Packing Your Hospital Bag… Do You Really Need ALL That Stuff?

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What to bring to the hospital when it’s baby time can be a struggle. You don’t want to forget something important, but do you really need to bring three suit cases?

As a labor nurse, I’ve seen many different variations in what people bring to the hospital. Personally, I pack light.

I only bring one bag of essentials and that is it. Anymore than that can be difficult to haul. Plus most rooms aren’t that big, so extra and unnecessary items just cause clutter and take up space.

Here are some of the things I will have packed and ready to go:

  • Hair Ties- If you have long hair, don’t forget to pack a few hair ties.
  • Nursing Bra- Nursing Bras are a must if you’re planning on breastfeeding. They make nursing so much easier and provide support.
  • Nursing Pads- Your milk probably won’t come in for a few days, so you may not need these. Just in case, pack a handful of nursing pads to have available if you start to leak.
  • Flip-Flops- Hospital floors are pretty gross. I personally don’t let my feet touch the floor at all when I’m in the hospital. Flip Flops are perfect to throw on to walk around your room or wear in the shower.
  • Comfortable Pants- If you choose to wear your own clothes instead of the hospital gown, bring some baggy, comfy pants. Nothing is worse than having tight leggings on after delivery. You need some room for a diaper pad and an ice pack. Also if you have a C-Section you want pants that don’t hit right at the incision site.
  • Clothes/Pajamas- Some mamas feel more comfortable in the hospital gown, some feel more comfortable in their own clothes or pajamas. Pack only what you think you’ll wear.
  • Socks- If you get cold easily, pack a couple pair of socks to wear to keep your toes warm. Non-skid socks with cute sayings on the bottom are fun and handy to have.
  • Boppy-  Boppy pillows are super helpful while learning how to breastfeed. They give you extra support to hold your baby in the right position to nurse.
  • Snacks- The hospital provides food for you, but if you’re a snacker like I am then you’ll likely be hungry in between meals. It’s nice to have a few options with to grab if you need a little something to hold you over.
  • Chapstick- Hospitals are dry places and pushing is hard work! Your lips will likely get dry during your stay, don’t forget the Chapstick.
  • Going Home Outfit for Baby- I usually keep my baby in a hospital gown throughout our stay. For me it’s easier and less laundry to do once you get home. I will be bringing a going home outfit and that’s it. If you’d prefer you can bring some sleepers to use instead of the hospital gown. I recommend gowns or sleepers that zip rather than the button up ones which can be difficult to maneuver in the middle of the night when you’re half asleep.
  • Car Seat- You’ll need a car seat to go home, so make sure you have it ready to go. You can wait and have someone bring it up to the unit after baby arrives, but at least have it in the car. The day you think you’re going to go home, put the baby in the car seat and adjust the straps to fit. That way it’s all ready to go when you get the go ahead to leave and you’re not trying to figure it out last minute.

There are some things that will have to be packed when it’s time to go:

  • ID and Insurance Card- You’ll probably be asked to provide these when you check in so make sure you have them.
  • Phone Charger- Obviously you’ll be needing to keep your phone charged to keep everyone updated on your sweet little baby.
  • Toiletries- Sure, the hospital may have shampoo there, but it won’t be as good as your stuff! Don’t forget the shampoo, conditioner, and body wash.
  • Toothbrush & Toothpaste- These are an obvious thing to pack, but often forgotten!
  • Deodorant- Have I mentioned pushing is hard work? You’ll want to bring some deodorant to help curb the sweat.
  • Make-up- If you are a make-up kind of gal, don’t forget your make-up bag.
  • Blow-dryer and Straightener- If you feel like you’ll have the energy to do your hair, bring them!

There are also some items that I will NOT be bringing to the hospital:

  • Underwear- The hospitals usually provide you with lovely mesh underwear. Birthing babies is a messy business, I’d recommend wearing theirs so yours don’t get ruined. If you choose to bring your own, make sure you bring some you don’t mind getting ruined.
  • Formula- If you’re choosing to bottle feed, the hospital should provide you with formula while you’re there. Save your formula for when you get home.
  • Pads– Unless you’re super picky about the pads you use, the hospital should supply those as well.
  • Lanolin- This is usually given to breastfeeding moms at the hospital. It’s only a small tube, but it should last until you go home and can use your Lanolin .
  • Money- I’d leave your purse/wallet at home. You really shouldn’t need large amounts of money. If anything, bring a few dollars for the vending machine and have your debit card packed away in a hidden spot in your bag.
  • Breast Pump- Unless you plan on pumping exclusively, I would leave the pump at home. If for some reason you need to pump, the hospital should have one for you to use.
  • Blankets-  Many moms bring their own blankets, but there’s no guarantee that it won’t get ruined in labor. If you’re really attached to the blanket, don’t bring it.

