Wonderfully Made

Labor And Delivery

Three Angels Broadcasting Network

Program transcript

Participants: Amy Wellard, Cherie Lon Fernandez

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Series Code: WM

Program Code: WM000443


00:34 Welcome to "Wonderfully Made"
00:35 I'm Amy Wellard with the Wildwood Lifestyle Center
00:38 and today we're talking about
00:40 labor and delivery of your precious baby.
00:43 With me in the studio is Dr. Cherie Lou Fernandez
00:46 Welcome Dr. Cherie Lou Thank you
00:48 It's an exciting time, isn't it?
00:50 The baby is about to come...
00:52 You've got mixed feelings of perhaps a little fear
00:55 and trepidation about what could happen
00:57 because the unpredictable is possible.
01:00 So what are the BEST ways to prepare yourself for the birth?
01:03 Always preparation comes BEFORE, not just on the event, per se
01:10 So it is very important for you to think who you are going to
01:14 trust to deliver your baby, and not only on time,
01:18 but you would have thought about it even previous
01:20 when you were going to have your prenatal checkups
01:23 and everything and follow-ups.
01:25 You would have already then have chosen who is
01:27 supposed to deliver your baby...
01:29 Whether you would want a doctor to deliver your baby
01:35 or a nurse midwife or a midwife or a doula or whatever,
01:39 you would be thinking of this already in advance.
01:42 It's very important because you need to have a BOND
01:45 with the person who is going to deliver your baby.
01:48 You have to TRUST, learn to trust...
01:50 Trust doesn't just come like split second, you know,
01:53 it has to be developed.
01:55 So you have to choose the person
01:57 you are going to put your trust in.
01:59 And it's important, as well, that that health care provider
02:03 knows your history so they know what
02:04 possible complications could arise... Yes
02:07 And what are the different options in front of the
02:09 pregnant lady in terms of hospital, birthing center...
02:12 What's the difference between those?
02:14 Oh, there is a lot of things going around like
02:17 home births versus birthing center births,
02:21 versus hospital births.
02:24 Well in the olden days, when the hospitals weren't there yet,
02:29 of course we can say that there were a lot of mortalities
02:34 from delivering at home.
02:35 It's just probably because people didn't know
02:37 how to do delivery well and they didn't have enough
02:41 clean things to use...
02:43 So women were dying from delivery infections, whatever,
02:47 because we just didn't know...
02:49 They just didn't know yet.
02:50 But, midwives doing home deliveries,
02:53 or nurse midwives doing home deliveries now at home,
02:58 they are fairly doing very, very well.
03:02 Delivering at home would really be the best
03:04 because you're delivering under circumstances where
03:07 you are comfortable.
03:10 Your relatives are there, your husband, your mom,
03:13 your dad, your grandfather or grandmother to help you.
03:16 The home setting is the most physiologic, if you would say...
03:21 And I'm sure the mother would have more endorphins as well
03:23 being around her loving husband. Yes, she's comfortable!
03:25 Yeah but then they want to make it a little bit more hybrid
03:29 between the hospital, which is more sterile,
03:31 and everybody is masked and you wear this gown,
03:36 and sometimes the husband is not there or nobody is there at all;
03:40 you are in a labor room or delivery room,
03:43 a very sterile environment;
03:44 then they make a half bid between that...
03:46 they have the birthing centers.
03:48 So you have to see where you would want to be,
03:53 and know the pros and the cons of each of these...
03:58 And if I'm high-risk... I'm probably going to take
04:01 the advice of my doctor to deliver in the hospital?
04:05 The high-risk pregnancies which
04:07 are those 16-year-old and below pregnancies,
04:12 and 36 and above - because the
04:18 15 below does not know what to do.
04:20 The 36 and above usually is sick,
04:23 and all the other medical conditions that might be
04:26 accompanying the pregnancy
04:28 because pregnancies can complicate already
04:31 existing diseases and existing diseases can complicate
04:36 the pregnancy - making it high-risk.
04:38 So definitely - you would choose to stay in an area where
04:45 you're easily rushed to the hospital
04:47 or already in the hospital for high-risk pregnancies.
04:51 It's like you already know you have a problem,
04:53 and you choose to stay in an area where you live
04:57 7 miles or 10 miles away from the hospital -
05:00 that's going to be hard.
