Participants: Amy Wellard, Cherie Lon Fernandez
Series Code: WM
Program Code: WM000443
00:34 Welcome to "Wonderfully Made"
00:35 I'm Amy Wellard with the Wildwood Lifestyle Center 00:38 and today we're talking about 00:40 labor and delivery of your precious baby. 00:43 With me in the studio is Dr. Cherie Lou Fernandez 00:46 Welcome Dr. Cherie Lou Thank you 00:48 It's an exciting time, isn't it? 00:50 The baby is about to come... 00:52 You've got mixed feelings of perhaps a little fear 00:55 and trepidation about what could happen 00:57 because the unpredictable is possible. 01:00 So what are the BEST ways to prepare yourself for the birth? 01:03 Always preparation comes BEFORE, not just on the event, per se 01:10 So it is very important for you to think who you are going to 01:14 trust to deliver your baby, and not only on time, 01:18 but you would have thought about it even previous 01:20 when you were going to have your prenatal checkups 01:23 and everything and follow-ups. 01:25 You would have already then have chosen who is 01:27 supposed to deliver your baby... 01:29 Whether you would want a doctor to deliver your baby 01:35 or a nurse midwife or a midwife or a doula or whatever, 01:39 you would be thinking of this already in advance. 01:42 It's very important because you need to have a BOND 01:45 with the person who is going to deliver your baby. 01:48 You have to TRUST, learn to trust... 01:50 Trust doesn't just come like split second, you know, 01:53 it has to be developed. 01:55 So you have to choose the person 01:57 you are going to put your trust in. 01:59 And it's important, as well, that that health care provider 02:03 knows your history so they know what 02:04 possible complications could arise... Yes 02:07 And what are the different options in front of the 02:09 pregnant lady in terms of hospital, birthing center... 02:12 What's the difference between those? 02:14 Oh, there is a lot of things going around like 02:17 home births versus birthing center births, 02:21 versus hospital births. 02:24 Well in the olden days, when the hospitals weren't there yet, 02:29 of course we can say that there were a lot of mortalities 02:34 from delivering at home. 02:35 It's just probably because people didn't know 02:37 how to do delivery well and they didn't have enough 02:41 clean things to use... 02:43 So women were dying from delivery infections, whatever, 02:47 because we just didn't know... 02:49 They just didn't know yet. 02:50 But, midwives doing home deliveries, 02:53 or nurse midwives doing home deliveries now at home, 02:58 they are fairly doing very, very well. 03:02 Delivering at home would really be the best 03:04 because you're delivering under circumstances where 03:07 you are comfortable. 03:10 Your relatives are there, your husband, your mom, 03:13 your dad, your grandfather or grandmother to help you. 03:16 The home setting is the most physiologic, if you would say... 03:21 And I'm sure the mother would have more endorphins as well 03:23 being around her loving husband. Yes, she's comfortable! 03:25 Yeah but then they want to make it a little bit more hybrid 03:29 between the hospital, which is more sterile, 03:31 and everybody is masked and you wear this gown, 03:36 and sometimes the husband is not there or nobody is there at all; 03:40 you are in a labor room or delivery room, 03:43 a very sterile environment; 03:44 then they make a half bid between that... 03:46 they have the birthing centers. 03:48 So you have to see where you would want to be, 03:53 and know the pros and the cons of each of these... 03:58 And if I'm high-risk... I'm probably going to take 04:01 the advice of my doctor to deliver in the hospital? 04:05 The high-risk pregnancies which 04:07 are those 16-year-old and below pregnancies, 04:12 and 36 and above - because the 04:18 15 below does not know what to do. 04:20 The 36 and above usually is sick, 04:23 and all the other medical conditions that might be 04:26 accompanying the pregnancy 04:28 because pregnancies can complicate already 04:31 existing diseases and existing diseases can complicate 04:36 the pregnancy - making it high-risk. 04:38 So definitely - you would choose to stay in an area where 04:45 you're easily rushed to the hospital 04:47 or already in the hospital for high-risk pregnancies. 