Transcript: Precipitous Labor: Preparing for Short Labor

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Preggie Pals
Precipitous Labor: Preparing for Short Labor

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[00:00:00]

[Theme Music]

Gerri Ryan: If your entire labor and delivery is three hours or less it’s known as a precipitous labor. And while the thought of having a condensed labor may sound like a good thing there are possible complications and decisions to make if you think you and your baby may be at risk. I’m Gerri Ryan, a licensed midwife with an active birth practice here in San Diego and this is Preggie Pals episode 45.

[Theme Music/Intro]

Sunny Gault: Welcome to Preggie Pals, broadcasting from the Birth Education Center of San Diego. I’m your host, Sunny Gault. Have you downloaded our amazing Preggie Pals app? This is a great way to listen to our shows on the go and they are available in both the Amazon and iTunes marketplace. Did you miss an older episode of Preggie Pals? Then join the Preggie Pals Club. You’ll get access to all of our episodes, transcripts and special bonus content after each show. Our club members even get a one-year free subscription to Pregnancy Magazine. Visit our website for more information and to sign up. Ok, so let’s dive into this. Let’s introduce our panelists here. We have one panelist joining us over the phone and one here in the studio. So we’re going to start here in the studio with Amy. Hi, Amy!

Amy Askin: Good morning, hi. I’m Amy Askin. I’m 39, really 29. (Laughs)

Sunny Gault: I’m going to start using that I think.

Amy Askin: I’m 29 in my mind. I am a work-at-home mom and I blog for belovedatmosphere.com and do a side business of vacation rental property. I have three girls. Yes, three girls, three little mermaids who are 8, 3, and a newborn who’s one month today.

Sunny Gault: Oh, congratulations! And you did have with the last one a precipitous labor.

Amy Askin: I did have a precipitous labor and didn’t know what that was until I experienced it.

Sunny Gault: Ok. We’re going to dive into that a little more later in the conversation because I do want to hear about your experience. And joining us on the phone is Rachel Adams Gonzales. Rachel has been a panelist on our show before. Hello, Rachel!

Rachel Adams Gonzales: Hello! My name is Rachel Adams Gonzales, like you said. I am 29 and I am a product consultant for doTERRA Essential Oils. My son will be three in a couple of weeks – I had a water birth with him – and my daughter is three weeks old and 34½ weeks gestation and we had an unexpected hospital birth.

Sunny Gault: Ok. Thank you, ladies, for joining us today.

[Theme Music]

[Featured Segment: Ask The Experts. Comfort Through Miscarriages]

Sunny Gault: Alright! We have a question from one of our Facebook friends. This comes from Becky and Becky writes:
“My sister and brother-in-law are having a hard time conceiving their first child. To date they have had three miscarriages, all in the first trimester. It’s really hard to watch my sister go through this. What advice do you have for being supportive yet practical with my sister so she doesn’t get her heart broken if this happens again?”

Yvonne Rothermel: Hi! This is Yvonne Rothermel, licensed clinical social worker. Hi, Becky! First of all I would like to say that just by the fact that you cared enough to write into Preggie Pals about your sister’s multiple miscarriages tells me that you already have what your sister needs most from you. It must be such a helpless feeling for you to watch your sister and brother-in-law endure so many losses. Unfortunately, as much as you want to, there’s nothing you can do to protect their hearts from being broken again. However there is a lot you can do to provide them with support. Everyone copes differently with losses. And I would stay in tune to what their needs are individually and as a couple. You can let them know that you think of them all the time and that you know this is a difficult time for them. You can frequently call and check in if this is helpful for your sister. Or, if she and your brother-in-law are isolating more, which isn’t uncommon with losses, I’d write them emails or send a quick text saying “Just thinking of you. No need to get back to me. Just letting you know I’m here for you.”

I would stay sensitive to how your sister and brother-in-law are experiencing their world right now. Are there many friends and relatives around them that are pregnant or having babies? As you know, this will be difficult for them and they may not want to attend as many social events. As someone close to them you can provide sensitivity to these types of issues. Just being someone who gets it in their life can be so incredibly helpful. Unfortunately many of us do not know what to say or do for others when there are these types of losses. Well-meaning friends and family may not bring up the losses or they may avoid having much contact with them because they don’t know how to help. This is the worst thing you can do. It’s important to acknowledge what they’re going through. Since they’re trying to have their first baby it’s not uncommon for couples to delay their grief and keep on the track of trying to get pregnant again. What is most important is that no matter how they are coping you respect their decisions, stay open to being an emotional support for them when they are open to it and need it most.

I would recommend reading the book “A Silent Sorrow: Pregnancy Loss - Guidance and Support for You and Your Family” by Ingrid Kohn and Perry-Lynn Moffitt. This will give you more information how to best help your sister and brother-in-law. And they may even be interested in reading the book themselves. There are also online supports through Share Pregnancy and Infant Loss, which has links to local support groups. And you can find them at www.nationalshare.org. And also there is the Postpartum Support International at www.postpartum.net. And they can also direct you to a chapter “Where you live”, where you can find information on local perinatal loss support groups. They are lucky to have you, Becky, someone who cares for them so much.

[Theme Music]

Sunny Gault: Today’s topic comes from one of our listeners: Hailey from Jackson, Mississippi and Hailey writes: “I was wondering if you’ve thought of doing a show on precipitous labor. I’m sure it’s something every first time mom has thought of (giving birth in the car) at one point or another. My sister and I both had precipitous labor, around 90 minutes with our firsts.” She was planning a natural labor and loved the whole experience. It was also during the day, so the doctor made it on time. She says that she was planning an epidural and her water broke at home and there were contractions in the car. She sat in triage for about 30 minutes and then Hailey’s baby was delivered by the nurse 20 minutes later. No IV, no hospital gown, nothing. She had wanted to get an epidural, but that didn’t happen and she says she wasn’t mentally prepared for the pain and everything that she experienced. And she also had bad tearing, she says, because the baby came so quickly. So thank you, Hailey, for sending this in. I know you have a lot of questions now that you’re pregnant again. She wants to know, could this happen again? I think that’s a common question that a lot of women might have if they’ve had precipitous labor before. Joining us here in the studio is Gerri Ryan. She is a licensed midwife who has attended hundreds of births and she also teaches and she is the director at the Nizhoni Institute, which is a local midwifery school here in San Diego. Welcome, Gerri.

Gerri Ryan: Thank you for having me.

Sunny Gault: Sure, of course. So let’s start with just talking about what is precipitous labor. I’ve never heard of this term before until Hailey sent this email. So what is it that defines it?

Gerri Ryan: Clinically speaking precipitous labor is a labor that from start to finish is three hours or shorter. In her case, probably 90 minutes. It is a very rapid labor.
I would just say physiologically what’s happening is the uterus is contracting so quickly that sometimes it sets up a slightly hypoxic situation for the baby. The baby is a little bit in shock when they’re born. Generally the momma is pretty much in shock also, because all of this happens so quickly. I would just say, as far as feelings, what it feels like is that your body is so far ahead of your mind. When the baby comes out it’s almost difficult to bond with your baby for the first few hours because your head literally has not kept up with the body. So it’s not what we consider a normally progressing labor. It doesn’t mean it’s a terribly dangerous thing, but it’s certainly unexpected and yet as a midwife this is what I find: all my first time mommas – “I want to have a labor in three hours or less.” And for those of you who have experienced that, you look at them and think, “No, you don’t.”