05:02 And just a word to our viewers,
05:04 Dr. Cherie Lou is not suggesting that just because you are
05:07 over 36- means you HAVE to have a hospital delivery.
05:10 Of course, there are MANY women that do deliver
05:12 over that age - myself is one of them...
05:15 And you can deliver at home,
05:17 you don't HAVE to go to a hospital... That's right
05:18 So with prayerful consideration, the Lord will guide
05:21 every decision which is very
05:23 exciting and comforting, isn't it? Um hm
05:25 So what are the physical preparations
05:27 that we should make... some of them
05:29 Many women... it comes by in cultures.
05:34 Like for example, MY culture, what I grew up...
05:37 Women are SO sheltered...
05:41 and don't carry this, don't do that...
05:44 You can't bend over, you can't sit this way,
05:47 you can't walk so far and the woman is so restricted
05:52 and she doesn't get enough physical activity
05:55 which is REALLY important.
05:57 Again I say, we go back and say, "pregnancy is not a disease"
06:02 ...therefore, it's NOT supposed to limit your activity.
06:07 If you're a sprinter, if you can still sprint if you're pregnant,
06:11 as long as the pregnancy doesn't get in the way...
06:14 That's just an exaggeration but you know where I'm getting at,
06:18 but exercise is very much important,
06:23 as the pregnancy becomes bigger, as the baby becomes bigger,
06:27 the angle or the curve in your back changes,
06:29 and this causes the muscles in your lower back to go into spasm
06:34 And so, many times this pregnant woman would be complaining of
06:37 lower back pain, so then she could be exercising
06:40 There are exercises... you can go to a lot of books
06:44 that they have for exercising the back
06:48 and the other muscles of your body;
06:50 also exercising to enhance endurance.
06:55 You're going to breathe the biggest breath in your life.
06:59 You are going to PUSH the strongest PUSH in your life.
07:02 You have to learn how to make your chest...
07:06 against this BIG tummy here pressing on your chest...
07:11 You have to learn how to take deep breaths and psych yourself
07:15 I always teach my patients to pretend that the pain is coming,
07:20 the pain is there.
07:21 So as she is exercising, maybe walking,
07:25 and then she imagines in her mind... the pain is coming
07:29 The pain comes every 3 minutes, or every 2-3 minutes,
07:32 then it becomes ooOHH and it build up and it builds up.
07:35 When it starts building up like this,
07:37 you're starting to take deep breaths... okay DEEP breaths,
07:40 and then when it's painful, you take your BIGGEST breath,
07:44 and then hold it.
07:45 Of course, while you're not yet in labor, you don't push.
07:48 But you're fixing your head, it's just like the Lamaze
07:53 or the Bradley thing...
07:54 They TEACH you to... it's like a conditioning.
07:57 If you want to, if you have the means to go to a Lamaze class,
08:01 or a Bradley, it's up to you, but if you don't have the
08:05 means to do it and you would want to do it at home,
08:09 you could always teach yourself.
08:11 Again, always refer back to the times when,
08:15 even at present when we have those people in the tribes.
08:19 I think the important think is
08:21 that you're psychologically prepared in every way,
08:25 and let's talk about fear because
08:26 fear can be such a giant as you go especially
08:30 for the first-time mom.
08:31 You're going into labor, you really don't know
08:33 what to expect because you realize anything could happen
08:35 because the books tell you, really, anything CAN happen.
08:38 So how can we prepare to face that one?
08:41 The most... I mean at least for me, I wasn't afraid
08:45 WHAT my baby would become.
08:49 Maybe some people would say -
08:50 "What if my baby is abnormal," whatever, etcetera...
08:53 I didn't think about those things.
08:55 ...You know, I didn't think, but what was really
08:58 in my heart was...
09:00 "It's going to be painful, it's really going to be painful,
09:03 it's going to be painful" because you see
09:04 I deliver all the time and I see these screaming
09:08 and writhing women, you know, because they're not prepared...
09:11 But then so, you have to understand that this pain is
09:16 necessary.
09:18 It is NOT an enemy; it is supposed to be your friend
09:23 When it comes - because without the pain, you won't deliver.
