Listen or Read Stephanie Heintzeler’s Monthly Podcast Interview!

Topic: Signs of Labor – Tools and Techniques for Early Labor at Home

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Hello everyone, this is Liz Harvey coming to you from our razorcast™ studios in New York City where we are dedicated to bringing you cutting edge interviews from many of the leading industry professionals across the United States.

In today’s episode, we are speaking with Stephanie Heintzeler. Stephanie is a German educated midwife, a U.S. educated doula, an acupuncturist and she is a Certified Lactation Counselor (CLC). She is known as The New York Doula.

Stephanie has delivered over 1200 babies and has experience with twins, triplets, breech babies and water births. She also works with newborn parents in their postpartum stage and holds classes and seminars for moms and dads to be.

With a wealth of experience and knowledge in her field, Stephanie Heintzeler is widely considered to be one of the top doulas in the country. She is also a contributing member of our national network of industry professionals.

Today we are going to talk about a very important topic:
Signs of Labor – Tools and Techniques for Early Labor at Home.

RC: Hello Stephanie how are you today?

Stephanie Heintzeler: Hi, I’m very well, thank you.

RC: Well thanks for joining us.

Question 1: Going into labor can be a little scary, what are some of the signs that you are in labor?

RC: So I’m going to jump right in. Going into labor can be a little scary, what are some of the signs that you are in labor?

Stephanie Heintzeler: There’s quite a few different signs. So first we try to find out whether it’s early labor signs or labor signs and then we also have a difference between very early and early.

Because there are acute signs in mom’s body that are already showing that the body is getting ready for labor and birth which is things like inner heat or heartburn, some have nausea or more of a nesting urge.

And we have early labor signs that are things like the loosening of the mucus plug or a few contractions or breaking of the water. So breaking of the water is a very typical sign where you really know you are going into labor.

But then contractions – if you are not really sure if this is contractions or not, chances are you’re not really in labor. But in the end if you have a doula , if you call your doula, you make sure that she hears how often you’re having these contractions. And you can do a few things at home like take a bath, take a walk, try to sleep and try out basically everything that makes you feel better and see if those contractions change or don’t change. If you’re in labor, contractions always stay the same. They are regular, they are one minute long, they pick up and no matter what you do, they stay the same.

But if you’re in early labor but say you lay down, the contractions should stop or you start walking, the contractions should stop. That shows that you’re in very early labor and it could take another day or two until you’re really going in labor.

Question 2: Why is developing a birth plan in advance helpful?

RC: Okay and why is developing a birth plan in advance helpful?

Stephanie Heintzeler: We call it birth preferences nowadays and the birth plan or birth preference is really something you want to do because you don’t want to make decisions while you’re in labor. There are just so many options that you have in the delivery room but at the same time, there are a few things that are protocol of a hospital.

For example, IV fluids – you have to have a hep-lock – this little tube, a catheter in your arm and get fluids during labor and birth. There is monitoring for your baby, sometimes constantly so you are hooking up to a lot of cables. Sometimes there is induction, your doctor wants to induce you on your due date and doesn’t really want to wait until you are overdue. And those are things you can put in your birth preferences because that opens up the conversation with your OB team or midwife. And your doula can give you questions, you can discuss everything beforehand and then when you are in labor you know what to expect.

Many parents don’t really do that. They don’t want to prepare so much because they trust the doctor but we don’t know if the doctor is going to be there at the birth. They are usually in a team of four or five so then we end up with someone completely different who says “No we have to have the IV fluids; you have to lay down…” and that is stressful. And then the pain is increasing just because you are so stressed out and not relaxed so we try to avoid. Well the birth preferences are really great tools to give you more power and have a better birth experience.

Question 3: What are the roles and responsibilities of a typical birth team?

RC: Okay and what are the roles and responsibilities of a typical birth team?

Stephanie Heintzeler: So there are a lot of people during labor and birth, especially in New York City. Basically the typical birth team has either your obstetrician or the midwife present at your birth. They show up usually when the baby is about to be born so maybe the last hour or so. If they are available and they are in the hospital anyway then they might peek in here and there throughout your labor. But otherwise, the person who takes care of you – meaning your vital signs and the baby’s vital signs – that’s the obstetric nurse. So this nurse will be in and out, she usually takes care of several moms at the same time so she’s not really your support. She is just checking on you, making sure you’re okay and your blood pressure is fine and the baby’s heartbeat is okay and maybe give a few suggestions.

But in order to have constant support, you would hire a doula. So the doula lowers the C-section rate by forty percent because you have someone in the room who is like an expert and support person with you all the time from the start when you have contractions regularly, so actually at home first. So that is part of the birth team that you actually have someone with you at home then you can determine when you go to the hospital and in the hospital you have that same person with you in the room so the partner can also make sure they are supported and they can leave the room – maybe use the bathroom, maybe eat something. If you have an eighteen-twenty hour birth, it can get very stressful if you only have one birth support person because they may need to take some rest at some point.

