(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.)
Welcome to the birth prep podcast. I'm Taylor, your birth bestie, who's here to support you as you plan and prepare for the unmedicated birth of your dreams. If you're ready to ditch the fear, conquer the hospital hustle, support that bum and bod and walk into the delivery room like the HGIC you were born to be, then buckle up, babe.
This is where it all goes down. Hello, hello, and welcome back to the birth prep podcast. Today's another episode of the HGIC Hotline, where I answer your burning questions about prepping for your unmedicated birth in the hospital.
If you're new here, hi, I'm Taylor Miniberry, your birth bestie and coach, and I'm here to give you the real deal, no fluff, fully informed breakdown of everything you need to know for your big day. Today's episode, we've got some big ones. We're talking about transition, aka the final boss battle of labor.
What actually happens, how bad is it, and how do you survive it without losing your mind? We'll also be chatting about GBS positive results, because I know hearing you need IV antibiotics can make you panic a little bit, especially when you're wanting to stay free moving. What are your actual options here? We're going to talk about it. And then finally, we're going to be wrapping it up with membrane sweeps.
Are they helpful, or are they just another push to speed things up before your body is ready? I know you are just dying to know, so grab your little drink, your little birth ball, whatever you need to settle in, because this episode is going to get juicy. So Liza wants to know, what actually happens during transition? Everyone says it's the hardest part, but I need details. How long does it last? How bad is it? And how do I not freak out? Okay, let's get real about transition.
If early labor is the slow build-up and active labor is the grind, then transition is the final test before you cross the finish line. Let's talk about it from a medical standpoint first. Transition happens when you're dilating from about 7 centimeters to 10 centimeters.
Your cervix is finishing up its job, so to speak, so the baby can get nice and low and ready to be born. Your contractions are getting really close together, they're getting stronger, and they're not really playing nice anymore. I'm not going to sugarcoat it for you.
Can it be an easy walk in the park? Yes, I was napping during my last transition experience. That's not the reality for everybody, and that's totally okay. I have also had very intense, very extreme transition periods, and it has very much been the experience of close together, really strong contractions, and those contractions are just not playing nice.
They last about 60 to 90 seconds during transition period, with only a 30 second to maybe a minute in between, so your rest breaks are now shorter than your contraction periods, so it just gets rough, okay? It's just the reality of it. During labor, your body is riding a hormonal roller coaster. We've got oxytocin, we've got endorphins, adrenaline, you name it, but when you hit transition, things shift dramatically.
Now, in our early labor and our active labor, we really love the oxytocin. It's keeping those contractions moving along. That is giving us endorphins, which is our body's natural pain management system, but when transition hits, that is when adrenaline enters the picture, and if adrenaline is entering the picture before then, then that increases the pain that we feel and all of that, but if we can keep our stress levels down and our fear levels down, that doesn't actually biologically happen until the end, because while we want to avoid adrenaline during our early and active phases of labor, we want that adrenaline during the end, because that is going to be preparing our body for the pushing phase.
The logical thinking part of your brain is basically offline at this point. That triggers the deep primal part of your brain, and that is the one that is in full control most of the time. That's why the mindset stuff is so important, because when you get to this point, it is so hard to think logically and to remind yourself, hey, my baby's almost here.
This means we're literally almost to the finish line. It's almost time to meet my baby. You can't really think about that if you haven't done the work prior to this, because your body is in this survival situation, or so it thinks.
You're basically fighting for your life, and that is why your brain is doing that. It happened to me every single time, and I hear it from so many women. During transition, you often hear the phrase thrown out, I can't do this.
I don't want to do this. I can't do this anymore, and you believe that in the moment. It sounds really, really true, right? Those stress hormones are just flowing through your body during transition.
That is important, though. We need that. They serve as an important biological function.
They are getting you ready to birth your baby. Right before pushing, your body actually needs this surge of energy, like a runner in the final sprint of a marathon. You're going to want that little burst for when it's time to push your baby out.
I do really want to touch on that classic, I can't do this anymore moment, because so many of us experience it. I did with four of my pregnancy experiences, or birth experiences, rather. Many moms feel that sudden sense of panic, fear, even despair, almost like they've hit a wall.