Although I tend to be a minimalist when it comes to packing for the hospital, feel free to bring whatever you think you’ll use. If you don’t think you’ll use it, don’t bring it.

You’ll have enough things to bring home and unpack as it is, so don’t bring your whole house with you!

Is there anything you brought that didn’t make my list that you feel is a must? Comment below and let other mamas know!

 

 

 

Baby’s Heart Rate During Labor- What You Need To Know

There are many things that nurses and providers look at when we watch your baby’s heart rate during labor. It is important to monitor what your baby’s heart rate is doing to make sure that your baby isn’t in distress and is tolerating the contractions.

This information is a quick overview about your baby’s heart rate to help you understand why we do certain things while you’re in labor. It’s good to know the basics so there are no surprises. This isn’t meant to make you a professional. Interpreting baby’s heart rate takes a lot of practice to fully understand.

How Do We Monitor Your Baby?

The most common way of monitoring baby’s heart rate is by using electronic fetal monitoring. We hook you up to two round monitors, one that monitors the heart rate and one that monitors your contractions.

We look at a lot of different things to determine if your baby is tolerating labor. We look at how close your contractions are, what baby’s heart rate average is, and if the heart rate increases or decreases.

The Associate of Women’s Health, Obstetrics, and Neonatal Nurses (AWHONN) gives us the most up to date information on fetal monitoring and how to interpret your baby’s heart rate. You can check them out here if you want a more in depth detail of what it all means.

You’ll have to excuse my drawing out of the heart rate and contractions. I don’t want to mess with HIPPA or copyright issues!

What Am I Looking At?

The top line is baby’s heart rate. The second line is mom’s heart rate. The bottom line is the contraction pattern.

From one dark line to the next dark line is one minute. Each box and light line is ten seconds. When you time the contractions, you start from the beginning of one contraction to the beginning of the next. The contraction monitor doesn’t tell us how strong the contractions are, but how often you’re having them and how long they last.

What We Like to See

We like to see a lot of squiggling in baby’s heart rate. That means baby is well oxygenated and doing well. This is called variability.

We also like to see baby’s heart rate go up for a little bit. We call this an acceleration. That also means you have a happy baby that is tolerating labor.

When Baby’s Heart Rate Drops

There are four different types of drops in your baby’s heart rate.

  1. When the baby’s heart rate drops with the contraction, that means that your baby’s head is getting squeezed. This is normal when labor is progressing and is not concerning. Those are called early decelerations and look like this:
  2. When the baby’s heart rate drops after a contraction, that means the baby doesn’t like the contraction. Those are called late decelerations and look like this:
  3. When the baby’s heart rate drops quickly and comes right back up it means the cord is getting pinched somewhere. Those are called variable decelerations and look like this:
  4. When the baby’s heart rate drops from the average beats per minute for longer than a few minutes it means baby is possibly in distress. Those are called prolonged decelerations and look like this:

What Makes Us Concerned

Late decelerations and prolonged decelerations will make us concerned for your baby. Those are usually indicators that baby is not getting an adequate amount of oxygen and is getting stressed.

Variable decelerations can sometimes be concerning depending on how often they’re happening and how low the heart rate gets.

How Do We Fix Drops In Heart Rate?

There are a few things that we do if your baby’s heart rate is concerning.

  1. We may put an oxygen mask on your face. This will boost the amount of oxygen to your baby.
  2. We will help you change your position to see if baby’s heart rate improves. Sometimes if you’re positioned a certain way the cord is getting pinched or the placenta isn’t getting enough blood flow to it. Switching positions may help fix that. We may flip you to your left side, right side, or even on all fours.
  3. If your blood pressure has dropped due to an epidural, sometimes baby’s heart rate will drop because a decrease in blood flow to the placenta.There are some medicines we can give to help bring your blood pressure up.
  4. Worse case scenario would be a Cesarean section. Typically an emergent C-Section happens when baby’s heart rate has dropped low for a long period of time and nothing is bringing it back up. Those baby’s are in serious distress and need to be born. Having late decelerations with every contraction for a long period of time could also indicate a need to deliver the baby by C-section.

