The Mission of Doulas of Greater St. Louis is to support, educate and advocate for women and their families throughout
the childbearing year and to provide St. Louis Metro area doulas with supportive fellowship and continuing
education opportunities.
Acupressure: A treatment that can be used to relieve headache and backache pain caused by pregnancy. Finger pressure, instead of needles, is used at acupuncture points.
Acupuncture: Acupuncture originated in China over 5,000 years ago and is widely practiced all over the world now. It is based on the idea of there being a vital life force or flow of energy in the body (known as "chi"). In our bodies the "chi" flows through channels and sometimes there might be a blockage in these channels. An Acupuncturist will use very fine needles to remove the blockage and stimulate points along the channels. It can be used to relieve headache and backache pain, as well as relieving discomfort due to hemorrhoids during pregnancy. (*Certain points should not be used during pregnancy. Please make sure the acupuncturist you choose is aware of your pregnancy and that he/she has worked with pregnant women before.)
Afterbirth: Also known as the placenta.
Alpha-Feto-Protein (AFP): A test that may be ordered by your health care provider. The AFP test is usually performed during the 15th-20th week of pregnancy and is used to identify any defects in the babys nervous system. Elevated levels do not necessarily mean that baby has a neural tube defect. If the levels are high, your health care provider may then perform a very detailed ultrasound or may perform an amniocentesis to obtain amniotic fluid and to get a more account measurement of the AFP.
Amniocentesis: A procedure that involves collecting a sample of the amniotic fluid via the mothers abdominal wall and is performed between the 15th and 20th week of pregnancy while an ultrasound is being performed. It can be used to detect chromosomal abnormalities and many other genetic and prenatal problems. It can also be used during the last stages of pregnancy to determine whether the lungs of the baby are mature enough.
Amnio-Infusion: When your health care provider might believe that the baby is having distress due to cord compression (and delivery is not soon), he/she might decide to perform an amnio-infusion. A sterile saline solution is infused into the uterine cavity to relieve the pressure on the umbilical cord.
Amniotic Fluid: The fluid that is contained in the bag of waters that surrounds the baby. The fluid also contains cells and waste products from the baby.
Amniotic Sac: The "bag of water". It is thin membranes filled with amniotic fluid . (Stripping of the amniotic membranes is sometimes done in order to induce labor for a variety of reasons.)
Amniotomy: The "bag of water" will sometimes rupture on its own, but when it does not, health care providers may decide to rupture it artificially. It is sometimes done to induce labor or in hopes of "speeding up" labor.
Analgesic: Narcotic analgesics are sometimes administered during labor either by an I.V. or into a muscle. There are some side affects to these medications, that include, but are not limited to, drowsiness, an inability to concentrate and a feeling of "loss of control". These are given in early labor because when they are given later, babies tend to be sleepier and their reflexes and breathing are slowed down.
Anesthesia: During labor there are several forms of anesthesia that is used. These include, Epidural Anesthesia, Walking epidural, Spinal Anesthesia and General Anesthesia.
Apgar Scores: Newborns are given a numeric score at one minute and five minutes after birth. Sometimes there is a ten minute assessment also. The score given is based on the newborns respiration, muscle tone, reflexes, skin color and heart rate. The scores will range from 0 (lower range) to 10 (higher range). Babies who have experienced distress during labor and delivery may have lower scores at one minute but most will usually be higher after five minutes. If the scores do not improve, the baby will be immediately taken to the nursery for other tests and evaluations.
Augmentation of Labor: When a health care provider deems that labor is not "progressing", he/she may order drugs to enhance the strength of contractions. The drug most commonly given is Pitocin
Birth Plan: Documented preferences/choices that you and your partner have regarding how you would like for your labor and delivery to progress. Most women prepare their birth plan in advance and go over it with their health care provider. At that time, he/she may be able to inform you as to the policies regarding where you are planning to deliver and whether or not they will support those preferences/choices.
Braxton-Hicks Contractions: These occur usually in the last trimester. They feel like cramps but are contractions that are getting your body ready for labor. They can last for 30 seconds and up. These are the contractions that are responsible for "false labor". Sometimes women can get these contractions to stop or be less intense by drinking water and resting. (However, you should call your health care provider if you are not sure if they are Braxton-Hicks contractions or labor contractions!)
