Helen Dandurand (Host): Welcome back to the Well Within Reach podcast. I'm your host, Helen Dandurand. And today, I'm going to be joined by Abby Banter, Riverside Family Birthing Center night shift team lead, to talk about preparing for childbirth.

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Host: And we're back with Abby. Thanks for being here.

Abigail Banter, BSN: Thanks for having me on.

Host: Of course. This is your second podcast, so you're getting to be a seasoned pro, right? But for anyone who didn't listen to that podcast, could you just tell us a little about yourself?

Abigail Banter, BSN: Sure. As you mentioned, I'm the night shift team lead for the Family Birthing Center here at Riverside. I've been helping bring babies into this world as a Labor and Delivery nurse for the last two decades just about, and have spent the last ten of those years caring for our community here at Riverside.

In addition to my Nursing degree, I hold two Nursing certifications specific to Obstetrics. And I co-teach the Best Beginnings Childbirth Class offered by Riverside as well. And last but not least, which I know we talked about this last time as well, I am the mom of two sets of twins.

Host: That is so wild. I'll never stop saying how wild that is. That's awesome though. So, you've got a lot of experience. So, I think you'll be able to tell us all we need to know about this topic. So, my first question is in the process of preparing for childbirth, can you explain why classes are important and what parents can expect to learn from them?

Abigail Banter, BSN: Classes are important in so many ways. They are meant to help new parents prepare for the birthing process by learning how your body works during labor, delivery, and the early postpartum periods. With this, you will learn about signs of labor, different delivery methods, common interventions, and pregnancy-related complications to watch for during and after delivery. You will learn about a variety of pain management options, all the way from breathing and relaxation techniques to medication and epidurals. We also review what to expect for the baby while you're in the hospital.

The ultimate goal of a childbirth class is to increase your knowledge and understanding of the birthing process so that you can feel more confident in your body's ability to give birth. This will help ease some of the anxiety that can surround the birthing process. These classes are also able to help partners understand their role in supporting the birthing person and give them confidence to know how to advocate for them. And as a bonus, you get to meet other expectant parents who are going through the similar experiences as you.

Host: That's cool. I feel like they are definitely something. I feel like, in this day and age, people are like, "Well, I'll just look on TikTok and I'll do some research," but there's so much information out there that it can just be confusing. And so, I feel like knowing that, "Oh, my hospital offers some classes that gives me the details of what I need to know," are like a great place to start, you know?

Abigail Banter, BSN: Definitely a great place to start. And making sure that wherever you're getting your information from is a reputable source is always important too.

Host: Definitely. So aside from the classes, how can expectant parents prepare mentally and physically for the different like stages of labor?

Abigail Banter, BSN: Plan and practice. Labor is called labor for a reason. It can be hard work, and sometimes it's very, very hard work. The more e prepared you are ahead of time, and the more you practice the different coping skills, the better off you will be. Start by thinking about your personal experiences with stress and pain, and then think about how you best cope through those adversities. There are so many different methods out there to help with relaxation during labor. Here are just a few examples. Meditation, breathing techniques, movement, position changes, massage, aromatherapy, visualization, relaxation techniques, counterpressure, music, the list goes on and on. Try them out ahead of time and make a list of the ones that you like and want to use during labor and practice them ahead of time.

Some of you can practice by yourself, but others you may need to include your labor support person. For example, if you want to use guided relaxation or meditation techniques, choose a video or a sound clip ahead of time so that you're familiar with the sequence, and to make sure that the voice and music are calming and relaxing to you.

In addition to practicing, you may need a specific supplies for certain techniques like a diffuser and essential oils for aromatherapy or a picture of your pet or favorite vacation spot for visualization or maybe you love music and you want to create a labor playlist filled with songs that help you to focus and relax. Keep an open mind and have multiple techniques prepared so that you have a variety of relaxation tools to utilize throughout the labor process.

Host: Cool. What would you say is like the most commonly used one.

Abigail Banter, BSN: Oh, it really--

Host: It ranges? It really depends?

Abigail Banter, BSN: Yeah, there's a large range. And some people come in just kind of hoping that they can kind of work through it in the moment. And like I said, planning and preparing ahead of time definitely is your best bet. And then, some people come in with all sorts of techniques ready to go. So, definitely plan ahead, preparing ahead of time is to your advantage.

