.) Does your partner want to try to breastfeed immediately after birth? If the doctor or midwife or labor and delivery nurse doesn't make sure that happens, you'll need to be ready to advocate for her.
Third stage
• Delivery of the placenta. It's not over yet! This stage, which begins immediately after the birth of your baby and ends with the delivery of the placenta anywhere from one to 30 minutes later, is usually anticlimactic but necessary. Be aware, too, that your partner may get a case of the chills during this phase or feel very shaky. If that's the case, be ready to offer a warm blanket and to hold your newborn while she's regaining her strength.
5. Be an active participant
Costello looked at the half-dozen expectant fathers around the table. "Remember, dads, it's your baby, too. You're a critical part of the process."
In the days and weeks before your baby's due date, make sure both you and your wife are packed for the hospital, including a possible change of clothes, toiletries, and camera or camcorder, and other essentials. If you have a birth plan, you may need to let the labor and delivery nurses know about it (you should have already discussed it with your doctor or midwife).
During early labor, remind your partner to drink plenty of liquids. Pour her a glass of nonacidic juice such as apple juice or pineapple juice, honey and water, an herbal tea, or just plain water to ward off dehydration. Offer her a bagel, yogurt, or something bland — she might not get anything solid to eat at the hospital for many hours after the baby's birth. Finish packing.
When you head to the hospital, drive carefully. This isn't the time for taking unnecessary chances. When you get to the labor room, stick around to provide comfort and support. "The transition stage is not the time to head out for a long lunch," Costello advised. Feel free to bring fruit or other snacks along if it's in the middle of the night.
6. Be an advocate for your partner
The doctor or midwife and nurses are there to make sure your partner and baby do well during labor and birth. But you have a big role in helping your partner get comfortable and in communicating her wishes. You and she also have a big say in personalizing your room. When it's time to rest, soften the lighting. Freshen the smell by taking along aromatherapy balls, potpourri, or scented oils. Bring pictures and your own music. I found a portable CD player in the garage and packed some of my wife's favorite CDs.
7. Know how to play coach
Take your cues from your partner. Some women love having a massage or having their hair stroked during labor. Others don't. And it may be hard to predict ahead of time what your partner will prefer. In any case, try to reassure her that she's doing fine and be ready to help in any way she asks. See more tips on how to be a great labor coach.
8. Be prepared
We watched two videos of vaginal births and one of a c-section. All showed the messy, unglamorous side of labor. Don't be surprised if your baby's skin looks wrinkled or his head is molded into a cone shape, and, in truth, he doesn't even look like a baby.
9. Cut the cord if you want
Today, most dads choose to cut the baby's umbilical cord in the first minutes after birth. "It's your right, but sometimes they forget," Costello said, "so make sure you remind your doctor or midwife."
We decided to attend a one-day childbirth preparation class at our hospital (Alta Bates in Berkeley, California) rather than attend an offsite class, where the emphasis is more likely to be on natural childbirth. I'll confess up front that I thought 80 percent of the class would be about breathing exercises. Not quite.
We immediately hit it off with our instructor, Janaki Costello, a certified doula, childbirth educator, and board-certified lactation consultant. Here are the ten key lessons she passed along:
1. Recognize the onset of true labor
Late in their pregnancy, most women will experience false labor — Braxton Hicks contractions that may start out strong but taper off and then stop after a while. Look for these signs, among others, that your wife is experiencing the real deal:
• Her water may break, resulting in a trickle or a gush of fluid. When the amniotic sac (also called the bag of waters) breaks, 80 percent of women will spontaneously go into labor within 12 hours. Keep in mind, though, that contractions usually start before her water breaks.
• Persistent lower back pain, especially if your partner also complains about a crampy, premenstrual feeling.
• Contractions that occur at regular and increasingly shorter intervals and become longer and stronger in intensity.
• She passes the mucus plug, which blocks the cervix. This isn't necessarily a sign that labor is imminent — it could still be several days away — but, at the very least, it indicates that things are moving.
2. Know how to time the contractions
Make sure your watch has a readable second hand, and time your wife's contractions from the beginning of one contraction to the beginning of the next. If they're eight to 10 minutes apart and last 30 to 45 seconds each, your partner is likely in early labor. Your doctor or midwife can help you make the decision over the phone about when to come in. As a general rule-of-thumb, if the contractions are less than five minutes apart, last a minute or more, and continue in that pattern for an hour, you should get to the hospital. But some situations call for getting to the hospital sooner, so be sure to talk to your caregiver ahead of time about what's right for you.
