Down to Birth

#77 | January Q&A: Co-sleeping; Prodromal Labor; Switching Providers; Third Babies; Conceiving While Breastfeeding; Vaginal Dryness; Baby-Led Weaning; Hep-Locks and IVs

January 27, 2021 Cynthia Overgard & Trisha Ludwig Season 2 Episode 77
Down to Birth
#77 | January Q&A: Co-sleeping; Prodromal Labor; Switching Providers; Third Babies; Conceiving While Breastfeeding; Vaginal Dryness; Baby-Led Weaning; Hep-Locks and IVs
Chapters
1:16
Did you Co-Sleep with your babies?
4:50
I am thinking about leaving my provider. What do you recommend I say or do?
8:35
Do you have any tips for prodromal labor?
15:51
Is it common to have vaginal dryness while breastfeeding?
18:15
Is it true that the 3rd baby can be a "wild card?" And if so, is there anything I can do?
24:11
Do I need to make any changes to my breastfeeding schedule if I am trying to conceive?
24:48
What is baby-led weaning and can it work with exclusive breastfeeding?
28:22
Can I refuse a saline-lock IV in labor?
36:54
Outtake
Down to Birth
#77 | January Q&A: Co-sleeping; Prodromal Labor; Switching Providers; Third Babies; Conceiving While Breastfeeding; Vaginal Dryness; Baby-Led Weaning; Hep-Locks and IVs
Jan 27, 2021 Season 2 Episode 77
Cynthia Overgard & Trisha Ludwig

This month's Q&A is packed with valuable information!  Check it out below:

Did you Co-Sleep with your babies?

I am thinking about leaving my provider. What do you recommend I say or do?

Do you have any tips for prodromal labor?

Is it common to have vaginal dryness while breastfeeding?

Is it true that the 3rd baby can be a "wild card?" And if so, is there anything I can do?

Do I need to make any changes to my breastfeeding schedule if I am trying to conceive?

What is baby-led weaning and can it work with exclusive breastfeeding?

Can I refuse a saline-lock IV in labor?

Don't forget you can submit questions via our website downtobirthshow.com or via Instagram @downtobirthshow. See chapter makers to skip to a specific question.

* * * * * * * * * *

If you enjoyed this episode of the Down To Birth Show, please subscribe and share with your pregnant and postpartum friends.

Between episodes, connect with us on Instagram @DownToBirthShow to see behind-the-scenes production clips and join the conversation by responding to our questions and polls related to pregnancy, childbirth and early motherhood. You can reach us at [email protected] or call (802) 438-3696 (802-GET-DOWN). We are always happy to hear from our listeners and appreciate questions for our monthly Q&A episodes. To join our monthly newsletter, text "downtobirth" to 22828.

You can sign up for Cynthia's HypnoBirthing classes as well as online breastfeeding classes and weekly postpartum support groups run by Cynthia & Trisha at HypnoBirthing of Connecticut

Please remember we don’t provide medical advice, and to speak with your licensed medical provider related to all your healthcare matters. Thanks so much for joining in the conversation, and see you next week!

Support the show (https://www.paypal.com/paypalme/cynthiaovergard)

Show Notes Transcript Chapter Markers

This month's Q&A is packed with valuable information!  Check it out below:

Did you Co-Sleep with your babies?

I am thinking about leaving my provider. What do you recommend I say or do?

Do you have any tips for prodromal labor?

Is it common to have vaginal dryness while breastfeeding?

Is it true that the 3rd baby can be a "wild card?" And if so, is there anything I can do?

Do I need to make any changes to my breastfeeding schedule if I am trying to conceive?

What is baby-led weaning and can it work with exclusive breastfeeding?

Can I refuse a saline-lock IV in labor?

Don't forget you can submit questions via our website downtobirthshow.com or via Instagram @downtobirthshow. See chapter makers to skip to a specific question.

* * * * * * * * * *

If you enjoyed this episode of the Down To Birth Show, please subscribe and share with your pregnant and postpartum friends.

Between episodes, connect with us on Instagram @DownToBirthShow to see behind-the-scenes production clips and join the conversation by responding to our questions and polls related to pregnancy, childbirth and early motherhood. You can reach us at [email protected] or call (802) 438-3696 (802-GET-DOWN). We are always happy to hear from our listeners and appreciate questions for our monthly Q&A episodes. To join our monthly newsletter, text "downtobirth" to 22828.

