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Pearently Foundations: The Ultimate Guide to a Healthy Pregnancy

Build a healthy and safe pregnancy so that you can experience a natural birth without fear.

Pearently Foundations: The Ultimate Guide to a Healthy Pregnancy

Build a healthy and safe pregnancy so that you can experience a natural birth without fear.
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Welcome to Pearently Foundations
Welcome to Pearently Foundations, your complete pregnancy guide. We are going to coach you through preparing for pregnancy, first trimester, second trimester, third trimester, Labor & Delivery, and the postpartum period.
A few things you need to know even if you are already pregnant.
It is important to establish yourself with a good healthcare provider for the health of you and baby. Ask yourself, "Is my doctor able to give me relatable information, and can he/she take care of me in an emergency situation?"
9 Important points when considering an upcoming pregnancy 1. Interpregnancy Interval of 18 months or greater (delivery to conception) 2. Body Mass Index (BMI) less than 35 3. Nutrition 4. Exercise 5. Medications 6. Folic Acid 7. Vitamins *Recommended Prenatal Vitamins: Actif Organic Prenatal Vitamin, Garden of Life Prenatal, MegaFood 8. Vaccines: Be informed *Vaccine Safety: *FDA: *CDC: *ACOG: MMR (Measles, Mumps, Rubella): 9. Genetic Screening
1. Alcohol 2. Smoking 3. Raw: meats, eggs, and fish 4. Shellfish 5. Deli Meat 6. Old Paint 7. Hot tubs & Saunas 8. Kitty Litter 9. X-Rays 10. Medications *Herbs to avoid in pregnancy: -Peppermint (avoid during 2nd and 3rd trimesters) -Evening Primrose -Lemongrass -Dong Quai -Ginseng -Cohosh -Hibiscus -John’s Wort
Welcome to your 1st trimester.
Confirm pregnancy with a (+) pregnancy test Urine pregnancy test Blood (serum) Ultrasound Symptoms of early pregnancy Fatigue Spotting Due to hormones or implantation bleeding Usually is a common process (talk to your healthcare provider) Diet/Appetite Loss of appetite Cravings or aversions Nausea and vomiting BRATT diet: Bananas, Rice, Applesauce, Toast, Tea Eat frequent small meals (6 to 10 small meals per day) The recommended weight gain during pregnancy is 25 to 35 pounds (if your BMI was 18.5 - 24.9 before your pregnancy began) Hot flashes Raised basal body temperature Hormone changes Menses Menstrual cycles normally stop during pregnancy Some women do have menstrual cycles during pregnancy
Health tips for your pregnancy 1. Drink water A baseline of 8 to 12 glasses of water per day (60 to 100 ounces per day) Check to make sure your urine is clear Avoid soda, sports drinks, and fruit drinks Caffeine: less than 200 mg per day = 16 ounces of coffee per day (2 cups of coffee) 2. Eat but consider calories Calculate your daily caloric intake Add 300 calories per day during pregnancy Eat a variety of macronutrients Whole carbohydrates: brown rice, quinoa, barley, sweet potatoes, squash, apples, oranges, beans, etc. Healthy fats: avocado, cheese, whole milk, cream, butter, olive oil, salmon, almonds, etc. Antibiotic & hormone-free protein (75 to 100 grams of protein/day): steak, chicken, turkey, eggs, tofu, etc. Eat greens & fiber Gut health, immunity, metabolism, and brain function Green leafy vegetables have necessary fiber, vitamins, and minerals Spinach, arugula, kale, cabbage, broccoli, asparagus, etc. Vitamins Take one Prenatal Vitamin OTC (over the counter) per day What to look for in a Prenatal Vitamin? Iron Calcium Vitamin D Folic acid Active Organic Prenatal Vitamin Garden of Life Prenatal MegaFood 3. Let your body rest Practice 7 to 9 hours of sleep per night Maintain a consistent sleep schedule Make your bedroom dark and cool Avoid caffeine before bed Unwind before bed (read a book, take a bath, stretch) Enjoy intimacy (sex during pregnancy is safe, and will not initiate labor) Practice 8 to 12 hours of “no snacking” during the night Help your body rest and recover Lower inflammation, calm hunger hormones, and balance your blood sugar to help your body stay away from gestational diabetes! 4. Exercise smart 30 minutes (3 days) of increased heart rate: walking, elliptical, or swimming 30 minutes (3 days) of strength training: weight lifting, resistance training
1. Detailed History and Physical Medical History Obstetrical History Family Medical and Obstetrical History 2. Know your medications, dosages, and diagnoses 3. Know your allergies (know what happens during your allergic reaction) 4. Physical Exam *Discuss your anxieties with your healthcare provider prior to the exam Breast and pelvic exam Genitalia exam Lab work: Pap smear STD Blood draw: CBC, Blood type, Rubella, Hepatitis B, Hepatitis C, HIV Urinalysis & urine culture 5. Ultrasound/Sonogram May not be done on your first prenatal visit Establish dates based on LMP before having an ultrasound Vaginal/pelvic/internal ultrasound is most accurate Abdominal ultrasound is most frequently used during pregnancy 6. Understanding gestational dating Full term: 40 weeks as defined by the first day of your last menstrual period Alternative terms: 280 days 9 calendar months 10 lunar months 3 gestational periods (13 weeks long)
*Most women are placed in the low-risk category during their pregnancy. However, things can happen during the pregnancy that places you at high risk. Please refer to our Pregnancy Complications section for additional coaching if you are diagnosed and placed on high risk during your pregnancy.