Sunny Gault: Yeah. Amy, let’s talk a little bit about your experience with precipitous labor. Had you heard the term before? Did you know that that’s what was happening to you when it was happening?

Amy Askin: I did not. This kind of touches on something else, but I did hypno-babies, which is a very specific tailored hypnosis program for child birth and so I was in hypnosis when… I mean I did my finger drop technique and went into hypnosis and so when I was having these contractions the only thing that defined that this was precipitous labor for me was that I had my first child in about nine hours. My labor mirrored that one. And it was so quick and progressive that I said, “Oh, wait a second. We need to go to the hospital.” So I said, “Oh my gosh, four minutes apart and one minute in duration” or whatever. And I… with this pregnancy I didn’t have a contraction that lasted more than 30 to 40 seconds and that surprised me. So I kept waiting for them to get more regular and longer and they were so effective that I said, “Oh gosh, I can tell that we need to get to the hospital.” So I was very blessed and I got to UCSD in the birthing center and things slowed down a bit. But I was 8 cm dilated by the time they checked me and I was there.

Sunny Gault: So how long was the labor?

Amy Askin: A total of three hours. I was in labor for no more than three hours. I went into labor at about three in the morning and she was born at 6:11 in the morning.

Sunny Gault: Oh my goodness.

Amy Askin: So for me I was stoked, because I was like “Oh, wow, this was a really successful”… I’m third time momma and so I was like, “Oh, this is great”, you know. But yeah, the result of the precipitous labor was… they were concerned about sepsis and things like that. With her… she was not breathing properly because my contractions had not effectively massaged her lungs enough for her to clear out.

Sunny Gault: Right. Well there’s a lot of information that we want to dive into, but I do…

Amy Askin: Sorry.

Sunny Gault: No no no, that’s good, it’s good, because we do want to talk about that. Rachel, let’s have you share your experience with precipitous labor. Or your short labor I should say.

Rachel Adams Gonzales: I had been in the hospital the prior week with preterm labor and in a lot of pain and did not know that I had a ruptured appendix at the time. And I started having some contractions, but they were very irregular, like 18 minutes apart, 7 minutes apart. With my son I had like really intense, regular, like less than a minute and a half contractions. And they were like 20 seconds and I was not quite 31 weeks pregnant, so I was talking to the baby and, you know, “Ok, we’re not ready to come out yet.” And they were like 20 seconds. They would stop, everything would calm down. So I just thought, “Well, I’ll lie down and relax.” And then I got up in aches and was still having some contractions, but over two hours I wrote down 8 contractions total. So I definitely did not think that when I went to the restrooms to pee, I had that sensation where you feel like you need to poop really bad but it’s a baby. And so I just thought, “Oh my gosh, I need to feel.” And it was like right inside of my vagina; she was ready to come out.

And so I freaked out, not only because I was not quite 31 weeks pregnant, but there was a baby about to be pushed out; I was in my bathroom. And so my mom fortunately was there to stay with my three-year-old and the traffic opened up, it was 5 pm and we got to the hospital at 5:05 and she was born at 5:28. The contractions never got really close together. They never got really long. It was the total opposite in every way of what I had with my son, which was 5 hours total, but super, super intense. And I didn’t know at the time that my appendix was ruptured and I think my body - and obviously the big news, she had to get out – but my body also knew that if I had a really intense labor, that if I had to push really hard to get the baby out, I may have ruptured the abscess that was forming and we could have both lost our lives. So we’re very fortunate to be here and really happy that my body knew what to do.

Sunny Gault: That’s amazing to me. Gerri, does that happen with our bodies? If there’s something bigger going on inside the body, how does the body protect itself, protect the baby?

Gerri Ryan: You know, that is an interesting concept and I don’t know that there’s any studies that have been done on it, but certainly, anecdotally speaking, I’ve known of cases where women who have serious illnesses, their babies just come early. Interestingly the baby is larger than we would expect for that gestational age. There’s just a wisdom in women’s bodies that seems to know when a baby needs to be delivered early. And there’s a wisdom with babies. And sometimes they really understand their chances on the outside are better than their chances on the inside. And so when there are health issues going on with mom it’s not uncommon that we see those kind of things.

Sunny Gault: Right. I know both of the ladies talked about contractions. What can you expect with contractions and precipitous labor?

Gerri Ryan: In most cases with precipitous labor it’s not the on-again, off-again kind of contractions. There usually is a steady pattern to it. They may not seem all that intense, but they are extremely effective. So the uterus is working very effectively. We don’t often see precipitous labors in first time moms; their cervix has never opened before. So once a woman has had a baby or two, the body has some cellular memory there. And so it knows what to do and it just seems to be very efficient, very effective and the contractions can be quite intense, even if they’re not long lasting. It’s just an extremely effective labor, but often it does leave the baby a little bit shocky and there can be some risk factors for moms too.

Sunny Gault: Right. Are there ways to slow down labor once it progresses?

Gerri Ryan: You know, both the stories I heard here, as well as the one who wrote in… I find it very interesting that in each one of these cases the women knew they needed to be where they were going to birth, so there is that innate sense. If you were in a situation where we can talk to a woman who’s experiencing a labor like this usually we’ll try to get them horizontal. So don’t add gravity to it. In these cases they had to get up and go somewhere else to be at the spot where they were laboring and I noticed… sometimes when you change places contractions will slow down, your labor will slow down a little bit, the mammal side of us kind of looks at it and says, “Uuu, new environment – is it safe to have a baby here?” So certainly, listening to those urges that say get where you need to be and then proceeding with that, actually arriving at the spot, and then once the body settles in, even if it’s only 15 to 30 minutes later, now again that labor just kicks in and here comes baby.

Sunny Gault: Right. What about for women who were planning a sort of medical intervention, an epidural or something like that? If you get to the hospital and they realize that your labor is progressing very quickly, I would assume your chances are kind of slim to none that they’re going to want to take the time to give you an epidural and all of that.

Gerri Ryan: It can be very disconcerting for someone who has a specific birth plan. If they’re planning to get an epidural and they come in in labor, often times - because this is such an uncommon type of birth – often times the staff is busy doing the things that they need to do, getting her checked in, getting the IV, all of these things, and then they really don’t frequently see this type of a labor. So they don’t recognize it as “Jee, the baby is going to be here in 20 minutes or an hour and 20 minutes”. And so literally, because most labors take many hours, it’s very hard to recognize it. I think women have an innate power and when women say the baby is coming, they mean the baby is coming. Now. But again, that’s not the common experience, so as a result most of those women don’t get the epidural. It’s not that they couldn’t, but sometimes to get the IV going and get the anesthesiologist in there and get all of these things set up takes time. And in most cases you’re looking at probably a minimum of 20 minutes if “I want it now!” or as long as an hour and a half. So by that time the baby is already out.

