3 questions regarding labor: Cervix checks, BG's, Water births

  1. Hello, L&D nurses...I have my first OB clinical on Monday, and I have a few questions.
    1. Is there any reason a pregnant woman(or her partner) couldn't check her own cervix at home, before they came into the hospital? I understand infection control issues, but what if they washed their hands/used sterile gloves/etc. In a low-risk birth, it seems like a good way to avoid unnecessary interventions and just the boredom of being in a hospital for that long.
    2. How do you keep blood sugar up in laboring moms? The hospital I'm at places all moms on NPO x ice chips status...I'm thinking that after 12-15-24 hours of that, they'd be pretty hypoglycemic... Is that mainly prevented with IV dextrose, or am I missing something?
    3. My book talks about water births, and how the baby doesn't start to breathe until its head is out of the water. As long as the cord remains intact, this is ok, right? The book says to get the head out of water ASAP, but it seems to me like it wouldn't be all that big of a rush as long as you don't cut the cord(I mean, obviously get them out of the water eventually, but theres enough time to deliver normally and ease them out, right?)

    Thanks!
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  2. 11 Comments

  3. by   parteiranagua
    Quote from Jen,SN
    Hello, L&D nurses...I have my first OB clinical on Monday, and I have a few questions.
    1. Is there any reason a pregnant woman(or her partner) couldn't check her own cervix at home, before they came into the hospital? I understand infection control issues, but what if they washed their hands/used sterile gloves/etc. In a low-risk birth, it seems like a good way to avoid unnecessary interventions and just the boredom of being in a hospital for that long.
    2. How do you keep blood sugar up in laboring moms? The hospital I'm at places all moms on NPO x ice chips status...I'm thinking that after 12-15-24 hours of that, they'd be pretty hypoglycemic... Is that mainly prevented with IV dextrose, or am I missing something?
    3. My book talks about water births, and how the baby doesn't start to breathe until its head is out of the water. As long as the cord remains intact, this is ok, right? The book says to get the head out of water ASAP, but it seems to me like it wouldn't be all that big of a rush as long as you don't cut the cord(I mean, obviously get them out of the water eventually, but theres enough time to deliver normally and ease them out, right?)

    Thanks!

    go to waterbirth international.org where u will find a mine of info re water birth.

    maintaining the bb under water depends a lot of the level of comfort of the MW and when the cord stops pulsing... when the BB reaches the surface, the breathing reflex is activated by the difference of temp.on the the trigeminal nerve receptors.

    It is now recommanded to let women eat and drink what they want until active labor quicks in.. In real life b/c most women dont feel like eating anyway,,, u can give clear liquids such as juices popsickles etc... but it is best to check hospital policies first and/or bring evidence based references to try to changes ur policies...

    There is nothing legally that can stop a woman to check her own cervix, besides the fact that if she's ruptured, she can bring germs in her canal..
    Ginny
  4. by   mitchsmom
    Is there any reason a pregnant woman(or her partner) couldn't check her own cervix at home, before they came into the hospital? I understand infection control issues, but what if they washed their hands/used sterile gloves/etc. In a low-risk birth, it seems like a good way to avoid unnecessary interventions and just the boredom of being in a hospital for that long.
    Hard as I tried, I couldn't reach!!! LOLOL, I am serious though. Between the contour of a pregnant body, and a high cervix there was just no way
  5. by   cassioo
    sometimes that cervix is hard to find even when you know what you were looking for. You'd hate to have some partner in there digging around and not knowing what they were feeling for and if they did find it what would they do with it? There's more to cervical exam then finding it..you'd have to teach dialation, effacement, station, what if they put a finger through a placenta???
  6. by   CA CoCoRN
    Quote from cassioo
    sometimes that cervix is hard to find even when you know what you were looking for. You'd hate to have some partner in there digging around and not knowing what they were feeling for and if they did find it what would they do with it? There's more to cervical exam then finding it..you'd have to teach dialation, effacement, station, what if they put a finger through a placenta???
    Hopefully there wouldn't be a placenta across the cervix anyway...as she'd have begun bleeding long ago and placenta previa would have been dx'd. Or even if it hadn't been diagnosed...if it was previa, likely she'd be bleeding and what guy wants to put their fingers in THAT??

    Anyway, I checked myself before heading to the hospital. I delivered some two years ago. Citing not wanting to have to go in "early" and just be sitting around in early labor, I took some gloves from the hospital to have on hand. When the time came, I SROM'd. Wanting to know if I was dilated, I donned the glove and sat on the potty (to make it easier to get to my cervix) and checked. I was 2-3 cm. I was familiar with my own anatomy and knew it would be feasible
    a) my belly wasn't all that large, relatively
    and
    b) I'd mastered my own awkward checks/retreivals since I'd used intravaginal contraception before.

    Now, obviously, since I'd SROM'd I knew I'd have to go to hospital anyway...but I just wanted to know the goings on "in there".:chuckle
  7. by   cassioo
    but you knew what you were looking for also I'm saying I don't think most partners would know what they were feeling for and I'd bet the majority of women couldn't get to their own cervix to check...I never tried. But co-workers have been known to check each other when needed at work.
  8. by   BETSRN
    Quote from cassioo
    sometimes that cervix is hard to find even when you know what you were looking for. You'd hate to have some partner in there digging around and not knowing what they were feeling for and if they did find it what would they do with it? There's more to cervical exam then finding it..you'd have to teach dialation, effacement, station, what if they put a finger through a placenta???
    As a L&D nurse of many years, I can tell you it is often difficult (and sometimes impossible) to even find the cervix and I know what I am looking for.
    How would a lay person, who has no idea about dilitation and effacement know what they were looking for? The fewer cervical exams th better as far as chancing infection.
  9. by   madwife2002
    I take it you have never been pregnant, otherwise you would know how impossible it is to even bend in the middle, let alone try and get in a position to feel your cervix!!
    One day if you are fortunate enought to become pregnant and get to 40 weeks you will cast your mind back and it will bring a smile to your face remembering this thread.
    But I have to add a very slim friend of mine who is a midwife did manage to VE herself and then call in her midwife so she could have home birth.

    K
  10. by   SmilingBluEyes
    Slim women or those practicing YOGA can and do check their own cervices oftentimes. Not everyone can (or should). Good luck..........

    These folks gave you some great info.
  11. by   CA CoCoRN
    Quote from cassioo
    but you knew what you were looking for also I'm saying I don't think most partners would know what they were feeling for and I'd bet the majority of women couldn't get to their own cervix to check...I never tried. But co-workers have been known to check each other when needed at work.
    Ohhh, I wholeheartedly agree. I was just relating my story. My friends here got a chuckle out of it when I came in and told them what I'd been dilated to at home. :roll
  12. by   CA CoCoRN
    Quote from SmilingBluEyes
    Slim women or those practicing YOGA can and do check their own cervices oftentimes. Not everyone can (or should). Good luck..........

    These folks gave you some great info.
    Exactly!!! I'm not slim...more on the chunky (but cute) side, but you can ask anyone who knows me, I'm very limber. And as I said, my belly wasn't "basketball" at all, so I was able to work around it.
  13. by   Mimi2RN
    We had a sick premie, maybe 34 wks, whose parents decided to check before coming in, as mom was ruptured. Dad did not use gloves........it just compounded the baby's problems.

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