Almost Done!
Well, you have decided the "honeymoon" is over and you are ready to be done! It's hard to sleep, hard to eat, and...hard to do most everything. Are all these discomforts normal??

Braxton Hicks:
It is normal to have contractions with physical activity like while you are working, exercising and after sex.  Women often notice at least 3 contractions an hour during the last trimester of pregnancy.
Dehydration can also cause Braxton Hicks contractions, so it is important to drink a minimum of 2 liters (8-9 glasses) of water a day. And tea, juices, sports drinks, and milk don't count! If you are experiencing contractions; drink two large glasses of water, empty your bladder, lie down and rest for about an hour.  These interventions usually will decrease the contractions.  If the contractions continue and are occurring 6 or more times in 1 hour, then please call us.

Round Ligament Discomfort
As the uterus enlarges and rises in the abdomen, the round ligaments are stretched. These are attached on either side of the uterus and then down into the inguinal groin area, although we probably didn't have to tell
you that!  The round ligament discomfort may start as early as 13-15 weeks of the pregnancy.
​It is often on one side or the other and it may worsen with each pregnancy as the ligaments
lose some elasticity.  When it gets pulled (like with a cough or sneeze) it is initially a sharp,
stabbing pain.  If you hold still, the pain goes away. When you start to move again, you
will feel it to a lesser degree. Prevention/relief measures are: Avoid sudden
movements, turn slowly to your side and push up rather than trying to sit straight up
from a lying position.  Rise up from a seated position slowly. Soak in a warm tub. You
may apply local heat with a heating pad on low, but we suggest only short periods
of time and never go to sleep with one on! Maternity belts (abdominal sling) may
provide the much needed support as well. It may be especially helpful if you are on your
​feet for long periods of time. Sleep with an extra pillow underneath the uterus for
additional support when you lie on your side. Put one between your knees too! Tylenol
may help some women. Remember you should not use Motrin, Advil or Aspirin.

Signs of Preterm Labor
Contractions (when the top of the uterus gets hard like a wall, typically accompanied by discomfort) 6 or more times in an hour
Colored discharge (report pink, or red)
Constant leaking fluid
Pelvic pressure (feeling the baby is pushing down)
Low, dull cramping

If you have had a big day and feel like you are contracting more than 6 contractions in an hour, we advise that you drink 2 big glasses of water, empty your bladder and lay down on your left side to rest.  If the contractions do not decrease after this intervention, you need to call us at the office 402-884-7533.  If it is after hours, press option #3 to reach one of the midwives.  

Count The Kicks

By keeping track of each time your baby kicks, rolls or pokes, you can monitor your baby’s health and begin to create a bond with him or her.  As a parent, it’s reassuring to Count the Kicks to make sure your baby is active and healthy, and counting may reduce the risk of a stillbirth, which occurs in one out of every 160 pregnancies in the United States.
Count the Kicks every day, preferably at the same time.
Pick your time based on when your baby is usually active, such as after a snack or meal.
Make sure your baby is awake first; walking, pushing on your tummy or having a cold drink are good wake-up calls.
To get started, sit with your feet up or lie on your side. Count each of your baby’s movements as one kick, and count until you reach 10 kicks.
Most of the time it will take less than a half-hour, but it could take as long as two hours.
Log your recorded times using our Count the Kicks App or a kick chart.

Group B Strep screening

​​We practice the CDC recommendations for universal screening and do this somewhere between 36-37 weeks gestation.  It takes about 48 hours to get results back and it is important to have the results before labor starts.

​Perineal massage: 

We feel there can be some physical and emotional benefits for perineal massage and recommend this exercise starting at 34 weeks.  If you wish to practice perineal massage you can lay down a body memory that reduces your fear and helps you to relax into the stretching sensation, it may assist you through the pushing stage of labor.  

Cord Blood Banking:

From time parents ask about cord blood banking.  It is possible to bank cord blood in private banks for personal use, which requires $1,000-$2,000 in collection fees and yearly maintenance fees ($150-250) to keep it stored.  Current conditions that the cord blood can be used for are limited, scientists say the future possibilities are endless.  Many call it an expensive Life Insurance Policy for the Future.​  We will ask you to do the research.  Should you store or donate your child's cord blood is a recently published article.  Be the Match is operated by the National Marrow Donor Program, which operates the most diverse registry in the world.  Cord Blood Center helps families understand current treatments that use cord blood and hopeful future possibilities.

Birth Preferences: 

Close your eyes and picture your perfect birth.  This is your way to communicate your desires to us and your nursing staff.  We usually review these around your 32nd week.   BIRTHPLAN