09:29 It's a Bible verse - "In pain you will bring forth
09:34 this offspring you have. "
09:36 So there is a pain, but it is helpful.
09:39 Without the pain, you won't deliver.
09:40 So, it's something that you have to fix your mind and accept
09:45 because when you are ready to accept something,
09:47 it comes faster, easier.
09:50 Now you're not saying that it would be wrong to take any
09:53 intervention so we don't feel the pain.
09:55 You're just saying the pain there is an indicator that
09:57 this is a natural part of the process,
09:59 and working with the pain enables you to
10:02 work with your body rather than fighting it...
10:04 Because if we actually go into fear over the pain,
10:06 the contractions can actually stop because of fear,
10:10 and that has been known to happen.
10:11 Many women just go ahead and have their,
10:14 what-you-call "the epidural"
10:16 They put the catheter into your back and then they
10:19 inject pain anesthesia so that you don't feel the pain
10:22 or you sort of are numbed, you can't feel the pain.
10:27 The thing is... there are statistics that will tell you
10:30 that people with epidurals have problems
10:33 in delivering their babies.
10:35 Many times it becomes a C-section,
10:37 an operative procedure that happens because
10:40 the woman can't push enough...
10:42 Because, you see, the pain is the one that makes you PUSH!
10:48 You know, when you have this
10:50 thing when you're moving your bowels,
10:52 and there is this thing there, you HAVE to push,
10:55 but this is MUCH BIGGER than your bowels.
10:58 And so, you need EXTRA triggering thing to
11:03 MOTIVATE you to push. Right
11:05 It's the pain that makes you push;
11:07 without the pain, you won't push.
11:09 So that would mean that with an epidural,
11:11 you might need some kind of inducing drug to make you...
11:14 Yes and somebody has to help you really PUSH it
11:17 with more than you would regularly think you should push.
11:22 Okay, so let's go back to the signs of labor.
11:25 I used to hear stories of women walking around the supermarket
11:29 and their waters break, suddenly they are
11:30 standing in a pool of water in an embarrassing public setting.
11:33 Is that really the first sign of labor?
11:35 That's funny because we have been so much affected
11:39 by the media... not that the media is wrong,
11:43 but we go and watch movies and you see a woman
11:46 ..."Hey honey, my BACK" and she's rushed to the hospital
11:51 and in minutes she delivers!
11:52 It's not regulated that way.
11:55 There is a process...
11:57 Of course there are some women
11:58 who just deliver... they're blessed!
12:02 But that is the exception to the rule.
12:05 I have seen patients and I have had patients who
12:08 just when they think about it, it's there.
12:11 I had a close friend who would only know she was in labor
12:14 because her baby was there already.
12:16 She didn't have any pain!
12:20 Most of us would want it that way!
12:22 Not with her.. but it doesn't happen that way.
12:25 There are steps that will prompt you to know
12:29 that you're going to deliver and it's about time.
12:34 Okay, so let's talk about that...
12:35 What would be something I can look for...
12:37 I'm 40 weeks, nothing has happened and then boom...
12:40 Okay, oh - WHAT?
12:43 You're delivering right away now!
12:44 Again, I will say it varies the process.
12:48 But you won't regularly... if we'll say, this is a
12:51 normal delivery, of course you can deliver before term...
12:55 Term means the 37th to the 42nd week,
13:03 and the average is 40 weeks.
13:05 So from 37 weeks of your pregnancy
13:07 to 42 weeks of your pregnancy - that you call "term"
13:11 If you deliver before that, that's premature,
13:14 and if you deliver after 42, that is post-mature, okay?
13:20 You would want to deliver...
13:21 Let's say - we're not talking about abnormalities,
13:23 so let's say from 37 to 42...
13:26 You will know what... You see the saying in the Bible
13:29 "... Like a thief, it comes in the night"
13:33 Your delivery of the baby is ... will come like
13:36 a woman in labor... like a thief in the night.
13:38 You don't know when it's going to come.
13:41 But again it says that you don't need to be ignorant
13:45 about when I'm going to come
13:46 because I have signs and symptoms around.
13:49 We will see the signs.
13:51 Well there are signs, the first one is
13:53 not necessarily the first one but one of them is
13:57 "lightening"
13:59 Many women would say,
14:01 "I felt my uterus go down"
14:03 It's like the head of the baby now has finally entered
14:08 the pelvic cavity.
