Monthly Archives: December 2011

My ultrasound tech gave me different due dates, now I’m Really Confused

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Ah yes, the highly anticipated ultrasound appointment that leads to confusion and worry.

Unnecessarily I might add.

Did you get an early ultrasound? By early I mean in your first trimester (12 weeks) of pregnancy. If so, then your due date or EDC (estimated date of confinement) is nailed down. That is the non-invasive gold standard of dating a pregnancy. Our LMP dates can play into the dating a bit. But the problem with those is that not every woman has a predictable cycle. And not every woman keeps a perfect log of dates, add to that spotting that can happen with implantation…you get the picture.

Why is first trimester dating so accurate? Well, the first twenty weeks of pregnancy follows a very predictable growth cycle. All babies grow at the same rate. The technician is able to measure the thigh bone, or femur, and diameter of the head and:voila! An accurate date.

After twenty weeks genetics kicks in. Now you should start eyeballing dad and discussing his birth weight with his mom. Up until now the size of the fetus of the tiny Vietnamese lady and her small stature husband is identical in size to the 6+foot tall Norwegian couple’s. After that twenty week point mother nature takes over. There is no more ‘predictable’ rate, so the dates are going tobe off. The dates can be 2 weeks off for the second trimester, and up to three for the third.

So don’t let your “new” due dates confuse you. The only time they’re significant is if you’re being followed for a growth lag which could be caused by a not so great placenta, high blood pressure and other high risk conditions.  You’ll know if your doctor is concerned about any of these things-you’ll be the first person she tells!

I hope this shines a little light on a confusing subject. Please let me know if I can clarify any of my clarifying!

Peace, Yediah

Top Five Misconceptions

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I thought this would be a fantastic way to begin a blog on childbirth education. My main concern is having to limit myself to just five.  Many women can thank their mothers, cousins, sisters, sisters-in-law and of course, the internet for all sorts of freaky misconceptions. Add to that the random stranger with her horrible birth experience that she feels compelled to share in icky detail, and you have the perfect recipe for a terrified pregnant woman.

1.  An Epidural will cause permanent back pain

This is a common fear of women who are considering an epidural for pain relief.  There also seems to be a stigma associated with getting an epidural, as if this makes you less of a woman.

The statistics for complications associated with labor epidurals is 1:10,000 for things like bleeding and infection, 1:100,000 for something like paralysis 1:100 for a spinal headache. These are pretty good odds for anything a hospital can offer you.

But why the belief about chronic back pain? I really don’t know. It’s always someone’s aunt’s,cousin’s, best friend who allegedly suffers from horrendous back pain that is directly attributable to an epidural. Think of an epidural like an IV, they’re very similar. A needle is used to access the sub-dural space and a very small catheter, or tube is threaded in. After the catheter is placed, it’s attached to a pump that will continue to administer medication until it’s turned off.  Just like an IV, the insertion site hurts afterward. The epidural site has been poked with a needle twice or more times.This means that after the numbness wears off, those areas hurt. But, after time and healing those puncture sites heal. So, while nothing is impossible, I have to say it’s highly unlikely that an epidural will cause permanent pain after the puncture site heals, which is about 72 hours. Just like an IV site.

2. This shouldn’t take too long…

If this is your first baby, expect to be at this a while. The general rule of thumb is about one centimeter per hour. But that’s when you are in active labor. Active labor means that you are actively dilating. The nurse checked you at noon and you were 1 cm. Then she checked you at 1 and now you’re 2cm. Your cervix is actively changing, so you are in active labor. But now how long? At 1cm per hour and you’re 2 cms, that leaves 8 more centimeters until you’re 10 or “complete”. That means 8 more hours of labor and up to 3 hours of pushing. Don’t be discouraged, I’m describing the slower end of the spectrum, so hopefully your labor will be much shorter. But don’t depend on it.

3. My water broke but I’m not contracting. I should wait to go in.

No! I’ve seen several posts on different sites that support this.This concerns me. Chorioamnionitis is a very scary infection that can sicken both mom and baby. The membrane that keeps a water tight seal during the pregnancy also acts a physical barrier against nasty crawly bacteria. Once there is no longer an intact barrier, anything goes. Add to that, its’ entirely possible for an umbilical cord to slip out of the uterus and into the vagina. That’s called “cord prolapse”,and is considered an obstetrical emergency. Should you ever feel something pulsating in your vagina get down on your hands and knees with your butt sticking up in the air. Call 911.

4. My water broke and now I’m going to have the dreaded “dry birth”.

Amniotic fluid is fetal urine. So even if your water breaks and buckets come out, there will be more. In fact, you will keep leaking/gushing until you deliver. A woman’s vagina also becomes more mucusy, and bloody. So between all of these things, it is impossible for a baby to come skidding out of  the birth canal.

Amniotic fluid does act a as cushion between baby’s head and mom’s cervix.Once that fluid is gone, contractions get more intense, and labor often goes quicker

5. I’m so sick of being pregnant, What did my grandmother say about Castor Oil?

Old Wive’s tales often have a kernel of truth in them, and this one is no different. Drink a bottle of castor oil and yes, you will get uterine activity. But the castor oil is having a direct affect on your stomach and intestines who are nearby nieghbours of the uterus. When they get crampy and upset, so does your uterus. So why doesn’t that “throw” someone into labor? Remember, active labor is the cervix opening, not just contractions. You can have cramping and contractions until the cows come home, in fact, it will feel that way. But! No cervical change means all that for ought. Say no to Castor oil.

About Me

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I am a Registered Nurse with a certification in Inpatient Obstetrics. I  have been working at a level three tertiary care center for eight years. That means I help take care of the really sick moms and pre-term babies. Our Neonatal Intensive Care Unit can care for preemies 23 weeks and up. We are also […]