**This video contains medication information. Dr. Boyd is not prescribing medication or telling the consumer to take these medications. Please consult with your healthcare provider about your nausea and vomiting and possible medications that he/she recommends for you during pregnancy.
What is the reason for memory changes in pregnancy? There are many theories, but no research has revealed a definite answer. Most healthcare providers believe that the change in the body, circumstance changes, and sleep patterns are the main reasons for memory changes in pregnancy.
Dramatic changes happen in the first few weeks of your baby's life! Week 4 The heart is beating! The nervous system is forming Mouth, jaw, and throat are formed Baby is the size of an apple seed Week 8 The placenta is about to take over from the ovary and yolk sac Internal ears are formed Buds for arms and legs Fingers, toes, and eyeballs are formed Brain, spinal cord, and neural tissue is complete The digestive tract is formed Bone forms in place of the soft cartilage Baby is moving, but this is not felt by Mama yet Baby is the size of an olive Week 12 Baby is fully formed! Eyelids are formed but fused shut until week 27 Wrists and elbows bend and move Arms, hands, fingers, feet, and toes, and external ears are formed Fingernails, toenails, and teeth are developing Baby can open and close mouth and fists Baby produces urine and pees into the amniotic fluid Reproductive organs develop, but the baby's gender is difficult to distinguish by ultrasound at this point Baby is the size of a lime
*Dr. Boyd is covering all body systems in this video. Some of these symptoms may occur in the first trimester, and some may occur later in pregnancy. 1. Head “Not on your game” - memory changes and mood swings Headaches and lightheadedness Fatigue 2. Face, gums, nose, ears Swelling of the face Gum bleeding Bad breath Nose bleeding Ear bleeding (see healthcare provider) Hair growth on your face 3. Neck Low thyroid levels from the thyroid gland 4. Chest Lungs: a sensation of shortness of breath Heart: blood volume increases by 1.5 times Increased heart rate “Increased beat” Breast Increased size Tenderness Darkening of nipples and areolas (the skin around your nipples) Small bumps on the areolas (Montgomery's tubercles - glands) Leaking colostrum (a thick yellow substance for a baby to drink before breast milk develops) 5. Belly (abdomen) Skin changes Linea Nigra: a dark line on the belly due to increased pigmentation Hair growth Intestines Constipation Gas Bloating Acid Reflux Bladder Increased urge to urinate due to pressure from the uterus 6. Vagina Increased discharge Normal: white, no odor, no irritation, no bleeding Abnormal: cottage cheese, foul-smelling, irritation, bleeding Increased pigmentation and swelling Vagina and labia may turn purple or blue and become swollen or puffy due to increased blood flow 7. Legs and Feet Edema (swelling) If you have major swelling during the 1st trimester, see your healthcare provider 8. Joints (Musculoskeletal) “Laxity of ligaments” due to the hormone Relaxin that will loosen pelvic bone for delivery preparation.
Vaccinations are recommended by the FDA, CDC, ACOG. Vaccinations are not required. Do not feel pressured by your healthcare provider to receive the vaccines. It is important for you to make an informed decision about vaccinations. Read both sides of the debate: Vaccine Safety: FDA: CDC: ACOG: Before Pregnancy: MMR (mumps, measles, rubella) Offered before pregnancy if you are non-immune Your blood work will show if you have “immune” or “non-immune” status You will be offered the MMR vaccine if you are “non-immune” Wait 1 month after receiving MMR to conceive During Pregnancy: Influenza (flu): offered September - March Tdap (Tetanus, Diphtheria, Pertussis): offered weeks 27 - 36 Hepatitis B: 3 shot series offered anytime during pregnancy
Welcome to your 2nd trimester.
This is an overview of what to expect in your 2nd trimester! The 2nd trimester begins at the end of the 13th week and ends at the end of the 26th week. This trimester includes very important testing, baby movement, and the gender reveal anatomy sonogram!