 

If you think you see something concerning while you’re in labor, don’t panic. Your nurse is watching your baby’s heart rate at all times. There are most likely monitors all over the unit with your baby’s heart rate so we can see them wherever we are.

Like I mentioned earlier, reading and interpreting baby’s heart rate takes a lot of practice. This is not meant to make you a professional at it or to freak you out with any dip in the baby’s heart rate. My goal is that this helps you better understand what all those lines mean and why the heck we keep switching you from your left side to your right or put oxygen on your face.

 

This One’s For The Dads- 7 Tips On How To Survive Labor & Delivery

My husband, Andy, attended birthing classes with me before we had our first kiddo and was very involved with the pregnancy. However, when it came time for delivery he didn’t really know what to do. He ended up standing in the corner out of the way with my first two deliveries.

Andy is not the first dad to stand in the corner out of the way, without really being involved in the process. I would say that most dads are more hands off in the delivery room.

It doesn’t have to be that way. There are many ways dads can be involved. Although the day really is about the health of mom and baby, dads play a huge role in delivery as well and can be a major help. Here are some tips on how to survive labor and delivery:

1) BE SUPPORTIVE: This is my number one tip. Just be supportive. Support the decisions she makes when it comes to how she chooses to labor.

2) ENCOURAGE HER: Tell her what an amazing job she is doing and how strong she is. Tell her how proud you are of her and that she’s an awesome mom. A little positive affirmation can go a long way. Be sincere when you tell her these things, make her feel like she’s got this.

3) DO WHAT SHE SAYS: If she asks you to get her water, grab it for her. If she needs her back rubbed or counter pressure, do it.

4) OFFER TO HELP: Sometimes it’s hard for moms to verbalize what they want or need during labor. I know you can’t be a mind reader, but if she hasn’t had a sip of water in a while then you can offer her some. If she needs to go to the bathroom, offer to help her get there.

5) STAY CALM: Probably the worse thing you can do during labor is to freak out. If you freak out then she’ll freak out. Stay calm and reassure her that everything is going to be alright.

6) BE HER ADVOCATE: If you know she really wanted something a certain way, advocate for her! Help her get the labor she wants.

7) TAKE CARE OF YOURSELF: A lot of dads say “If she can’t eat, then I’m not going to eat!” This is sweet in theory, but many dads start to not feel great come delivery time. We don’t take care of grown men on labor and delivery, if you go down you’re on your own 🙂

Now that you know how to help, here are some things NOT to do during labor and delivery:

  • DON’T minimize her feelings. No laboring mom wants to hear her significant other tell her that it wasn’t that bad.
  • DON’T eat a big elaborate meal in front of her. I know I said you should eat, but do it in the waiting room or cafeteria.
  • DON’T be offended if she tells you to stop doing something or she gets short with you when you’re trying to help. Laboring moms sometimes lose their filters.
  • DON’T compare her birth to that of a farm animal, I promise she won’t find it amusing.
  • DON’T sit on the couch and play on your phone the whole labor.
  • DON’T sleep in your underwear. Its uncomfortable for everyone.
  • DON’T get in the tub with your significant other naked. Disclaimer, this has happened before. Did I mention we don’t take care of grown men on our unit? Swim trunks are always appreciated!

The most important tip on how to survive labor and delivery is to be present. That doesn’t mean just show up and hide away from the action. Be involved. Be helpful. Make it a memory between you and your significant other. Don’t let her labor on her own.

Feel free to comment helpful do’s or don’ts from your labor experiences!

 

 

Pain, Pain, Go Away- Choices for Pain Control During Labor

Birthing babies is a beautiful process, but it can also be a painful one. Contractions are no joke when they start to get intense, but every mom tolerates that pain differently. Some moms are really uncomfortable when they’re 2 centimeters dilated, while others are a 7 before really feeling the pain.

