Page de couverture de The Penn Medicine Labor Podcast

The Penn Medicine Labor Podcast

The Penn Medicine Labor Podcast

Auteur(s): The Penn Medicine Labor Podcast
Écouter gratuitement

À propos de cet audio

 A podcast to answer all of your questions for labor as a first time parentCopyright 2021 All rights reserved. Science
Épisodes
  • Induction of Labor

    Induction of Labor
    May 30 2021
    Today, we are joined by Dr. Lisa Levine, a Maternal Fetal Medicine specialist, who talks to us about induction of labor. We answer the following questions: What is an induction of labor? So first, of all, remember: labor is when a pregnant person has contractions of their uterus, or womb, and their cervix starts to open. If everything goes well, at the very end, the person is able to push and deliver their baby (or babies) vaginally. Labor induction, is very simply put, getting someone into labor who is not yet in labor. I often say it is like “jump-starting” labor. And the goal is for that person to give birth vaginally. Why do we perform an induction of labor? We absolutely would love if every pregnant person could go into labor on their own. That would make our jobs easier! However, there are some people who, because of medical problems they had before pregnancy, or medical problems they develop during pregnancy, need to be delivered earlier so that they and their babies can stay healthy. After a certain point, staying pregnant may not be the healthiest option for that person or for their baby. Some people may also choose induction after a certain point for their own reasons, such as help with childcare or needing to go back to work, but that does not usually happen before 39 weeks. There are many reasons to be induced, and you should talk to your doctor about when it is safest for both you and your baby to undergo an induction. Most people will be given a due date for their pregnancy the first time that they see a doctor. This is done by using the first day of your last period (if you have regular periods) and an early ultrasound. The “due date” simply means that that is the day that you will be forty weeks pregnant. That’s it. It is not a magic day that your body will suddenly go into labor, or a day that you HAVE to be delivered by, unless you are told by your pregnancy provider. We call a “term” pregnancy, meaning a fully developed pregnancy, anywhere between 37 and 42 weeks. And usually, that is when pregnant people will go into labor. So, most people are not considered “early” or “preterm” if they go into labor, say… when they are 38 weeks and 2 days-which is just 12 days before their due date. And for most people who don’t have medical problems before or during pregnancy, it is totally fine for them to go into labor sometime between 37 and 42 weeks. When do we perform an induction of labor? That depends on the patient’s medical condition, how the baby is doing inside, and a lot of other factors. This would have to be a discussion with your doctor. Most of the time, that date will be in the 39-40 week range, but if you develop high blood pressure of pregnancy, have a more serious medical condition or we think that baby is not doing well, we may recommend earlier. Also, for patients and babies that are healthy overall, if they go past their due date, we would also monitor them and their babies very closely because of that tiny increased risk of stillbirth. Therefore, your doctor may talk to you about induction of labor at 41 weeks or bring you in for monitoring of the baby if you are past 41 weeks and want to try to go into labor on your own. We usually do not recommend going past 42 weeks, because of that increasing stillbirth risk. What do we do for induction of labor, and what can patients expect on the labor floor? The first thing to expect is that we have to do a lot of stuff upfront to make sure that we are giving you the correct medicine to put you into labor and caring for you in a safe way. This will include bloodwork to see what your blood counts are and what blood type you have, testing you for some sexually transmitted infections, like HIV and syphilis, as well as an ultrasound to determine that the baby is head down. We don’t recommend induction if the baby is in any other position. We will also put in an IV so that we can give you medicines through it to help with your induction. We also put two monitors on your belly: one is to listen to the baby’s heartbeat, and the other is to monitor your contractions. Finally, we also have to do an internal vaginal exam to see how dilated and thin your cervix is. If your cervix is not very dilated or not thin (we mean anything under 3 or 4 centimeters), we would recommend first starting with some medicine that you take by mouth or that we place in the vagina. This medicine is called misoprostol, which is a medicine that can help soften and thin the cervix and get it to open up a little bit more. The second thing we may recommend is something called a “Foley” balloon, which is a thin tube that has a small, inflatable balloon at the very tip. Your doctor will place the foley balloon into the cervix through the vagina, and then inflate the balloon with some water. That balloon pushes on your cervix and allows the cervix to release natural hormones that thin the cervix and get it ready for labor. ...
    Voir plus Voir moins
    21 min
  • Postpartum Recovery