Maybe you are experiencing some new body changes this trimester! Back Pain Leg cramps and swelling (edema) Skin changes such as Linea Nigra Varicose veins Braxton-Hicks contractions (your body is practicing contractions) Increased appetite Recommended weight gain is 25 - 35 pounds during your entire pregnancy if your BMI was 18.5 - 24.9 before your pregnancy It is safe to travel up to 36 weeks for most pregnant women (talk to your healthcare provider) Baby Development Week 16 Eyebrows, eyelashes, nails, and hair are formed Teeth and bones becoming denser Baby can suck on thumb, yawn, stretch, and make faces Reproductive organs and genitalia are fully developed The heartbeat may be audible on doppler Baby is the size of an orange Week 20 Lanugo (soft hair) covers the body to protect the baby and will shed at the end of the first week of life Vernix, a cheesy protective substance covers baby's skin Meconium, a harmless mixture of swallowed amniotic fluid, digestive secretion, and dead skin cells that forms first bowel movement after delivery Quickening is when Mama first feels the baby moving Baby is the size of a banana Week 24 Skin is wrinkled and veins are visible through translucent skin Finger and toe prints are visible Eyelids begin to part and eyes open Mama may feel jerking movement from baby’s hiccups Baby can hear Mama’s heartbeat and voice Baby is the size of a papaya
A Level II ultrasound will be performed to determine the anatomy and reveal the gender of your baby! The Level II ultrasound will be performed around the 18th to 22nd-weeks gestation. This ultrasound is performed to provide information regarding the health and growth of your baby. How to Prepare? Full bladder to aid in the optimum visualization of baby Ultrasound may take 30 to 45 minutes An ultrasound technician may do the scan rather than your healthcare provider This ultrasound is performed to determine: Number of babies in utero Amniotic fluid volume Placental location Anatomy of Baby Head, brain, face Neck Chest size and symmetry Heart: 4 chambers, vessels Abdomen: intestines, bladder, kidneys Lower and upper extremities Measurements of head, humerus, abdomen, and femur Umbilical cord location and number of vessels Gender reveal (usually done last)!
1. Fundal Height Distance from the pubic bone to the top of uterus measured in centimeters Measuring fundal height is a tool for gauging fetal growth Fundal height matches weeks gestation after 20 weeks Example: fundal height at 30 weeks gestation should be approximately 30 centimeters Fundal height measurement might be less accurate: Obesity Carrying twins or other multiples A fundal height that measures small or large — or increases more or less quickly than expected — could indicate conditions such as: Slow fetal growth (intrauterine growth restriction) Significantly larger than an average baby (fetal macrosomia) Too little amniotic fluid (oligohydramnios) Too much amniotic fluid (polyhydramnios) Healthcare provider might recommend an ultrasound to determine the cause of atypical measurements 2. Fetal Heart Rate Monitoring Process of monitoring the baby’s heart rate with special equipment Doppler may be used in the office setting at 12 weeks and beyond A normal heart rate of baby: 120 - 160 beats per minute (BPM) Bradycardia: average heart rate is less than 120 BPM Tachycardia: average heart rate is greater than 160 BPM
*Most healthcare providers recommend counting kicks on a daily basis after 25 weeks gestation.
Also called "False Labor" Your body is practicing! Contraction lasts 30 to 60 seconds, but the interval between is not consistent. Contractions are not frequent, not predictable, and not painful. Triggers of Braxton-Hicks contractions: Dehydration Intercourse Activity
The quad screen test is a blood test obtained in the office setting to screen for possible abnormalities in the baby. Performed between the 15th and 22nd-week gestation. This is a screening test, and it is not diagnostic. ACOG recommends that all pregnant women be offered this test. This test is also called: Maternal serum screen Triple test Triple screen Multiple marker screen AFP High-risk pregnant moms are highly encouraged to have this test performed: Greater than 35 years of age History of the previous baby with chromosome abnormalities History of type 1 diabetes before pregnancy Family history of genetic abnormalities The test is looking for possible abnormalities: Brain or spinal cord such as open neural tube defects Down Syndrome Trisomy 21 Patau Syndrome Trisomy 13 Edward’s Syndrome Trisomy 18
ACOG standard is that all pregnant women should be screened for gestational diabetes. A screening test is not diagnostic. Screening is performed between week 24 - 28 gestation. Preparation: Not a fasting blood sugar test No preparation by Mom required Eat and drink before the test. Drinking glucola on an empty stomach may cause nausea. Test: Mom will drink a sweet drink (glucola 50 grams) Blood draw after one hour Normal screen: <140 mg/dL High blood sugar (positive test) may indicate that Mom’s body is not effectively processing the sugar Further testing needed if screening is positive Risk Factors for gestational diabetes: Pre-pregnancy BMI greater than 25 kg/m2 Age less than 21 and greater than 35 History of gestational diabetes History of having a large baby for gestational age Family history of diabetes
What is Rhogam? Medication is given as an injection to Rh- blood type Moms Blood types that will not receive Rhogam: A+, B+, AB+, O+ Blood types that might receive Rhogam: A-, B-, AB-, O- Explanation: Rh+ is a protein on red blood cell All positive blood types have this protein Rh- means that the red blood cells do not have this protein All negative blood types do not carry this protein Dangerous if Mom has a negative blood type Mom's blood becomes contaminated with baby's Rh+ protein Mom's body is then on alert! If Mom becomes pregnant in the future and the baby has Rh+ blood, then Mom's body will attack the baby Healthcare provider will offer Rhogam if Mom has Rh- blood type and baby has Rh+ blood type
Welcome to your 3rd trimester.