Breech Delivery: Breech delivery occurs when the baby is positioned in a way so that the head is not coming first. Breech deliveries occur in roughly 3-7% of all deliveries. Some babies turn on their own before delivery and some babies can be rotated by a health care provider by a procedure called External cephalic version (ECV).
Centimeters: This is one of the measurements used by health care providers to assess how near your delivery of your baby is going to be. Centimeters describes the dilation, or opening, of the cervix.
Cervical Effacement: The cervix needs to thin out, or efface, before it can dilate fully. Effacement is usually assessed as a percentage. (A fully effaced cervix is 100 % effaced.)
Cervical Ripening: When the cervix is still long, thick and closed, your health provider might suggest medications or other means to ripen, or soften, the cervix. When labor is going to be induced, your health care provider will have to find the appropriate way to soften your cervix in order for labor to begin.
Cesarean Section: A method of surgically removing a baby through a womans abdomen. The United States has one of the highest rates of Cesarean Sections in the world. Sometimes health care providers schedule a cesarean section in advance if there are factors that indicate one would be necessary. There are risks associated with a cesarean section, just as with other surgeries. Some risks are bleeding, infection, longer recovery time. It is also associated with delayed breastfeeding and delayed bonding with your new baby.
Chorionic Villus Sampling (CVS): Between the 10th and 12th week of pregnancy your health care provider might elect to perform a CVS test to eliminate the possibility of a chromosomal defect, such as Downs Syndrome. A sample of the placental tissue is looked at and the genetic material is analyzed. It can be done earlier than amniocentesis but it can not detect neural-tube defects such as spina bifida.
Circumcision: The removal of a piece of tissue, foreskin, that covers the tip of the penis. Circumcision is usually performed before your baby is released from the hospital. In the Jewish tradition, the "bris" is held on the eighth day after the birth of a baby boy. Circumcision is a widely debated issue and it is up to each family to decide whether or not to circumcise their baby.
Colostrum: Is the yellowish liquid that a newborn receives when breastfeeding until your breastmilk comes in. Colostrum is highly nutritious, low in fat and high in protein and antibodies. Some women may have leakage of colostrum during their pregnancy that might continue throughout the entire pregnancy, some have leakage closer to their due date.
Contractions: When the muscles of the uterus contract regularly and cause the cervix to thin and to dilate. The contracting of the muscles is what helps to push the baby out of your vagina.
Crowning: Crowning is when part of the babys head is out of the vagina.
Deceleration: Slowing of the fetal heart rate (FHR). It can be an indication of fetal distress.
Doula: A doula is someone who has received training through education or experience in order to help women with emotional, physical and informational support during their labor and delivery. Doula support will usually make things progress at an easier pace for the woman and her partner. A doula is not a doctor or midwife so a doula does not perform medical tasks (such as monitoring blood pressure, fetal heart checks, etc.).
Down Syndrome: A very common chromosomal abnormality in which the baby will have 47 chromosomes instead of 46. It is a genetic abnormality and has varying affects on the babies who have it. Some have problems such as heart defects, mental retardation and abnormal features such as a rounded head, thick tongue and unusual eyes. (Also known as Trisomy-21).
Eclampsia: Characterized by convulsions, cerebral hemorrhage and coma. Can be fatal to the mother and her baby. (See Pre-Eclampsia for more information.)
Engorgement: When a womans breasts become extremely full and painful which makes it difficult for the baby to latch on. The best solution for engorged breasts is to nurse the baby. If the breasts are too hard and full for the baby to latch on, the mother should express some milk either by hand or with the help of a breast pump.