You can sign up for Cynthia's HypnoBirthing classes as well as online breastfeeding classes and weekly postpartum support groups run by Cynthia & Trisha at HypnoBirthing of Connecticut

Please remember we don’t provide medical advice, and to speak with your licensed medical provider related to all your healthcare matters. Thanks so much for joining in the conversation, and see you next week!

Support the show (https://www.paypal.com/paypalme/cynthiaovergard)

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

So some of our listeners were curious about our co sleeping practices. The question is, did you guys co sleep with your babies? Did you co sleep?

I definitely did co sleep I don't remember what I thought I would do when I was pregnant. I'm sure I had all sorts of opinions about things. I really don't remember what I thought. But I remember most distinctly when I was getting Alex was initially in a bed in a bassinet on the other side of our room. And of course, I was getting up I think like every hour and a half or something like that. And I remember distinctly that I would get up on my feet before I would even fully wake up like he would make a peep and I was just on my feet and moving toward him, which I'm sure a lot of parents relate to, if you're you know when you're that attuned. But I remember once picking him up in my arms, and I felt my knees were buckling. I just felt like I was so asleep that I could just fall down with him. And I thought this is this is so difficult. This is so scary to me that I that I'm getting hammered. I'm so terribly exhausted, that I just started co sleeping. It was just the best happiest thing I ever did. I got so much more sleep, he got better sleep. And I did the same with my daughter. Did you?

I I do remember that with my first Lola. I definitely slept with her. Like on my chest, the first couple of nights.

Oh, yeah, like skin to skin.

And I think that I did not intend to go sleep with my first and I did really try to keep her in separate sleeping space. She was in the room, but in a separate in a separate cradle or bassinet. And she wasn't, she didn't love the CO sleeping situation, it didn't work well, I think like I would bring her into the bed at night and try to fall back asleep. But she would never fall back asleep. She is still of all my children, the one who will sleep anywhere by herself happy to be alone. So I didn't really sleep much with my first but I definitely did with my second and third, like for a long time. And right from the beginning and in bed and they really never had sleep schedules. And I did find that I got more sleep that way. Certainly if you are exclusively breastfeeding bed, either bed sharing or a co sleeper situation, I think relieves a lot of nighttime stress.

Yeah, and also you don't have to fully wake up in order to breastfeed them. You can just turn over and the baby can breastfeed and you're just dozing back asleep. And you don't have to do anything. You don't have to officially go put them somewhere and get yourself back in bed because for me that was a lot of the challenge was falling back to sleep. And then if I didn't fall back to sleep quickly, this anxiety would kick in and then I would think Oh great, you know, just didn't help the way my mind was working and the way I felt anxious about sleep. So definitely worked for me. The biggest thing I had to manage as I think a lot of people do as I didn't want my husband to accidentally clock the baby in the head when he was turning around in bed. I'm a big fan though. Big fan.

I think we both are especially even if it's just sharing a room, it just I was always much more comfortable knowing that I could hear my baby without, you know having to go through a baby monitor or just to be close to them.

And then the baby doesn't have to wake up and start crying in order to get you awake to breastfeed the baby, just kind of snuggles and breastfeeds and now even the baby sleeps a little bit better.

Alright, so let's jump into the questions from our listeners this week. Here's the first one. You guys have gotten me thinking a lot about looking for a different provider. But I can't imagine ever having that conversation with my group about leaving them. Other people struggle with this. And what do you recommend I say or do?