Sunny Gault: So if you have precipitous labor – for example in Hailey’s case she did have it with her first – but if you have it once what are the odds that you’re going to have it again?

Gerri Ryan: I couldn’t give you statistics as far as percentages, but a precipitous labor in one birth makes you slightly more at risk for it happening again. It doesn’t mean that it will, but it also doesn’t mean that it won’t. So some of the factors that we look at in terms of who’s more likely to have a precipitous labor – like you said, it’s a women who’s already had one or more babies. She has a very adequate pelvis, she has a smaller baby that’s well engaged. She may have very strong contractions. The other time that we will see precipitous labor is when a woman is maybe being induced, so she’s on Pitocin and all of the sudden the Pitocin level reaches what it needs to for her body to be effective. And so in that case what can be done is, the Pitocin can be turned down or off. So that would be one way to slow it down. But in most cases the labor just starts and literally by the time the individual recognizes that they’re in labor, gets to where they need to be to have their baby, it’s usually only half an hour to maybe an hour and a half before the baby’s out. Which is very unusual.

Sunny Gault: Ok. I want to talk a little bit about pain, since we were talking about epidurals and pain medication. Is the pain different when you are experiencing those surges, those contractions? Or does your body somehow adapt because there’s just so much going on? Amy, let’s start with you, what do you think?

Amy Askin: I found that my pain level was not – again, this is my third and so I think doing hypnosis I managed to… Again, I think it mirrored the labor, although completely contracted by two thirds. It very much mirrored my first birthing experience with my 8-year-old. And so I think I just innately felt that anew and so I just kind of went with it. I got to be in the birthing pool and I did – kind of because I’m like “yeah, I’ll manage it, but I’m no hero” and not like “ok, let’s do this, bring it!” So I sat in the birthing tub and I was like “ok, I’m ready now”. And they were like “wow, you might want to slow down just a little.” I didn’t know about all this stuff and I was like “you know… I think it’s time…” But again, I think listening to your body, breathing through it… there’s nothing your body can’t do if you put your mind to it. That’s the attitude I’ve always had and it’s been very successful for me.

Sunny Gault: Rachel, what was the pain like for you and how did you handle it?

Rachel Adams Gonzales: The level of pain that I had been in for a while was significantly more than my labor. I have a really bizarrely high tolerance for pain, I’ve learned, so it’s very skewed, but my contractions, while they were intense at the very end, I think part of that was the change in environment and being in the car, being in the hospital. But they were so mellow that I didn’t even realize that I was in labor and really the only thing that was really hard for me was when the nurse checked me at check-in. When I first got to triage – that was the only memorable, really horrible moment: being fully dilated, with the baby about to come out and the nurse fitting her whole hand inside of me.
Breathing makes all the difference and breathing through the contractions… yeah, it was pretty mild, which sounds really weird, but…

Gerri Ryan: So the one question I have for you two ladies, you two moms with us, how did it differ from your first birth after the birth? Where did your mind go like directly after the birth, within the first hour after the birth? What were you thinking?

Rachel Adams Gonzales: I’m still trying to wrap my head around all of this, but… I don’t know. I mean, I wanted to be with my baby, but I was still in shock and trying to just… in that numb moment, my body being overcome with hormones and everything else pumping through it that I was just kind of in a numb state.

Gerri Ryan: Aham, ok.

Amy Askin: My experience was very similar to Rachel’s as well. Looking back – again, it was only a month ago – one thing that was huge was that I was in shock. I wanted to be with her and they took her to the warming unit. And at that point I knew… I had brought my other two to breast right away and really was intent on getting skin to skin and nursing her and things. And they just kept saying to me “mmm we’re going to wait a minute.” And I know now that that’s nurse code for “there’s something wrong with this baby”.

Gerri Ryan: Or at least “we need to monitor this baby before…”

Sunny Gault: “We’re questioning”, right.

Amy Askin: …that there was something going on. And then they called up the Peds team and I said, “there’s no way you’re taking the baby out of the room without me getting her to breast first”. And they said “ok, ok”. And so she had to have a bag, she had low O2 sats… So at any rate, they were wonderful about letting me have that closure I think. Because they knew what was going on, they knew it wasn’t critical condition or anything and so they let me bond with her. But long and short is I was in shock. And my adrenaline and my hormones, like Rachel said, were just through the roof. I tried to sleep; my doula really encouraged me to sleep and she said, “Promise me you’re not working on the blog or writing right now, you’re not posting on Facebook; it’s time to sleep.” And I promised and I did, I put everything away and my body was just... pulsing. I could not close my eyes and I thought, “This is my ADD or something”. But it’s a whole other realm. I think my body was just in shock.

Gerri Ryan: Yes. So what I’d like to speak to you for just a minute is the hormonal changes that happen. So in a normally progressive labor what happens is the body, over a period of hours, has time to ramp up the hormones, including oxytocin, endorphins – which are our body’s own pain relief – all these things to match the level of what the body is processing right now. But when you condense that into a very short period of time the body doesn’t have the opportunity to produce the hormones and get them delivered as quickly as they’re needed.

So for many women, what they experience is, with the actual birth itself and then afterward they’re sitting there in this somewhat shocky state and all of the hormones are still being produced. They don’t just get turned off. So the hormones continue to rise. And for a lot of women – and I’ve worked with a lot of women, both as a doula and as a midwife, who’ve had precipitous births – and what I hear them need to do is to process the birth. So they talk about it again and again and again, what just happened. Because – probably the best way I can state it is – their mind is trying to catch up with what the body already did. And so there is that need to connect the experience with the mental perception. So the body has experienced it, physically you have felt it, but your mind just couldn’t process it. So, as a result, the retelling of the birth helps you to be able to incorporate that into what really just happened.
For some women, initially having their baby with them is almost overwhelming, because they’re not expecting their baby to even be out right now. I remember one woman took her baby initially and then shortly thereafter handed it off to someone else and really wasn’t ready to receive her baby until she got up and showered. And that was her way of kind of coming back into her body. And at that point she sat down, nursed her baby and felt very connected. But there’s a huge disconnect – hormonally, physically and sometimes even spiritually, in the sense that you just can’t bring it all quite together in the same moment.

Amy Askin: That makes good sense. I wish you were in there with me. (Laughs)

Gerri Ryan: And I’m happy to be talking about it here because this way other women will know: a precipitous birth is a very different kind of labor. And there is another cause for precipitous labor, something that can be controlled. And I just want to bring it out because it is something that often… if a women has a precipitous labor, they may actually do a blood check on her to make sure she’s not using cocaine. Because cocaine is one of the primary causes of precipitous labors. So sometimes in a hospital setting they may actually do a tox screen, either on baby or on mom, just to verify that’s not an issue. And you can understand that they’re simply ruling out do we need to address both a social issue and also a physical need for this baby.

Sunny Gault: Ok, thank you. We’re going to take a quick break and when we come back we’re going to talk about some of the potential risks from having a precipitous labor. We’ll be right back.