14:10 The head is usually is floating above your pelvic brim.
14:14 Lightening means the head enters the brim...
14:18 so that when your uterus was high this way, now it goes down.
14:22 So when you have that, you can be sure that labor
14:25 is coming soon because the head is now PINCHING on your
14:28 lower uterine segment and your cervix,
14:31 and then now it's going to start
14:33 to mature and cause labor to come.
14:37 So actually, that now you mention that,
14:40 I don't remember that happening with me,
14:42 so that can happen without you
14:43 being aware of it... is that right?
14:44 Yes, many are aware but if you didn't know about it,
14:50 maybe you wouldn't notice it
14:52 because it is just something that - it goes down.
14:56 It has to before it can come out. Yes
14:58 Because the head has to go into the pelvic cavity;
15:01 however, this happens the majority of the time
15:04 ONLY in primigravid, first pregnancy.
15:09 First pregnancy, the head of the
15:11 baby will go into the pelvic cavity before you go into labor.
15:15 For multigravid or women who have delivered before.. already,
15:20 the head is usually floating until the cervix is opened
15:24 fully before the head comes down.
15:26 Anyway, primigravid - the head comes down.
15:29 Okay, so what other signs?
15:32 We have also bloody show, you would call that.
15:36 There is the show - it will show I'm coming!
15:39 The show is the mucous plug of the cervix.
15:43 You see the Lord has created the cervix to be closed
15:47 so that the vagina is not sterile...
15:52 There is bacteria in the vagina and the bacteria in the vagina
15:56 can get to the baby...
15:58 But because of this mucous plug, this is a tenacious guard;
16:04 bacteria can go to the baby but when you come into labor,
16:08 this mucous plug comes out.
16:11 So it's like the cervix is now ready - ripening.
16:15 So this mucous plug comes out,
16:17 and this mucous plug, of course, is mucous you know,
16:20 and it's blood-tinged; sometimes it's brownish,
16:23 but the mucous plus will come out and you know...
16:26 Oh okay, I'm almost there.
16:28 So should I call my doctor as soon as that happens
16:31 or should I go straight to the hospital?
16:33 Well because you don't know really, you could...
16:36 You could call your doctor but there are other things that
16:40 can come together with it like, for example,
16:43 ...some women have diarrhea.
16:45 It's because when labor starts to come, your hormones change
16:50 and your gastrointestinal tract "sympathizes" with you,
16:57 and so it starts... Woooo, so then "Ah, I must be going into
17:01 labor because I'm having diarrhea"
17:03 Of course, don't say - Oh I'm going into labor because
17:05 I'm having diarrhea.
17:06 Sometimes the diarrhea might be infectious.
17:08 You must be sure though
17:09 that it is infectious VERSUS the one that just accompanying labor
17:13 Okay - they are two... don't get me wrong here.
17:16 Okay, so when are the contractions going to start?
17:19 This is when we start getting
17:20 into the full-blown labor, as we call it.
17:23 The contractions will come then, you know, soon.
17:27 But contractions do not come straight-away fast.
17:30 You start first far apart, maybe every 2, every 3 hours,
17:35 and then it starts coming closer,
17:37 it starts coming closer, closer, closer...
17:41 And then you will be - when you're about every 15
17:45 ...you have a persistent consistent frequency increase.
17:51 The frequency is closer to each other,
17:54 and the duration is becoming longer.
17:58 First, it's starts as a vague hypogastric pain,
18:02 lower down here, hypogastric pain just up here in front,
18:06 and it's every 2 hours.
18:09 And then it becomes, and it was only 20 seconds,
18:12 then it becomes 30 seconds, then it becomes 40 seconds.
18:15 It becomes longer and longer and then later
18:18 the pain will move to the back.
18:21 And then, later on you will feel like you have to push
18:25 because the head is already down there.
18:27 But then that's when the pain is really close apart...
18:29 So when you see a persistent, consistent frequency becoming
18:35 closer, maybe depends on how
18:37 far your house is from the hospital...
18:39 then you call your doctor, or you go to the hospital,
18:42 or you call your midwife and you notify your caregiver
18:46 or the one who is going to deliver your baby.
