Practice scenarios and conversations
Make a smooth path
Practice for A Fluid Transfer
If a couple plans to or needs to go into the hospital for any reason, it may be helpful to prepare for communication, common routine procedures and to develop skills to navigate complicated scenarios quickly, effectively and easily. This practice can make a transfer into a place of birth more fluid and calm for the laboring mother, and as a result her breathing and relaxation may not being inhibited.
Protect the laboring mom from stimulation and stress
The Car Ride
The first intervention is leaving home.
There are many ways to make this easier on the mom. Bring a pillow from home that you don't mind getting wet or lost. This will smell familiar and be comfortable, unlike hospital pillows. It will also give her the ability to place her face into something comforting while driving through public places and bright lights. Bring a few towels in case the baby comes quickly.
NOTE: Babies that come fast in the car are almost always doing really well, because they have not been exposed to labor medication, drugs, long drawn out inductions and stressful procedures. If baby comes quickly, pull over if possible. One of the most important things to remember is to not pull on anything. Call your care provider and they will guide you through the next steps. It is possible that your care provider would want you to call 911 so that you can get help on had right away. It might be a good question to ask at an appointment. Support the baby as it emerges and place it skin-to-skin for optimal temperature regulation and to help reduce maternal bleeding. Gently use one towel to dry the baby. Then place another blanket or towel over both the mother and the baby to insulate them. No one should cut the cord as this provides oxygen to the baby. No one should separate the mother and baby as they are safer when together. Don't stress this scenario as it is very unlikely.
Some mothers feel more comfortable in the back seat and having a doula ride with you is an amazing option for comfort. It is a good question to ask in an interview, because it is not a service that every doula will offer. A sleep mask or rebozo blindfold may help block out stimulation along with ear buds that play nature sounds, music or birth affirmations. If the doula rides with the mom in the car, she can continue to offer fluids, food, counter pressure and the hip squeeze. She can also continue to guide the mother through relaxation techniques and help her with her breathing.
What is your car plan?
When a mom arrives at a hospital she is often greeted with a wheelchair. Some moms might not mind getting a ride, but for others and for most perhaps, sitting while laboring might range from uncomfortable to seemingly impossible. What would you do in this situation? You might begin with saying "no thank you, she will walk." This might elicit a response that is insistent, "We can not allow her to walk."
If a mom does not want to walk or sit, she can get in the wheelchair backwards on her knees and her partner can grab the wheelchair so that the staff does not have any chance to give input into the position of the mom. Don't wait around for them to comment. Just go where you need to go for her benefit.
This is a great article on how the mother is the one who makes all of the decisions that pertain to her body.
When a mom arrives in triage she may be exposed to lots of people, bright lights, and intake questions. The nurse will most likely want to monitor the baby, check for cervical dilation, place an IV, and check the mom's vitals. She may have more forms and questions for the mom to sign and answer. How will you protect her laboring space, help her relax, breathe and stay within?
If a mom wants to refuse any procedure, it is her right to do so. She is paying the hospital for a service and they work for her. She is literally the boss and makes all of the final decisions. Some mother's want to have an IV placed, but avoid the continuous saline drip
Read more about IV Saline and Heparin Locks