1. Labor is Like A Card Game!

2. You have to make the best hand with what you get! Sometimes you get dealt a great hand, sometimes you have to look at what else is available, and sometimes you just get dealt stinky cards! Sometimes you get dealt a great hand, sometimes you have to look at what else is available, and sometimes you just get dealt stinky cards! When life gives you lemons – When life gives you lemons – make lemonade!

3. You may be able to discard some cards you get dealt. Always ask about your options! Always ask about your options! Hire a doula to help you in this process. Hire a doula to help you in this process.

4. You can’t know what cards you will be dealt before the game starts. Birth plans should not be written in stone. Birth plans should not be written in stone. Flexibility and a good attitude go a long way! Flexibility and a good attitude go a long way!

5. The people you choose to play cards with, will often determine how much fun you have playing the game. Choose your support team wisely. Choose your support team wisely. Consider a doula. Consider a doula. Do NOT let anyone in to view the birth that you do not honestly want there deep in your heart! Do NOT let anyone in to view the birth that you do not honestly want there deep in your heart!

6. It is a good idea to know the rules of the game before you start playing. Read about your options. Read about your options. Educate yourself and your husband/wife. Educate yourself and your husband/wife. Attend a good childbirth class that meets your needs. Attend a good childbirth class that meets your needs.

7. Stages of Labor

8. Medications Offered in Childbirth

9. Narcotics/Analgesics Commonly used in early-active labor. Commonly used in early-active labor. If given late in labor, the baby must be given an antidote called Narcan. If given late in labor, the baby must be given an antidote called Narcan.

10. Narcotic Advantages: Help relax mother Help relax mother Takes the edge off Takes the edge off Can speed labor if mother is “fighting it” Can speed labor if mother is “fighting it” When her head’s in the way, her cervix can’t dilate. When her head’s in the way, her cervix can’t dilate.

12. Narcotic Disadvantages: Itching Itching Allergic reaction Allergic reaction Vomitting Vomitting Do enter the blood stream and baby may be lethargic at birth Do enter the blood stream and baby may be lethargic at birth Can produce very sleepy or high feeling Can produce very sleepy or high feeling Can slow labor Can slow labor Breastfeeding may be adversely affected Breastfeeding may be adversely affected May require additional intervention May require additional intervention

13. Epidural Best received between 4-7 centimeters

14. Receiving an Epidural

15. Epidural Advantages: Mother remains awake and the epidural does not affect her state of mind Mother remains awake and the epidural does not affect her state of mind Usually takes away the pain of labor Usually takes away the pain of labor Very little of the medication enters the baby’s blood stream. Very little of the medication enters the baby’s blood stream.

18. Giving Birth with an Epidural

19. Epidural Disadvantages: Mother and baby must be constantly monitored Mother and baby must be constantly monitored Can slow labor Can slow labor Pushing stage may be prolonged Pushing stage may be prolonged Increased risk for instrumental delivery (forceps or suction) Increased risk for instrumental delivery (forceps or suction) May cause maternal fever, requiring possible separation of mother and baby and additional testing on baby May cause maternal fever, requiring possible separation of mother and baby and additional testing on baby Must have IV fluids before epidural Must have IV fluids before epidural

20. Epidural Disadvantages Cont. Must be in bed for remainder of labor Must be in bed for remainder of labor No use of gravity No use of gravity Pitocin may be needed to speed labor Pitocin may be needed to speed labor Mother must be catheterized Mother must be catheterized Increased risk of additional interventions and cesarean section Increased risk of additional interventions and cesarean section May cause itching and shaking May cause itching and shaking Risk of severe headache Risk of severe headache

21. Cesarean Sections The surgical removal of the fetus from mother

22. Birth by Cesarean

23. Reasons for Cesarean Failure to progress Failure to progress CPD (cephalo-pelvic disproportion) CPD (cephalo-pelvic disproportion) Fetal Distress Fetal Distress Placenta Previa Placenta Previa Placental Abruption Placental Abruption Maternal or Fetal Medical Condition Maternal or Fetal Medical Condition Multiple Births Multiple Births Cord Prolapse Cord Prolapse Previous Cesarean Previous Cesarean Fetal Malpresentation Fetal Malpresentation

24. How to Avoid Cesarean Go to a childbirth class Go to a childbirth class Hire a labor doula Hire a labor doula Consider a midwife Consider a midwife Avoid medication Avoid medication Move around in labor Move around in labor Avoid unnecessary inductions Avoid unnecessary inductions Avoid continuous fetal monitoring Avoid continuous fetal monitoring Avoid unnecessary interventions Avoid unnecessary interventions Be an informed consumer Be an informed consumer Stay at home early in labor Stay at home early in labor Limit medications in early labor Limit medications in early labor

25. Cesarean Recovery

26. Vaginal Birth After Cesarean Focus on good nutrition and exercise Focus on good nutrition and exercise Take a refresher birth class that supports VBAC Take a refresher birth class that supports VBAC Find caregiver/hospital who believes in VBACS ~ know their policies! Find caregiver/hospital who believes in VBACS ~ know their policies! Hire a doula Hire a doula Practice relaxation, visualization, and affirmations Practice relaxation, visualization, and affirmations Write a birth plan Write a birth plan Establish safe supportive environment Establish safe supportive environment Work on left-over negative emotions Work on left-over negative emotions Learn to trust, cooperate with and listen y9ou your body and baby Learn to trust, cooperate with and listen y9ou your body and baby Try variety of positions Try variety of positions Continue calorie and fluid intake Continue calorie and fluid intake Avoid medical intervention Avoid medical intervention Avoid artificial induction Avoid artificial induction Avoid an epidural – try natural pain relief Avoid an epidural – try natural pain relief

27. “Finding my Voice” ~ VBAC

28. BRAIN When making a decision, we need to ask the right questions so that we can see our options clearly. This is a little acronym to remind you to use your brain when making decisions. It is useful in labor, but can be used for making all kinds of decisions along life's journey! When making a decision, we need to ask the right questions so that we can see our options clearly. This is a little acronym to remind you to use your brain when making decisions. It is useful in labor, but can be used for making all kinds of decisions along life's journey! Benefits-- what are the benefits of doing this? Benefits-- what are the benefits of doing this? Risks-- what are the risks involved in doing this? Risks-- what are the risks involved in doing this? Alternatives-- what are the alternatives to doing this? Are there other options? Alternatives-- what are the alternatives to doing this? Are there other options? Instinct or intuition-- what is my intuition telling me to do? Instinct or intuition-- what is my intuition telling me to do? Now what will happen?-- what will change if I do this? Now what will happen?-- what will change if I do this?