[Theme Music]

[00:26:33]

Sunny Gault: Welcome back, everyone. Today we are talking about precipitous labor, which is short labor. Our special guest today is Gerri Ryan. She is a licensed midwife and she also teaches and directs at the Nizhoni Institute, which is a local midwifery school right here in San Diego. So, I want to talk a little bit more about what some of the potential risks and effects are from having a precipitous labor? So let’s talk about that a bit.

Gerri Ryan: Ok. Some of the physical risks I spoke about earlier were for the baby – sometimes the baby can be somewhat hypoxic. In other words, during those last usually few contractions the baby is not given enough oxygen. About a third of their blood volume is sitting up in the placenta for delivery after the birth. But also, the contractions being so strong, the oxygen is being fed to the uterus, because it’s the largest muscle that’s working in the body, so it gets the baby ready to breathe. But sometimes the contractions are so strong that the baby actually doesn’t get enough oxygen during that time period. Now we know that babies are very adjustable, very malleable, but it can cause some respiratory issues afterwards. Sometimes those babies have to spend greater time in the NICU and will maybe deal with respiratory issues for the first few hours for most babies. Sometimes it can be a little bit longer than that.
There are certainly risk factors for women. When a baby comes through that fast and the cervix dilates that fast , sometimes there can be cervical lacerations, which bleed fairly heavily. There can be vaginal lacerations. So generally the care provider, after a birth like that, is going to be in there really looking things over well to make sure that everything is back together the way that it should. Perineum damage is also a possibility because of the rapidity with which the baby shoots through there if you will.

Sunny Gault: Right.

Amy Askin: It really was like that.

Gerri Ryan: Yeah, it really is. That’s a terrible word to use, but it really… And as a result of some of these lacerations as well as just the rapidity, there can be some hemorrhaging. The uterus may become very flaccid, just does not contract down well afterward. So it may be a little more difficult to get the placenta out… So those are all risk factors that care providers pay close attention to. It’s not something that the birthing woman needs to tune into so much. I mean that’s why you have staff there. Fetal distress is something that’s watched – we’ve talked about that. And one thing that we don’t talk about too much, because it doesn’t happen very often, but if the baby is very small, if it’s a preterm baby, then we have a greater risk of intracranial damage, bleeding, because, again, of being forced through so quickly. So those are some of the basic risk factors that we look at.

Sunny Gault: You know, we had some activity about this topic on our Facebook page and some people say that they live in rural areas where it’s going to take a good amount of time to get to their care provider. So the question of inductions comes up. And I know that’s not something a lot of women choose to do, they want to have it as naturally as possible, but what are your thoughts on inducing to avoid some of these complications that we’ve talked about?

Gerri Ryan: You know, an induction is not going to necessarily prevent a precipitous birth. So one of the risk factors with precipitous births is Pitocin induction, and Pitocin augmentation. There are other ways to induce.
I have had a client one time who lived out in the desert and she was planning to birth in La Jolla and so that was her choice. She didn’t want to drive up over the mountains in the fog of night that time of year. And I went into that with her with the idea that “Ok, first time mom, I could be here 24-36 hours, oh well…” She had a beautiful birth. She birthed in about 12 hours from beginning to end. So every woman has to be well informed, they have to know the risks and benefits. I like to tell them to take their brain to the birth – what’s the benefit, what’s the risk, what does your instinct tell you? Are there any alternatives? And does it have to be done now? And if you can answer those five things to any procedure and make your choice, then go with what is comfortable for you.

Sunny Gault: Are there additional resources that you would recommend? Because I know we just kind of scraped the surface on this topic.

Gerri Ryan: One of my favorite resources is Childbirth Connection. ChildbirthConnection.org – they’re one of the best educational sources in terms of really researching what goes on that site. And just know about yourself; know about your body. Some of my other favorite books are the books by Sears & Sears – The Birth Book, The Baby Book. Be an advocate for yourself. Know what’s important to you. Have someone there with you who can advocate for you, as in Rachel’s case – hers happened so quickly that her husband didn’t get to be there. And sometimes these things do happen. But also take the time afterward to process the birth; talk it through. Talk until people don’t want to hear you anymore; find a different friend and talk to them. Because it’s part of that assimilation that happens, that needs to happen between what happened physically, what happened mentally, and what happened spiritually in terms of what you were preparing for. And it brings it all together, synthesizes it into the experience of who this little person is. And then honor this person and the journey that they made.

Sunny Gault: Good advice. Alright. Well thank you, Gerri, for joining us today and sharing all this information with us. For more information about Gerri and her practice as well as information about any of our panelists visit the episode’s page on our website. For members of our Preggie Pals Club the conversation continues. We are going to explore what you should do if your labor is progressing quickly and you can’t seek medical attention. So that’s our special bonus content for our members right after the show.

[Theme Music]

[00:32:52]

[Featured Segments: Maternity Fashion Trends. Dressing Your Bump for Work!]

Sunny Gault: Before we wrap today’s show, here’s some maternity fashion trends from Krystal Stubbendeck of Borrow for your Bump.

Krystal Stubbendeck: Hello, Preggie Pals! I’m Krystal Stubbendeck, maternity fashion expert and founder of Borrow for Your Bump, where you can buy or rent maternity styles for a monthly rent. Today we are going to talk about the office essentials for moms to be. These wardrobe essentials are still professional for the working mom even as you spore a new bump. The first must-have is a structured jacket. A tailor jacked will make you feel polished and strong. A style with a stretching material will grow with your changing body and will give you a sweet look that can be worn many different ways. Tailor trousers at the office and boyfriend jeans for the weekend. The next essential is a colorful sleeveless dress. Try darker but feminine tones for the office, like purple, cobalt and dark teak. But make sure that it is not too loose and bohemian. For a tighter fitting dress, pair with a tailor jacket or cardigan.

Our third office must-have is a pair of chic Blasts. These will be a lifesaver as you are trying to stay comfortable but still professional at work. Use dark colors, like black or metallic, which will go with mostly any outfit combination.
The next essential is for a perfect blouse fit. In white, black, and neon tone like hot pink or yellow and stripes. Choose styles that may be a little larger in the beginning of the pregnancy and use belts to gently define your waist. This look is flattering on any body shape. Then, as your bump grows, the blouses will be more fitting to last even beyond your pregnancy. Roll up the sleeves for a more casual look that is perfect for the weekend. Finally, the last office must-have is a comfortable pair of black pumps. Moms to be can have a career while still feeling sexy. Make sure to find a nice leather material, but avoid pattern, which doesn’t have much stretch. Also avoid the platforms or sky-high heels. Even two inch can be sexy as long as the toe is pointy, which gives a modern edge. Don’t forget to check out more great styles for moms to be at BorrowForYourBump.com. Enter promo code “PreggiePals” at checkout to save 20% off your entire order. Thanks for listening to today’s tips on office essentials and be sure to listen to Preggie Pals for more great pregnancy tips.

[Theme Music]

Sunny Gault: That wraps up our show for today. We appreciate you listening to Preggie Pals. Don’t forget to check out our sister show Parent Savers - for parents with newborns, infants, and toddlers – and our show The Boob Group for moms who breastfeed their babies. Next week we’ll be discussing how to handle pregnancy when you already have young children. This is Preggie Pals – your pregnancy, your way.