Your 3rd trimester is from the end of your 26th week until 40 weeks gestation. You will see your healthcare provider every 2 weeks until your 36th-week gestation. Then you will see your healthcare provider every week until the birth of the baby. Visits: Blood pressure & weight check Urine evaluation Fundal height & fetal heart rate monitoring GBS swab at week 36 gestation Cervical exam & baby position check around week 38 gestation
You may be experiencing... Difficulty getting comfy in your sleeping positions Hemorrhoids Swelling in legs, ankles, and feet A sensation of shortness of breath Baby Development Week 28 Baby is gaining weight! Can survive in the NICU if born at this point Baby is the size of a cantaloupe Week 32 The brain is developing rapidly Gaining ½ pound per week Lungs are still maturing The baby begins having dreams Baby is the size of a coconut Week 36 Gaining 1 to 2 pounds per week Blink, close eyes, turn head, grasp, respond to sound, light, and touch The baby may drop down into the birth canal (lightening) Baby is the size of romaine lettuce Week 40 Skull bones are not fused, which allows them to overlap during delivery Baby is the size of a watermelon!
What is Group B Streptococcus? Normal bacteria in the vaginal and rectal area that does not cause harm to Mom Bacteria can cause pneumonia, meningitis, and death to a baby born vaginally in a Group B Strep environment Healthcare provider will swab the vaginal and rectal area, and send a culture to the lab to be tested Mom will be offered antibiotic treatment for Group B Strep Treatment will reduce bacteria in vaginal and rectal area to reduce the risk of the baby developing an infection at birth *It is very important for you to know if you test positive for Group B Strep. And it is important for you to inform your nurse in the Labor & Delivery Unit when you arrive.
This is the evaluation of the fetal heart rate (your baby's heart rate). Who needs an FNST? Low-Risk Mom: "I don't feel the baby move as I should" Mama is an overdue date High-Risk Mom: Hypertension Preeclampsia Heart disease Kidney disease Diabetes What to expect? A Fetal Non-Stress Test can take 20 minutes to 1 hour Sit in a chair or lay in a bed Two monitor probes are attached to belly using elastic bands One probe will monitor the fetal heart rate One probe will monitor uterine contractions How does a healthcare provider assess fetal well being? 1. Fetal heart rate baseline = average heart rate: The rate should be 120 - 160 beats per minute 2. Variability = neurological process of baby shown in a sawtooth pattern: Good variability or poor variability 3. Heart rate accelerations = heart rate goes up when baby moves: 2 accelerations of at least 15 beats above baseline in a 20 minute period of time Recorded as reactive or nonreactive 4. Uterine contractions: Normal deceleration = baby’s heart rate goes down with the contraction Late deceleration = baby's heart rate goes down after contraction (more evaluation is needed) How is FNST categorized? Category 1 = Healthy baby Category 2 = Further monitoring needed Category 3 = Imminent delivery
*This tool assesses intrauterine fetal well-being (baby's health) to establish if the baby needs further testing or delivery. 5 parameters with a score out of 10: 1. FNST: reactive = 2/2 2. Amniotic fluid volume: 2 pockets that need to equal 2 cm or greater = 2/2 3. Fetal movement: 3+ movements in 30 minutes = 2/2 4. Fetal tone: 1+ movement in 30 minutes = 2/2 5. Fetal breathing movements: 1 rhythmic breathing session of 30 seconds in 30 minutes = 2/2
Exam: No preparation is needed Provides objective information about Mom's cervix and position of the baby Most healthcare providers begin examining cervix around week 36 to 38 gestation Assess the opening (dilation) and thinning (effacement) of the cervix Dilation (opening of the cervix): 1 cm - 10 cm (fully dilated) Effacement (shortening/thinning of cervix): 0% - 100% (fully effaced) Position of baby: location of the baby’s head needs to be down before delivery (vertex)
This section is for your husband. Ask him to take a moment to watch these videos to be fully prepared to be your Husband Hero.