Epidural Anesthesia: An epidural numbs a woman from the waist down. The woman will be fully awake but will not be allowed to get up and move around or go to the bathroom. She will need a catheter to empty her bladder. The procedure is performed while a woman is seated or lying down. The anesthesiologist will then numb the area of the skin where the epidural will be placed and then inserts a tube between the vertebrae of the backbone. The tube is then taped to the back and then brought around to the top of the shoulder. They can give "boosters" if necessary. Within 15-20 minutes most women do not feel any more pain. The anesthesiologist will usually let you know if you can sit up or if you have to lie in a semi-sitting position. The epidural stays in place until the baby is delivered. Epidurals do have risks for you and your baby. You should ask your health care provider about the risks associated with any anesthesia or medications before delivery or before they administer them. A trained labor support person, also known as a Doula can help you gather information necessary before you deliver and can also help support you during your labor if you are choosing to not use an epidural or any other medications/anesthesia.
Episiotomy: An episiotomy is a surgical cut into the perineum in order facilitate the delivery of your baby. Episiotomies are a widely debated topic as to whether or not they are really necessary. Some health care providers do them routinely while others will only perform one if it is deemed medically necessary. Ask your health care provider what his/her protocol is regarding episiotomies. This is certainly one of the issues to bring up while working on your birth plan. Alternatives to episiotomies are using warm compresses and supporting the perineum.
Erythromycin: A medication that is placed in the babys eye shortly after birth to prevent serious eye infection or blindness due to bacteria present in the vagina of the mother. Erythromycin protects against chlamydia and gonorrhea. In some states this is a mandatory procedure.
External cephalic version (ECV): A procedure that is used to turn a breech baby. Your health care provider will decide when and if this procedure should be performed. (Also see Breech Delivery)
External Electronic Fetal Monitoring (EFM): If you will be delivering your baby in a hospital, you will have to decide whether or not you would like electronic fetal monitoring. EFM is equipment that the hospital will use to monitor your contractions and the heartbeat of your baby while you are in labor. This information is recorded by the machine and is used to assess your labor and the condition of your baby during your contractions. External EFM is less accurate than Internal External Fetal Monitoring.
Fetal Distress: When your baby is having to adjust to lower oxygen levels. At any point if your health care provider notices any changes in how your baby is doing, he/she might believe your baby is in distress. Your health care provider will decide if this can be fixed by a change in position in case the baby is on the umbilical cord or whether immediate delivery, either vaginal or cesarean, is the only way to avert any other problems. Most often a woman will always be given extra oxygen if her health care provider believes the baby is not getting enough oxygen.
Fetal Station: Is how your health care provider measures the degree of descent of the presenting part of your baby into the birth canal. Station is measured in centimeters and ranges from minus 4 to plus 4. A 0 station means that the babys head is right at the mothers mid-pelvis. The greater the plus number, the closer the baby is to the outside and being delivered.
Fetoscopy: When a narrow tube is inserted into the pregnant womans abdomen, piercing the uterus. The fetoscope, which is a viewing instrument, is then inserted into the tube to allow your health care provider to observe the fetus and the inside of the placenta. Fetoscopy is usually performed when the Alpha-Feto-Protein test or a ultrasound has led the health care provider to suspect a malformation.
Forceps: Metal instruments that are used to assist in the delivery of a baby. Forceps look like two big spoons that are locked together. Once in place they can not be tightened any more which protects the babys head from unnecessary pressure. Your health care provider will pull during the contraction while you are pushing. Discuss the use of forceps with your health care provider before your delivery to find out under what conditions he/she would use them.
General Anesthesia: When general anesthesia is used is causes a loss of consciousness so this type of anesthesia is usually reserved for emergency situations when there is not enough time to administer an epidural or spinal block.
Genetic Testing: Usually advised for women age 35 or older who are pregnant or planning to become pregnant or those with a family history of genetic defects.
Glucose Screening: A test performed to rule out diabetes. If your test is abnormal you will also have to undergo a glucose tolerance test to diagnose whether you have gestational diabetes.
Group B Strep: Pregnant women are generally tested for Group B Strep between 34 and 36 weeks into their pregnancy. Secretions from the outer vagina and the rectum are sampled and a culture is done. If the culture is positive, the mother will be given antibiotics during her labor. Her health care provider may want her to proceed immediately to the hospital if she thinks she is in labor so that the antibiotics can be administered before delivery. Group B Strep has been associated with severe neonatal infection.