04:51 It's like you already know you have a problem, 04:53 and you choose to stay in an area where you live 04:57 7 miles or 10 miles away from the hospital - 05:00 that's going to be hard. 05:02 And just a word to our viewers, 05:04 Dr. Cherie Lou is not suggesting that just because you are 05:07 over 36- means you HAVE to have a hospital delivery. 05:10 Of course, there are MANY women that do deliver 05:12 over that age - myself is one of them... 05:15 And you can deliver at home, 05:17 you don't HAVE to go to a hospital... That's right 05:18 So with prayerful consideration, the Lord will guide 05:21 every decision which is very 05:23 exciting and comforting, isn't it? Um hm 05:25 So what are the physical preparations 05:27 that we should make... some of them 05:29 Many women... it comes by in cultures. 05:34 Like for example, MY culture, what I grew up... 05:37 Women are SO sheltered... 05:41 and don't carry this, don't do that... 05:44 You can't bend over, you can't sit this way, 05:47 you can't walk so far and the woman is so restricted 05:52 and she doesn't get enough physical activity 05:55 which is REALLY important. 05:57 Again I say, we go back and say, "pregnancy is not a disease" 06:02 ...therefore, it's NOT supposed to limit your activity. 06:07 If you're a sprinter, if you can still sprint if you're pregnant, 06:11 as long as the pregnancy doesn't get in the way... 06:14 That's just an exaggeration but you know where I'm getting at, 06:18 but exercise is very much important, 06:23 as the pregnancy becomes bigger, as the baby becomes bigger, 06:27 the angle or the curve in your back changes, 06:29 and this causes the muscles in your lower back to go into spasm 06:34 And so, many times this pregnant woman would be complaining of 06:37 lower back pain, so then she could be exercising 06:40 There are exercises... you can go to a lot of books 06:44 that they have for exercising the back 06:48 and the other muscles of your body; 06:50 also exercising to enhance endurance. 06:55 You're going to breathe the biggest breath in your life. 06:59 You are going to PUSH the strongest PUSH in your life. 07:02 You have to learn how to make your chest... 07:06 against this BIG tummy here pressing on your chest... 07:11 You have to learn how to take deep breaths and psych yourself 07:15 I always teach my patients to pretend that the pain is coming, 07:20 the pain is there. 07:21 So as she is exercising, maybe walking, 07:25 and then she imagines in her mind... the pain is coming 07:29 The pain comes every 3 minutes, or every 2-3 minutes, 07:32 then it becomes ooOHH and it build up and it builds up. 07:35 When it starts building up like this, 07:37 you're starting to take deep breaths... okay DEEP breaths, 07:40 and then when it's painful, you take your BIGGEST breath, 07:44 and then hold it. 07:45 Of course, while you're not yet in labor, you don't push. 07:48 But you're fixing your head, it's just like the Lamaze 07:53 or the Bradley thing... 07:54 They TEACH you to... it's like a conditioning. 07:57 If you want to, if you have the means to go to a Lamaze class, 08:01 or a Bradley, it's up to you, but if you don't have the 08:05 means to do it and you would want to do it at home, 08:09 you could always teach yourself. 08:11 Again, always refer back to the times when, 08:15 even at present when we have those people in the tribes. 08:19 I think the important think is 08:21 that you're psychologically prepared in every way, 08:25 and let's talk about fear because 08:26 fear can be such a giant as you go especially 08:30 for the first-time mom. 08:31 You're going into labor, you really don't know 08:33 what to expect because you realize anything could happen 08:35 because the books tell you, really, anything CAN happen. 08:38 So how can we prepare to face that one? 08:41 The most... I mean at least for me, I wasn't afraid 08:45 WHAT my baby would become. 08:49 Maybe some people would say - 08:50 "What if my baby is abnormal," whatever, etcetera... 08:53 I didn't think about those things. 08:55 ...You know, I didn't think, but what was really 08:58 in my heart was... 09:00 "It's going to be painful, it's really going to be painful, 09:03 it's going to be painful" because you see 09:04 I deliver all the time and I see these screaming 09:08 and writhing women, you know, because they're not prepared... 09:11 But then so, you have to understand that this pain is 09:16 necessary. 09:18 It is NOT an enemy; it is supposed to be your friend 09:23 When it comes - because without the pain, you won't deliver. 