Is it safe to have sex during pregnancy and after baby is born? Yes! It is safe to have sex up to delivery day, then take a break until your doctor gives you the okay (usually at the six week mark).
It is time to enter into one of the most exciting, overwhelming, and incredible moments of your life. It is time for you to be the Husband Hero. It is time for you and your wife to go through some hard times together and come out on the other end with a marriage that is stronger and deeper.
Everything you need to be equipped and confident for natural birth without fear.
This amazing process allows for the miracle of baby coming into this world! This is a labor process, and We will help you get prepared and confident. Here's to a healthy Mama and baby. Labor On!
Get in the mindset! Talk about it Talk to women who have done it before Get perspective and get encouragement! Talk to women who have had delivery with and without pain medication Watch movies about pregnancy, labor, and delivery Read books about labor and delivery Laugh about it, cry about it, and get all of your anxieties out in the open Get a birth plan but know that it might change Decisions: Think about staying home once labor begins Think about laboring positions that will make you more comfortable Decide if you want an epidural Decide if you do not want any pain medications Do you want a family in the room? Do you want pictures? Decide on whether you want vaccinations for baby Etc. Tour the hospital labor & delivery unit: Where to park (valet or paid parking) Labor & Delivery Emergency Department first or go straight to the unit Nurse, resident, internist, or on-call doctor may take care of you Pack your bag now! Dad has a Go Bag list too Get car seat ready, and know how to use it.
The mucus plug: Grows in the cervix during pregnancy Present for the protection of the baby Prevents bacteria from entering the cervix, weakening the bag of waters, and rupturing membranes early Will “come out” around week 37 gestation Maybe clear, pink or brown in color You may ask, “Is my labor going to start now that my mucus plug has come out?” There is no correlation between time of mucus plug discharge and onset of labor Loss of the mucus plug is a preparatory phase in late pregnancy as the cervix begins to open (dilate) and thin (effacement)
Also known as... "Are you ruptured?" "Is my bag of waters broken?" "Am I leaking?" "Are my membranes ruptured?" "Is it water or vaginal discharge?" What is a false alarm? The cervix begins to open and the glands secrete watery fluid late in pregnancy This clear watery discharge is normal, but it is not the bag of waters Discharge should not be malodorous, gray, brown, or green Bladder spasms can occur frequently in late pregnancy and cause a gush of urine How to know if your bag of waters has ruptured? You may have a big gush of watery fluid You will then have a continuous leak as the amniotic fluid comes from the baby urinating (peeing) What to do if you feel a big gush or a leak? Make note of the time Empty bladder Change clothes Wait and continue to keep the bladder empty Stay home for 6 to 12 hours until true labor begins *Exception: If you are Group B Strep Positive, then go to the hospital and tell the nurse you need to be treated with antibiotics before a baby is delivered.
Labor occurs for the purpose of delivering the baby through the vagina in a successful and healthy manner for you and your baby. Labor: the uterus contracts (tightens) and causes pain False Labor: irregular uterine contractions *Don’t go to the hospital The uterus is firm and causes cramping No change in cervical dilation Can occur before week 37 gestation Braxton-Hicks contractions (the body practicing labor) Pre Term Labor: true/active labor before week 37 gestation True Labor or Active Labor: regular painful contractions The regular interval from the end of one contraction to the beginning of the next contraction The contraction itself will last approximately 60 to 90 seconds Labor part 1: regular contractions that are 2 to 4-minute intervals for 2 hours Labor part 2: painful contractions that increase in pain for a minimum of 2 hours Labor on!
First Stage: the onset of true labor to 10 cm dilated cervix Early Phase: Make a note when labor begins Don’t go to the hospital Stay comfy at home or walk Practice breathing techniques Drink water and eat small snacks Sleep between contractions (5 - 30 minutes) Active Phase: Go to the hospital as active labor begins to turn into the transition phase Transition Phase: This phase is hard, but it is the shortest You may experience hot flashes, chills, nausea, vomiting, or gas Second Stage: 10 cm dilated cervix to delivery of the baby Pushing Phase: You will experience an overwhelming sensation to push if you do not have an epidural An epidural causes numbness and difficulty in feeling when to push The nurse will prompt you to push if you are not sensing when to push Begin to push when you feel a contraction starting: Take a deep breath Tuck your chin Begin to push (hold your breath as you push like you are having a bowel movement) Keep pushing until the contraction ends Take a deep cleansing breath and rest until the next contraction Third Stage: Delivery of the placenta Your healthcare provider may push on your belly to make sure all of the placentae are delivered You get to hold the baby while this is occurring! Fourth Stage: skin-to-skin This phase is all about bonding, nursing, and resting
Why is the Caesarean Section performed? Repeat C-Section: Mamas that have had a C-Section in the past Failed Labor (arrest of labor): Mama cannot deliver vaginally How is the Caesarean Section performed? Performed by a surgeon Surgery will last approximately 20 minutes to 2 hours Anesthesiologist or nurse anesthetist will monitor pain relief during surgery What are the types of Pain Relief? Regional anesthesia (epidural or spinal): numbness from chest to feet General anesthesia: Mama goes to sleep What will happen after the surgery? Recovery room for 1 to 3 hours Transferred to the postpartum room for 2 to 5 days (average of 3 days) Anesthesia will wear off The nurse will remove the Foley catheter and help Mama get up to walk What pain relief will be provided during recovery? Narcotics Over The Counter NSAID (non-steroidal anti-inflammatory): Ibuprofen or Advil Prescription NSAID: Toradol How to care for surgical incision? Soap and water sponge bath Allow skin to be exposed to air Monitor for infection: redness, malodorous drainage, bleeding, fever, chills *Follow up with your healthcare provider within one week of discharge.