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

[00:36:16]
[End Of Audio]

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Episode Transcript

Preggie Pals
Precipitous Labor: Preparing for Short Labor

Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.

[00:00:00]

[Theme Music]

Gerri Ryan: If your entire labor and delivery is three hours or less it’s known as a precipitous labor. And while the thought of having a condensed labor may sound like a good thing there are possible complications and decisions to make if you think you and your baby may be at risk. I’m Gerri Ryan, a licensed midwife with an active birth practice here in San Diego and this is Preggie Pals episode 45.

[Theme Music/Intro]

Sunny Gault: Welcome to Preggie Pals, broadcasting from the Birth Education Center of San Diego. I’m your host, Sunny Gault. Have you downloaded our amazing Preggie Pals app? This is a great way to listen to our shows on the go and they are available in both the Amazon and iTunes marketplace. Did you miss an older episode of Preggie Pals? Then join the Preggie Pals Club. You’ll get access to all of our episodes, transcripts and special bonus content after each show. Our club members even get a one-year free subscription to Pregnancy Magazine. Visit our website for more information and to sign up. Ok, so let’s dive into this. Let’s introduce our panelists here. We have one panelist joining us over the phone and one here in the studio. So we’re going to start here in the studio with Amy. Hi, Amy!

Amy Askin: Good morning, hi. I’m Amy Askin. I’m 39, really 29. (Laughs)

Sunny Gault: I’m going to start using that I think.

Amy Askin: I’m 29 in my mind. I am a work-at-home mom and I blog for belovedatmosphere.com and do a side business of vacation rental property. I have three girls. Yes, three girls, three little mermaids who are 8, 3, and a newborn who’s one month today.

Sunny Gault: Oh, congratulations! And you did have with the last one a precipitous labor.

Amy Askin: I did have a precipitous labor and didn’t know what that was until I experienced it.

Sunny Gault: Ok. We’re going to dive into that a little more later in the conversation because I do want to hear about your experience. And joining us on the phone is Rachel Adams Gonzales. Rachel has been a panelist on our show before. Hello, Rachel!

Rachel Adams Gonzales: Hello! My name is Rachel Adams Gonzales, like you said. I am 29 and I am a product consultant for doTERRA Essential Oils. My son will be three in a couple of weeks – I had a water birth with him – and my daughter is three weeks old and 34½ weeks gestation and we had an unexpected hospital birth.

Sunny Gault: Ok. Thank you, ladies, for joining us today.

[Theme Music]

[Featured Segment: Ask The Experts. Comfort Through Miscarriages]

Sunny Gault: Alright! We have a question from one of our Facebook friends. This comes from Becky and Becky writes:
“My sister and brother-in-law are having a hard time conceiving their first child. To date they have had three miscarriages, all in the first trimester. It’s really hard to watch my sister go through this. What advice do you have for being supportive yet practical with my sister so she doesn’t get her heart broken if this happens again?”

Yvonne Rothermel: Hi! This is Yvonne Rothermel, licensed clinical social worker. Hi, Becky! First of all I would like to say that just by the fact that you cared enough to write into Preggie Pals about your sister’s multiple miscarriages tells me that you already have what your sister needs most from you. It must be such a helpless feeling for you to watch your sister and brother-in-law endure so many losses. Unfortunately, as much as you want to, there’s nothing you can do to protect their hearts from being broken again. However there is a lot you can do to provide them with support. Everyone copes differently with losses. And I would stay in tune to what their needs are individually and as a couple. You can let them know that you think of them all the time and that you know this is a difficult time for them. You can frequently call and check in if this is helpful for your sister. Or, if she and your brother-in-law are isolating more, which isn’t uncommon with losses, I’d write them emails or send a quick text saying “Just thinking of you. No need to get back to me. Just letting you know I’m here for you.”

I would stay sensitive to how your sister and brother-in-law are experiencing their world right now. Are there many friends and relatives around them that are pregnant or having babies? As you know, this will be difficult for them and they may not want to attend as many social events. As someone close to them you can provide sensitivity to these types of issues. Just being someone who gets it in their life can be so incredibly helpful. Unfortunately many of us do not know what to say or do for others when there are these types of losses. Well-meaning friends and family may not bring up the losses or they may avoid having much contact with them because they don’t know how to help. This is the worst thing you can do. It’s important to acknowledge what they’re going through. Since they’re trying to have their first baby it’s not uncommon for couples to delay their grief and keep on the track of trying to get pregnant again. What is most important is that no matter how they are coping you respect their decisions, stay open to being an emotional support for them when they are open to it and need it most.

I would recommend reading the book “A Silent Sorrow: Pregnancy Loss - Guidance and Support for You and Your Family” by Ingrid Kohn and Perry-Lynn Moffitt. This will give you more information how to best help your sister and brother-in-law. And they may even be interested in reading the book themselves. There are also online supports through Share Pregnancy and Infant Loss, which has links to local support groups. And you can find them at www.nationalshare.org. And also there is the Postpartum Support International at www.postpartum.net. And they can also direct you to a chapter “Where you live”, where you can find information on local perinatal loss support groups. They are lucky to have you, Becky, someone who cares for them so much.

[Theme Music]

Sunny Gault: Today’s topic comes from one of our listeners: Hailey from Jackson, Mississippi and Hailey writes: “I was wondering if you’ve thought of doing a show on precipitous labor. I’m sure it’s something every first time mom has thought of (giving birth in the car) at one point or another. My sister and I both had precipitous labor, around 90 minutes with our firsts.” She was planning a natural labor and loved the whole experience. It was also during the day, so the doctor made it on time. She says that she was planning an epidural and her water broke at home and there were contractions in the car. She sat in triage for about 30 minutes and then Hailey’s baby was delivered by the nurse 20 minutes later. No IV, no hospital gown, nothing. She had wanted to get an epidural, but that didn’t happen and she says she wasn’t mentally prepared for the pain and everything that she experienced. And she also had bad tearing, she says, because the baby came so quickly. So thank you, Hailey, for sending this in. I know you have a lot of questions now that you’re pregnant again. She wants to know, could this happen again? I think that’s a common question that a lot of women might have if they’ve had precipitous labor before. Joining us here in the studio is Gerri Ryan. She is a licensed midwife who has attended hundreds of births and she also teaches and she is the director at the Nizhoni Institute, which is a local midwifery school here in San Diego. Welcome, Gerri.

Gerri Ryan: Thank you for having me.

Sunny Gault: Sure, of course. So let’s start with just talking about what is precipitous labor. I’ve never heard of this term before until Hailey sent this email. So what is it that defines it?

Gerri Ryan: Clinically speaking precipitous labor is a labor that from start to finish is three hours or shorter. In her case, probably 90 minutes. It is a very rapid labor.
I would just say physiologically what’s happening is the uterus is contracting so quickly that sometimes it sets up a slightly hypoxic situation for the baby. The baby is a little bit in shock when they’re born. Generally the momma is pretty much in shock also, because all of this happens so quickly. I would just say, as far as feelings, what it feels like is that your body is so far ahead of your mind. When the baby comes out it’s almost difficult to bond with your baby for the first few hours because your head literally has not kept up with the body. So it’s not what we consider a normally progressing labor. It doesn’t mean it’s a terribly dangerous thing, but it’s certainly unexpected and yet as a midwife this is what I find: all my first time mommas – “I want to have a labor in three hours or less.” And for those of you who have experienced that, you look at them and think, “No, you don’t.”

