Learn the 5 surefire signs that you’re in labor.

Moms can’t always tell when labor is starting. Without tangible proof, the signs of labor are easily misinterpreted:  Is that liquid from my water bag, or is it pregnancy incontinence?  Is that gas, or am I really contracting?

To help you figure out when you really need to get to the hospital, check out these cues.

Your water breaks

Look out! Delivery could be right around the corner.  Although it doesn’t always happen, in some cases, this is the first sign that   labor is about to start. Whether it comes out in a gush or a trickle, notify your doctor or midwife. Eighty percent of women spontaneously go into labor within 12 hours after their water breaks. And those who don’t are likely to be induced because the risk of infection increases once the amniotic sac has ruptured. 

Contractions are strong and regular

Many women are fooled by Braxton Hicks contractions in the last few weeks of pregnancy. Unlike these “practice contractions,”  real labor pains do not abate until delivery.  Typically, they get more intense and and have shorter intervals in between as time  passes. That crampy feeling you started out with will progress from ten to eight to five to three minutes apart. 

You pass your mucus plug or notice “bloody show.”

You may pass your mucus plug — the small amount of thickened mucus that has sealed your cervical canal during pregnancy and  protected your baby from infection— as your cervix dilates and you progress towards labor.  The plug may come out in a lump or  as increased vaginal discharge for several days. The mucus may be tinged with brown, pink, or red blood, which is why it’s  referred to as “bloody show.” But sex or a vaginal exam can cause the bloody show, too, even when labor is still days away.

Loose Bowels

During the early part of labor, your body begins to release prostaglandins, a group of hormonelike substances that cause the  uterus to contract and help soften and dilate the cervix. But prostaglandins can also hyperstimulate the bowels, causing frequent  stools or even diarrhea.

Back Pains

These are not the usual back pains experienced by all pregnant women.  The day the pain becomes extremely harsh, this can be a  sign that you’re experiencing “back labor.” ”Most of the time, you’ll feel those contractions as a tight band that starts in your  back and radiates across the front of your belly,” says Kay Johnson, a certified nurse-midwife in Atlanta.

Take care of yourself so you can take good care of your baby.

Having a new baby is a joyous life-changing event, true. But life changes often come with difficult transitions as well — childbirth in particular. Becoming a new mother can be overwhelming. Suddenly you have a demanding little person to take care of, you’re exhausted, your body has been battered by delivery, you’re struggling with breast feeding — add to that a few other life matters that need your attention.

Hormones are also still in flux so all these factors contribute to the baby blues that many new mothers experience. What’s the best way to ride it out? How do you know if it’s already post-partum depression?

If you just gave birth your emotional state can vary widely. One minute you feel overwhelmed and anxious, then weepy with happiness, and then, out of nowhere, resentful your partner is at work and you’re stuck at home.

These mood swings are expected. However, many women report being overwhelmingly sad. Some even feel a sense of disconnect with the baby or fear of what lies ahead. These feelings are also normal, but should be watched closely in case a more serious depression develops.

Kicking The Baby Blues

Your body is still recovering from the sudden drop in hormones, and there are still lifestyle upheavals to get a grasp on. Maybe motherhood is not the romanticized image in your head or perhaps you still don’t feel a connection with your baby. Maybe you can’t stand looking at your body in the mirror. Whatever it is, try these tips to lift your spirits:

Get some fresh air. Even if it’s just to run to the store or take a walk, taking in fresh air and taking a break from the mundane routine of diapers and feedings will help you clear your head.

Get dressed. Ah, the things you once took for granted! It will get easier, but yes, the long, hot shower will be more of a luxury during the first few of weeks. But you must find a way to clean up, even – gasp! – put on some makeup and fresh clothes that aren’t stained with spit up. This can help make you feel human once again.

Get help. Have your mother, mother-in-law, sister – someone! – come over, if not to help, then to just keep you company. Being isolated mothering a newborn can get you down. Just having someone to talk to and laugh with can do wonders for your mood.