Well, the first thing I recommend you do is shop around. And you definitely don't need to tell your current provider that you're doing sell because this is just your business, you're hiring someone to be your attendant at your birth. So I would say, if you can ask your childbirth educator or your doula or friends who had the kind of birth that you would like to have, who they saw, if you're interested in midwives, look for any midwifery group around you, and call them and see if they offer a meet and greet. They sometimes do them in person, they sometimes do them via zoom these days, but have some kind of meet and greet, bring all your questions, you have every right to bring all the important questions that you learned from this podcast, or from your childbirth class. And, and go check them out. I do always recommend checking out at least two other providers if that's available to you, because I think it leads to a more interesting discussion with your partner, when you have a bunch to choose from, it takes away some of the intensity of like, do I stay with this one provider I've been with for so long, versus this new one that I really kind of liked. But I'm not sure just meet with a whole bunch. And just say, you know, this is how I felt in this location. This is how I felt about that person in that group. I liked how this one answered our questions. You know, if you have any kind of condition or medical condition that they address, then you might really feel best and safest with the way one particular provider answers that. And that might be your indication, by law, you have the right to obtain your medical records. So my suggestion is just call the receptionist at your current obstetrician or provider and ask for your records. And that is it. Sometimes the new group will even obtain those for you when you sign a release. I don't like to coach people through having that conversation with their provider because we don't need to invite fear inducing comments from them, or guilt. Like you know, sometimes they can bring nonsense into the conversation like well, don't you think I'm qualified? Or don't you realize I've been birthing? attending babies this long? Or you've been with me all these years? You're you know, now is when you're leaving? Why would you ever volunteer yourself for that kind of conversation, I say just find the right provider. Remember, your loyalty is to your baby and to yourselves, it's not to the provider, it doesn't matter how long you've been seeing them, you have every right to find the one that feels right to you, you can always go back to them after you have your baby for your annuals, or you can just stick with the new group. Just to add to that, I think also it's you know, fair to say that if you are leaving a practice of a large group practice, for something like a home birth, or a birth center birth, and you feel that you owe your provider an explanation, like you said, you certainly don't. But if somebody has a if if somebody feels that they want to have that conversation, I think it's very reasonable to explain that you are interested in a birth situation where you're going to have the provider there to attend your birth who is there for all your prenatal appointments. So that's one of the reasons that people choose home birth is because they, they want to have the midwife that they see for every visit, be there for their birth. And that's there is never going to be that guarantee in a large group practice. If you don't like the person, like you said, you don't have to say a word. Just go.

I'm just afraid that the provider will make them feel worse. All right. Next question. Trisha, can you talk about prodromal labor? This really amuses me.

I've been

in labor for 12 days now. And it's driving me crazy. I find that so endearing. She's been in labor for 12 days. And she's texting us like help. Please edit and publish the episode and get back to me before I've been in labor for you

know, can we do a live call with this?

I mean, seriously around the line, we need to get on the line now.

Yeah, 12 days is a long time to be in prodromal labor. And the fact that she clarified it with the fact by saying it's driving me crazy is not nuts. Yeah. Sounds Poor thing.

But isn't it to Trisha? Is it very intense? I mean, what is it like? Is it kind of a nuisance because it keeps you up at night? And there's just this mild thing happening? Or do you feel like you're in intense labor when this is going on?

No, it can be more often on it's definitely more of an off and on thing, especially if it's been going on this long. Typically prodromal labor doesn't last more than three days. So I'm curious what number baby this is for her because if it's not her first baby, if it's the second, third or fourth baby, sometimes you do get these more prodromal type symptoms, but they're usually more mild. The key to Perdomo labor is to do everything you can possibly do to forget that you're experiencing some type of labor contraction. You want to just live your life as if you're not in labor and try to get your mind off focusing on? Are these contractions getting closer? Are they getting stronger is this it and you know, looking for changes that indicate that labor's progressing. If you can just kind of get your mind off it, and relax, then it tends to actually help you get into active labor. So, the most important things are that you continue to eat normally, that you rest adequately, which means getting good sleep at night, the best that you can do, and staying very well hydrated. Sometimes dehydration and exhaustion can be the reasons that we get prodromal labor and can't get into active labor. So electrolyte drinks, coconut water, magnesium drinks before bed to help you sleep. Bone broth, for for nutrition, if you're having a hard time eating solid foods.

Watch a movie. A lot of people, a lot of people in early labor like to bake a cake. Well, I, I just had a baby a birthday cake, I joke about movies, because it's the kind of movie my husband would normally pick, it's like it would keep the cervix so tight, you'd be afraid to have a baby and bring a baby into the world. It's like, typical, yeah, you just want a movie that makes you happy a movie that makes you like a romantic comedy, something that makes you feel a romantic comedy is the perfect thing. So either a comedy or a romantic comedy, because romantic will help get the oxytocin flowing. And the laughter is very good for relaxing. So stress, as we know is a big inhibitor of active labor. So warm baths, some people will go actually and get a massage, and go for acupuncture. You might choose to have an orgasm, you might choose to have an orgasm, like that.