And so we have all these different people who are doing different things during labor and birth but for the birth, we then have more people in the room. So often times, there is a pediatrician, a pediatric nurse, a second nurse in the room, often times there is an anesthesiologist who comes in here and there throughout your labor and is around during the birth as well. So we end up having eight sometimes ten people in the room, especially in a teaching hospital because there is just a lot going on. Before that, we try to keep the room a little bit more quiet and soothing and have it a little more dark so that the mom really feels safe and supported throughout all these changes.

Question 4: Do childbirth classes teach different tools and techniques to prepare for laboring at home?

RC: Great, so switching gears a little. Do childbirth classes teach different tools and techniques to prepare for laboring at home?

Stephanie Heintzeler: Yeah, that’s a very good question – it comes hand in hand with everything else. So basically depending on what a couple is maybe planning on at birth, there are different classes. There are classes like Bradley Classes. Bradley® is an approach that’s really when you’re planning on a natural birth. So the partner is very involved. You should have a doula – it’s really very hands on – and it is a class that goes over the course of six weeks. It is three hours every week, you have a lot of homework. Really you become your own birth coach in a way. So that’s more of an advanced class.

Then there are a lot of other classes which I actually prefer and teach a lot. My own method is more taking the best out of everything out of all the approaches because you don’t know how birth is going to go. You don’t know how long it is going to take, if you need an induction, if the baby ends up being breech. So we can plan everything for a natural birth but then it just goes down the drain because you had an induction and that’s not a huge intervention but it is something that might be surprising to you because you might end up with an epidural because it’s more painful. And then you don’t know how to deal with that and it’s important to really know that there are a lot of things you can do even when you have a medicated birth like moving around, have your doula move you in a good position so the baby’s head can come down. And all these tools and techniques are part of our classes and the idea is that we learn the physical parts – what is going to happen with your baby, how is the baby going through the pelvis but also what’s going to happen with you, how can the partner help, how do the emotions affect part of labor, how you feel safe, how to communicate with the doctor and mainly of course positioning and breathing techniques – how you can deal with all these contractions, there’s a lot of techniques that are amazing.

There are other classes also like HypnoBirthing that offer very specialized look towards a natural birth. So HypnoBirthing is not for everybody, I know it is in New York especially. So I do take parts from the HypnoBirth, especially the breathing and the focusing, the relaxation parts but there is also a lot of information about what is going on in the hospital, what is triage, what does it mean when they tell you your partner has to leave the room because they need to ask you a few questions. You need to know about that. You need to know that there are a certain few things that need to be done in a hospital because it is a hospital and you will be prepared for those as well.

Question 5: How do you know when it is time to deliver?

RC: Great, so how do you know when it is time to deliver the baby?

Stephanie Heintzeler: Well yeah that’s a great question. So basically there are a lot of parents who end up in a hospital way too early because they think the baby is about to be born and they don’t have a doula maybe and they’re just getting there and the doctor says the cervix is closed or maybe it’s one centimeter. So you are in super early labor and so they go home and that is stressful because you really thought something was about to happen.

A good sign is when the contractions are really really intense and also very close to each other. So every five minutes, one minute long and this is over the course of an hour but also it has been going on for a while. Because sometimes contractions start very quickly in the middle of the night but they are not intense. So a mother calls me and she might say, “Oh I have contractions every five minutes” but while she has one, she actually speaks to me on the phone. The mother who is really in true labor, she’s not able to talk. She actually has to breathe and focus and is really not so happy during the contractions and needs all the support. And if we are about to have the baby, a mother is not really herself anymore – she’s kind of out of it. Her hormones kick in because the pain reach the hormones and she’s very sleepy in between contractions. Contractions are very intense because she needs to breathe through these contractions and also usually where the pain is – the contractions feel – some don’t even feel as pain, they just say as pressure. So that’s a good sign, right – pressure shows the baby is moving down the pelvis and is hopefully about to be born.

And we try to really be on the phone as a doula. Where are we at? What’s changing? What’s happening? Are you okay with these contractions? And then we labor a few more hours at home together to avoid a C-section, to avoid more intervention because if you end up in the hospital too early and the cervix is only two centimeters and the hospital would take you on, usually they don’t even take you on that early but say if you put your foot down and say I want to stay now, then contractions should stop again because you’re stressed out and you weren’t in labor and then the hospital has admitted you so then they have to induce you because you are in the system and you know you’re there now so you have to leave with your baby. They can’t just let you go. So that is why they try to not take you on too early and it is a good thing. So we really look at all these different signs but mainly time, it’s really the time that shows where a mother is in labor.
RC: Okay well thank you so much Stephanie. We know you are extremely busy, so I just want to thank you for all your time and your help today.

Stephanie Heintzeler: You’re very welcome.

RC: And for our listeners across the country, if you are interested in speaking with Stephanie Heintzeler, you can either go online to www.thenewyorkdoula.com or call (917) 399-2031 to schedule an appointment.

On behalf of our entire team at razorcast™, we want to thank you for listening and we look forward to bringing you more top quality content from our country’s leading industry professionals.