Thank goodness we live in an age where we have choices on how to manage that pain! It is good to know your options ahead of time so you can mentally prepare yourself for those choices when it comes time to make them.
 Non-Medicated Coping
There are so many ways that you can use non-medicated coping for pain relief. You can also choose to do some of these things even if you decide on a different method, such as an epidural or IV pain medication.
Position changes are a great way to try and get some relief. You can try walking around, sitting on a birthing ball, or even sitting on the toilet. Getting into all fours on hands and knees is also a great position to help relieve pressure and discomfort. As long as you have a low risk pregnancy, your provider should be okay with you being up and active during labor.
Water therapy also does wonders with pain relief during labor. If your hospital offers the use of a tub, give it a go. The jets can help sooth contraction pain, especially if you’re feeling a lot of back labor. Showers are also wonderful. Run the water over where it’s hurting the most, like your tummy or back.
Aromatherapy can also help reduce discomfort. The theory behind it, is that using your other senses during labor will help take away from the pain you’re feeling. Pick out a smell you really enjoy, grab a diffuser, and you’re good to go!
Massage can be effective and get your support person involved in the labor process. Some moms dislike being touched during labor, but others benefit greatly from massage. Whether it be a foot rub, back rub, or even applying pressure to the lower back.
There are so many other non medicated ways to reduce pain, but those are just a few to get you started.
  • PROS: Movement helps progress labor and different positions can help lessen the pain.
  • CONS: If you’re high risk, movement may be limited. Otherwise there really aren’t any!
Laughing Gas (Nitrous Oxide)
Nitrous oxide has been used for years to help alleviate pain during labor and it’s starting to make a comeback. Not all hospitals have this option, but it’s worth a try if the hospital you choose has it and you’re trying to avoid the epidural.
The nitrous won’t take away your pain completely and you will still feel the contractions. It will hopefully help you relax through the contractions and take the edge off. Some moms are disappointed after they try it because they have the misconception that they will be pain free while using the laughing gas.
To use the laughing gas, you have to hold a mask on to your face throughout the contraction. The key is to put the mask on your face right before the contraction hits, take big deep breaths with the mask on throughout the contraction, then take the mask off when it’s over. It takes a few tries to get the hang of it. The moms I’ve taken care that have gotten the hang of it were happy with the outcome.
  • PROS: Nitrous takes the edge off without limiting movement. It stays in your system for a short time and does not affect baby.
  • CONS: It can cause a dizzy or lightheaded feeling. Difficult to hold mask in place while in pain. May cause claustrophobic feeling.
IV Pain Medication
IV pain medicine is a great option if you’re not sure if you want the epidural or if you just need a little something to get you through. The most common medicine that I’ve given is called Fentanyl. It won’t take away the contraction pain, but it should hopefully take some of the edge off.
Fentanyl usually works really well the first couple doses, but then as your pain increases and your body gets used to the medicine, it’s not usually as effective for most women. The medicine also crosses the placenta, so you can’t have any if it’s close to delivery because it’ll make your baby a little sleepy when he or she comes out.
  • PROS: IV pain medicine doesn’t limit your movement during labor and helps take the edge off.
  • CONS: Usually only a few doses are effective. You can’t take it too close to delivery. It may give you that woozy feeling and makes some moms nauseous.
Epidural
Epidurals work by placing a little plastic tube in a specific spot in your back. The medicine that is put through the tube numbs the nerves that cause contraction pain. Some risks associated with epidurals are a drop in blood pressure, infection, or a bad headache that is worse while sitting or standing, and better while laying down. There are precautions taken to reduce those risks.
Epidurals are the last ditch effort for pain control. Epidurals will usually take away the contraction pain, but not necessarily the pressure when it comes time to push. Epidurals affect everyone differently. Some moms have great experiences with them, while others still feel a lot of discomfort even after they get an epidural. There is so much more to say about epidurals that they will get their own post soon.
  • PROS: Most moms are essentially pain free during labor. Moms report being able to enjoy their labor and get some rest.
  • CONS: Unable to get out of bed. Increased risk of blood pressure drop. May make it more difficult to push if unable to tell when having contractions or not being able to feel pressure.
No matter what you choose to use for pain control during labor, know that your nurses will support you! There is no right or wrong way to labor and to have a baby. Whether you just use non medicated coping or end up trying all three, as long as you are laboring how you want to that is all that matters!