Yeah, you might choose to have somebody give you an orgasm or having orgasms wherever you want to do it, or I'll take one of those, you know, well, the set ordered out sex is sex is usually one of the last things we feel like doing. But semen has prostaglandin, which is one of the drugs that they can give women to soften the cervix when they're inducing. And of course, we produce oxytocin, when we're doing anything from hugging all the way up to having an orgasm, we're co creating oxytocin. So anything on that scale, if this pitocin is synthetic oxytocin, but the natural hormones you and your partner can create, have no side effects. There, you can take too much of it. And they're more effective. So and enjoyable. Yeah, I mean, well, potentially enjoyable. I've had some women I'm, I'm thinking more like massage. Oh, yeah, I've had some women say like they're having sex, they kind of overdo it a little like, they're just feeling like it's clinical. Like, let's get to it, let's get the baby and you want to mind your thoughts. And make sure you're in a good mental place and you're feeling happy and relaxed, as much as possible. And you've got to make sure your partner keeps you in that state, they have to understand not to do anything to add to your, your anxiety or stress that the baby isn't coming at.

Right. The other thing about sex is it's important to make sure that you haven't ruptured your membranes if you're going to have actually have sex, thanks for remembering that.

But you can still have an orgasm without having sex. nipple stimulation is also a helpful way to get oxytocin going. And you can do that in a warm shower. You can do that through touch massage, walking.

Did I ever tell you the nipple stimulation story? I have? Can I tell you? Yeah, so one of my couples from Greenwich took my class years ago, and they were seeing their doctor and happy pointment the husband said to the doctor, doctor as an alternative to pitocin should labor stall, you would you be supportive of our doing nipple stimulation. And the couple sat there on the edge of their seats, looking at the doctor waiting for a response and the doctor went on? No, because I can control the pitocin I can't control the nipple stimulation. And and I said, That's what you get for asking another man permission to touch your wife's breasts. You only have to ask her. You don't ask a third party for permission. You get some privacy. You see what she feels like doing? how she feels like being touched. And that's the end of the story.

Yeah, and that actually is a very typical response. And the reason that sometimes providers respond that way is because nipple stimulation is that effective. And it can cause really strong contractions and of course, in our fear based medical, obstetric culture, we like to monitor everything about labor and birth. And the fact that nipple stimulation is effective, can make providers worried that they are over stimulating the mother over stimulating the uterus. And, well, I think we didn't touch on the fact that you have prodromal labor is often a result of the baby not being properly positioned, and so on. We've talked about this in a lot of our episodes, getting your baby's head in the proper position so that it can adequately apply pressure to the cervix is essential for the labor process to get into the mode it needs to get into. So doing spinning babies techniques or taking a walk, doing stairs or hills or even walking along a road with a curb or you have one foot up and one foot down, all these things can help the baby twist and move down and get the head in proper alignment to help get labor going. That's the reason chiropractic care also is helpful. There's some herbs, blue cohosh, you can do castor oil, sometimes therapeutic rest in the hospital is ordered, or even sweeping the membranes but these are a little bit further down the line interventions.

Okay, Trisha, this came from a doula. And she wrote as a doula, I find many of my clients talk to me about vaginal dryness while breastfeeding. Is this to be expected? And is there anything that can be done about it? I have never heard of that. Trisha. What is this common? Very well, okay, totally, absolutely. Why.

And unfortunately, the hormones of breastfeeding tend to inhibit the hormones that keep our vagina well hydrated. So it is very common, and most women experience it and it is temporary. Once your period comes back, once you start menstruating regularly, again, it usually gets better. But the solution to it is that if it doesn't, if it's uncomfortable, then you use lubrication.

I am glad that someone asked this question because what I would have assumed is that there was a lubrication shortage because so few postpartum women are up for having sex because they're just so incredibly exhausted and touched out. I just would have figured it had something to do with the mind more than breastfeeding.

Remember to that in the early weeks of breastfeeding, or really in the first six months our bodies are naturally trying to prevent pregnancy. So vaginal dryness is one way to do that preventing sex is an excellent way of preventing pregnancy.

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I'm thinking about having a third child. And I have heard that the third baby can be a wild card as far as what to expect from the birth. Is that true? What can I do to help my body have the best birth the third time around?

It's my understanding that there is no rhyme or reason to how each birth will go beyond the actual details around that birth, for example, the care the mother is taking to ensure she's hydrated good fetal positioning, how is she doing emotionally? I think these are always the drivers in any birth to say that the third is a wild card. Sounds like a bit of a you know, I don't know if wives tale is the term but it just doesn't sound like a very helpful thing to believe. Trisha, you're you're smiling. And I've got to just stop before I continue and find out why you're wrong. Is there some noting here to the third baby?