Sunny Gault: Yeah. Amy, let’s talk a little bit about your experience with precipitous labor. Had you heard the term before? Did you know that that’s what was happening to you when it was happening?

Amy Askin: I did not. This kind of touches on something else, but I did hypno-babies, which is a very specific tailored hypnosis program for child birth and so I was in hypnosis when… I mean I did my finger drop technique and went into hypnosis and so when I was having these contractions the only thing that defined that this was precipitous labor for me was that I had my first child in about nine hours. My labor mirrored that one. And it was so quick and progressive that I said, “Oh, wait a second. We need to go to the hospital.” So I said, “Oh my gosh, four minutes apart and one minute in duration” or whatever. And I… with this pregnancy I didn’t have a contraction that lasted more than 30 to 40 seconds and that surprised me. So I kept waiting for them to get more regular and longer and they were so effective that I said, “Oh gosh, I can tell that we need to get to the hospital.” So I was very blessed and I got to UCSD in the birthing center and things slowed down a bit. But I was 8 cm dilated by the time they checked me and I was there.

Sunny Gault: So how long was the labor?

Amy Askin: A total of three hours. I was in labor for no more than three hours. I went into labor at about three in the morning and she was born at 6:11 in the morning.

Sunny Gault: Oh my goodness.

Amy Askin: So for me I was stoked, because I was like “Oh, wow, this was a really successful”… I’m third time momma and so I was like, “Oh, this is great”, you know. But yeah, the result of the precipitous labor was… they were concerned about sepsis and things like that. With her… she was not breathing properly because my contractions had not effectively massaged her lungs enough for her to clear out.

Sunny Gault: Right. Well there’s a lot of information that we want to dive into, but I do…

Amy Askin: Sorry.

Sunny Gault: No no no, that’s good, it’s good, because we do want to talk about that. Rachel, let’s have you share your experience with precipitous labor. Or your short labor I should say.

Rachel Adams Gonzales: I had been in the hospital the prior week with preterm labor and in a lot of pain and did not know that I had a ruptured appendix at the time. And I started having some contractions, but they were very irregular, like 18 minutes apart, 7 minutes apart. With my son I had like really intense, regular, like less than a minute and a half contractions. And they were like 20 seconds and I was not quite 31 weeks pregnant, so I was talking to the baby and, you know, “Ok, we’re not ready to come out yet.” And they were like 20 seconds. They would stop, everything would calm down. So I just thought, “Well, I’ll lie down and relax.” And then I got up in aches and was still having some contractions, but over two hours I wrote down 8 contractions total. So I definitely did not think that when I went to the restrooms to pee, I had that sensation where you feel like you need to poop really bad but it’s a baby. And so I just thought, “Oh my gosh, I need to feel.” And it was like right inside of my vagina; she was ready to come out.

And so I freaked out, not only because I was not quite 31 weeks pregnant, but there was a baby about to be pushed out; I was in my bathroom. And so my mom fortunately was there to stay with my three-year-old and the traffic opened up, it was 5 pm and we got to the hospital at 5:05 and she was born at 5:28. The contractions never got really close together. They never got really long. It was the total opposite in every way of what I had with my son, which was 5 hours total, but super, super intense. And I didn’t know at the time that my appendix was ruptured and I think my body - and obviously the big news, she had to get out – but my body also knew that if I had a really intense labor, that if I had to push really hard to get the baby out, I may have ruptured the abscess that was forming and we could have both lost our lives. So we’re very fortunate to be here and really happy that my body knew what to do.

Sunny Gault: That’s amazing to me. Gerri, does that happen with our bodies? If there’s something bigger going on inside the body, how does the body protect itself, protect the baby?

Gerri Ryan: You know, that is an interesting concept and I don’t know that there’s any studies that have been done on it, but certainly, anecdotally speaking, I’ve known of cases where women who have serious illnesses, their babies just come early. Interestingly the baby is larger than we would expect for that gestational age. There’s just a wisdom in women’s bodies that seems to know when a baby needs to be delivered early. And there’s a wisdom with babies. And sometimes they really understand their chances on the outside are better than their chances on the inside. And so when there are health issues going on with mom it’s not uncommon that we see those kind of things.

Sunny Gault: Right. I know both of the ladies talked about contractions. What can you expect with contractions and precipitous labor?

Gerri Ryan: In most cases with precipitous labor it’s not the on-again, off-again kind of contractions. There usually is a steady pattern to it. They may not seem all that intense, but they are extremely effective. So the uterus is working very effectively. We don’t often see precipitous labors in first time moms; their cervix has never opened before. So once a woman has had a baby or two, the body has some cellular memory there. And so it knows what to do and it just seems to be very efficient, very effective and the contractions can be quite intense, even if they’re not long lasting. It’s just an extremely effective labor, but often it does leave the baby a little bit shocky and there can be some risk factors for moms too.

Sunny Gault: Right. Are there ways to slow down labor once it progresses?

Gerri Ryan: You know, both the stories I heard here, as well as the one who wrote in… I find it very interesting that in each one of these cases the women knew they needed to be where they were going to birth, so there is that innate sense. If you were in a situation where we can talk to a woman who’s experiencing a labor like this usually we’ll try to get them horizontal. So don’t add gravity to it. In these cases they had to get up and go somewhere else to be at the spot where they were laboring and I noticed… sometimes when you change places contractions will slow down, your labor will slow down a little bit, the mammal side of us kind of looks at it and says, “Uuu, new environment – is it safe to have a baby here?” So certainly, listening to those urges that say get where you need to be and then proceeding with that, actually arriving at the spot, and then once the body settles in, even if it’s only 15 to 30 minutes later, now again that labor just kicks in and here comes baby.

Sunny Gault: Right. What about for women who were planning a sort of medical intervention, an epidural or something like that? If you get to the hospital and they realize that your labor is progressing very quickly, I would assume your chances are kind of slim to none that they’re going to want to take the time to give you an epidural and all of that.

Gerri Ryan: It can be very disconcerting for someone who has a specific birth plan. If they’re planning to get an epidural and they come in in labor, often times - because this is such an uncommon type of birth – often times the staff is busy doing the things that they need to do, getting her checked in, getting the IV, all of these things, and then they really don’t frequently see this type of a labor. So they don’t recognize it as “Jee, the baby is going to be here in 20 minutes or an hour and 20 minutes”. And so literally, because most labors take many hours, it’s very hard to recognize it. I think women have an innate power and when women say the baby is coming, they mean the baby is coming. Now. But again, that’s not the common experience, so as a result most of those women don’t get the epidural. It’s not that they couldn’t, but sometimes to get the IV going and get the anesthesiologist in there and get all of these things set up takes time. And in most cases you’re looking at probably a minimum of 20 minutes if “I want it now!” or as long as an hour and a half. So by that time the baby is already out.