First Stage: the onset of true labor to 10 cm dilated cervix Early Phase: Contraction feels like a menstrual cramp Make a note of when labor begins Don’t go to the hospital Stay comfy at home or walk Practice breathing techniques Drink water and eat small snacks Sleep between contractions (5 - 30 minutes) Active Phase: Contractions increase in intensity Transition Phase: Cervix dilates to 10 cm ("fully dilated" or "complete") The phase is painful, but the shortest before the pushing phase You may experience hot flashes, chills, nausea, vomiting, or gas Second Stage: 10 cm dilated cervix to delivery of the baby Pushing Phase: Overwhelming sensation and need to push, just like you need to poop Begin to push once you begin to feel a contraction: Take a deep breath Tuck's chin Hold your breath as you push like you are having a bowel movement (poop) Push until the contraction ends Take a cleansing breath and rest until the next contraction Stinging sensation as the baby delivers known as the "Ring of fire" Third Stage: Delivery of the placenta Your healthcare provider may push on your belly to make sure all of the placentae are delivered You get to hold the baby while this is occurring! Fourth Stage: skin-to-skin Bonding, nursing, and resting
Tools: Birthing ball (exercise ball) Relaxing playlist Essential oils (lavender, frankincense, clary sage) Husband Legs Labor on!
You are a capable woman with wisdom. We are here to inform and help you learn to cope with labor pain using: Meditation Breathing techniques Relaxation techniques Comfortable positions for rest Our beliefs about Labor & Delivery: Pain during childbirth is normal Birth is a natural and healthy process You have the right to your preferences during childbirth With preparation, you can avoid pain medication Staying home as long as possible will help to decrease interventions and risk of C-Section Preparation is important for labor pain even if you want an epidural
Rhythmic breathing techniques, also considered abdominal or diaphragmatic breathing is for active concentration and relaxation during labor and delivery. During Labor: Walk, rest, or be in the position of your choice during each contraction Tune into your breath Concentrate on the exhale (out-breath) Breathing is low, easy, relaxed Pain builds, peaks, eases Relax face, shoulders, arms, legs Concentrate on normal breathing during contraction as tendency will be to breathe fast and shallow Start and end each contraction with a cleansing breath (blow out slowly) *You may experience an urge to push before the cervix is 10 cm (complete). This can cause swelling of the cervix and problems with delivery. Don't push until nurse says you are ready. Push with contraction (work with normal feeling to push) Breathe in gently when a contraction begins Tuck's chin Bare down towards your bottom Push like you are pooping Let the breath escape through lips (don’t blow out during pushing) Blow out your breath once contraction ends Take a deep cleansing breath *Alternate between pushing and blowing the breath out as baby's head begins to emerge (to control the speed of delivery).