    Postpartum Recovery
    May 30 2021
    Today, we are joined by Dr. Dacarla Albright, an Ob/Gyn, who talks to us about recovery postpartum. We answer the following questions: I’ve had my baby… now what? What I will tell our patients is that the postpartum period lasts for six weeks. So basically, that means that it takes your body six weeks to go back to working like it did before pregnancy. And there are some things that may change forever. They should rest and recover from their delivery. And while that is easy to say, it is hard to do with a newborn. Most people will start to feel like they are back to normal usually a couple of weeks after they deliver, and this can vary depending on if you have a vaginal or cesarean delivery. But your life is changed forever, and people are especially vulnerable during this time. You likely will not get as much sleep as you did before. You probably will have many more responsibilities because of your new baby. You’re going to be tired. That is why it is very important for new parents to pay attention to their mood. Especially people who have a history of anxiety, depression, or other mental illness, are at higher risk for postpartum depression. But postpartum blues or depression can happen to anyone. If you do feel like you are becoming irritable, you are feeling down, you’re crying all the time, or thinking about hurting yourself, hurting your baby, or other people, please reach out and call your provider’s office. We have resources to help you. We know that postpartum depression is very common. What is it like to recover from a vaginal delivery? Let’s first talk about immediately what happens when the baby and the afterbirth comes out. One of the things that we want to prevent is heavy bleeding, which can put a person’s life in danger. So, we usually will give a medicine through the IV, called Pitocin. If you don’t have an IV, we can give the same medication through a shot that goes in your leg. Your provider will also check to make sure that your uterus is contracting down. They need to do that every fifteen minutes for the first hour after you give birth, and will continue to need to check at different times while you’re in the hospital. I know that it is not very comfortable, but please understand that it is very important to make sure that you aren’t bleeding too heavily. Now, of course it is normal to bleed after birth. The bleeding after giving birth is called “lochia,” and may be bright red, dark red, and later on, will become brown. For most people it can start like a heavy period, but it should start to get lighter every day. It is normal to have some clots, especially after you have been sitting or laying down for a while. However, if you are bleeding more than two pads an hour for more than two hours, that would be a reason to alert your nurse. Or, if you are at home, to call your provider’s office or come into the emergency room. It is very common for people to have some tearing of the skin or muscle around the vagina. The area between the vagina and the anus is called “the perineum,” and this is the most common place to have tearing when the baby’s head comes out. Depending on how much you tear after delivery, that could determine how sore you are. Your doctor or midwife will repair these tears with stitches that dissolve on their own after a few weeks. Most people do well with just Tylenol and Ibuprofen. Your nurse will usually give you ice to put on your bottom to help with the discomfort. You will also be given some numbing spray or pads and a spray bottle that you can fill with water to help clean down below, because it might be too uncomfortable to use toilet paper. It is also common to have burning with peeing. Usually, the first or second day after delivery is when you will be the most uncomfortable because that is when swelling occurs and also when you start moving around more and doing more for yourself. Also, you won’t have your epidural. It is also important to make sure that you are on a good regimen to help you go poop. Usually, your doctors in the hospital will prescribe you a stool softener, but sometimes, women will not poop until they go home. You should try to not become constipated, because pushing hard to go can be very uncomfortable, and in some cases, may open the stitches. If you do become constipated, please let your providers know so that they can give you other medications to help with bowel movements. Sometimes, there can be bigger tears. If you have a larger tear that involves the anal muscles or the rectum, your providers will tell you more about what to expect. We do know that women with bigger tears will have more discomfort, and may require stronger pain medications. It is even more important that you are on a good regimen to go poop, and sometimes, your doctors may put you on multiple medicines to ensure that you don’t become constipated. And your doctors will ask you to follow up sooner after discharge to ...
    Voir plus Voir moins
    20 min
  • Second Stage of Labor - What Happens When You're 10 cm Dilated