3. Don't get to the hospital too early
Costello hit us over the head with this admonition: Don't head to the hospital the minute your partner goes into labor. If she's dilated to only 1 centimeter, chances are they'll send you home because you have a good ways to go. "Take a walk, go to the mall or a museum, hit the beach, catch a movie — anything to help you take your mind off the contractions," Costello said. "Try not to fixate on the clock. If it happens at night, try to get back to sleep for a few hours." Easier said than done, says my wife.
4. Know what to expect during labor
Forget those TV sitcom images where a woman goes into labor and a baby pops out by the second commercial. It sometimes happens that fast, but only rarely. For most, especially first-time mothers, labor is a journey, not an event. Bottom line: Don't expect this will be over in just a few hours. Every woman's experience is different, but it's helpful to understand that there are three distinct stages of labor:
First stage
The first stage really consists of three phases:
• Early phase. This phase typically lasts up to 14 hours or longer, although it's usually considerably shorter for second and subsequent babies. As labor progresses, the contractions get longer and stronger.
• Active phase. Often this phase lasts up to six or more hours, although it can be a lot shorter. You should be in the hospital or birth center by now or en route. Contractions are much more intense, last about 40 to 60 seconds, and are spaced 3 to 5 minutes apart. Breathing exercises, relaxation techniques, and coaching are all important now. If your partner is having trouble coping or she's not interested in a drug-free labor, this is when she might opt for an epidural or other pain relief.
• Transition phase. This phase can last anywhere from a few minutes to a several hours. It's here that your partner is most likely to swear at you like a truck driver. (Don't take it personally; even women who have coped well up to this point often "lose it" during the transition phase.) Contractions last 60 to 90 seconds and come two or three minutes apart.
Second stage
• Pushing and birth. The second stage can last from minutes to hours — the average is about an hour for a first-time pregnancy (longer if she's had an epidural) — and ends with a moment that's made up in equal parts of relief and breathtaking beauty: the birth of your baby. There's a lot to think about during this phase: Do you want to record the birth on video? Will you want to cut the cord? (Be sure to remind your doctor or midwife if you do.) Does your partner want to try to breastfeed immediately after birth? If the doctor or midwife or labor and delivery nurse doesn't make sure that happens, you'll need to be ready to advocate for her.
Third stage
• Delivery of the placenta. It's not over yet! This stage, which begins immediately after the birth of your baby and ends with the delivery of the placenta anywhere from one to 30 minutes later, is usually anticlimactic but necessary. Be aware, too, that your partner may get a case of the chills during this phase or feel very shaky. If that's the case, be ready to offer a warm blanket and to hold your newborn while she's regaining her strength.
5. Be an active participant
Costello looked at the half-dozen expectant fathers around the table. "Remember, dads, it's your baby, too. You're a critical part of the process."
In the days and weeks before your baby's due date, make sure both you and your wife are packed for the hospital, including a possible change of clothes, toiletries, and camera or camcorder, and other essentials. If you have a birth plan, you may need to let the labor and delivery nurses know about it (you should have already discussed it with your doctor or midwife).
During early labor, remind your partner to drink plenty of liquids. Pour her a glass of nonacidic juice such as apple juice or pineapple juice, honey and water, an herbal tea, or just plain water to ward off dehydration. Offer her a bagel, yogurt, or something bland — she might not get anything solid to eat at the hospital for many hours after the baby's birth. Finish packing.
When you head to the hospital, drive carefully. This isn't the time for taking unnecessary chances. When you get to the labor room, stick around to provide comfort and support. "The transition stage is not the time to head out for a long lunch," Costello advised. Feel free to bring fruit or other snacks along if it's in the middle of the night.
6. Be an advocate for your partner
The doctor or midwife and nurses are there to make sure your partner and baby do well during labor and birth. But you have a big role in helping your partner get comfortable and in communicating her wishes. You and she also have a big say in personalizing your room. When it's time to rest, soften the lighting. Freshen the smell by taking along aromatherapy balls, potpourri, or scented oils. Bring pictures and your own music. I found a portable CD player in the garage and packed some of my wife's favorite CDs.
7. Know how to play coach
Take your cues from your partner. Some women love having a massage or having their hair stroked during labor. Others don't. And it may be hard to predict ahead of time what your partner will prefer. In any case, try to reassure her that she's doing fine and be ready to help in any way she asks. See more tips on how to be a great labor coach.
8. Be prepared
We watched two videos of vaginal births and one of a c-section. All showed the messy, unglamorous side of labor. Don't be surprised if your baby's skin looks wrinkled or his head is molded into a cone shape, and, in truth, he doesn't even look like a baby.
9. Cut the cord if you want
Today, most dads choose to cut the baby's umbilical cord in the first minutes after birth. "It's your right, but sometimes they forget," Costello said, "so make sure you remind your doctor or midwife."
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