Some moms cry, some moms shake, some moms are throwing up, some moms say things like, I need to go home now, or I've changed my mind, like crazy. Obviously, you can't do that, but your brain is literally grasping at straws at this point. This is not you failing.
This is a biological marker that you are right at the edge of meeting your baby. I need you to hear that from me today. It can be difficult to know, like, okay, this is what my body's supposed to be doing, especially when that hormone surge can cause things like the shaking and the shivering, even when you're not cold.
That is a totally normal reaction. Many women also feel nauseous or even throw up during this experience. This is your body's way of making sure it's 100% focused on birth, not digestion.
And I know these symptoms can feel overwhelming, and I know that they can trigger a lot of fear about that experience, like, oh, I don't want to have to go through that. But they're temporary, and they are a sign that you're incredibly close to the finish line. And they don't happen to everybody.
I've never thrown up during my birth experiences. And I've had five babies, you know? I'm just like, that's just how it is. And I've eaten during my birth experiences.
I've eaten 10-15 minutes before I've given birth. I did have one birth experience was I was shaking a little bit, like kind of shivering. I was not cold at all.
I was hot. But I definitely noticed a little bit of the shaking during that experience. But just so you know what to expect, that's typically the experience you can survive it.
I do want to talk about how long it lasts, because for first-time moms, it's usually about 30 minutes to two hours, which that two hours is like, oh, my gosh, I got to go through that for two hours straight. You might have to, okay? That's why we are preparing for this experience. That's why knowledge is power, right? We are knowing this in advance, so we can be like, I can do that for two hours.
You've been uncomfortable for two hours. You've been in pain for two hours. I can almost guarantee it.
You're going to survive it. You have those periods of rest. I know you've been preparing your team.
You have all the little tools in your tool belt. You are going to do this wonderfully. For second or more babies, it could be as short as like 15 to 30 minutes.
It really just depends, right? Everybody has a different experience. This is just the typical experience, but yours could look totally different. You could be like me and napping at nine centimeters on your couch and be like, la-di-da-di-da.
Everything is great. Everything is wonderful. I'm not even in labor.
You could. You totally could. I'm not special.
It's available to anybody. I just want you to not get stuck on those times or anything like that, but also be prepared for it too. The question, how bad is it? I won't lie.
It can be pretty intense, but the key is remembering that intensity doesn't mean suffering. It means progress. Instead of thinking, oh my God, this is unbearable.
Try thinking, oh my gosh, this means I'm about to meet my baby. Because honestly, what is more exciting than that? One of my favorite birth affirmation things is I can do anything for one minute. I was born with how hard could it be, Jean, because I could totally do anything for a minute.
There's not much that I don't think I could do for a minute, especially for my baby. That's one of my favorite things to get to the end of when the contractions are about a minute long and it's getting really intense and it's like you really have to focus inward on what you're doing and really keeping that mindset in check. I just kept reminding myself during my fourth labor, which was my one unmedicated birth that was really hard.
They weren't Pitocin contractions. It was just straight up natural contractions. They were really difficult.
I was in my living room doing this for the first time and I was like, oh my gosh, but you know what? I can do anything for one minute. That kept me so grounded. I kept repeating it to myself over and over again.
I can do it. I can do anything for one minute. I can do anything for this baby.
I can definitely do it for a minute. If you just focus on one contraction at a time instead of like, oh my gosh, it could still be two more hours. Just really keep focused in the moment, focus inward.
And if you can do that, I really truly think that you're going to crush it. I think, I think you're going to blow yourself away, honestly. So how are we going to mentally and physically handle this? First, I need you to recognize that I can't do this moment for what it is.
A sign that you are almost done. Two, deep breathing, low sounds like guttural, like moans and stuff. Relaxed jaw.
Keep everything loose to prevent more tension because we know fear creates tension in the body. That tension creates the pain that we feel. So keep everything loosey goosey.
Okay. Third, we're going to remember that movement is your best friend. A body in motion stays in motion.
So if you can change, change positions up between contractions, even if it's just rocking or leaning forward, I love a good swing side to side motion. I like to be on my hands and knees during transition. I have done that.
