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Friday
Jul282006

Word Search - Random Questions & Answers

Folks coming to my site from Google use the most interesting keywords. In the interest of answering the keywords, here is the search criteria and then my answer.

- how to know that stripping membrane was successful

Because you go into labor within a few hours to a couple of days.

- how can i make my own subway sandwiches

Since I once worked at Subway, let me share what I know. Buy a great roll in the size and type you prefer. Layer the different meats and cheeses you want (but be careful not to put too much on! Weigh it if you are worried about giving yourself too much). The choices of toppings include onions, lettuce, tomatoes, pickles (dill), green peppers, banana peppers, salt, pepper, oil & vinegar, mayonnaise, mustard, Ranch, dijon mustard, and more. There really is no secret to a Subway sandwich. They use regular mayonnaise in the tuna and seafood salads, they use regular cheeses that you'd find in the supermarket. The oil and vinegar is just regular ol' canola oil and red wine vinegar.

The thing about Subway making your subs instead of you is the work involved! They shop, bake, slice, and assemble. And then charge you for it.

(HOW did this search find its way to my blog?!?)

- anterior cervix

This is when the cervix is forward in the vagina. If you have a vaginal exam, an anterior cervix is easy to find. Some women have anterior cervices as a matter of course and some pregnant women don't have an anterior cervix until well into labor. The baby's head pressing down can bring the cervix forward.

- posterior cervix

This is when the cervix is facing back towards a woman's lower spine instead of forward towards her pubic bone. It is absolutely normal to have a posterior cervix. It can take hours of labor or a lot of pressure from the baby's head to pull some cervices from posterior to anterior. A posterior cervix is absolutely normal during pregnancy and even in early labor.

- her breasts flopped around inside the large tee shirt

No comment

- chamomile vs manzanilla

These are the same thing. The first in English, the second in Spanish.

- how quick can my cervix ripen

Oh, you'll hate this answer!

It depends.

It depends on so many factors, there is simply no way to say. Plus, ripening is on a continuum as opposed to a today-I'm-not-ripe-and-tomorrow-I-will-be sort of way.

If you are being given medications to ripen your cervix, it will happen a whole lot faster. That isn't necessarily a good thing.

- reasons sluggish fetal movement

I hope your baby has woken up by now. Sluggish fetal movements, especially since you are noticing the difference from before, should be reported to your care provider (if you have one). If you don't have a provider, you might consider getting checked out anyway.

When a mom calls me telling me the baby is really slowing down or hasn't moved in awhile, the first thing I do is have her drink something with sugar and/or caffeine. A full-sugar soda, a cup of coffee or some juice can perk up a sleepy baby, giving you the piece/peace of mind you were looking for. Some midwives suggest ice cold water... a full glass... but I tend to jump to the big guns of sugar and caffeine.

As I tell mom to drink these things, I am getting my butt in the car to get to her so I can listen to the baby. If the mom is too far away, I will send her to the hospital. Better to be embarrassed that everything is fine and dandy than to have a baby in trouble and not do anything about it.

- how soon can you do a scheduled c section

It is really important to wait until the baby is ready to be born. If there is a true medical reason to have a cesarean before that, an amniocentesis can be done to see if the baby's lungs are mature enough for birth. Most doctors would say anytime after 36-37 weeks of pregnancy. Other OBs wouldn't even consider birth before 38 weeks. I encourage erring on the side of caution.

- what does kelly ripa eat to stay so skinny

Not much.

- soft stretchy cervix thick and posterior

Soft and stretchy? Sure. Thick and posterior? Sure. All of that together? Not likely.

- is polyhydramnios dangerous to my baby

All that extra water isn't typically the issue. A baby floating around in excessive amniotic fluid can have a higher chance of cord entanglement because s/he can do somersaults and such more easily. Cord accidents in general are a concern with polyhydramnios, but most especially if the membranes rupture and the baby is still high in the pelvis. It isn't unusual for the baby to remain high or the cervix to not dilate very efficiently until the membranes have ruptured. The cervix needs pressure from the presenting part in order to do its job.

One other concern is that of malpresentation. If the baby is moving around and the membranes rupture, the baby can fall right into place in a position that isn't optimal for delivery. A transverse position (sideways) is another risk of malpresentation. The more space the baby has, the more gymnastics the kiddo can do.

All that gloomy stuff said, polyhydramnios can signal an anomaly in the baby. Gastrointestinal issues, spinal cord issues and heart defects can all cause polyhydramnios. So do twins and other multiples. Moms with diabetes or insulin resistance issues also can have polyhydramnios. Multiple pregnancies and moms with diabetes are the most common reasons for poly.

Sometimes... some would say more times than not... we never know why there is extra amniotic fluid. If prenatal testing shows your baby is fine and healthy, it is a good sign that you can relax some. Your baby will be checked out at birth to make sure nothing was missed prenatally.

If your water breaks before labor starts, I encourage my moms to lie on their sides until I get there... and if a woman is UCing, to feel inside her vagina for a cord and call 911 if one is found/felt.

By far, most of the babies with polyhydramniotic fluid position themselves just fine and birth perfectly fine. Please remember that part.

- dilating cervix in fingertips

Hmmm. Do you mean manually dilating a cervix? Is there ever a reason to manually dilate a cervix? I'd say yes.