Most moms shed the blues in a couple of weeks, but if your sadness persists, call your doctor. Postpartum depression (PPD) affects about 15 percent of women. Sometimes it sets in right after delivery, but it can take months or even a year to occur for other women. Due to fluctuating hormones and lifestyle stress, anyone is susceptible to PPD, but you’re at risk if you:

• Suffered from depression in the past
• Have severe PMS
• Have a family history of depression
• Felt sad and depressed during the pregnancy
• Had a complicated labor and/or delivery
• Have a sick baby

If you feel you’re at risk, talk to your doctor about taking preventative measures. Signs it could be postpartum depression, not just baby blues, include:

• Loss of appetite
• Long crying spells
• Feeling hopeless or out of control
• Fear of touching the baby
• Little or no concern about your appearance
• Inability to sleep or excessive sleep
• Disturbing thoughts that scare you

If your symptoms last for more than two weeks, talk to your doctor about your options. There is hope for you. PPD has treatments that are safe for breastfed infants.

Seven months into my pregnancy, after much reading and consulting with my doctor, I had a clear idea of how I wanted my delivery to go. It’s the same for most pregnant women. By this time, some have already decided they want a natural, drug-free birth; others sign up for an epidural vaginal birth; or there are women who just want a c-section.

The choice is yours, but it’s important you make it clear to your hospital and medical team or your midwife how you really hope your delivery will go. This is where a birth plan will come in. Trust me, in the throes of labor and delivery you don’t want to be answering too many questions. Your birth plan should be there for everyone’s reference.

A birth plan is a written document that outlines how you want your delivery carried out. From pain-relief methods to delivery positions to the number of support people, your options and preferences should be stated in your birth plan. Your doctor or midwife should be able to help you think of all possible options that you may want included.

You may, for instance, put down that you want your husband with you throughout the delivery. I had this in my own birth plans, along with having my babies on my chest right after delivery so I could make them latch onto my breast as soon as possible. I had also specified no water or any formula feeding for them during our entire hospital stay.

Dr. Patricia Rodriguez, obstetrician gynecologist at Northwest Hospital in Seattle says that about 80 percent of her patients write birth plans. “The process gives them a chance to clarify which aspects of childbirth are important to them, and it helps me better understand my patients,” says Dr. Rodriguez.

A good format for the document would be no longer than one or two pages. You can type it up or hand-write it legibly. Organize your thoughts into a concise bullet-point format.  Start with what’s most important to you.

Now, a birth plan is not going to guarantee a perfect delivery. You should be open to the possibility that on the big day itself, some parts of your plan may be impossible to execute. Labor can be unpredictable. It’s a plan, not a contract. For instance, you can’t get hostile if you are not allowed to hold your baby right away in case there was a complication. You may even have planned for an all-natural, no medication birth, but if your baby was struggling with a chord coil or the heartbeat isn’t normal, doctors may just have to give you a c-section.

A good birth plan shouldn’t just be a list of demands. It should be written with warmth and should have some details to convey who you are. The medical staff who reads such a birth plan will tend to be more sympathetic and undertanding. For instance, you can add such details as “it took us 5 years to get pregnant so use every bit of technology you need to to make sure our baby is born healthy.”

Finally, go over your birth plan with your husband. You are a team. It’s possible your husband way want a very medicated birth but you opt for going all-natural, no meds at all. Negotiate your terms, come up with a compromise and write up a plan that you have mutually agreed on.

Yes, labor can offer surprises and it may not always go exactly as planned. Still, you can always hope for the best. Besides, we make to-do lists to plan a regular day, why not make one for one of the biggest day you have ahead?

Doctors are easing up and letting women in labor have a sip or two.

The standard protocol for years in maternity wards has been no food or water for women in labor. The best thing you can get after hours of panting and sweating trying to get your baby out would be a few ice chips or sucking on wet wash cloths. Well, doctors say the practice may be outdated. Read on and make sure you know what this is all about before you write down your birth plan.

Drinks and food have long been banned during labor to prevent Mendelson’s syndrome. The conditions occur when stomach contents are drawn into the lungs while someone is under general anesthesia. This is a rare occurrence, but when it does happen it can be fatal.