09:29 It's a Bible verse - "In pain you will bring forth 09:34 this offspring you have. " 09:36 So there is a pain, but it is helpful. 09:39 Without the pain, you won't deliver. 09:40 So, it's something that you have to fix your mind and accept 09:45 because when you are ready to accept something, 09:47 it comes faster, easier. 09:50 Now you're not saying that it would be wrong to take any 09:53 intervention so we don't feel the pain. 09:55 You're just saying the pain there is an indicator that 09:57 this is a natural part of the process, 09:59 and working with the pain enables you to 10:02 work with your body rather than fighting it... 10:04 Because if we actually go into fear over the pain, 10:06 the contractions can actually stop because of fear, 10:10 and that has been known to happen. 10:11 Many women just go ahead and have their, 10:14 what-you-call "the epidural" 10:16 They put the catheter into your back and then they 10:19 inject pain anesthesia so that you don't feel the pain 10:22 or you sort of are numbed, you can't feel the pain. 10:27 The thing is... there are statistics that will tell you 10:30 that people with epidurals have problems 10:33 in delivering their babies. 10:35 Many times it becomes a C-section, 10:37 an operative procedure that happens because 10:40 the woman can't push enough... 10:42 Because, you see, the pain is the one that makes you PUSH! 10:48 You know, when you have this 10:50 thing when you're moving your bowels, 10:52 and there is this thing there, you HAVE to push, 10:55 but this is MUCH BIGGER than your bowels. 10:58 And so, you need EXTRA triggering thing to 11:03 MOTIVATE you to push. Right 11:05 It's the pain that makes you push; 11:07 without the pain, you won't push. 11:09 So that would mean that with an epidural, 11:11 you might need some kind of inducing drug to make you... 11:14 Yes and somebody has to help you really PUSH it 11:17 with more than you would regularly think you should push. 11:22 Okay, so let's go back to the signs of labor. 11:25 I used to hear stories of women walking around the supermarket 11:29 and their waters break, suddenly they are 11:30 standing in a pool of water in an embarrassing public setting. 11:33 Is that really the first sign of labor? 11:35 That's funny because we have been so much affected 11:39 by the media... not that the media is wrong, 11:43 but we go and watch movies and you see a woman 11:46 ..."Hey honey, my BACK" and she's rushed to the hospital 11:51 and in minutes she delivers! 11:52 It's not regulated that way. 11:55 There is a process... 11:57 Of course there are some women 11:58 who just deliver... they're blessed! 12:02 But that is the exception to the rule. 12:05 I have seen patients and I have had patients who 12:08 just when they think about it, it's there. 12:11 I had a close friend who would only know she was in labor 12:14 because her baby was there already. 12:16 She didn't have any pain! 12:20 Most of us would want it that way! 12:22 Not with her.. but it doesn't happen that way. 12:25 There are steps that will prompt you to know 12:29 that you're going to deliver and it's about time. 12:34 Okay, so let's talk about that... 12:35 What would be something I can look for... 12:37 I'm 40 weeks, nothing has happened and then boom... 12:40 Okay, oh - WHAT? 12:43 You're delivering right away now! 12:44 Again, I will say it varies the process. 12:48 But you won't regularly... if we'll say, this is a 12:51 normal delivery, of course you can deliver before term... 12:55 Term means the 37th to the 42nd week, 13:03 and the average is 40 weeks. 13:05 So from 37 weeks of your pregnancy 13:07 to 42 weeks of your pregnancy - that you call "term" 13:11 If you deliver before that, that's premature, 13:14 and if you deliver after 42, that is post-mature, okay? 13:20 You would want to deliver... 13:21 Let's say - we're not talking about abnormalities, 13:23 so let's say from 37 to 42... 13:26 You will know what... You see the saying in the Bible 13:29 "... Like a thief, it comes in the night" 13:33 Your delivery of the baby is ... will come like 13:36 a woman in labor... like a thief in the night. 13:38 You don't know when it's going to come. 13:41 But again it says that you don't need to be ignorant 13:45 about when I'm going to come 13:46 because I have signs and symptoms around. 13:49 We will see the signs. 13:51 Well there are signs, the first one is 13:53 not necessarily the first one but one of them is 13:57 "lightening" 13:59 Many women would say, 14:01 "I felt my uterus go down" 14:03 It's like the head of the baby now has finally entered 14:08 the pelvic cavity. 