If a woman is 8 centimeters (or 7) and the baby is having a very difficult time, it might behoove the mom and midwife to seriously consider a manual dilation. Sometimes, the cervix will open and allow the baby to be born; sometimes just the knowledge that the baby is in trouble can help the mom cope with the pain of manual dilation.

Let me describe how manual dilation is done.

A standard vaginal exam is done, but the midwife doesn't leave the vagina or even the cervical area. Cervices in labor can feel soft and mushy or stiff and like tight elastic. Much more success will happen with the softer cervices. The midwife does a cervical exam and if she spreads her fingers and is able to touch both sides, she can spread her fingers harder to try and make the cervix open more. This can be really painful to the mom, so she must be warned ahead of time... permission, of course, being given by her first.

The more likely scenario is the mom is beyond the spread finger ability, so the midwife would put her two fingers together and then pull and push the edges of the cervix working to press it backwards. I'm doing the finger movements as I write this, trying to find the right words to describe it. This is a similar scenario to stripping the membranes, but much more aggressively. Some parts might "give" more than others, so working the unforgiving side might take more work than the softer side. The goal is to press the cervix enough that the head is able to come through it, keeping it completely dilated all on its own. I'm not sure this is a sufficient description.

So, all that said, it is absolutely inappropriate to try and dilate a cervix just because a woman (or midwife!!!!) is impatient or because someone has a time-clock running. I don't think I have ever seen it done in a hospital, either. I've only seen out-of-hospital midwives (both CNMs and LMs alike) do manual dilation. Doesn't mean it should be a matter of course, however. I believe it should be reserved for when a baby needs to get out NOW and the ambulance is on the way. Pretty serious stuff.

- do not want a vaginal exam during delivery

Tell anyone who comes towards you with gloves, "No!" Keep your legs together. Keep your undies on. Don't be coerced into allowing "just one". It might not work so well with street drugs, but it can work with vaginal exams - JUST SAY NO!

Well, that ends tonight's session of Word Search. I hope everyone learned something!

Reader Comments (6)

My doula tells a harrowing tale of an OB doing a brutal manual dilation of a cervix on one of her mamas during a pretty unsuccessful induction. Mama screaming 'stop!' and the physician holding her down with the other hand.
If that's not birth rape I don't know what is. Doula and mama pretty significantly traumatized by that little maneuver. Good to know though, that with permission this may occasionally be indicated.

July 29, 2006 | Unregistered CommenterLouisa

i had manual dilation during an attempted homebirth after 59 hours of labor and still at 6. it was definitely the most harrowing part of my labor (until i got to the hospital that is, haha). it did dilate me another centimeter but in retrospect it wasn't worth it. but at least i know i tried everything.

July 29, 2006 | Unregistered CommenterChandelle'

actually the searcher is probably wondering how many fingertips = how many centimeters dialation...

I can not imagine having my cervix manually dialted.8-O

July 31, 2006 | Unregistered CommenterBabylady

Looking for some input..
I am 39 wks into my pregnancy andn just found out that i have an anterior cervix. What exactly is this?
I have been one cm dialaited for the past 3 wks. And today my ob tells me that I will likely have to get a c-section. He says that my baby is not very big, but will be too big for me to deliver naturally.
Is this common? Should I be worried? what is the cause of the anterior cervix?

February 15, 2007 | Unregistered CommenterSarah bear

An anterior cervix just means the cervix is right in the front of the vagina... not right or wrong, just in the front. Anterior cervices are more likely to be closer to delivery than posterior cervices.

Being one cm for 3 weeks isn't unusual at all and it is RIDICULOUS for a doctor to tell you you will need a cesarean because of the baby's size when you haven't even been in labor. I HATE HATE HATE when doctors say that crap. It is fucking ridiculous. (Excuse my language.) The baby's head moulds and folds over and your pelvis is not concrete - it also moves... shifts... the baby's head will shift with the pelvis and as you remain mobile in labor, you and the baby "dance" with each other... neither of your bones is a solid at all... you are both much more of a liquid.

Why, why, when they know this do they set you up for failure by telling you before you even start labor that you will need a cesarean? It is so ridiculous there are really no words to describe it.

Your body is working perfectly.

See if you can find another care provider. Find someone who believes in you and your body. It isn't too late until the baby is coming out.

TELL YOUR DOCTOR NO when he says he wants to cut you because your baby is too big.

*sigh*

Much good luck to you.

February 16, 2007 | Unregistered CommenterNavelgazing Midwife

I had been in labor for about 36 hours when my dr. decided a manual dilation was required- even though I had only dialated to about 4-5cm. They had to peel me off the ceiling I was in so much pain afterwards. The funny part was that she said "this may sting a little bit..." right before she shredded my womb. Afterwards, my cervix swelled shut and I had to have a c-sect. Before the manual dilation, I was content to keep laboring since the baby was ok, but was preassured to think there was an abnormality. I gave birth in a private hospital in China, and the doctor told me this is a normal process before they do an unscheduled c-sect so they can say they "did their best" for a vaginal delivery. After that procedure, any chances of a natural delivery were gone.

I'm only now beginning to research the whole process to see what that doctor did is not typical. Reading your thoughts on it has clarified a lot for me. Thanks for having these keywords easily accessible by the search engines~

February 27, 2007 | Unregistered CommenterMelanie

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