These days, however, general anesthesia is rarely used during birth. Even c-sections are typically done using regional anesthesia. So the practice of fasting during labor has been called into question. A new medical review published last week by the Cochrane Collaboration says the practice is outdated and unnecessary.

Using 11 studies and covering 3,130 women — medical researchers found no benefit to restricting foods and fluids during labor. Their report says, “given these findings, women should be free to eat and drink in labor, or not, as they wish.

The New York Times reports that some hospitals have already eased up on the no eating or drinking rule during labor. They have lifted the ban on drinking fluids while giving birth late last year, since The American Congress of Obstetricians and Gynecologists issued new guidelines.

Still, some doctors are concerned despite the study’s assertion. The Times quotes obstetrician Dr. William Henry Barth, Jr. who says, “the problem is going to be for emergency c-sections, which are rare but not unheard of… there’s just not time in that setting to stop and do regional anesthesia and it can be unpredictable.”

How a certified labor companion help you through child birth.

If you are expecting, there are a few things you want to plan for during your birth. A major consideration for many pregnant women these days is wether or not they will hire a doula to help them through delivery.

I didn’t use one myself, but from what I have read and heard, doulas are a wonderful help especially for first time mothers or those who plan on having a home birth or natural delivery at the hospital. Curious about wether a doula is for you? Read more to find out.

Doula is the Greek term for women’s servant. It may seem like the doula is a recent phenomenon, but for centuries women have been “serving” fellow mothers during childbirth. Certified labor support companions have been proven to make labor and delivery easier, safer and a much more positive, memorable experience.

Many women report needing fewer medical interventions or less complications with the support of a doula. Studies have shown that when a doula assists a mother in labor, cesarean rates decrease by 50 percent, length of labor by 25 percent, the use of oxytocin by 40 percent, epidurals requests by 60 percent, forceps delivery by 40 percent. That’s a lot!

Labor companions achieve this by giving emotional support to women and helping them understand more about the natural birth process. They also use massage or touch therapy to reduce stress and anxiety during labor. When properly executed, massage can stimulate the pituitary gland to secrete natural oxytocin. When oxytocin flows into the bloodstream it promotes uterine contractions and secretes into the brain – inducing drowsiness, higher pain threshold and a sense of well-being. The magic of hormones!

Synthetic oxytocin IV (also known as pitocin) only helps with the contractions, as it does not give women that “natural high” from natural oxytocin. Many women report that oxytocin IV makes contraction more painful and harder to bear .

If you decide to get a doula, you should choose one a few months before the birth. It’s likely you will have to meet a few candidates before the big day, so look around early. Most doulas do not charge for initial consultations. You’re not just looking for qualifications, you have to find someone you trust and who you are comfortable with, so this may take some time.

Questions to ask include:

• What are her qualifications? What training has she had?
• How many years of experience? How many births assisted?
• How much does she charge?
• What is her child birth philosophy?
• Can she give references?
• What happens when she cannot make it to your time of birth?

You should also ask other mothers you know for referrals. And here are some books you might want to pick up:

• Mothering the Mother: How a Doula can help you have a shorter, easier and healthier Birth by Marshall H. Klaus, Phyllis H. Klaus, and John Kennell.
• The Doula Book by Marshall H. Klaus, John Kennell, and Phyllis H. Klaus.
• The Doula Advantage by Rachel Gurevich.

You can contact the Doulas of North America (DONA) or the Childbirth and Postpartum Professional Association (CAPPA) for good leads.

So what’s to expect – in the bedroom – when you’re expecting?

Even with that growing belly occupying more space, there should be room for romance. Sex during most pregnancies is safe. On top of that, those extra hormones can even give your sex life a boost. Multiple orgasms anyone? It’s a hot topic, and questions about sex and pregnancy abound. We have the answers… uncensored!

Is it really okay to have sex? My husband thinks he might hurt the baby.

If your doctor has determined no pregnancy complications, you can continue to have an active sex life. A penis won’t harm or traumatize the fetus. No matter how well-endowed, it won’t even reach your uterus! Your husband also can’t break your water bag. Thrusting motions will not disturb your little bun. These are all common misconceptions.