I think every single birth, maybe not the first one. I really don't remember a lot during the first one. That was a very traumatic experience, which is why I do this work with you guys so that you don't go through that and you're prepared and better equipped to handle it that day.
So I don't remember a lot of that experience. I know a lot because of pictures and videos. And thank God for those.
I am very appreciative that those exist, but movement is your best friend. And even if it's just, oh, that's what I was saying. I always get in hands and knees position.
That's where I feel the most comfortable during that time. So stick that in your pocket. If you're feeling uncomfortable in the way that you're laying in the bed, sidelying, sitting, whatever, maybe get on your hands and knees for a little bit.
That also helps baby engage and, you know, gravity's on your side in that position, stuff like that. You're able to shift your pelvis in different ways just by moving your knees and feet and stuff. So, you know, just food for thought when you're planning your birth experience, make sure you are also looking into different labor positions and, uh, uh, yeah, labor positions and birthing positions.
I like to birth in hands and knees position. I've done that twice now. Um, it's a, it's a good one.
It always feels right for me and it might feel really right for you too. Um, so just keep that in mind. And the fourth thing, remind yourself, you don't have to get through transition.
Your body is doing it for you. You're not stuck. You're progressing there.
It's like, it can be very like in the moment and be like, oh my gosh, this is gonna, it feels like this is going to last forever. And I, I get that this isn't something you have to get through or survive. Your body is going to be doing the work for you.
You just have to keep your mind in check and just ride it out. Great question, girl. Okay.
We are moving on to question number two from Mary Ann. I found out that I'm GBS positive and my provider said that I'll need IV antibiotics and labor. I want an unmedicated birth.
And I really want it to be as free moving as possible. What are my options here? First and foremost, I'm going to call out that little tiny word because language totally matters, but your doctor said you need the IV antibiotics. I'm going to be Frank.
What your doctor should have said was we recommend IV antibiotics because you are GBS positive. Here is why we generally recommend this for this diagnosis, but at the end of the day, it's your decision. Your provider saying that you need them is, is just a lie.
That's not true. You get to decide whether or not you want to implement those into your experience based on the risks and benefits. If you want some evidence that you don't need them, that that is a poor choice of words there.
It's a very deliberate choice of words, but it's a poor choice of words. Um, I have had GBS and have had a healthy baby without receiving IV antibiotics and have had no issues whatsoever. Now, please do not take my experience and decide that that's what you're going to do just because it happened to me.
I want you to be informed when making this decision. I was incredibly informed when I made that decision, the benefits of implementing the IV antibiotics did not outweigh the risks of implementing them for me and for what I was trying to accomplish and for what I wanted for my baby and my experience. You might look into it and decide the exact same thing as me, but you might look into it and decide the exact opposite.
And both of those are okay, but let's break it down a little bit. Group B strep or GBS is a bacteria that about one in four pregnant women carry. It's not an infection.
It's just a normal part of your body's microbiome. The reason hospitals push IV antibiotics is to reduce the small risk of GBS passing to your baby during a vaginal delivery. Let me back up before I get to your options.
Hang on a second. Let me just touch on the test for group B strep. This happens around 36 weeks gestation.
It is done with a cotton swab. They take a swab of your vaginal and anal areas and they go like in and around the vaginal area and they just like go around the anal area. Just so we're clear.
You can request to do this test all by yourself. I see it a lot where doctors just like, oh, well, since we're already down here today, let's do a cervical check. Y'all cervical checks at 36 weeks pregnant is a wild to me.
If you truly are informed about cervical checks, cervical checks during pregnancy is wild. So if you don't want somebody between your legs for this test, because you don't want to have to have a conversation about cervical checks that early in the game, you might just want to request to do it yourself. Also, it's your booty hole.
You might just want to request to do it yourself just based off of that. So I don't know, maybe that's just me. Anywho, just so you're informed and know what to expect.
If you're listening to this at 20, 24, 27 weeks pregnant, that's, uh, that's how they do it. And it's really not that bad. It's like three seconds, if that, but I'm here to inform.
So the more, you know, anywho, now that I've been talking about your nether regions for way too long, let's get to those options. We've already touched on it, but the reason providers recommend IV antibiotics for GBS positive moms is to reduce the very small risk of passing GBS to baby during your birth experience. If your membranes have ruptured at any point, even if you are going in for a C-section and your waters have broken, you chance the risk again, a very, very small risk.