*You have the right to push and give birth in the position that is most comfortable for you. *Mamas with epidurals cannot get out of bed to labor or push. Your healthcare provider may help you get into the lithotomy, recumbent, or lateral position to push. *Mamas without epidurals benefit from the upright positions during the second stage of labor (pushing) as this provides benefits such as a lower risk of abnormal fetal heart patterns, decreased use of vacuum, forceps, and episiotomy. Lying Down Lithotomy: back lying in supine with hips and knees flexed, thighs apart, and legs in stirrups or pulled up to abdomen by thighs Recumbent and semi-recumbent: lying on back or in a semi-sitting/lying position with the head of the bed raised up ("C Position") Lateral: side-lying position with one leg raised Upright Hands-and-knees Sitting on a birth seat Squatting Standing supported by a partner or prop
The second stage of labor and delivery begins once your cervix has dilated to 10 cm and you begin to push. Pushing time: Primip/Nullip (first-time mama) average: 2 to 3 hours Multip average: 1 to 2 hours Cords and wires: Monitor for baby’s heart rate and your contractions Internal scalp electrode to better monitor baby Intrauterine pressure catheter to better monitor uterine contractions IV fluids such as Lactated Ringers (“IV Gatorade”) Epidural pump Caput! (head crowning): It takes time to deliver the head, but the rest of the body delivers very quickly A vacuum may be applied to baby’s head or forceps may be used to guide the head out of the vagina if the baby has a low or high heart rate (used for a small percentage of women) Episiotomy: a surgical cut at the opening of the vagina (most healthcare providers do not perform episiotomy) Tissue may tear during delivery Baby is born: Baby and Mama bond with skin-to-skin Labor nurse will stimulate baby and check airway and breathing Cord clamped and cut (Dad can cut the cord to be involved!) Healthcare provider will drain the umbilical cord to collect a blood sample to identify the baby’s blood type Placenta delivered (2 to 15 minutes) The provider will manually remove placenta if it does not deliver spontaneously Labor nurse will initiate uterine compression and massage to decrease the risk for bleeding (uncomfortable but necessary) Healthcare provider will repair tissue tear with dissolvable sutures Labor nurse will administer intravenous (IV) Pitocin (Oxytocin) to help the uterus contract and prevent bleeding Cytotec (Misoprostol) may be administered to help uterus contract if Pitocin does not decrease bleeding sufficiently Labor nurse will assist you in cleaning up once you are stable *The delivery process has ended and your postpartum period will begin!
Childbirth is the most beautiful process! You were made to do this. Maybe you are set on having an epidural, and maybe you want to try to deliver without pain medicine. Whatever you choose, be confident in your abilities. I want to give you some words of encouragement and help you find your story.
That was quite the journey! Now people are about to ask 100 different questions and do 100 different things. Be prepared to write information down, or ask your husband to take notes and answer questions. What is the nurse doing to my baby? Measuring weight, length, and head circumference Recording body temperature Cleaning umbilical cord stump and giving the baby a bath Inform nurse beforehand if you don’t want your baby to have a bath Applying antibiotic ointment to eyes to treat for STI gonorrhea and chlamydia Inform nurse beforehand if you choose to decline Administering Vitamin K to help blood clot Inform nurse beforehand if you choose to decline Administering Hepatitis B vaccination Inform nurse beforehand if you choose to decline Be informed with CDC Vaccine Schedule Collecting baby’s footprints and applying identification bands to wrist and leg What happens in the postpartum room? Hospital stay: Vaginal delivery with no complications: 2 days Cesarean delivery with no complications: an average of 3 days Baby will “room-in” with Mama You can ask the nurse to take your baby to the nursery Ask for ibuprofen, water, juice, food, etc. Epidural Medicine will wear off The nurse will remove the Foley catheter and assist you to the restroom Ask for help if you want to shower (fainting is common after delivery) Ask for the lactation consultant to assist with breastfeeding Record baby’s poops, pees, and feedings The lab technician will draw your blood to check hemoglobin and hematocrit Heel-stick blood test to screen your baby for metabolic disorders The pediatrician will examine the baby within 24 hours of delivery Hearing screening for baby Cord stump care education Circumcision Birth certificate paperwork Discharge class covering how to care for the baby at home
Welcome home! We are here to help you feel confident as a new parent.
We have 15 things you might not know about newborns. Conehead The baby had to do some work to get through the birth canal. This will correct itself. Make sure baby gets some tummy time to prevent a flat head in the back. Soft spots Fontanels are on top of the head and the back of the head. The skull bones are not attached yet as this allowed the head to come out of the birth canal. It is okay to touch the soft spot. Be aware that it will pulsate because it is over the blood vessels and brain. Cradle cap The reason for the flaky scalp is unknown. It will resolve on its own. Newborn skin Dry skin doesn't need lotion as this will clog the pores. Lose 5 - 8 percent of birthweight This may occur within the first week of life. He or she should gain that weight back by week two. Make sure baby is weighed at the pediatrician’s office. Also, count diapers, and there should be six to eight wet diapers per day with at least one stool. Acne and boobs Mama’s hormones are affecting the baby. Meconium The first poop is tarry, black, and sticky. Colorful poop Breastfed newborn poop is liquid with “mustard-seeds” mixed in. The color should be brown, green, or yellow with some white seed type particles. Bloody diaper Blood in the diaper can result from many different things: the little boy had a circumcision, the little girl is having a “mini period” from the hormone withdrawal, had a hard time pooping the meconium, or has a little scratch on the bottom. Sneezing Baby is experiencing dust for the first time. Sneezing a lot is normal even though he or she isn’t sick. Pay attention to make sure it doesn’t change sounds into wheezing. That’s when to worry. Jerking movements The baby may appear to be flailing. This is good as it means that the baby is getting the hang of his or her reflexes. Squeak, grunt, irregular breathing The baby may have irregular breathing while sleeping until the nervous system fully develops. Rapid, shallow, and pauses in breathing are normal. Nostril flaring or grunting with every breath is when to be concerned. Crying This is a good thing, most of the time. Babies communicate with crying. He or she wants to eat, needs a diaper change, needs some TLC, is tired, or has gas. Do all that you can, and if you get overwhelmed, then ask someone to help out. If no one is around, then put the baby in a safe place, close the door, and go take a breather. Baby will be safe, and you don’t have to worry about doing something you will regret. Healthy
Baby does a lot of growth and development in the first two years of life. What will the Pediatrician do at the appointments? Vaccinations Be informed Vaccine safety CDC Know that vaccinations have side effects Download the CDC Vaccine Schedule Check skin tone, alertness, reflexes, and hip stability Weigh baby (do not be alarmed if baby lost a little bit of weight) Measure body length and head circumference Examine ears, eyes, mouth, genitalia, soft spots, heart sounds, and lung sounds Evaluate development and behavior *This is your baby, and this is your pediatrician visit. Remember to find a Pediatrician that fits with your beliefs, and is not too pushy.