14:10 The head is usually is floating above your pelvic brim. 14:14 Lightening means the head enters the brim... 14:18 so that when your uterus was high this way, now it goes down. 14:22 So when you have that, you can be sure that labor 14:25 is coming soon because the head is now PINCHING on your 14:28 lower uterine segment and your cervix, 14:31 and then now it's going to start 14:33 to mature and cause labor to come. 14:37 So actually, that now you mention that, 14:40 I don't remember that happening with me, 14:42 so that can happen without you 14:43 being aware of it... is that right? 14:44 Yes, many are aware but if you didn't know about it, 14:50 maybe you wouldn't notice it 14:52 because it is just something that - it goes down. 14:56 It has to before it can come out. Yes 14:58 Because the head has to go into the pelvic cavity; 15:01 however, this happens the majority of the time 15:04 ONLY in primigravid, first pregnancy. 15:09 First pregnancy, the head of the 15:11 baby will go into the pelvic cavity before you go into labor. 15:15 For multigravid or women who have delivered before.. already, 15:20 the head is usually floating until the cervix is opened 15:24 fully before the head comes down. 15:26 Anyway, primigravid - the head comes down. 15:29 Okay, so what other signs? 15:32 We have also bloody show, you would call that. 15:36 There is the show - it will show I'm coming! 15:39 The show is the mucous plug of the cervix. 15:43 You see the Lord has created the cervix to be closed 15:47 so that the vagina is not sterile... 15:52 There is bacteria in the vagina and the bacteria in the vagina 15:56 can get to the baby... 15:58 But because of this mucous plug, this is a tenacious guard; 16:04 bacteria can go to the baby but when you come into labor, 16:08 this mucous plug comes out. 16:11 So it's like the cervix is now ready - ripening. 16:15 So this mucous plug comes out, 16:17 and this mucous plug, of course, is mucous you know, 16:20 and it's blood-tinged; sometimes it's brownish, 16:23 but the mucous plus will come out and you know... 16:26 Oh okay, I'm almost there. 16:28 So should I call my doctor as soon as that happens 16:31 or should I go straight to the hospital? 16:33 Well because you don't know really, you could... 16:36 You could call your doctor but there are other things that 16:40 can come together with it like, for example, 16:43 ...some women have diarrhea. 16:45 It's because when labor starts to come, your hormones change 16:50 and your gastrointestinal tract "sympathizes" with you, 16:57 and so it starts... Woooo, so then "Ah, I must be going into 17:01 labor because I'm having diarrhea" 17:03 Of course, don't say - Oh I'm going into labor because 17:05 I'm having diarrhea. 17:06 Sometimes the diarrhea might be infectious. 17:08 You must be sure though 17:09 that it is infectious VERSUS the one that just accompanying labor 17:13 Okay - they are two... don't get me wrong here. 17:16 Okay, so when are the contractions going to start? 17:19 This is when we start getting 17:20 into the full-blown labor, as we call it. 17:23 The contractions will come then, you know, soon. 17:27 But contractions do not come straight-away fast. 17:30 You start first far apart, maybe every 2, every 3 hours, 17:35 and then it starts coming closer, 17:37 it starts coming closer, closer, closer... 17:41 And then you will be - when you're about every 15 17:45 ...you have a persistent consistent frequency increase. 17:51 The frequency is closer to each other, 17:54 and the duration is becoming longer. 17:58 First, it's starts as a vague hypogastric pain, 18:02 lower down here, hypogastric pain just up here in front, 18:06 and it's every 2 hours. 18:09 And then it becomes, and it was only 20 seconds, 18:12 then it becomes 30 seconds, then it becomes 40 seconds. 18:15 It becomes longer and longer and then later 18:18 the pain will move to the back. 18:21 And then, later on you will feel like you have to push 18:25 because the head is already down there. 18:27 But then that's when the pain is really close apart... 18:29 So when you see a persistent, consistent frequency becoming 18:35 closer, maybe depends on how 18:37 far your house is from the hospital... 