Sunny Gault: So if you have precipitous labor – for example in Hailey’s case she did have it with her first – but if you have it once what are the odds that you’re going to have it again?

Gerri Ryan: I couldn’t give you statistics as far as percentages, but a precipitous labor in one birth makes you slightly more at risk for it happening again. It doesn’t mean that it will, but it also doesn’t mean that it won’t. So some of the factors that we look at in terms of who’s more likely to have a precipitous labor – like you said, it’s a women who’s already had one or more babies. She has a very adequate pelvis, she has a smaller baby that’s well engaged. She may have very strong contractions. The other time that we will see precipitous labor is when a woman is maybe being induced, so she’s on Pitocin and all of the sudden the Pitocin level reaches what it needs to for her body to be effective. And so in that case what can be done is, the Pitocin can be turned down or off. So that would be one way to slow it down. But in most cases the labor just starts and literally by the time the individual recognizes that they’re in labor, gets to where they need to be to have their baby, it’s usually only half an hour to maybe an hour and a half before the baby’s out. Which is very unusual.

Sunny Gault: Ok. I want to talk a little bit about pain, since we were talking about epidurals and pain medication. Is the pain different when you are experiencing those surges, those contractions? Or does your body somehow adapt because there’s just so much going on? Amy, let’s start with you, what do you think?

Amy Askin: I found that my pain level was not – again, this is my third and so I think doing hypnosis I managed to… Again, I think it mirrored the labor, although completely contracted by two thirds. It very much mirrored my first birthing experience with my 8-year-old. And so I think I just innately felt that anew and so I just kind of went with it. I got to be in the birthing pool and I did – kind of because I’m like “yeah, I’ll manage it, but I’m no hero” and not like “ok, let’s do this, bring it!” So I sat in the birthing tub and I was like “ok, I’m ready now”. And they were like “wow, you might want to slow down just a little.” I didn’t know about all this stuff and I was like “you know… I think it’s time…” But again, I think listening to your body, breathing through it… there’s nothing your body can’t do if you put your mind to it. That’s the attitude I’ve always had and it’s been very successful for me.

Sunny Gault: Rachel, what was the pain like for you and how did you handle it?

Rachel Adams Gonzales: The level of pain that I had been in for a while was significantly more than my labor. I have a really bizarrely high tolerance for pain, I’ve learned, so it’s very skewed, but my contractions, while they were intense at the very end, I think part of that was the change in environment and being in the car, being in the hospital. But they were so mellow that I didn’t even realize that I was in labor and really the only thing that was really hard for me was when the nurse checked me at check-in. When I first got to triage – that was the only memorable, really horrible moment: being fully dilated, with the baby about to come out and the nurse fitting her whole hand inside of me.
Breathing makes all the difference and breathing through the contractions… yeah, it was pretty mild, which sounds really weird, but…

Gerri Ryan: So the one question I have for you two ladies, you two moms with us, how did it differ from your first birth after the birth? Where did your mind go like directly after the birth, within the first hour after the birth? What were you thinking?

Rachel Adams Gonzales: I’m still trying to wrap my head around all of this, but… I don’t know. I mean, I wanted to be with my baby, but I was still in shock and trying to just… in that numb moment, my body being overcome with hormones and everything else pumping through it that I was just kind of in a numb state.

Gerri Ryan: Aham, ok.

Amy Askin: My experience was very similar to Rachel’s as well. Looking back – again, it was only a month ago – one thing that was huge was that I was in shock. I wanted to be with her and they took her to the warming unit. And at that point I knew… I had brought my other two to breast right away and really was intent on getting skin to skin and nursing her and things. And they just kept saying to me “mmm we’re going to wait a minute.” And I know now that that’s nurse code for “there’s something wrong with this baby”.

Gerri Ryan: Or at least “we need to monitor this baby before…”

Sunny Gault: “We’re questioning”, right.

Amy Askin: …that there was something going on. And then they called up the Peds team and I said, “there’s no way you’re taking the baby out of the room without me getting her to breast first”. And they said “ok, ok”. And so she had to have a bag, she had low O2 sats… So at any rate, they were wonderful about letting me have that closure I think. Because they knew what was going on, they knew it wasn’t critical condition or anything and so they let me bond with her. But long and short is I was in shock. And my adrenaline and my hormones, like Rachel said, were just through the roof. I tried to sleep; my doula really encouraged me to sleep and she said, “Promise me you’re not working on the blog or writing right now, you’re not posting on Facebook; it’s time to sleep.” And I promised and I did, I put everything away and my body was just... pulsing. I could not close my eyes and I thought, “This is my ADD or something”. But it’s a whole other realm. I think my body was just in shock.

Gerri Ryan: Yes. So what I’d like to speak to you for just a minute is the hormonal changes that happen. So in a normally progressive labor what happens is the body, over a period of hours, has time to ramp up the hormones, including oxytocin, endorphins – which are our body’s own pain relief – all these things to match the level of what the body is processing right now. But when you condense that into a very short period of time the body doesn’t have the opportunity to produce the hormones and get them delivered as quickly as they’re needed.

So for many women, what they experience is, with the actual birth itself and then afterward they’re sitting there in this somewhat shocky state and all of the hormones are still being produced. They don’t just get turned off. So the hormones continue to rise. And for a lot of women – and I’ve worked with a lot of women, both as a doula and as a midwife, who’ve had precipitous births – and what I hear them need to do is to process the birth. So they talk about it again and again and again, what just happened. Because – probably the best way I can state it is – their mind is trying to catch up with what the body already did. And so there is that need to connect the experience with the mental perception. So the body has experienced it, physically you have felt it, but your mind just couldn’t process it. So, as a result, the retelling of the birth helps you to be able to incorporate that into what really just happened.
For some women, initially having their baby with them is almost overwhelming, because they’re not expecting their baby to even be out right now. I remember one woman took her baby initially and then shortly thereafter handed it off to someone else and really wasn’t ready to receive her baby until she got up and showered. And that was her way of kind of coming back into her body. And at that point she sat down, nursed her baby and felt very connected. But there’s a huge disconnect – hormonally, physically and sometimes even spiritually, in the sense that you just can’t bring it all quite together in the same moment.

Amy Askin: That makes good sense. I wish you were in there with me. (Laughs)

Gerri Ryan: And I’m happy to be talking about it here because this way other women will know: a precipitous birth is a very different kind of labor. And there is another cause for precipitous labor, something that can be controlled. And I just want to bring it out because it is something that often… if a women has a precipitous labor, they may actually do a blood check on her to make sure she’s not using cocaine. Because cocaine is one of the primary causes of precipitous labors. So sometimes in a hospital setting they may actually do a tox screen, either on baby or on mom, just to verify that’s not an issue. And you can understand that they’re simply ruling out do we need to address both a social issue and also a physical need for this baby.

Sunny Gault: Ok, thank you. We’re going to take a quick break and when we come back we’re going to talk about some of the potential risks from having a precipitous labor. We’ll be right back.