Care Instructions for approximately 5 to 10 days: Maintain a dry stump Do not tear or pull on the stump Fold diaper down below belly button before applying side flaps Sponge bathe the baby and pat belly dry Do not submerge baby in the water The stump will fall off on its own The site may bleed a little when the stump falls off as it is a scab
Circumcision is considered cosmetic surgery, and it is not required. The procedure involves the removal of the foreskin, and it can be done at the hospital or in the office setting. Care Instructions: Leave lubricant gauze on for 24-hours after circumcision Some bleeding and oozing is normal Maintain a clean site Apply petroleum-based ointment to the site before applying new diaper Monitor for risk of infection Green or yellow drainage with odor, fever, or chills
Kegel exercises assist with diminishing stress incontinence, which is annoying and embarrassing. How to do Kegel exercises? Sit on the toilet Start the flow of urine Stop the flow of urine completely Start the flow Stop the flow Stop the flow 10 times in one sitting Practice Kegel 3 to 5 times per day
Sex is not always right around the corner after birthing a baby. Let’s talk about when it is safe to resume sex, what to expect, and some reasons you may not feel like it. Vaginal delivery: wait at least 6 weeks A vaginal laceration may be painful C-Section: wait at least 6 weeks Monitor for infection, heavy vaginal bleeding, clots, and severe pain Body changes Vagina Vaginal dryness Pain No sex drive Hormone changes Weakened vaginal muscles Vaginal flatulence Breast Sore nipples Let-downs Feed baby right before intercourse Wear a nursing bra Abdomen Allow 4 weeks for the uterus to contract Stretch marks Weight Linea Nigra Good sex life Eat healthily Exercise Rest Talk to your partner Some women wait 6 months before returning to sex
Congratulations on your baby bundle of joy.

About the instructors

Dr. W Marc Boyd, Jr

Physician, OB/GYN
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Dr. Boyd is a Board-Certified Obstetrician Gynecologist licensed in Florida and Illinois with strong clinical experience performing over 8,000 deliveries, 900 minimally invasive advanced daVinci robotic surgeries, and director of Women's Healthcare at Unity Point-Methodist for 10 years. Dr. Boyd has been practicing obstetrics and gynecology for over 26 years and continues to pioneer advancements in women's healthcare. He enjoys time around the table with great meals and family, traveling, reading, studying the Bible, cycling, and snowboarding. His faith-based compassionate care has lead him to help advance numerous areas in his field including but not limited to:

  • Leader in managing women's health issues.  
  • Early adopter of creating and directing an Obstetrical Laborist program. 
  • Expert in minimally invasive gynecologic surgery with the advancement of daVinci Robotic Surgical System.  
  • Special interest in nutrition and educating the medical community and the public on the effects of obesity.  
  • Disease specialization proficiency.  
  • Multi-site and single-site daVinci certified.  
  • Advancement of office-based surgical procedures.  
  • Creator and director of the first Laborist program in Central Illinois.  
  • Director of Women's Healthcare at Unity Point-Methodist for 10 years driving policy and implementation of core service.  
  • OB/GYN Department Chairman for 6 years. 
  • Assistant Professor of Medicine for OB/GYN and Family Practice Residents - University of Illinois at Peoria.  
  • Developer and Director of Multi-Disciplinary Committee for the Department of Obstetrics (The model was subsequently used as a template for other hospital departments). 
  • Directly involved in developing an active daVinci
  • Robotics program and developing guidelines for maintenance.  
  • Medical Director and President of the Laborist program, directly involved in all aspects of quality management.
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