You can look into the numbers of passing that along to your baby, but how you receive those antibiotics, if you even want them at all is totally up to you. Option one, accept the IV antibiotics, but stay mobile. This is for the who wants to receive the antibiotics, but doesn't want to be stuck in bed the whole time.
So you can request a saline lock or a hep lock. This is when the IV is placed, but is not constantly hooked up to fluids. So you only get the antibiotic dose and then you're unhooked.
So you can move freely. The other half of this request is intermittent IV use. So you're going to get a dose about every four hours, typically takes about 15, maybe 30 minutes per dose.
And then between those doses, you are free to move. Here's a little hospital hustle to watch for. Some hospitals might try to keep you on a continuous IV drip.
Instead of just giving the antibiotics every few hours, you can decline unnecessary fluids to avoid swelling and discomfort, et cetera, because yes, even those, those harmless IV fluids, those come with risks to your experience. They interrupt the physiological process during and after your experience. Option two, you can request a one-time dose instead of a continuous IV.
This is for the mamas who want antibiotics, but don't want to deal with an IV throughout labor. You can ask your provider if you need multiple doses or if a single dose would be effective. You can also ask if an oral antibiotic treatment is an option.
Now, when your hospital has the policy of nothing by mouth, except clear liquids, this one might be a little harder to advocate for, but this could be an option for you. This option gets a little bit tricky because hospitals can be strict about their IV policies and they might not offer this as a standalone option. The effectiveness of a single dose varies as well, so discussing it with your provider if it's something you're considering is wise, in my opinion.
One that might not be a great option is if you are really wanting those antibiotics to reduce that risk of passing GBS to baby. You're at higher risk of passing that to baby if you've had a prolonged rupture of membranes, so if it's been 12, close to 24 hours, whatever, you may want to reconsider those additional doses at that point. Option number three is declining antibiotics and opting for a watch and wait approach.
This is for the mamas who want to go unmedicated and is comfortable declining antibiotics. Here's what you need to know. You can absolutely decline antibiotics in hospital settings, but you may need to sign a waiver.
Some hospitals might push back really hard on this using scare tactics, please, please, please, please know your rights. If you're refusing antibiotics, the odds of your hospital wanting to do extra newborn monitoring afterwards for about 24 to 48 hours are pretty high. Have a conversation about it in advance.
That's my best piece of advice here is like, hey, I'm GBS positive, or maybe you're not even opting for the test because you've already decided that you're not going to get them. That's what I did last time. I'm like, I'm not even going to do the test because what's the point? I'm going to make the same decision either way.
Just have the conversation. Hey, this is what I'm choosing. What does that actually look like? How do you typically handle that? What would that mean for myself and for my baby? What are we watching and waiting for? And if something comes up, what does that look like? How is it handled? Questions absolutely worth asking.
Now, if you're a dead set on not getting the antibiotics, that is totally cool with me. I get you girl. But if you have additional risk factors, like your water has been broken for over 18 hours, maybe you have a fever during your labor experience, or you have a baby with a GBS situation, declining antibiotics might not be ideal.
And then finally, the fourth option, try to test negative for GBS before birth. This is for the mama who wants to avoid the entire GBS conversation and labor by testing negative before 37 weeks. Now, obviously, it's too late for Marianne.
Marianne, I'm sorry. There are some ways to try to reduce GBS before testing, and these methods are not guaranteed, but they are known to be somewhat effective. Okay, so first we have probiotics.
The lactobacillus strains, I may be butchering that word. I'm sorry. Those strains may help balance your vaginal flora.
The second one is garlic suppositories. Some midwives suggest inserting a clove of garlic vaginally overnight. I've never tried it, but if that's something you do, message me about it.
I would love to hear how that goes. You could implement vitamin C and echinacea to boost the immune system. And then the last one on here you might want to look into is chlorhexidine vaginal wipes or rinses.
These are actually used in some other countries instead of antibiotics during your labor experience, and they're basically like antibacterial wipes, so they reduce the bacteria on the area. They're used before C-sections and stuff, so just, you know, it's an option. Look into it.