[Theme Music]

[00:26:33]

Sunny Gault: Welcome back, everyone. Today we are talking about precipitous labor, which is short labor. Our special guest today is Gerri Ryan. She is a licensed midwife and she also teaches and directs at the Nizhoni Institute, which is a local midwifery school right here in San Diego. So, I want to talk a little bit more about what some of the potential risks and effects are from having a precipitous labor? So let’s talk about that a bit.

Gerri Ryan: Ok. Some of the physical risks I spoke about earlier were for the baby – sometimes the baby can be somewhat hypoxic. In other words, during those last usually few contractions the baby is not given enough oxygen. About a third of their blood volume is sitting up in the placenta for delivery after the birth. But also, the contractions being so strong, the oxygen is being fed to the uterus, because it’s the largest muscle that’s working in the body, so it gets the baby ready to breathe. But sometimes the contractions are so strong that the baby actually doesn’t get enough oxygen during that time period. Now we know that babies are very adjustable, very malleable, but it can cause some respiratory issues afterwards. Sometimes those babies have to spend greater time in the NICU and will maybe deal with respiratory issues for the first few hours for most babies. Sometimes it can be a little bit longer than that.
There are certainly risk factors for women. When a baby comes through that fast and the cervix dilates that fast , sometimes there can be cervical lacerations, which bleed fairly heavily. There can be vaginal lacerations. So generally the care provider, after a birth like that, is going to be in there really looking things over well to make sure that everything is back together the way that it should. Perineum damage is also a possibility because of the rapidity with which the baby shoots through there if you will.

Sunny Gault: Right.

Amy Askin: It really was like that.

Gerri Ryan: Yeah, it really is. That’s a terrible word to use, but it really… And as a result of some of these lacerations as well as just the rapidity, there can be some hemorrhaging. The uterus may become very flaccid, just does not contract down well afterward. So it may be a little more difficult to get the placenta out… So those are all risk factors that care providers pay close attention to. It’s not something that the birthing woman needs to tune into so much. I mean that’s why you have staff there. Fetal distress is something that’s watched – we’ve talked about that. And one thing that we don’t talk about too much, because it doesn’t happen very often, but if the baby is very small, if it’s a preterm baby, then we have a greater risk of intracranial damage, bleeding, because, again, of being forced through so quickly. So those are some of the basic risk factors that we look at.

Sunny Gault: You know, we had some activity about this topic on our Facebook page and some people say that they live in rural areas where it’s going to take a good amount of time to get to their care provider. So the question of inductions comes up. And I know that’s not something a lot of women choose to do, they want to have it as naturally as possible, but what are your thoughts on inducing to avoid some of these complications that we’ve talked about?

Gerri Ryan: You know, an induction is not going to necessarily prevent a precipitous birth. So one of the risk factors with precipitous births is Pitocin induction, and Pitocin augmentation. There are other ways to induce.
I have had a client one time who lived out in the desert and she was planning to birth in La Jolla and so that was her choice. She didn’t want to drive up over the mountains in the fog of night that time of year. And I went into that with her with the idea that “Ok, first time mom, I could be here 24-36 hours, oh well…” She had a beautiful birth. She birthed in about 12 hours from beginning to end. So every woman has to be well informed, they have to know the risks and benefits. I like to tell them to take their brain to the birth – what’s the benefit, what’s the risk, what does your instinct tell you? Are there any alternatives? And does it have to be done now? And if you can answer those five things to any procedure and make your choice, then go with what is comfortable for you.

Sunny Gault: Are there additional resources that you would recommend? Because I know we just kind of scraped the surface on this topic.

Gerri Ryan: One of my favorite resources is Childbirth Connection. ChildbirthConnection.org – they’re one of the best educational sources in terms of really researching what goes on that site. And just know about yourself; know about your body. Some of my other favorite books are the books by Sears & Sears – The Birth Book, The Baby Book. Be an advocate for yourself. Know what’s important to you. Have someone there with you who can advocate for you, as in Rachel’s case – hers happened so quickly that her husband didn’t get to be there. And sometimes these things do happen. But also take the time afterward to process the birth; talk it through. Talk until people don’t want to hear you anymore; find a different friend and talk to them. Because it’s part of that assimilation that happens, that needs to happen between what happened physically, what happened mentally, and what happened spiritually in terms of what you were preparing for. And it brings it all together, synthesizes it into the experience of who this little person is. And then honor this person and the journey that they made.

Sunny Gault: Good advice. Alright. Well thank you, Gerri, for joining us today and sharing all this information with us. For more information about Gerri and her practice as well as information about any of our panelists visit the episode’s page on our website. For members of our Preggie Pals Club the conversation continues. We are going to explore what you should do if your labor is progressing quickly and you can’t seek medical attention. So that’s our special bonus content for our members right after the show.

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[00:32:52]

[Featured Segments: Maternity Fashion Trends. Dressing Your Bump for Work!]

Sunny Gault: Before we wrap today’s show, here’s some maternity fashion trends from Krystal Stubbendeck of Borrow for your Bump.

Krystal Stubbendeck: Hello, Preggie Pals! I’m Krystal Stubbendeck, maternity fashion expert and founder of Borrow for Your Bump, where you can buy or rent maternity styles for a monthly rent. Today we are going to talk about the office essentials for moms to be. These wardrobe essentials are still professional for the working mom even as you spore a new bump. The first must-have is a structured jacket. A tailor jacked will make you feel polished and strong. A style with a stretching material will grow with your changing body and will give you a sweet look that can be worn many different ways. Tailor trousers at the office and boyfriend jeans for the weekend. The next essential is a colorful sleeveless dress. Try darker but feminine tones for the office, like purple, cobalt and dark teak. But make sure that it is not too loose and bohemian. For a tighter fitting dress, pair with a tailor jacket or cardigan.

Our third office must-have is a pair of chic Blasts. These will be a lifesaver as you are trying to stay comfortable but still professional at work. Use dark colors, like black or metallic, which will go with mostly any outfit combination.
The next essential is for a perfect blouse fit. In white, black, and neon tone like hot pink or yellow and stripes. Choose styles that may be a little larger in the beginning of the pregnancy and use belts to gently define your waist. This look is flattering on any body shape. Then, as your bump grows, the blouses will be more fitting to last even beyond your pregnancy. Roll up the sleeves for a more casual look that is perfect for the weekend. Finally, the last office must-have is a comfortable pair of black pumps. Moms to be can have a career while still feeling sexy. Make sure to find a nice leather material, but avoid pattern, which doesn’t have much stretch. Also avoid the platforms or sky-high heels. Even two inch can be sexy as long as the toe is pointy, which gives a modern edge. Don’t forget to check out more great styles for moms to be at BorrowForYourBump.com. Enter promo code “PreggiePals” at checkout to save 20% off your entire order. Thanks for listening to today’s tips on office essentials and be sure to listen to Preggie Pals for more great pregnancy tips.

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Sunny Gault: That wraps up our show for today. We appreciate you listening to Preggie Pals. Don’t forget to check out our sister show Parent Savers - for parents with newborns, infants, and toddlers – and our show The Boob Group for moms who breastfeed their babies. Next week we’ll be discussing how to handle pregnancy when you already have young children. This is Preggie Pals – your pregnancy, your way.

[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are related to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.

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