18:39 then you call your doctor, or you go to the hospital, 18:42 or you call your midwife and you notify your caregiver 18:46 or the one who is going to deliver your baby. 18:49 Okay, now something that I really didn't want to do 18:51 when I was delivering my son was vomit, 18:54 and I was told by my midwife 18:56 that that's what every woman does in labor. 18:58 Is that really something that 18:59 has to happen to empty the stomach? 19:02 Yes - you see, because in the hospital, 19:07 I delivered most of my babies in the hospital, 19:10 although I delivered outside of the hospital in homes too, 19:14 but because doctors usually don't let their women 19:20 in labor eat... because we have the IV 19:25 But the midwife doesn't have the IV and you don't know 19:28 really how fast the labor goes. Right 19:31 So then in home deliveries, they are permitted to eat. 19:36 In the hospital, most of the time, 19:39 they are not permitted to eat. 19:40 So I have only in my practice seen, 19:43 because of severe pain, women vomiting. 19:48 It's because their tummy is relatively empty. 19:50 But the ones who have been permitted to eat 19:54 while they are in labor, it's very common. 19:57 That's why you said your midwife said that it's common 20:00 because they allow the women... Well that makes sense - Yes 20:04 Now, is there any hydrotherapy that you could recommend 20:08 for people that are having a home birth 20:09 and they are experiencing these intense contractions, 20:12 what can we do? 20:14 Oh, there is hydrotherapy, definitely... 20:17 It's these hot packs - or if you have this... 20:23 Hot packs - they buy them sometimes. 20:26 They are these packs that have.. ... Like a towel, a hot towel? 20:31 A hot towel if you don't have the hot pack, 20:33 but you can buy the hot packs and put them on your back. 20:35 But let's say we don't have a hot pack, 20:38 we can get a towel and maybe wet it and wring it, 20:42 and then put it in the microwave and/or steam it 20:47 so that it becomes wet or else soak it in hot water 20:50 and wring it. 20:52 And this hot towel, hot enough for the mom to be able to 20:54 stand - you're not going to burn the back. 20:57 So push it against the lower back. 20:59 It helps alleviate or diminish or increase your capacity 21:07 to take the pain... 21:08 Because you are sort of changing where the pain is to the back. 21:13 Your attention is brought to the hot pack 21:17 which is easier to stand than the pain. 21:21 And, are there any herbs that we can take 21:24 at this point in the labor? 21:25 Any herbal teas that could help the uterus? 21:28 I wish I had a BIG list, but I only am very, 21:38 very sure of red clover. 21:43 For the mechanism of action is red clover is phytoestrogenic 21:49 Estrogens help the uterus contract and prepare the 21:52 passage for easy delivery. 21:57 There must be others I know, and many midwives 22:00 are very, very knowledgeable in these to help 22:05 with labor and delivery. 22:06 Now what if the lady is not progressing very well? 22:10 It's been several hours in active labor... 22:14 What interventions are available for her? 22:17 According to the bible of obstetrics... 22:20 we have the bible which is "Williams Textbook of OB" 22:24 There are limitations for... you know, we have different 22:29 signs to know whether the labor 22:36 is not going any more further... 22:38 The cervix does not open any further than it has opened. 22:42 Of course you start first from 22:44 zero closed cervix to around 4 cm which is just 22:49 a preparation "latent phase" you would call that. 22:52 You are not yet in active labor. 22:55 Sometimes you don't even need to go to the hospital yet then. 22:59 It's a time when you can still relax... 23:00 The uterus is just contracting on-and-off, on-and-off, 23:03 not really regularly, but when you start to 23:05 go on regular contractions, especially when they are 23:08 every 3, every 2 minutes, 23:10 then your cervix starts to open really fast. 23:14 And then from 4 cm to 10 cm, it takes time. 23:19 It's not really long, but from 4 to 10, 23:22 sometimes the cervix goes up 23:23 to 6 or 7 and it doesn't open anymore... 23:27 And it stays there for 2-3 hours, 4 hours, 5 hours, 23:31 and for whatever reason, the one delivering would know. 23:35 And sometimes the head comes down just halfway, 23:38 and it stays there - you have the arrest of the dissent 23:42 of the head and the arrest of the dilatation of the cervix. 