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Friday, March 5, 2010

Early Decelerations

Early decelerations follow the shape of the contraction, but inverted. The heart rate begins to dip as the contraction starts. The bottom of the dip is at the peak of the contraction, and it returns back to baseline at the end of the contraction. It looks somewhat like a U-shape. The descent and return are also gradual, and they rarely dip below 40 beats per min. below baseline.

It is thought that these are caused by the cervix overriding the front fontanel of the baby's head. This causes an altered cerebral blood flow, with a subsequent slowing of the FHR due to what is called the Vagal reflex. It usually occurs between 4 to 6 cm of dilation, and is not an indication of a decrease in oxygen.

Obstetrics: Normal and Problem Pregnancies, 5th ed. Gabbe et al.
Fanaroff and Martin's Neonatal-Perinatal Medicine, 8th ed. Martin et al.

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Birth is a Journey: Does it have to be life changing?

  • One woman might have to climb on an overfilled boat, risking her life and nearly dying as she escapes over the ocean to come to this land. This experience could certainly be life altering. It may very well color the rest of her life, positively or negatively. (I overcame this amazing struggle and here I am triumphant! OR Holy crap, that was SO hard I don’t know if I can go on! By the way, neither response is “right”. No one would judge the woman with the 2nd response.)
  • One woman may buy an airplane ticket, sit on a comfortable 747 and fly to America with a nice smooth flight and landing. She is happy to be in America. Those welcoming her are glad she is here safe and sound. She may only travel by plane 2-4 times in her life, so it is pretty memorable. But the journey itself probably wouldn’t be life changing; it would simply be a journey.
  • One woman may learn to fly an ultra-light plane to lead a flock of geese into America teaching them to migrate. This experience could certainly be empowering and life altering.