Pregnancy and Postpartum Questions
Pregnancy and Postpartum Questions
Preeclampsia, VBAC, Elective Inductions, Perennial Massage and more
In this newsletter, we provide you with notes on Ask an OBGYN Anything with Dr. Jennifer Lincoln, an episode of Mommy Labor Nurse.
Hosted by Liesel Teen, a labor and delivery nurse and the creator of Mommy Labor Nurse. She is joined by Dr. Jennifer Lincoln, an OB/GYN whose passion is helping women at birth understand their bodies and feel empowered to advocate for themselves.
Read our notes below.
Topics Covered in this Summary
What is Gestational Hypertension and Preeclampsia?
All About VBACs
Postpartum Complications
Elective Inductions at 39 Weeks
Lactation Consultant in the Hospital
Perennial Massage
Uterine Massage after Childbirth
What is Gestational Hypertension and Preeclampsia?
Both of them are high blood pressure that begins after 20 weeks and not related to anything else.
The difference between gestational hypertension and preocclampsia is that with preclampsia, there's symptoms involved
Preeclampsia, on the other hand, is diagnosed when a woman with gestational hypertension also has an increase in protein in her urine. This condition needs to be treated by a healthcare provider.
The difference between gestational hypertension and preeclampsia is that with preeclampsia, there are symptoms involved, such as headaches, blurry vision, right-side abdominal pain, and sudden swelling of the face, hands, or feet. It typically goes away after your baby is delivered.
It can be a scary diagnosis, but this is something common. We see it in 2 to 8% of pregnancies, but that doesn't mean you can't have a healthy baby and mother.
All About VBACs
VBAC is vaginal birth after cesarean. In order to do it safely, you have to have an in house OBGYN, an in house anesthesiologist, and the ability to do an emergency delivery (due to the 1% risk of uterine rupture). Not all hospitals are able to provide this.
There's a really cool calculator out there to help you kind of see where you fall in terms of potential success to help give you an informed decision. Speak to your healthcare provider if you would like to consider this option.
Postpartum Complications
All women need postpartum care after giving birth. Your body goes through lots of changes after giving birth, and it needs time to heal. It’s normal to feel some discomfort in the weeks after you give birth, whether vaginally or through a C-section.
Postpartum symptoms to watch out for:
Heavy bleeding, like soaking through more than one pad in an hour or noticing large blood clots
Chest pain
Dizziness
Trouble breathing or shortness of breath
An incision that isn’t healing
Swelling or hardness in breasts
Postpartum depression or anxiety
Always contact your healthcare provider if you feel something isn’t right.
Elective Inductions at 39 Weeks
Elective Inductions: Induction which is there's no reason other than you want to have one.
There has been a lot in the press the past couple of years after the Arrive Trial, which said that inductions at 39 weeks were associated with decreased risk of C section (22% to 19%). It did decrease the chance of issues that you would expect to see if somebody stays pregnant longer, like preclampsia, etc, which is not the result of the induction itself.
When deciding if this is an appropriate route for yourself, it’s important to talk to your healthcare provider about the pros and cons. Either way, it is important to note that inductions are not good or bad. It just depends on the scenario.
Lactation Consultant in the Hospital
How to get the Most out of Your time with a Lactation Consultant in the Hospital:
Ask how much time you have with them (so that you know what you need to absorb now or if you can ask questions later)
Raise concerns you may have (e.g. latch)
Take videos (e.g of the latch, so that you can watch a later date)
Ask for recommendations for lactation consultants in the area should you require additional help once you get home
Perennial Massage
Massaging of the perennial area while pregnant to decrease the risk and/ or degree of tearing during birth.
There is some, however, not strong, evidence to suggest this. For the most part, it's one of those things where Dr. Jennifer Lincoln tells people that if you want to do it, have at it, it's not going to cause any harm.
Uterine Massage after Childbirth
A Uterine (fundal) massage is done after you've given birth where the healthcare provider pushes down on the top of your uterus with a goal that we're helping it contract down.
Why is it important after childbirth?
After delivery of the baby, it is important for the uterine muscle to continue to contract to prevent any excessive bleeding. Sometimes, the uterus does need a little help.
Interesting fact: breast crawl is the concept that if you put your baby right up on their skin to skin, that if babies are left alone they will crawl up to the breast because they can see that areola (that contrast between dark and light). And when they're crawling up they're actually doing uterine massage with their feet. Like we were actually designed to have this done by our babies.
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Listen to the original episode