18:49 Okay, now something that I really didn't want to do
18:51 when I was delivering my son was vomit,
18:54 and I was told by my midwife
18:56 that that's what every woman does in labor.
18:58 Is that really something that
18:59 has to happen to empty the stomach?
19:02 Yes - you see, because in the hospital,
19:07 I delivered most of my babies in the hospital,
19:10 although I delivered outside of the hospital in homes too,
19:14 but because doctors usually don't let their women
19:20 in labor eat... because we have the IV
19:25 But the midwife doesn't have the IV and you don't know
19:28 really how fast the labor goes. Right
19:31 So then in home deliveries, they are permitted to eat.
19:36 In the hospital, most of the time,
19:39 they are not permitted to eat.
19:40 So I have only in my practice seen,
19:43 because of severe pain, women vomiting.
19:48 It's because their tummy is relatively empty.
19:50 But the ones who have been permitted to eat
19:54 while they are in labor, it's very common.
19:57 That's why you said your midwife said that it's common
20:00 because they allow the women... Well that makes sense - Yes
20:04 Now, is there any hydrotherapy that you could recommend
20:08 for people that are having a home birth
20:09 and they are experiencing these intense contractions,
20:12 what can we do?
20:14 Oh, there is hydrotherapy, definitely...
20:17 It's these hot packs - or if you have this...
20:23 Hot packs - they buy them sometimes.
20:26 They are these packs that have.. ... Like a towel, a hot towel?
20:31 A hot towel if you don't have the hot pack,
20:33 but you can buy the hot packs and put them on your back.
20:35 But let's say we don't have a hot pack,
20:38 we can get a towel and maybe wet it and wring it,
20:42 and then put it in the microwave and/or steam it
20:47 so that it becomes wet or else soak it in hot water
20:50 and wring it.
20:52 And this hot towel, hot enough for the mom to be able to
20:54 stand - you're not going to burn the back.
20:57 So push it against the lower back.
20:59 It helps alleviate or diminish or increase your capacity
21:07 to take the pain...
21:08 Because you are sort of changing where the pain is to the back.
21:13 Your attention is brought to the hot pack
21:17 which is easier to stand than the pain.
21:21 And, are there any herbs that we can take
21:24 at this point in the labor?
21:25 Any herbal teas that could help the uterus?
21:28 I wish I had a BIG list, but I only am very,
21:38 very sure of red clover.
21:43 For the mechanism of action is red clover is phytoestrogenic
21:49 Estrogens help the uterus contract and prepare the
21:52 passage for easy delivery.
21:57 There must be others I know, and many midwives
22:00 are very, very knowledgeable in these to help
22:05 with labor and delivery.
22:06 Now what if the lady is not progressing very well?
22:10 It's been several hours in active labor...
22:14 What interventions are available for her?
22:17 According to the bible of obstetrics...
22:20 we have the bible which is "Williams Textbook of OB"
22:24 There are limitations for... you know, we have different
22:29 signs to know whether the labor
22:36 is not going any more further...
22:38 The cervix does not open any further than it has opened.
22:42 Of course you start first from
22:44 zero closed cervix to around 4 cm which is just
22:49 a preparation "latent phase" you would call that.
22:52 You are not yet in active labor.
22:55 Sometimes you don't even need to go to the hospital yet then.
22:59 It's a time when you can still relax...
23:00 The uterus is just contracting on-and-off, on-and-off,
23:03 not really regularly, but when you start to
23:05 go on regular contractions, especially when they are
23:08 every 3, every 2 minutes,
23:10 then your cervix starts to open really fast.
23:14 And then from 4 cm to 10 cm, it takes time.
23:19 It's not really long, but from 4 to 10,
23:22 sometimes the cervix goes up
23:23 to 6 or 7 and it doesn't open anymore...
23:27 And it stays there for 2-3 hours, 4 hours, 5 hours,
23:31 and for whatever reason, the one delivering would know.
23:35 And sometimes the head comes down just halfway,
23:38 and it stays there - you have the arrest of the dissent
23:42 of the head and the arrest of the dilatation of the cervix.
23:45 These things sometimes can change, you know...
23:49 But in the hospital when you go here or you go here,
23:53 it's a C-section after a number of hours -
23:56 when the doctor sees that it's not progressing anymore.