No Judgment From Me, I Promise!

I am a mom of three kids, with another baby due in early July. I’ve had two of my kiddos before I became a labor nurse and I remember worrying a lot about whether what I did was normal or not. I was nervous about being judged by the nurses and physicians taking care of me. I didn’t want to be that “weird” patient. My third delivery was so much better because I knew that I wasn’t being judged by my choices. We see a lot of crazy things as healthcare providers, a little poop isn’t going to phase us.

I want you to know, that as a labor nurse, I promise I will not judge you. Our job as nurses is to take care of you and your baby in the safest way possible. We are going to pay more attention to your baby’s heart rate on the monitor than to the spot you missed shaving your legs that morning. Honestly, I’m not just saying that! You would have to do something pretty far out there for us to bat an eye. These are the most common things that I’ve seen moms worry about that I want you to NOT worry about when baby day arrives!

1. Shaving: I tell you what, it is hard to shave those legs when you have a big baby belly and can barely reach them. We don’t care if you don’t have perfectly smooth legs. We probably won’t even notice! Speaking of shaving, grooming down there is another thing we won’t criticize you for. Whether you shave it all, some, or none, we really don’t care.

2. Getting an epidural: Pain management is your choice. If you are adamant that you are not going to get an epidural, and then change your mind, that is fine by me. I’m not going to judge! It’s your labor, do it how you want. If you come in knowing you want an epidural and get it early on, that’s up to you as well. I won’t think you’re a wuss.

3. Not getting an epidural: If you want to go pain medicine-free, good for you! I will support you and do my best to make that possible. I won’t doubt you or make you feel like you can’t do it, because you can!

4. Being emotional: Pregnancy makes your hormones crazy. Labor makes your hormones crazy. Delivering the baby makes your hormones crazy. I get it. Cry if you need to cry. Laugh if you need to laugh. Do both at the same time if you feel like it. I promise that I’ll understand and not judge you for how you’re feeling.

5. Dropping some F bombs: Labor hurts. It’s hard to control that pain and what comes out of your mouth when you’re feeling that pain. I will not judge you if you do a little cursing or have a potty mouth during labor. It happens to the best of us.

6. Getting a little out of control while pushing: Been there, done that. It’s hard to control that pain, especially if you’re a first time mom and don’t really know what to expect. I won’t judge you for getting out of control, but I will probably have to get a little stearn to get you to focus.

7. Not being married: I usually don’t even know if you’re married or not. As long as you love and care for that child, it’s none of my business!

8. Asking questions: I feel like I get a lot of moms that apologize for asking so many questions. Seriously, don’t apologize for that! It’s so much better to know and understand what is going on than to sit there and wonder about it. Please, ask away!

9. Having a birth plan: A lot of moms with birth plans come in feeling like we’re judging them and that we don’t want them to have a pain medicine-free birth. We’re not! It’s good to know your choices and be prepared.

10. Pooping while pushing: No big deal, it happens. It usually means you’re pushing in the right spot. Don’t worry about it or be embarassed. Usually, we’ll have you all cleaned up before you even know it happened.

11. Passing gas: This is also one of those things that happens a lot. If you have an epidural, there’s no controlling it. Any extra air in there just comes out when it wants to. We are used to it!

12. Leaking blood or amniotic fluid onto the floor: Whenever this happens I always say, “It’s not a normal day unless I’m wiping some sort of fluid off the floor!” That is the truth! Don’t worry about it, it’s my job! Labor is a dirty job sometimes and there’s not much to do about that.

This list could go on and on. Enjoy the birth of your child and don’t sweat the small stuff. Healthcare providers are there to help you, not judge you. I promise, we’ve seen it all and not a whole lot phases us! If you’re not sure if something is normal or not, ask and we’ll be happy to reassure you.

Labor is a messy and sometimes gross process. It is also amazing and life changing. While you’re laboring, think about the beauty in what you’re doing and the amazing life you are giving birth to. Those babies are so worth the pooping, pain, and awkward body fluids.

 

Labor- It’s Not the Same!