Hydramnios: Is a condition that occurs during the later stages of pregnancy. The condition is characterized by an excessive amount of amniotic fluid in the amniotic sac. Hydramnios is common in women with twin pregnancies and those with pre-eclampsia. This condition can put the woman at risk for premature labor.
Induction of Labor: When your health care provider decides that the benefits of delivering the baby at that time outweigh those of continuing the pregnancy to term. Usually involves being admitted to the hospital and receiving drugs to stimulate contractions and to ripen, or soften, the cervix.
Internal Electronic Fetal Monitoring: A method of monitoring your baby where a thin, sharply pointed spiral needle is attached to your baby. Internal electronic fetal monitors can sometimes come loose and will need to be replaced. It is shown to be more accurate than External Electronic Fetal Monitoring.
Jaundice: A yellowish tinge that a baby will have when born. All newborns are born with some degree of jaundice because their liver cannot process bilirubin. Your babys health care provider will assess the level of jaundice your baby has and decide if it needs to be treated with phototherapy.
Lamaze Method: A childbirth class in which parents-to-be are taught relaxation and breathing techniques for each stage of labor.
Lochia: Postpartum uterine discharge that will be present for several days (or weeks). Your health care provider will advise you of what is normal and what symptoms might be abnormal.
Mastitis: Usually occurs in women who are breastfeeding. It is associated with tenderness and redness of the skin. It can be treated with antibiotics.
Meconium: The babys first bowel movement. Sometimes when a baby is in distress during delivery, it will pass the meconium. Swallowing meconium can be extremely dangerous to the baby. The baby will have to be closely monitored by his/her health care provider if it is believed that he/she swallowed the meconium.
Midwife: A midwife is someone who has had special training to take care of women during their pregnancy, labor and delivery and postpartum. Women typically require less pain medications when attended by a midwife. A midwife should be aware of your health history (including any previous pregnancies). Just as with any health care provider, you should check references and find one you feel comfortable with.
Mucous Plug: The cervical opening is sealed by a mucous plug created by the mucous glands. Before labor begins, the mucous plug may break loose and be discharged. It is sometimes mixed with blood and is also called "bloody show".
Multipara: This is used to describe a woman who has had a previous birth.
Neural Tube: A fold of the outer embryonic cells that appears approximately 3 weeks after conception and later develops into the central nervous system.
Obstetrician-Gynecologist: A medical health care provider that specializes in the reproductive health of women. They typically work in a hospital setting.
Oxytocin: The natural hormone that is secreted by the brains pituitary gland. The secretion of oxytocin stimulates labor by causing the uterus to contract.
Paracervical Block: Anesthetic is directly injected into the cervix. A paracervical block is less invasive than other forms of anesthesia (another less invasive anesthesia is a Pudendal Block).
Perinatologist: An obstetrician-gynecologist who is specializes in maternal-fetal medicine. If there are complications with your pregnancy, your baby or both, your health care provider may consult with a perinatologist. Chorionic villus sampling for genetic purposes is performed by a perinatologist.
Perineum: The area between the vagina and the anus.
Pitocin: A synthetic form of oxytocin. Pitocin is used to induce (or augment) labor.
Placenta: This is the organ that links the blood supply of the woman to her baby. It is attached via the umbilical cord. The umbilical cord carries oxygen and nutrients from the woman to her baby. It allows nourishment to flow to the embryo and wastes to flow away and maintains the separation of the two circulatory systems.
Placenta Accreta: A condition in which the placenta is attached to the uterus and is not easily removed after the birth of the baby. Placenta accreta may cause severe postpartum hemorrhage and could require an emergency hysterectomy.
Placental Abruption: An emergency during delivery, it is when the placenta detaches from the uterus before the birth of the baby.
Placenta Previa: This is also called a low-lying placenta. Placenta previa can cause painless bleeding late in pregnancy and cause extreme bleeding during labor when the cervix begins to dilate. Health care providers can diagnose different degrees of previa, such as marginal previa, partial previa and complete previa. Your health care provider can confirm what degree of previa you might have and will discuss your condition with you.