24:00 But in home deliveries and/or birthing centers
24:03 where midwives and nurse midwives are,
24:05 they have certain maneuvers to move the head
24:08 out of position and fix it.
24:10 If the head was malpositioned or whatever...
24:13 And sometimes even if there are arrests of dilatation,
24:16 and/or arrest of descending of the head,
24:20 they are able to bring it to normal delivery
24:24 just by patient watchfulness and taking time.
24:30 Now you mentioned about C- sections,
24:32 let's just have a brief word on that.
24:33 There are different types of C- sections that you can have,
24:36 and some make it possible for you to have a vaginal birth
24:39 after that... Can you tell us about that?
24:44 Whatever the scar is in the front, is not what is inside.
24:50 You have a vertical scar on the uterus.
24:53 You have a transverse scar on the uterus.
24:56 The vertical scar, you call the classical C-section;
24:59 you cannot deliver normally anymore after that.
25:03 The next baby would be C-section.
25:05 But the transverse scar, low cervical transverse,
25:08 or low uterine transverse, these ones you can deliver again
25:12 Okay, now you told me earlier, Dr. Cherie Lou, about an
25:15 amazing story - a lady that technically or physiologically
25:19 wasn't going to be able to deliver vaginally,
25:21 but she ended up... Could you tell us that story?
25:24 Oh YES! This became a sensation because she was a...
25:29 I'm not tall, I'm only 5'1" but this patient of mine
25:32 was 4'10" and she had a really, really BIG, BIG baby;
25:38 the estimated fetal weight was something like a 9-pounder.
25:42 So she was very small and she
25:44 had an estimated fetal weight of 9 pounds.
25:47 We did an x-ray pelvimetry
25:50 which is an x-ray to see the pelvis and compare it to
25:54 the head of the baby.
25:56 And the x-ray pelvimetry said there is a marked disproportion.
26:04 The pelvis is too small for the head of the baby,
26:06 and this wasn't even taken at term.
26:09 But she said, "Doctor, just watch me, I KNOW I'm
26:13 going to deliver normally. "
26:15 And a 9-pounder and a 4'10" woman and a contracted pelvis
26:21 and a big baby!
26:23 Oh, I would just be watching for whether she cannot
26:25 deliver or not.
26:27 Because if I was watching, she was going to go into arrest,
26:29 the head is going to stop coming down,
26:32 the cervix is going to not complete...
26:33 BUT, miraculously, because she had made up her mind
26:38 she is going to deliver normally, she delivered NORMALLY
26:39 She delivered NORMALLY, with a normal baby,
26:42 just like normal labor and delivery would go!
26:45 It's just amazing the mindset...
26:47 Yes, how the mind can work!
26:49 How it can work in your favor,
26:50 and the Lord has really given us strength of mind
26:53 so that we can get through this...
26:55 What could be otherwise a traumatic experience,
26:58 and make it beautiful, make it really beautiful!
27:00 Just let's have one more word about natural remedies
27:03 in the recovery period.
27:04 I'd like to mention about tearing...
27:06 If we could just briefly talk about when episiotomies
27:08 have happened, what we can do in the recovery
27:10 to speed up the healing.
27:12 Oh you can have cold in the first few hours,
27:17 and then hot and cold afterwards... sitz baths.
27:21 That's actually what I did.
27:23 I was torn quite badly and I used ice for the first 12 hours,
27:26 and then afterwards in the shower,
27:27 just applying the hot water for a minute or 2,
27:30 and then a little bit of cold water and alternating,
27:32 and it was very, very healing.
27:34 So I encourage you, if you are going through any of
27:36 those post-situations, that sitz baths
27:40 can really help you.
27:41 Well Dr. Cherie Lou, thank you so much for being with us today.
27:44 It was wonderful and inspiring to hear about
27:46 birth and delivery again.
27:48 It seems no matter how much we learn about it,
27:49 we can always be encouraged by learning more.
27:51 And thank you for joining us today.
27:53 I want to leave you with a Bible promise that Jesus said,
27:56 ...that a woman, when she travails, she has sorrow,
27:58 but AFTERWARDS when her hour has come and she is delivered,
28:02 she doesn't remember the anguish
28:03 for the JOY that a child is born into the world...


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Revised 2014-12-17