Host: Okay. So, kind of switching gears here. When would you say that parents should start preparing their hospital bag? And what are some must have items that you think should be included?

Abigail Banter, BSN: I'd suggest starting to pack your hospital bag during your third trimester, somewhere between 28 to 32 weeks, and have it pretty much ready to go by 36 weeks. In the U.S., about 12% of babies are born before term, which is 37 weeks or earlier. This way, you'll give yourself enough time to consider what you'll need for your hospital stay, even if your baby comes a little bit early. There are a lot of online packing checklists out there to help with this task. My first pregnancy, my babies were cooperative and they stayed until their scheduled delivery date. With my second pregnancy, however, my bag of water broke early at 34 weeks. But thankfully, I'd at least started packing my bag. Otherwise, who knows what my husband would have thrown together for me in the last moment?

As for things to bring with you, make sure that you bring your ID and insurance card with you to the hospital as well as a printed copy of your birth plan if you have one. The hospital will have all the necessities needed to care for you and baby. That being said, you may prefer some items from home, more than what the hospital has to offer. Comfortable clothes for after you deliver baby, like comfy PJs, a supportive bra, a robe, cardigan, easy slip-on shoes or slippers.

Currently, Riverside is offering a free photo session during your hospital stay, so you might want to have an outfit ready to take a few pictures with baby. And then, toiletries, if you have a preference, like toothbrush, toothpaste, deodorant, lip balm, lotion, shower products, hairbrush, all that kind of thing are good to have packed and ready to go.

We do also offer really nice plush towels at Riverside, which is a nice bonus for taking a shower after delivery. If you're like me, you may want to bring your pillow with you, and a lot of people like to have a blanket from home as well. Just make sure that everything is freshly washed and ready to go and to be around a brand new baby.

The hospital will supply everything you need for perineal care. If you have anything particular that you want, you can definitely bring that in with you. And then, Riverside also is going to provide meals for mom and a support person during your stay, but you may want to have some snacks or something like that too during the labor process.

An extra long cell phone charging cord is always handy to have because outlets are not always in convenient locations in the hospital. And that way, you're able to charge your personal items as you need to. Again, think of comfort items that you might want to help with relaxation, like a Bluetooth speaker, diffuser, personal fan, framed photo, or stress ball.

Host: That's cool. I feel like I would be rolling in with like an extra large suitcase. It seems like a lot of things, and I am an overpacker .

Abigail Banter, BSN: I also am an overpacker. And definitely with my first ones, I overpacked like crazy. And the second time around, like I said, I was only partway packed, so I didn't, you know, overpack that time as much, but definitely, you know, a possibility.

Host: Yeah. Okay. So, you mentioned within all of that, a birth plan as a potential thing to bring with. Can you explain like the role of a birth plan and maybe how that functions at Riverside?

Abigail Banter, BSN: A birth plan is a written document that lists your preferences for your baby's birth. It gives you a chance to think about and discuss your wishes with your support person and your healthcare provider prior to your due date. It also helps you advocate for yourself when you may not be able to communicate your wishes fully, like if you are having really painful contractions when you arrive to the hospital.

Keep in mind that having a birth plan is not a guarantee that labor and delivery is going to go according to that plan. Unexpected things can happen, and you're allowed to change your mind about what you want during your labor as well. Your safety and the safety of baby is always a top priority. It can also help you to plan for things like who you want to be with you during your labor and if you want visitors in the hospital or not and then also for care items for baby as well. And maybe you want to delay first bath at like 24 hours or something like that.

If you choose to create a birth plan, please be sure to review with your OB provider during your third trimester. There are options that you might desire that your OB provider in the hospital may not be able to accommodate or have even that service available to them. So, a discussion with your OB provider will help to align expectations and help you all to work together to develop a plan.

Host: We are going to take a quick break to talk about finding a primary care provider.

Riverside knows that health is your greatest asset and that your primary care provider is your partner in health. Find a primary care provider that fits your needs at riversidehealthcare.org/primarycare.

Okay. We are back. What should parents do when they start experiencing early signs of labor and how do they know when it's time to go to the hospital?