    Second Stage of Labor - What Happens When You're 10 cm Dilated
    May 30 2021
    Today, we are joined by Dr. Kirstin Leitner, an Ob/Gyn, who answers our questions about what happens when we are 10 cm dilated, or what we call "the second stage of labor." What is the second stage of labor and how long does it take? Before we talk about the second stage of labor, let’s go back and talk about how labor is divided up. The first stage of labor is when someone is contracting, and the cervix is changing, from 0 to 10 cm. This, I think, is what people traditionally think of as “labor.” The second stage of labor starts when the person is 10 cm dilated, and ends when they give birth to their baby. And finally, the third stage of labor is after the baby is born, up until the placenta, or the afterbirth, is delivered. What can patients expect as they are giving birth? People’s experience of second stage sometimes depends on if they are a first time mom or if they have had babies before. I want to highlight that pushing during the second stage is a hard process. It’s lots of work, just like exercising! Also, for a first time mom with an epidural, it can be normal to push for up to four hours, as long as they are making progress and pushing the baby’s head down in the pelvis. Not everyone needs four hours, of course! But most first time moms need maybe one or two hours of pushing, especially with an epidural, before they give birth. With people who have had babies before, this is usually a shorter process. It can still be normal to push for up to 3 hours with an epidural, but many times, for people who have had babies before, it can even be just a few pushes before birth. This time is also shorter for people who don’t have epidurals, simply because sometimes with an epidural, it may be difficult to feel exactly where to push. But without an epidural, you can’t mistake it! What is key here is that we want you to listen to the guidance of your nurse, midwife, or doctor during this part of labor. Pushing can be different for everyone. If something is working for that person, and the baby’s head is coming down through the birth canal, then that is the correct way for them! But, I also understand that for first time moms, this may be a challenge and they may need some more guidance. We usually tell people to wait for a contraction to push, so that they are working with their bodies to give birth. We usually ask people to take in a big deep breath, hold the breath in their lungs, curl up around their belly, and push downward, into their bottom, almost as if they have to poop. The most effective way to push is to hold the push for as long as possible, usually about 10 seconds is what most people can manage. Then, because most contractions last anywhere between 30 seconds to 1.5 minutes, we ask our patient to try and push three times with each contraction. That means three times taking a big deep breath and pushing down, for a total of 30 seconds of pushing with each contraction. What are episiotomies, and do we still cut them? So first, what is an episiotomy? An episiotomy is when your midwife or doctor uses scissors to cut a small portion of the skin or muscle on the perineum, which is the area between the vagina and the anus. This is usually done to allow for the baby’s head to deliver more quickly or to allow for other necessary procedures to be performed. Also, the thought used to be that if we cut an episiotomy, mom will have less tearing from the baby’s head coming out. That being said, we don’t normally cut episiotomies anymore if everything is going well. We have many studies that now show that it is better for mom if we allow there to be natural tearing of the area from the baby’s head instead of cutting an episiotomy. If you do need to have an episiotomy, your doctor or midwife will tell you and explain why. But again, this is not something that we routinely do anymore. Why do mom and baby need to be monitored during second stage of labor? Sometimes, pushing can be a very easy process, but sometimes, even though birth is natural, there are some things that can go wrong. That is why we always keep monitors on the baby. In the Induction of Labor podcast, we talked about different types of monitors, including the contraction monitor and the fetal heart rate monitor. Both of these monitors can be placed either inside the uterus or on mom’s belly, whichever is best to keep track of the contractions or the baby’s heartbeat. If we compare labor to a marathon, the second stage of labor, or when mom is pushing, is very much like that last leg of the marathon. We know that both mom and baby are tired. This can be a very vulnerable time for the baby, and we always want to make sure by looking at the heart rate monitor, that the baby is not becoming too stressed out. We want to make sure that the baby is still getting good oxygen from the placenta. Any time that we are afraid a baby is not getting enough oxygen from the placenta during labor, we have to think ...
    Voir plus Voir moins
    15 min

Ce que les auditeurs disent de The Penn Medicine Labor Podcast

Moyenne des évaluations de clients

Évaluations – Cliquez sur les onglets pour changer la source des évaluations.

Évaluations sur Audible.ca

Évaluations sur Amazon.ca
Il n'y a pas encore de critiques pour ce titre.