It is it may be a wives tale, but it's it's very prevalent wives tale in midwifery and obstetrics. I don't think that there's a whole lot of validity to it. I can't give you the reasons why people say that basically what they mean is that this is why this is where I think it comes from your first birth takes the longest, your second one is generally shorter. In when it comes to your third. They say it's a wild card as far as we don't know if it's going to be longer or shorter than your second. That's, I believe what she's referring to.

So here's my perspective, because I just want to come at it a little differently. Now that we've covered that, because that's helpful. You answered the question. But let me let me give it to you this way. I had a refresher class last Friday night on zoom. So I had a, I think seven couples who've taken my class before now they're pregnant with babies Number two and three, and they just came in for a refresher class. And one of my moms who took my class A few years ago, and she's pregnant again. You know, at the beginning of every refresher class, we spend about 30 minutes where I just check in with everyone emotionally. And I'm like, so what's going on for you guys? Let's talk about how you're feeling expecting another baby, what, you know, what emotions are you going through? What's what are you struggling with right now. And they usually share things like, I feel like I'm not giving this baby any time or attention. I was so much more aware in my first pregnancy of where I was every week, or they talk about the impossibility of loving another baby as much as they love their first. But I had this mom who just started her lips were quivering, and she started just crying while we were talking. And I thought, Oh, she's got something really pretty heavy to share. So when we get to her, you know, let's see, let's see what it is. And when she spoke, she was crying and crying. And she said, Well, my first birth was so beautiful. It went so perfectly. And I'm just panicking, that my second birth won't be. And what I've noticed is that when women are pregnant a second or third time, I think especially a second time, they absolutely replay their first birth over and over and over if they had preeclampsia the first time, they think they're going to get it the second time, if they had a breech baby the first time they think they're gonna have a breech baby the second time, and they just relive it, oh, I went two weeks late, I'm probably going to go two weeks, like this time or so. Even when she had a great birth, she's literally just crying tears, because she's afraid it won't be. So what I want to say is the attachment we have, and the beliefs we form around the next birth are my bigger concern for women. So if it serves you to think that it's a wild card, that's one thing. But I don't really I don't know that it does, I would just, you want to say things like I give birth easily. You know, I take care of myself. I'm working on fetal positioning, I'm increasing the likelihood of a beautiful, easy birth. What else can we do?

I agree with you completely. I really think this simply comes from the fact that if you look at the statistics of labor, second, babies come faster than the first, the vast majority of the time. And what you don't see is that third babies come even faster than the second. They're either similar, or maybe slightly longer. I just think somehow in the birthing community, this became a thing. Well, the third, we don't know if it's going to be whatever, but it's like, how can I say like bad things happen in threes, like, don't tell someone who's suffered one or two bad things that something else is gonna happen? Look, what matters is that you empower yourself. It's such an overused word, that I'm always reluctant to use it. But to empower yourself is to control what's in your control. The care you take of yourself, practicing yoga, practicing any kind of deep breathing, meditation, fetal positioning, go on spinning babies, calm and work on it. Anything that's going to make you feel well, physically and emotionally, mentally, nothing can top that nothing is going to top that off. So just to be clear, I think when they when she's referring to this as a wild card, they're only talking about length of labor. I don't think she's talking about. I don't think she's actually talking about like, Oh, no, I do. I do, Trisha.

Well, then then let's just be clear that in the birthing world, it's the third is about length of labor, that whole thing about it being on, you know, hit or miss wildcard, we don't know. It's,
I'm glad you Yes, I'm glad you clarified, because I'm not about whether you're going to have a vaginal birth or a horrible night or an easy birth or long difficult, but I understand. Yeah, I think that what she's asking, because I've heard people ask things like this before, and I always go another direction with it. But I do. I'm glad you clarify that you are only talking about the duration of labor, because I'm pretty sure she was thinking, Oh, my gosh, what's in store? It's a big question. Just focus on what you can. And we have so much information about how to how to prepare for an easier birth, that just focus on those things and feel happy and keep yourself in a good place. Here's the next one. If I'm trying to conceive, while breastfeeding on demand, my 17 month old, do I need to make any changes to feedings?