Abigail Banter, BSN: First, I just want to start by saying there's a difference between term labor and preterm labor. So if you're earlier than 37 weeks of gestation, we would want you to come into the hospital with any kind of sign of labor, just to be on the safe side.

So otherwise, let's start with contractions. Contractions feel like really bad period cramps. They're usually in the lower abdomen, but they can also be felt as intermittent low back pain or pain that wraps around the lower abdomen and back and may also go down into your thighs. Usually, we say that once your contractions are in a regular pattern at about every five minutes over a one to two-hour period and are getting progressively stronger in intensity, it's time to come into the hospital. Now, if you've had a fast labor with a previous pregnancy, we would want you to head into the hospital as soon as painful contractions begin, again, just to be on the safe side.

Another sign of labor is your bag of water breaking. This could be a small leak or a big gush. Amniotic fluid is usually clear, but it can also be yellow, green, or pink-tinged. And it doesn't really have much of an odor. So if you're experiencing leaking and you can't tell if it's your bag of water or not, we would want you to come into the hospital to get checked out. We are able to do a test at the hospital that determines whether or not your bag of water is ruptured. So if you think it might be broken, like I said, head on in. If your bag of water might be broken, the nurse is going to want to know the time that you started noticing the leaking, the amount of fluid that you've seen, the color of the fluid, and if there's an odor or not.

And then, another sign would be possibly a bloody show. The cervix is super vascular during pregnancy, which means that it has a lot of blood vessels in it. So, as you dilate and as labor is progressing, you might have some bleeding. Typically, we don't want to see bleeding during pregnancy, but a bloody show in labor can be a sign that things are progressing. Again, if you're bleeding, we would want you to come into the hospital to be evaluated.

Host: Got it. So, you kind of mentioned that if you had had a previous fast labor or birth, whatever that, you know, you should go in as soon as you think that you are experiencing those kind of symptoms. How much does it play a role in like, if you say somebody doesn't have kids, but their mom is like, "I delivered all my kids incredibly fast." Does it even have, you know, anything to do with that or no?

Abigail Banter, BSN: I mean, there can be some genetic components and whatnot, but every birth is kind of totally different. And even from one person, from one delivery to the next can be different. But definitely something to keep in mind, you know, if you have a strong family history of like fast labor or something like that, just keeping it in mind, it doesn't hurt to get to the hospital a little bit on the early side.

Host: What can parents expect upon checking into the hospital? Like where do you go? What do you do?

Abigail Banter, BSN: So, if labor has started and you're coming into the hospital during the day, you can head just straight back to the Labor and Delivery Unit and bypass the ER. Overnight, though, most of the hospital exterior doors are locked, and so you have to come in through the emergency room, and then they're going to show you back to Labor and Delivery.

Once you get to Labor and Delivery, we're going to begin our triage evaluation. So, we're going to get you put into the computer system, have you sign a consent form for treatment. And then, we will have you change into a gown, so that we can better evaluate you. This includes putting monitors on your belly, which will help us determine what's happening with baby's heart rate and your contractions. We're going to take some vital signs from you, review your health history, and discuss the symptoms that you've been experiencing. If you're leaking, that's when we're going to do that test to see if there is a hole in your bag of water. And then, we also may perform a cervical exam during this initial evaluation to see if you're dilating or not.

Once we do our initial assessment, we're going to call the on-call OB physician and discuss the plan of care with them. Once it's determined that you are, in fact, in labor, we're going to begin the hospital admission process, which includes starting an IV, obtaining some blood work, and completing admission paperwork, which again includes some more consent forms and various things. At this point too, we're going to discuss your birth preferences for labor and kind of review your birth plan if you have one.

Host: Got it. I know at Riverside, there is like a separate area for, you know, people in labor versus postpartum. When you first do that initial exam, are you taken back to that area or do you do that in the front?

Abigail Banter, BSN: Yeah, you're all the way back in Labor and Delivery, which is the back part of the unit. Our unit is a locked unit, so there are doorbells outside of the unit that you can ring, especially overnight, because, you know, there's not as many just general staff around. So, the doorbells, you ring them. And then, we will let you back and get you checked out.

Host: So, we've kind of talked through, you know, what you need to know before to pack and prepare and then get there. And so, now you're there, what would you say that a partner or support person-- how can they be the best support that they can? I guess, is that the question? Does that make sense?