You get to decide if any of these are even worth your time and energy. These methods are not guaranteed to make you test negative. If you already have a positive diagnosis and then you choose to implement these things and ask for a retest, your provider might question why you're wanting to retest if you've already tested positive, so just be aware of the potential pushback that could come with that.
And as always, I definitely recommend asking in advance if you are actually wanting to do a retest to avoid that conversation and to try to test negative. But if you are actually GBS positive and you're set on avoiding the antibiotics, those are some things that you could also try to help reduce the risk of being positive on your day of labor. And just to summarize all of that and just little final takeaways, if you will, you're the head girlie in charge of your birth.
Whether you the antibiotics but stay mobile or you ask for an intermittent dose or you decline them and opt for monitoring or you try to clear GBS before your test or you're exploring alternative treatments like oral antibiotics or the wipes or something like that, it's your call. Don't let hospital policies make the decision for you. Ask your questions, stand firm, and choose what you feel is best for yourself and for that sweet little babe.
Next we have a question from Chloe. She said my OB offered a membrane sweep today at 39 weeks to move things along. I wasn't expecting it and didn't know what to say, so I said that I'd think about it and let them know at my next appointment.
Is there any reason I should or shouldn't do it? All right, let's talk about membrane sweeps for a second because surprise, this is actually a form of induction. Even though it's often framed as a gentle nudge or we're moving things along, it's still an attempt to artificially kickstart your labor before your body is ready to do so. Let's talk about what actually happens during a membrane sweep.
Your provider is going to insert a gloved finger or two into your cervix and does a sweeping motion between the cervix and the amniotic sac. This stimulates the release of prostaglandins, which can soften the cervix and potentially encourage labor within 24 to 48 hours if your body is already primed for it. If your body isn't ready, it could just lead to discomfort, cramping, spotting, or prodromal labor, aka contractions that don't actually progress into active labor.
And as a first-time mother or even second or third time, honestly, if prodromal labor feels like real labor, you could be going into the hospital and they could just be like, oh yep, okay, you're in labor, you're having all these contractions, and then they admit you and then you're not actually in labor but you're already there and maybe they come in and break your water or maybe they come in and do pitocin or maybe they come in and start implementing these interventions and your body wasn't actually ready for it so now you're having a full-blown medical induction and your body might not have actually been ready for another week to three or even more. A membrane sweep is very often the first step in the cascade of interventions. The cascade of interventions is what it's commonly called in like the birth space.
It's when one intervention leads to another and then another and then another and then another, creating a literal domino effect that ultimately changes your birth experience. So here's a little hypothetical example, but this kind of stuff happens all the time, okay? How a membrane sweep could start the cascade of interventions. Maybe you're 39 weeks and your OB offers a sweep.
You say yes because you're eager to meet your baby and avoid an induction, even though it literally is an induction. Your provider is just a little sneaky about it this time. So next we're 39 weeks in one day.
You start cramping. You have irregular contractions for the next 24 hours, but no real labor. You can't sleep because they're annoying, but you're not actually progressing.
So the next day, you're exhausted and you go to labor and delivery. They check you. You're still two centimeters dilated.
Because you're cramping, they say, well, you're in early labor. We could break your water to speed things up. So now your water's broken.
The clock starts ticking. Once your water breaks, you are on the hospital's clock. Your contractions still aren't strong, so now they're suggesting pitocin to get things moving.
Pitocin contractions hit hard. Now you're dealing with way more intense contractions than your body was naturally creating. You weren't planning on an epidural, but now you're reconsidering.
You opt for that epidural that you swore you wouldn't get, but now you're stationary in bed. Your body, which wasn't really ready in the first place, slows labor down because it's taking away from your natural movement and the feedback of your body. Insert more pitocin.
Okay, we're just going to up the pitocin. Okay, well, now your baby isn't tolerating the pitocin well because while you can't feel anything from the epidural, your baby feels all of that. Suddenly, baby's heart rate starts dipping, and now a C-section is on the table, all because of a sweep that seemed like no big deal at 39 weeks.
Now, is this the case for everybody? No. But does this happen a lot? Absolutely. And the kicker and why this situation keeps happening over and over again is they're going to tell you that they saved the day.