So the short answer is no. So long as you have your period. If you are 17 months out and you still haven't started menstruating again, then reducing breastfeeding will help your period come back and then you would be able to conceive. If you are regularly menstruating and oscillating then there is no need to make any changes to your breastfeeding schedule.

Great simple. Let's do another.

I've just heard about the idea of baby led weaning would love to hear more about the benefits or drawbacks to this approach does any one approach to introducing Let's pair better with exclusive breastfeeding.

Well, I'll take a stab at it. I did this. I never knew what kind of weaning I would do with my babies. But once I was a breastfeeding mom, in both cases, the only thing that worked for me or made sense for me and my babies was for them to drive basically. So when it was time for them to have solids, you just recognize it. I remember the pediatrician saying months before my son was ready to try introducing food. But really, they're reaching for food, you can't stop a human being from going for food. So when you're eating, they're going to be opening their mouth and reaching for your food and then you know, they're ready to eat. I don't know if there's an answer to this, everything was just instinctual. We had our routine for breastfeeding. I woke up breastfed my baby. And then I think I just started offering them banana and I made, you know, squash or I gave them avocado, and I just started offering them food. And as they started eating more, they still breastfed very, very frequently for either hydration or for comfort. But I just played with it, it didn't matter to me because it was all good. It was all nutrition. It was just very much art and very little science. That's the only thing that really worked for me. Trisha, do you have advice on this beyond what what I experienced?

Well say with my first which was now 16 years ago, I took the whole approach of it was very eager to introduce solid food. And it took the whole approach of the pureed food. And I definitely didn't do rice cereal, even though that was recommended by my pediatrician. But I started around six months with, you know, spoon feeding the pureed food and made the homemade baby food. And, you know, went through all that for a couple of months before I introduced more solid food. But by the second and third, I didn't do any of that I naturally did this concept of whatever we're eating as a family, the baby eats. And again, right around six or seven months, when my children started to reach for things or look interested in whatever was on my plate, I would simply cut it up in very small pieces, put it in front of them, and they would use their hands to pick it up and put it in their mouth. And we never did spoon feeding and we never did pureed foods. And I thought that was far better, far easier. And it just, it was again, it just looks like it happened because it made sense. with subsequent children to just do it that way was easier. So that Trisha whoever heard our q&a Episode A couple of months ago is wondering if you're giving your babies hot wings and chocolate milk as their first raise because we learned all about you and your food preferences in that episode. Anyway, I I didn't I wasn't usually serving hot chocolate milk for dinner a little hot sauce for you. But I'm sure it wasn't, you know, I was probably my kids were a year a year and a half old.

That's only when you took that to a bar. I got it. Yeah, exactly. Then I might let them suck on a hot. But yes, I think this way of introducing solid foods is a far better approach. And I'm glad it's actually catching on and has a term that kind of is not. It doesn't make a lot of sense the terminology, but the concept works great.

Okay, Trisha, here is one on half blocks. It says I'm getting conflicting information on the half block while giving birth. The hospital tour informed us it was necessary. And while my doctor said it was not another doctor in her office told me, we can just wait and see which felt patronizing. Because I wanted a commitment that they wouldn't bring this up during labor without a medical necessity. I know they plan on pressuring me once I'm there. Well, right there. I want to say why aren't you looking into other providers because your intuition is definitely speaking loudly. When I asked why they might want or need to do it, they said in case of an emergency. So I said if there is an emergency, I hope a doctor or nurse can install an IV very quickly. I just can't imagine putting my complete focus on my birthing on birthing my baby while I have a needle in my arm for no apparent reason other than quote in case of emergency. However, I'm beginning to feel that I may have to compromise on this one. What are your thoughts? I love this woman's perspective and her intuition because she is spot on on this whole topic. What do you say, Trisha?

Well, I say that it is routine in most hospitals to put in an IV upon admittance to the hospital. But that does not mean that you cannot refuse, though it doesn't doesn't mean it's evidence based.