If you notice some bleeding after sex, consult your doctor as soon as possible. But do note that pregnancy increases blood flow in the cervix and sometimes this can cause light spotting after intercourse.

When should sex be avoided?

Here are some typical reasons why doctors will advice a pregnant woman not to have sex:

• a history of premature birth or labor;
• placenta previa – when the placenta is covering the cervix;
• when there is spotting (blood on your underwear) and a cause has yet to be determined;
• when the mother or her partner have a sexually-transmitted disease.

How about oral sex and masturbation?

If your doctor says you’re okay to have intercourse, you’re clear for oral sex and masturbation. You should skip cunnilingus  if your husband has a mouth sore – it might be the herpes virus. He should also avoid the blowing-into-the vagina move. This can lead to an air embolism. Women are more prone to this when pregnant since blood circulation is stronger in the cervix.

I found out we were pregnant a month ago. My friends say sex was good when they were pregnant. Not for me. I’m tired most of the time and I feel fat. What’s wrong?

In the first 3 months of pregnancy, most women face nausea, dizziness and fatigue. You are dealing with major changes inside and outside your body. It’s common to feel overwhelmed and not-in-the-mood. But there’s good news from Lou Paget, author of Hot Mamas: The Ultimate Guide to Staying Sexy Throughout Your Pregnancy and the Months Beyond, “Once you hit your second trimester, the nausea lifts and estrogen kicks in, which jump-starts your sex drive.” This is the time your friends were talking about. Many women say it’s during pregnancy when they experience multiple orgasms. Un-orgasmic women suddenly turn orgasmic. If you’re not there yet, your husband should understand that kissing and cuddling is all you can handle, for now.

My big belly makes our favorite position feel awkward. Any suggestions?

Here’s where you can get creative, maybe even kinkier than usual. The missionary position may not be ideal with your big belly. Besides, women should not be lying on their backs when their stomachs are already heavy. There are other options. Try woman-on-top, side-lying, spooning with rear-entry, or get on your hands and knees. Enjoy experimenting to see what works for you. You may end up having new favorite positions!

Talk About It

It’s important to communicate with your husband and make him understand what you’re going through. Same goes for him. You are about to have a child, your life – sex life included – is about to change. It doesn’t have to be for worse. Sometimes the bedroom acrobatics may stall, but when it revs up again, it could be for the better!

I’m going to be a super big brother!

Mom and dad are usually caught up with preparations for the new baby. Parents may even be overwhelmed. But don’t forget, future big brother or big sister is going to face major changes too. There are a few things we can do to help them along this major transition.

News of my being pregnant with Baby No. 2 came as a surprise. Dad-to-be was ecstatic. But in my case, the unexpected development threw me off. Baby No. 1 wasn’t even 2-years-old yet… here we go again! Maybe hormones were already to blame, but tears were shed and some anxiety set in.

I realize that I was most anxious because of my first child. How would he handle sharing all our love and attention with a sibling? I turned to books and google for advice. I learned a few things and eventually embraced pregnancy no. 2 along with soon to be big brother.

First, realize that it is common for an older sibling to feel jealous of a new baby. They can act up in reaction to changes at home brought about by the coming of a new family member. To ease this transition, make your older child part of the preparations. Talk about coming changes and make them something to look forward to. Here are a few things that helped us:

Read toddler-appropriate books about becoming a big sibling. My son loved Best Ever Big Brother by Karen Katz (there’s a Big Sister version) and The New Baby by Fred Rogers. These books showed him what to expect and how to deal with the changes positively. The Mr. Rogers’ book was great, because it acknowledged that part of the experience may be difficult, but for the most part being a big brother can be fulfilling.

Talk to your child about the experience and make it relevant to his life. We showed him his old baby pictures and told him about how we prepared for his birth – just like we’re doing for his sister now. We told him that his little sister will also be born in the hospital like him and she would have to breast feed like he used to. I remember telling him that with him around there would be another person to help in taking care of the baby. This seemed to make him feel important… and relevant to our new family situation.