They saved your baby. They saved your baby's life and yours too. But really, they cost it all.
Now, does this mean everybody should say no to the membrane sweep? I don't think so. First of all, I'm not here to make decisions for you. That's not my job.
You need to be informed and understand the reasons why you're doing things or why you're not doing things all with your plan in mind. But there are real reasons why someone might want to opt for one. It could help you avoid a medication-induced induction, but that's only if your body is already on the verge of labor, which we really have no way of knowing beforehand.
So the benefits of choosing to do this would be you can trigger those contractions without the need for pitocin or any other medication, meaning no synthetic drugs are involved, just a physical stimulation. Some downsides that you're definitely going to want to consider is that it doesn't always work. If your body isn't ready, labor won't start.
It can cause cramping, spotting, and irregular contractions that can last for days without actually progressing into real labor. Also, the membrane sweep itself can be painful for some women. Many women describe it as very uncomfortable or even painful if their cervix isn't already soft and open.
And it can also lead to unnecessary interventions, as we've already discussed, especially if it causes stress, exhaustion, or contractions that do not actually lead to labor. So for most of you unmedicated HGIC girlies, you're probably going to say no to this procedure. If you're considering it, please make sure you understand the potential domino effect that it could create and also the risks of that situation too.
Your provider could accidentally or purposefully, without your knowledge, rupture your membranes. I already talked about spotting, cramping, contractions, things like that. You're also opening yourself up for the potential of infection.
Anytime anything or anyone enters your vaginal canal, there is that risk. Being impatient, in my opinion, is not a reason to get a membrane sweep. And if your provider is suggesting it because they're getting impatient, that's an even bigger problem in my eyes.
So you might want to consider waiting it out and letting your body do its thing, especially if you're aiming for an unmedicated birth. The more physiological or as nature intended it, that we can keep things, the better. Your baby and body will work together when the time is right.
There's no artificial nudging required. The cervix is hard to reach for a reason. All right, mamas.
If you take one thing from today's episode, let it be this. You are in charge of your birth. Not your provider, not your hospital's policies, not anyone else's timeline.
You. Your body knows what to do. Your baby knows when to come.
And you are more powerful than you think. So whether you're navigating the intensity of transition, making decisions about your GBS, or weighing the pros and cons of a membrane sweep, trust yourself. Educate yourself.
Advocate for what you want because at the end of the day, you are the HGIC, the head girly in charge of this birth. And mama, you don't have to figure it out all alone. I am here to help you.
I have a free event coming up that I would love for you to be at. It's three mistakes that can sabotage your unmedicated birth. And I am going to be dishing out all about these mistakes and how to avoid them before the big day gets here.
It's going to be live on March 21st at 1 p.m. Eastern Standard Time. I'm going to try to keep it to an hour, but you know your girl can talk. So if you've been prepping for an unmedicated birth, but you're still wondering, what if I cave under the pressure? Or what if my provider isn't really supportive? What if I end up needing interventions that I don't want? Then you need to be at this training.
I'm breaking down the three biggest mistakes that can totally derail an unmedicated hospital birth and how to avoid them like a pro. You can pull off the birth that you want, and I can show you how. Spots are limited, so go sign up now.
I'm going to put the link in the show notes for you guys. Invite all your pregnant friends. I know they will literally be thanking you.
This stuff isn't just like, oh, these cute little three things. Like this is big stuff, like game-changing stuff. So I'll see you Friday, March 21st at 1 p.m. Eastern Standard Time.
If you cannot make it live, do not stress. Still grab your ticket. I'm going to have a replay for you.
I will send it to the email that you signed up with. But if you can make it live, please try to make it live because I'm saving time for coaching and some Q&A at the end. You can bring your biggest questions, your yucky thoughts and fears, and we'll chat about it.
And one more thing. If you are one of my birth prep course girlies, I have a super special surprise for you that day, so you're not going to want to miss it. If you're not one of my students and you want to be one of my students so you can get that super awesome surprise, check the show notes for the information.
But anyways, I cannot wait to see you there. Grab your free ticket, mark your little calendar, and get excited. It's going to be amazing.
Thanks for hanging out with me. As always, happy prepping.
(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.)