And it doesn't mean that's right. It Well, it's not. In part, it's not evidence based because there are very few studies to look at whether it's it is a worthwhile procedure or not. There's really only one study out there on it. But I think more importantly is to think about the reasons that we put an IV in place and then to make a personal choice but whether you feel that that's important or not and what she And our question is, they do it because in case of emergency, that's one reason. It's also used for IV fluids. It's used for antibiotics if you need them in labor, it's used to administer. It's used to administer pitocin, either in labor or the standard postpartum injection that's given with the birth of the placenta. So you don't have you don't have the intramuscular injection, if you have an IV in place, they, they put it in through the IV. If you're going to have an epidural, if you needed a Syrian, if you had a postpartum hemorrhage, and have all of those reasons, most of them, you can no going into your birth, whether you are going to need them or not. IV fluids if you're allowed to eat and drink and labor, you're not going to need them. If you're GBS negative, you're not going to need the antibiotics. pitocin is something that, you know, you can decide later with your care provider, if that's something you're going to need or want and labor. So really the only thing are an epidural pain management, that's also again, something you can decide in labor. If that's, you know, that's not going to be part of your birth plan, all of these reasons, would lead me to say you do not need an IV, the only exception would be the postpartum hemorrhage. So in the case of an emergency, postpartum hemorrhage, which is very uncommon to have an IV would be helpful. But again, we're talking about a rare occurrence. And you're also dealing with, you know, providers who can put in an IV, quickly, if need be. So the one study that's out there looked specifically at I think postpartum hemorrhage and the need for IV. And they found that in zero cases, women needed emergency IV placement in about 8% of verse, women needed, urgent, which is not emergency. Urgent just means, okay, we're seeing a situation that we don't like something given IV, whether that's fluids or antibiotics, or whatever would be helpful. We're going to put in put in an IV. So I think you just have to, it comes down to personal choice, what really matters is that you feel confident and comfortable in your choice, and that that choice is respected if you choose to decline it. And it is standard at almost every hospital.

You Yeah, I mean, I would just say that a hep lock is attached to nothing. So there is no argument for a hap lock beyond that of, let's say ourselves, the few seconds it takes to put this in. If and when we need to hook you up to some kind of IV to have a hep lock in the hand in the hand that's attached to nothing is just, you know, I think women have every right to say, I don't want that I see what you're saying. The reason is, I'm just going to give you the providers perspective, I'm going to, I'm going to play the devil's advocate and be the be the provider or the nurse here saying if I am caring for a patient who suddenly has a massive postpartum hemorrhage or suddenly needs an emergency cesarean section, the last thing I want to have to worry about is placing an IV. So in some cases, getting the IV in some women is can be difficult. I think there's a big distinction between being hooked up to an IV and having a hep lock though, so the hep lock not attached to anything is you know, it's it's a mild intervention, it's there, it's a painful to have it put in there's risk of infection, there's risk of it being an annoyance To me, it's like a little bit. It's like the the idea of like walking in the hospital and putting on the hospital gown and getting the headlock. It's like this psychological thing that it does to you that it kind of makes you puts you in that different headspace of being in a medical environment and being a patient. And if you know that those things are going to disturb your peace and confidence, then I would decline them. But if you know that getting a headlock is like, you know, to you, it's like getting a finger prick. Some women actually would probably feel a lot safer having it because they say, you know if something happens urgently, urgently, I don't want to be worried about you getting an IV and I just want it to be there. It's really, really personal choice.

Yeah, I always say to my classes like, Look, if you put your hand up and say, Hey, knock yourself out, this isn't going to disturb me at all. Go put it in, then fine. And I say sometimes to my class, like how would you feel sitting through class today having an App Lock in, if you could still focus and be comfortable, then it won't disturb you very much. In the grand scheme. This is a lesser controversial matter than some of the other things we talked about.

And just for clarification to a there is no needle left in the arm. It's soft. It's just a soft catheter that goes in you use a needle to insert it but then you pull the needle out and the catheter the soft, pliable catheter is left so you really don't even notice it's there.

If I were if I were personally having a birth in hospital, I would decline it.

Yeah, I would. I definitely want to.

But I think I guess I'm just trying to make sure that people clearly understand the difference between a hep lock and an IV hookup right.

But it's one step closer. That's the whole thing. It's like now they're gonna be like, well, let's just give you a little pitocin. It's right here. That's, I think what we have to be careful of in this country because we are right over using those interventions, as you know, routinely when it isn't, you know, it isn't supported by evidence, and we're having worse outcomes as a result. And it can start with something as seemingly innocuous as a headlock. That's why it's right this woman is it's true.

Yes. Oh, and it's also anything that is mandated like if I don't want to put the hospital gown on when I get in there, sorry, I'm gonna wear my clothes. That's another thing I talked about that too. You don't have to wear that hospital gown, know where you want to wear. So right.

And you can say no to this too.

On that note, that's a wrap.

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Outtake