Abigail Banter, BSN: Yes. I would start by encouraging that ongoing discussion during the pregnancy with the birthing person and their support people regarding their preferences and expectations for labor and delivery. That way, everybody's on the same page and the support persons are Better able to give that support and advocate for the birthing person during labor.

Attend a class together is always a wonderful thing too. Work together with the birthing person to practice the labor coping strategies throughout the pregnancy as well. Watching your loved one in pain can be quite difficult. And so, having a shared understanding of the preferences and coping strategies can be empowering for everyone involved. And remember to approach the labor process with patience, encouragement, and flexibility.

Host: Awesome. What advice would you have? So, I mean, do you have any different pieces of advice for people who are planning different types of deliveries, such as like, do you have any specific natural birth advice versus epidural versus people who know they're getting a C section?

Abigail Banter, BSN: As I mentioned before, I definitely encourage you to discuss your birth preferences with your support people and with your OB provider. That way, your entire birth team will be aware of what you're hoping for. Your OB provider will be able to give you specific advice and educational information on your specific type of birth. So if you are planning a scheduled C section or something like that, they would be able to give you the rundown of all of that process. And then, educate yourself. Make sure that you're using reputable sources as well. Take a childbirth class. A lot of those different types of labors and deliveries are discussed during those classes. And if you have any hospital-specific questions, you can always call into the Labor and Delivery Unit to talk with the nurse as well.

Host: Got it. Okay. So my last question is I thought it would be very interesting to hear from you what some of the most common misconceptions about childbirth that you wish more parents knew about before delivery? Like, what do you hear?

Abigail Banter, BSN: So, I've been doing this, like I said, for quite a while, and so I've heard quite a few different misconception over the years. Here are a few of the common ones though. Number one, losing your mucus plug means you'll immediately go into labor. This is not true. The mucus plug is basically a collection of mucus that is in your cervix and acts like a barrier to help protect baby from any kind of infection or bacteria or anything like that during the pregnancy. Towards the end of your pregnancy, you may notice that you have like a discharge, a mucous discharge. If this happens, it could mean that labor is going to be starting within a few hours, but it could be a few days, it could be even a few weeks before labor begins. So if you're noticing that, and you can't tell if it's your bag of water leaking or the mucous discharge, you can head into labor and delivery to get checked out. You can also let your provider know that that's been happening, but it doesn't necessarily mean labor is happening right away.

The second thing, I would want to let people know about is getting an epidural will not necessarily slow down your labor. This one is kind of a half truth. If you get an epidural, before labor progress has really started, it could possibly slow the labor process down because it limits movement. And movement is a huge part of the early labor process. If you're making good cervical change and labor is progressing as it should, an epidural won't actually slow labor down. And in fact, sometimes getting an epidural will actually help to relax the laboring person and actually speed labor up, or just help it to progress in general. So, epidurals can work kind of both ways in that situation.

And then number three, birth is not like you see on TV or in the movies. It's not your bag of water breaking with a huge gush, followed by a few minutes of intense labor, and then baby's out. Well, at least not for most people/ maybe on a rare occasion that happens. But labor is usually more like a marathon than a sprint, especially when it's your first baby. In addition to this one, your labor and delivery will not be just like your mom's experience, or your cousin's, or your aunt's, or your friend's. Your labor experience is going to be your very own experience.

And then, the last thing is there's no birth that's less or more than another. Birth is birth. Whether it's by vaginal delivery or by C section, with no pain medication or with an epidural, by induction or by labor starting on its own, each and every birth is unique, special, and sacred.

Host: That's so awesome. Cool. I think that we covered just about everything. Is there anything else you'd want to add?

Abigail Banter, BSN: I don't think so, but we do have a lot more information and a lot more detail in our childbirth class. So definitely, if pregnancy is either in your future or if you are currently pregnant, definitely keep that in mind. We usually schedule them about every six weeks, so try to get that in probably in like your third trimester, early third trimester. And we have a lot more information for you in that as well.

Host: Great. Thanks for being here today, Abby.

Abigail Banter, BSN: Thank you for having me.

Host: Of course. And thank you listeners for tuning in to the Well Within Reach podcast brought to you by Riverside Healthcare. For more information, visit riversidehealthcare.org.