Postpartum Depression: A condition that occurs after the birth of the baby. Women may feel sad or very emotional and might have a lack of interest in the new baby. A spouse, friends or family might be the first to notice changes in the mother and should talk to her about her condition. She should also bring it up with her health care provider to rule out any other conditions. (In its mild form it is called postpartum blues and in its most severe form it is called postpartum psychosis.)
Postpartum Hemorrhage: Excessive blood loss after the delivery of a baby. The primary cause is that the uterus is not contracting firmly enough to control the bleeding. It can sometimes be caused by pieces of the placenta remaining inside the uterus. Your health care provider can diagnose whether your blood loss is normal or if you would need to be examined more thoroughly and possibly given medications to firm up the uterus.
Pre-Eclampsia: Also called toxemia. A complication that occurs during some pregnancies. The cause of pre-eclampsia is unknown. Symptoms include swelling, high blood pressure and protein in the womans urine. Some women experience headaches, blurred vision, nausea, vomiting and "seeing spots". Women who have any of those symptoms should call their health care provider immediately.
Premature Labor: Labor that occurs before 37 weeks into a pregnancy.
Premature Rupture of Membranes: When leakage of amniotic fluid occurs before the onset of labor. If the membranes rupture before the 36th week of your pregnancy, you will be admitted to the hospital in order for your health care provider to determine whether or not they can delay your delivery.
Primapara: A woman who is having her first baby.
Prolapsed Cord: When the umbilical cord descends out of the birth canal before the baby. The babys oxygen supply is affected by this event. This is an obstetric emergency and if not promptly and correctly managed it could result in the death of the baby.
Pudendal Block: Anesthesia that numbs the vagina, rectum and anus. This type of anesthesia is less invasive than other forms of anesthesia (another less invasive anesthesia is the Paracervical Block).
Retained Placenta: When the placenta fails to separate and is not delivered within a specific amount of time after the birth of your baby. To resolve the problem, your health care provider will press down on your abdomen and gently pull on the umbilical cord.
RH Factor: An antigen, a protein found on the surface of blood cells, which causes an immune response.
Rupture of the Membranes: This is when your "water breaks." See Amniotomy, Artificial Rupture of the Membranes, Premature Rupture of Membranes.
Spinal Anesthesia: A spinal block completely numbs a woman leaving her unable to move. It is a one time injection into the cerebrospinal fluid surrounding the spinal column in the lower back. The spinal block is typically used for cesareans and tubal sterilizations. As with other forms of anesthesia, it carries risks. Discuss the risks associated with spinal anesthesia with your health care provider.
Thrush: A yeast infection in the babys mouth that can spread to the mothers nipples. Thrush can be identified by the white patches in the babys mouth. Consult your health care provider if you think that your baby might have thrush.
Toxemia: See Pre-Eclampsia.
Umbilical cord: One blood vessel that carries oxgenated blood and nutrients from a woman to her baby and two that carry blood to the placenta for purification and cleansing. The umbilical cord is attached to the baby and to the placenta.
Umbilical Cord Prolapse: When the umbilical cord descends out of the birth canal before the baby. The babys oxygen supply is affected by this event. This is an obstetric emergency and if not promptly and correctly managed it could result in the death of the baby. (Also see Prolapsed Cord)
Vacuum Extraction: A method of delivering a baby in which your health provider places a plastic suction cup on the babys head. Your caregiver will pull on the device during a contraction while you are pushing. The suction cup will come off if pulled too hard therefore protecting the babys head from trauma.
Vaginal Birth After Cesarean (VBAC): An option to have a vaginal birth that is available to most women who have had one previous cesarean. You should discuss this with your health care provider to find out if you are a candidate for a VBAC.
Vitamin K: Vitamin essential in the clotting of blood. Newborns are at risk for excessive bleeding because they are relatively slow in clotting their blood for the first few weeks. The Vitamin K they receive in the hospital is usually sufficient to last them until they begin making their own Vitamin K.
Waterbirth: A method of natural childbirth that is thought to ease the transition for the baby into the outside world. For the laboring mother it is shown to ease stress and pain during labor. Waterbirths can be performed at home and in some hospitals.
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