23:45 These things sometimes can change, you know... 23:49 But in the hospital when you go here or you go here, 23:53 it's a C-section after a number of hours - 23:56 when the doctor sees that it's not progressing anymore. 24:00 But in home deliveries and/or birthing centers 24:03 where midwives and nurse midwives are, 24:05 they have certain maneuvers to move the head 24:08 out of position and fix it. 24:10 If the head was malpositioned or whatever... 24:13 And sometimes even if there are arrests of dilatation, 24:16 and/or arrest of descending of the head, 24:20 they are able to bring it to normal delivery 24:24 just by patient watchfulness and taking time. 24:30 Now you mentioned about C- sections, 24:32 let's just have a brief word on that. 24:33 There are different types of C- sections that you can have, 24:36 and some make it possible for you to have a vaginal birth 24:39 after that... Can you tell us about that? 24:44 Whatever the scar is in the front, is not what is inside. 24:50 You have a vertical scar on the uterus. 24:53 You have a transverse scar on the uterus. 24:56 The vertical scar, you call the classical C-section; 24:59 you cannot deliver normally anymore after that. 25:03 The next baby would be C-section. 25:05 But the transverse scar, low cervical transverse, 25:08 or low uterine transverse, these ones you can deliver again 25:12 Okay, now you told me earlier, Dr. Cherie Lou, about an 25:15 amazing story - a lady that technically or physiologically 25:19 wasn't going to be able to deliver vaginally, 25:21 but she ended up... Could you tell us that story? 25:24 Oh YES! This became a sensation because she was a... 25:29 I'm not tall, I'm only 5'1" but this patient of mine 25:32 was 4'10" and she had a really, really BIG, BIG baby; 25:38 the estimated fetal weight was something like a 9-pounder. 25:42 So she was very small and she 25:44 had an estimated fetal weight of 9 pounds. 25:47 We did an x-ray pelvimetry 25:50 which is an x-ray to see the pelvis and compare it to 25:54 the head of the baby. 25:56 And the x-ray pelvimetry said there is a marked disproportion. 26:04 The pelvis is too small for the head of the baby, 26:06 and this wasn't even taken at term. 26:09 But she said, "Doctor, just watch me, I KNOW I'm 26:13 going to deliver normally. " 26:15 And a 9-pounder and a 4'10" woman and a contracted pelvis 26:21 and a big baby! 26:23 Oh, I would just be watching for whether she cannot 26:25 deliver or not. 26:27 Because if I was watching, she was going to go into arrest, 26:29 the head is going to stop coming down, 26:32 the cervix is going to not complete... 26:33 BUT, miraculously, because she had made up her mind 26:38 she is going to deliver normally, she delivered NORMALLY 26:39 She delivered NORMALLY, with a normal baby, 26:42 just like normal labor and delivery would go! 26:45 It's just amazing the mindset... 26:47 Yes, how the mind can work! 26:49 How it can work in your favor, 26:50 and the Lord has really given us strength of mind 26:53 so that we can get through this... 26:55 What could be otherwise a traumatic experience, 26:58 and make it beautiful, make it really beautiful! 27:00 Just let's have one more word about natural remedies 27:03 in the recovery period. 27:04 I'd like to mention about tearing... 27:06 If we could just briefly talk about when episiotomies 27:08 have happened, what we can do in the recovery 27:10 to speed up the healing. 27:12 Oh you can have cold in the first few hours, 27:17 and then hot and cold afterwards... sitz baths. 27:21 That's actually what I did. 27:23 I was torn quite badly and I used ice for the first 12 hours, 27:26 and then afterwards in the shower, 27:27 just applying the hot water for a minute or 2, 27:30 and then a little bit of cold water and alternating, 27:32 and it was very, very healing. 27:34 So I encourage you, if you are going through any of 27:36 those post-situations, that sitz baths 27:40 can really help you. 27:41 Well Dr. Cherie Lou, thank you so much for being with us today. 27:44 It was wonderful and inspiring to hear about 27:46 birth and delivery again. 27:48 It seems no matter how much we learn about it, 27:49 we can always be encouraged by learning more. 27:51 And thank you for joining us today. 27:53 I want to leave you with a Bible promise that Jesus said, 27:56 ...that a woman, when she travails, she has sorrow, 27:58 but AFTERWARDS when her hour has come and she is delivered, 28:02 she doesn't remember the anguish 28:03 for the JOY that a child is born into the world... |
Revised 2014-12-17