I have the privilege of working as a labor nurse, so I get to see first hand how different labor and pregnancy can be from mom to mom. Every mom has a birth story, and people love to share their birth stories with pregnant women. The downside to this is that we get a perception of how labor is supposed to be, and then we feel like we fail when it doesn’t go a certain way. Even women who have had more than one baby have an expectation that labor will be a certain way based off their other deliveries. In reality, every labor is different!

Some mamas have quick labors, some labor for days. Some mamas push for hours, while some have a baby in a few pushes. Some mamas get pain medicine or epidurals, some go without any pain relief. Some mamas deliver vaginally, while some end up with a Cesarean section. It is so important to understand that it is ok if you don’t labor like your friend or relative did. There are so many variations to labor, and the good news is that it’s ok to labor differently!

Length of Labor:
It may seem like common sense, but everyone’s length of labor is different. I get asked almost with every delivery how long until the baby will arrive. My answer is always the same, “I have no idea! If I had a crystal ball I could tell you!” Sometimes healthcare professionals are good at guessing, but definitely not always! So if your nurse or doctor is brave enough to guess a time, don’t take it too seriously or be disappointed if it doesn’t happen in that time frame.

First time moms typically labor longer than moms who have had more than one baby, but that is not always the case. A normal labor time for a first time mom tends to be around 12 hours or more. Not very often does it happen quicker than that, but it does happen. Moms who have had more than one baby can labor quickly or not. It depends on your body, the size of the baby, the positioning of the baby, and if you are induced or labor on your own. I feel like I’ve had so many moms be upset that labor is taking so long, but that can be normal and the end result is worth it!

Trust your body, and trust that it knows what it’s doing. If you’re starting to get concerned, talk to your nurse about it. The more you communicate the more we can help put your mind at ease and reassure you that you and your labor are normal. If your labor is getting longer than average, your nurse or provider will hopefully discuss that with you.

Length of pushing:
Pushing is also one of those things that varies from mom to mom. If you are a first time mom, you can expect to push for about 2 hours. Sometimes it will go longer than that up to 4, or even 5 hours. Moms with more than one baby usually don’t have to push that long, but it does happen. I pushed longer with my third baby than my whole second labor. Pushing is hard work! It’s very easy to get discouraged and exhausted when you’ve been pushing for a while.

Unfortunately I’ve been in deliveries where the patient has been pushing for a while and their family member or friend goes on and on about how when they had their baby they only pushed twice and that was it. One patient’s mom even went so far to say “I can’t believe this is taking so long, you’re obviously not pushing hard enough!” That isn’t very encouraging, and it is ok to ask people to wait in the waiting room if they aren’t being as supportive as you’d like. As long as baby is moving with each push, there is no need to be concerned. Sometimes those little ones take their sweet time, centimeter by centimeter.

Pain Control:
Labor can also be different based on the type of pain control you choose. I will tell you now, and probably with multiple other posts, whatever you choose is awesome! Epidurals and pain medicines are great things, they help some moms relax and even take a nap. Going without any pain medicine is awesome as well, it’s tough to labor without any pain control help!

As a nurse, I promise I will not judge you for your choice in pain control. We want you to have the labor you want! Don’t ever let anyone make you feel guilty for your choices! Family members are notorious for making comments about how they never had an epidural, or that you could do it without if you just tried. Remember, it is your choice. It’s also ok to change your mind. Just because you decide to get an epidural when you originally planned to go without, doesn’t mean you are weak or failed.

Everyone is has different perceptions of pain and different ideas of how they want to labor. You are strong no matter what pain control methods you choose!

Cesarean Sections:
The thought of having a Cesarean Section, often called C-Section, can be really scary. Whether you have a scheduled C-Section for whatever reason or an unplanned C-Section, many moms feel like they failed because they didn’t deliver vaginally. Sometimes vaginal deliveries just don’t work. It could be because your baby isn’t tolerating labor and is having severe drops in heart rate, or the baby is positioned in a way that doesn’t allow him or her to decend into the pelvis, or your cervix just hasn’t dilated after many hours. It is normal and ok to feel sad that you didn’t have the delivery you wanted or planned, but you did not fail.

Labor is such an amazing process. It is ok for labor to be different and to have a different experience from your family or friends. Trust your body and know that you are strong. There is no failing while going through the birthing process. You may come in with one plan and finish with another, and that is ok! The goal at the end of the day is to have a healthy mom and healthy baby.