Released Waters (a.k.a. Ruptured Membranes,Water Breaks) – What to Do!

Your waters just released – now what?  Waters can release as a few drops at a time or in a gush.  Only 10% of women will experience waters releasing before labour has started.  In that case labour usually starts within 24 hours.  The other 90% of women’s waters will release at some point during labour, usually in active labour.  Below is info on self-care and warning signs.  

C-19 Updates in our Local Birth & Postpartum Care

Here’s a list of updates for the RGH Labour/Birth Unit and Mother/Baby Units. These are significant. Anything is subject to change. 
 
Some tips for navigating this journey without your extra support people:  
  1. Article: How to Set Up your Birth Room (i.e. What Your Doula Would Normally Do!)
  2. Easing Labour Pain: An online 2-hr class this weekend (Sunday at 1:30) that teaches partners how to provide hands-on birth-support, comfort, and decrease labour pain.
  3. If anyone’s looking for online prenatal classes or virtual hospital tours, check out my site. I teach all the sessions live but online so you can ask questions.
Prenatal Care
  • OB / MD offices, ultrasounds etc are not allowing partners/companions to attend appointments. The pregnant person goes in solo. 
  • Some visits might be done over the phone or spaced out a little. Anyone with health concerns, high risk will get the care they need including extra appointments as needed.  
  • Midwifery offices are doing the discussion part of the consult by phone and then a quick in-person appointment for the hands-on part. They prefer pregnant patients attend alone but will allow partners. No other family members/friends/support are allowed.
  • Anyone under midwifery or GP care who tests positive for C-19 at any point in their pregnant, birth or postpartum will be immediately transferred to OB care.
  • If you’re an early-bird you may be asked to wait in your car until your appointment time.
Antenatal Care (Labour, Birth)
The previous section, plus:
  • Hospital is locked-down. No visitors except for compassionate visits (no, meeting a cute new babe does not count).
  • Everyone entering RGH at ER, main entry and 15th St Admitting door will be screened for C-19 risk factors. 
  • Doors that don’t have an admitting desk are locked tight; security will not let anyone in. That includes the convenient door just below the MBU.
  • The bigger Robins/Freshii is closed. The Robins Kiosk at the 14th St entry and the cafeteria are both open.
  • Galleys (the kitchenettes) in the units are closed to patients/support person. Food Services is limiting snack delivery. Bring your own snacks and food!  Maybe a little kettle if you like to make hot drinks. There’s a small fridge in every LBU & MBU room. There is no access to the microwaves, kettles, food, water-ice machines. There is no access to the fridges and freezers, except for the small ones in your room.
  • For everyone’s safety, only ONE support person is allowed for the entire process (labour, birth, postpartum). In other words, whoever attends the birth also stays in MBU. No swapping. The support person should plan to stay for the entire admission.
  • Labouring woman and support person are both screened before entering the LBU. If the support person doesn’t pass screening, they will not be allowed in either unit. An alternate may be invited, who must pass screening and plan to stay for the duration of the admission. If the labouring woman doesn’t pass screening then her and her partner will be put into an isolation room for the birth and postpartum, and not allowed to leave the room.
  • Bring everything you need for the duration of your birth and postpartum stay, including the car-set, when you go in the first time. I recommend you bring your stuff even if you’re just going in for an early labour check in case you are admitted (kept).
  • Early discharge is being offered as an option for those that are healthy and feel comfortable with newborn care.  That means to go home a few hours after your birth instead of staying 24-36 hours.
  • Women getting a cervidil induction will be monitored and then sent home to wait for labour to start, as per usual, then rescreened at RGH doors and LBU doors upon return.
  • People who show up too early in labour will be sent home, as usual, then rescreened at RGH doors and LBU doors upon return.
  • There will be no in-hospital water-birth for midwifery clients. The installed bath-tub is available for comfort in labour.
  • Support people are allowed at homebirths but must be screened. If anyone in the home (residents or support people) doesn’t pass screening, then the birth must be transferred to RGH. In that case, the one support person rule applies. Home birthers – screen your people before they come over!
Screening questions:
1. Have you or anyone in your home been out of the country and returned to Canada prior to March 6th?
2. Have you or anyone in your home been out of the country and returned to Canada March 6th or after?
3. Are you, or someone in your home feeling sick? If yes, what are your symptoms?
4. Have you or anyone in your home been directed to self-isolate? If yes, by who? What date?
 
Postpartum Care
Previous 2 sections, plus:
  • Families are being asked to stay in their room as much as possible. Partners can leave the unit to get food (from the cafeteria or Robins or meet a delivery-person at one of the main doors) but not visit any other patient areas.
  • Partners are not to leave the building during their stay in MBU as this could introduce risk to themselves, their family and other patients. (If you’re a smoker, ask your nurse where to go.)
  • Food trays are still being provided for new moms in the MBU.
  • Midwives and public health nurses are still providing postpartum home-visits. Some may be done by phone or video, depending on your needs.
 
Let’s be respectful of these guidelines and grateful that one support person is invited to the birth and the postpartum stay. Other cities don’t even get that. 
My clients are reporting excellent care in the midst of these restrictions.

Hospital Birth Room Set-up 101

Birth Room
One of the important tasks I do for my clients is to set up their hospital birth room for comfort, safety and efficiency.  Here’s a list of what I take care of I go into a birth room.  In my local hospital the birth rooms all have a small closet, mini-fridge, blanket-warmer, some empty shelves and an adjoining private washroom with a tub. If you’re DIYing then find out ahead of time what your local birth rooms are like and modify as needed.

Doulas and Dads

Although the information here will reassure any partner, this article intentionally addresses dads-to-be. All the quotes, links and videos are made by dads for dads-to-be, about their most common concerns about birth support:  1) Value; why should I pay for a doula if I’m going to be there?  2) Why do we even need a doula; what does she have that I don’t?  3) How will I be included if a doula attends?

Use of Herbs During Pregnancy & Lactation

hers for pregnancy

Herbal medicine is specific category of health-care.  Many herbs, including essential oils, are safe and beneficial during the childbearing year, while others can be dangerous.  Pregnant women must be cautious with any remedies, especially during the first trimester when the fetus is most vulnerable.  There’s a lot of misinformation concerning herbs.  Here are lists of commonly used herbs that are considered safe and unsafe through pregnancy and postpartum.

Here We Go Again: Facts vs Fear-Mongering in Placenta Encapsulation

Placenta capsulesYesterday the CBC posted another article on placenta encapsulation.  The article is low on fact and filled with fear-mongering.  Certainly an article like this should lead service-providers to pay attention to their practices, ask questions, and re-evaluate protocols to ensure safe services are being offered.  An article of this nature should also lead clients to ask questions of their encapsulators.  Unfortunately, when a big media company publishes an article with an inflammatory headline, most people don’t read through, and of those that do, few know how to evaluate the information presented.

Let’s get to the facts.

Exercise During Pregnancy

Birth has been compared to climbing a mountain or completing a marathon.  Being physically fit is an advantage.  Exercise generally improves pregnancy, birth and newborn outcomes for people with normal pregnancies.  There may be a protective factor for gestational diabetes, congenital anomalies, miscarriage, placental problems, intrauterine growth restriction, high blood pressure or fetal death.  Evidence suggests that abnormal heart rates, cord entanglement, and the presence of meconium are significantly reduced.  While there is no increase in premies, there may be fewer postdate gestations.