Considerations After Vaginal Birth

Video Content Coming Soon! For now, here’s my Cliff Notes 🙂 

Unmedicated

In a nutshell, in Vaginal Birth, you are generally allowed to move around the labor floor, including use of tub, for labor (as long as water isn’t broke), but hospitals will vary in whether they allow you to actually have the baby in the tub (ask about this). 

You may or may not have monitors attached to you and baby.  If the monitors are affecting your ability to move, and everything is going well, you can ask to disconnect them for a period of time to move differently. 

If allowed by your birth setting, a goal is generally to ingest 100 calories an hour, and at least 3 oz of water an hour…but sometimes hospitals will not allow this. Talk to your medical team about what is, or isn’t, allowed.  

When it’s time to push, the room will TRANSFORM!!  Lights drop out from everywhere, pictures get pulled away and there are medical supplies behind them, and a bunch of people come into the room.  Some are doctors, most are nurses.  2-4 of them are there just to check on baby when baby comes out.  You will push in whatever position you end up in, for hopefully less than 2 hours.  Remember your goal is to relax as much as possible.  In the end, if you do have a strong urge to push, it is okay to do so, as long as nurses and docs say that it’s time.  If they are telling you to push and you have no urge, though, ‘just relaxing the pelvic muscles’ tends to be a better option, as this allows the uterus to do it’s thang.  

Baby’s head will crown first, then the doctor will ask you to pause and NOT PUSH for a moment.  This is to ensure that the umbilical cord is not around the neck.  When we are sure it is not, then you can resume pushing. Once the shoulders are out…the baby kind of slides out like a slippery eel really fast.  YAY!!  The nurses will put him-her on your chest immediately, as long as it is safe to do so.  You can request that they wait until the umbilical cord stops pulsing before cutting it.  That is advised.  Especially if you are having a baby at higher elevations, the baby needs all the oxygen they can get!  Once the nurses ensure the baby is fine, they tag baby with an anklet and take footprints and handprints…they usually give you a souvenir of this.  The doctor, and nurses, meanwhile, will attend to you at this time.  They will make sure the placenta comes fully out (one nurse might push on your (now very cuddly and soft) belly to help this along.  It doesn’t hurt, just feels weird to have an empty space there, where baby has been.  As the placenta comes out, the doctor may assess you for any tears that have occured, and will repair you under lidocaine, if needed.  

Once you’re cleaned up, the nurses and doctor will want you to walk to the bathroom and try to empty your bladder.  This will feel shaky, and most likely, for the next 2-3 days, when you walk into a bathroom, your bladder will start to empty on its own before you reach the toilet.  This is NORMAL in the first few days (the bladder just went through a lot), but ought to reduce drastically after day 2-3, and be gone by 1 week after in all but the most extreme cases.  

The baby will be encouraged to suckle, but no milk will come out (it takes about 2 days).  If it was a long labor, the baby may be dehydrated and low blood sugar, and may need formula or an IV.  This is common in long labors, but not otherwise.  If this is the case, the baby may go to the nurses station for these treatments.  

The baby will then possibly be taken to a nursery so you can rest, or the baby may be kept in your room. In certain cases, the baby may require oxygen and-or to ‘go tanning’ under the UV lights for a day or 2, also behind the nurses station, but the baby is allowed to be with you as much as possible.

Epidural:

As above, until you get the epidural.  Then you are sitting at the edge of a bed in a BIG forward bend, with a nurse stabilizing you so you don’t move as the anesthestetist is putting it in.  You breathe, feel some pressure on your back, then 10-15 seconds later, the contractions are more like pressure than pain.  I highly recommend this if you have a trauma response, or experience excruciating back labor.  While it can slow labor in ‘normal’ deliveries…those that have high pain levels, or complex trauma histories may require an epidural to let go of the deep muscles.  

In this case, we need to be sure if our leg(s) are numb, that we are not having anything place undo pressure on them for longer than 15 minutes at a clip (ie, someones hand holding a leg, a stirrup, bedrail, etc), as well as we should alternate placing a towel under L sacrum for a half hour, then right, to avoid sores, and to allow the sacrum freedom of movement, as you’ll likely be confined to bed/room.  

In this case, your sensation to push is indeed diminished. Remember that it is your uterus that pushes the baby out.  Channel how you felt during the ‘relaxed pelvic floor’ activities in Push Prep.  Find that head space.  

After baby comes out, you’ll have same steps as above, except you have to wait until you can feel your legs until you’re allowed to use the bathroom. OH, and you’ll have had a catheter in for the time the epidural was in.  Don’t’ freak out–they put it in after the epidural and you don’t feel a thing.    When you stand up to pee, expect to feel cold and shaky.

Some stiffness at epidural site is normal, but contact your provider if it is itchy or red.