Visit friends with babies. Taking him over to a friend’s home who had just given birth to twins got him excited about having a new addition to our own brood. On a practical level, there’s nothing like showing a real, actual newborn. The twins would also visit us at home and we’d even let him “carry” them to practice for his little sister.

Get them involved. We made him help pack the baby’s clothes for the hospital. I took him to the toy store to pick out a welcome gift – a teddy bear he was to give her for their first meeting. Then I got him to choose his own new toy – a token of appreciation for being so helpful in preparing for the new baby.

Stick to routines. As much as possible, we worked to keep a sense of normalcy. It’s always a good idea to stick to your toddler’s daily routine as much as possible, but this sense of security becomes even more important during times of transition. Sticking to regular bedtime, story telling, playing and eating schedules can go a long way in making them feel that “there’s another baby coming, but this is still the home I know.”

All in the Family

Now, you will even see sibling prep classes along with birthing classes. This may help you as well. Again, it’s all about making your big sibling part of the family – and not left out by the baby.

When the younger one finally came, I took time off from baby care to have “dates” with my son. Just him and I in his favorite pancake house. Sometimes it would just be him and his Dad. Just to let him know he can still get our undivided attention.

At home, we would let him hold her and gently make her go up and down on her bouncy chair. He also loved getting down on the floor with her on her play mat.  Almost 4 years later, brother and sister enjoy each other’s company – at least most of the time. The siblings do love each other, though there are days when sibling rivalry rears itself…. Now that’s something for a future post!

Another pregnancy Rx… get active!

Doctors should add another prescription for expectant mothers – exercise. Most MDs don’t seem to emphasize it enough, but active moms are healthier and happier, so are their babies. According to a report in this year’s August issue of the Journal of the American Academy of Orthopedic Surgeons (JAAOS), physicians and mid-wives should be advising their pregnant patients to engage in low to moderate exercise.

Even if the expectant mother has not exercised prior to her pregnancy, now would be a good time to start – just as any. Read on to find out why, and what the best exercises are for moms-to-be.

Many doctors even advice women to “take it easy” while they’re pregnant “just to be on the safe side.” Some physicians still hold on to the old belief that physical activity  can hurt a pregnant woman and her fetus. New medical findings already disprove this. There are only a few medical cases that will call for pregnant women to skip their work-outs. Experience also accounts for healthy, full-term pregnancies that include a healthy regular dose of exercise.

According to the review article published in JAAOS, aerobic exercise, impact and non-impact activities, resistance training and swimming can help with:

• lowering maternal blood pressure;
• lowering glucose levels;
• reducing pregnancy-related swelling;
• easing lower-back and other musculoskeletal pain;
• and improving hormonal mood swings.

Active pregnancies are also linked to easier labor and deliveries with less complications. This not only benefits mothers, but helps newborn health outcomes as well.

Study author Dr. Marlene DeMaio says women who did not exercise regularly before becoming pregnant should not be discouraged – or have an excuse not to exercise. ”When a woman becomes pregnant, she often re-evaluates her lifestyle. She is motivated in a new way to deliver a healthy baby, and be healthy herself,” explains Dr. DeMaio.

If you are pregnant and have not been exercising regularly before, you can start a more active lifestyle. Just begin with low impact activities such as walking or swimming. Even prenatal yoga classes or light weights can do you good.

It is best to be under the guidance of a fitness professional, especially if you were not very active before. Consult with your doctor to make sure you do not have a pregnancy condition that can be aggravated by exercise. Otherwise, most normal pregnancies can have – or rather, should have – exercise as part of the daily routine.

And remember that they recommend low to moderate exercise. The goal is to adapt fitness to your current state of health, along with the stage of your pregnancy. For example, long-time runners can switch to running in a swimming pool later in their pregnancy when it is harder to take road impact with a heavier belly.

Caring for a baby is a physical and emotional feat. Might as well get physically fit to take on the challenge. Those exercise endorphins should also be good for you. Happy mommies make happy babies!