prenatal care Archives | Doulas of Baltimore

Tag Archive for: prenatal care

What is Head Molding? Caput Succedaneum in Newborns

“Why does my baby’s head look like a cone?!” New parents are often confused when their new addition’s scalp features bruising, swelling, or an odd shape. Not to worry, Caput succedaneum and head molding are incredibly common (temporary!) adjustments your baby made during birth. Let’s break down what these terms mean and why there’s usually no cause for concern.

What is Caput Succedaneum?

Caput Succedaneum is a soft, squishy, sometimes bruised swelling on top of the scalp, crossing suture lines (the seams between skull bones). You can think of it as localized fluid buildup.

What is Head Molding?

Head Molding is an elongated or cone-shaped head that is caused by the overlapping of the baby’s soft skull bones during passage through the birth canal.

Why do these conditions happen?

These conditions are caused by pressure from the uterus, cervix, or birth canal while baby is being born. They can present in any delivery but are more common when labor is prolonged, membranes are ruptured early, if a vacuum is used to assist delivery, or can even be seen in first-time pregnancies. While it can be unnerving for your baby’s head to look less than normal, remember that this is a very common thing that happens and it will in most cases resolve on its own without intervention.

What are the essentials to know about Caput Succedaneum and Head Molding?

Timing: These conditions will likely appear immediately or shortly after birth. Caput swelling typically resolves within hours to a few days. Head molding usually corrects itself within 1–2 weeks as bones shift back.

Appearance: Caput feels like a soft, puffy area; may have bruising. Molding makes the head look pointy or asymmetrical.

Pain Levels: Neither of these common issues are painful for your baby!

Other things to watch for: Another condition, Cephalohematoma, is similar in appearance to Caput. This condition is a hemmorhage that causes swelling under the skin but over the skull. While it typically isn’t anything to worry about, it can come with complications that are. That’s why it’s always important to work with your pediatrician to monitor and treat as needed.

FAQs

Q: Does this mean my baby’s brain was injured?
A: Absolutely not. Caput and molding are external or bone-related changes. They don’t affect the brain.

Q: Will my baby’s head stay this shape (head molding)?
A: Nope! Skull bones shift back naturally. By 2 weeks, most little heads have rounded out beautifully.

Q: Why does the swelling (Caput) move if I touch it?
A: Because it’s fluid under the scalp! Gentle pressure can temporarily displace it—this is normal.

Q: Do I need to treat these conditions?
A: Usually no treatment is needed. Just handle baby’s head gently. If bruising is present, it will fade like any other bruise.

Q: Is this the same as having a flattened head?
A: No, that’s a different type of positional head molding that can happen later on in baby’s life. Flattened heads typically occur due to prolonged time on flat surfaces and can be avoided or addressed by things like Tummy Time or a baby helmet (as prescribed by your pediatrician).

Q: When should I worry?
A: Contact your provider if:

Swelling worsens after 2–3 days.
Baby develops a fever, is excessively fussy, or refuses feeds.
Jaundice appears (bruising from caput can increase bilirubin levels).

The Bottom Line

Caput succedaneum and head molding are common, harmless, and temporary results of birth. They highlight the amazing flexibility of your newborn’s skull. While unusual head shapes can be startling, they’re rarely a medical concern. Trust your pediatrician to monitor progress—and trust your baby’s body to find its perfect shape.

Got questions? Your birth team and pediatrician are always your best resource.

Birthing Parental Health Resources from Doulas of Baltimore

Childbirth Education, Postpartum

As birth professionals, birthing parental health is paramount to our roles in the birth and parenting space. We know that our advocacy is vital to improving outcomes. Around 3.7 million babies are born each year in the US, but we are the only developed country with a rising mortality rate for birthing individuals. Not to mention that rate is worse for marginalized groups.

Black women are three to four times as likely to die of pregnancy and birthing complications as white women. Disabled people have a significantly higher risk of dying from pregnancy and childbirth than their able-bodied counterparts.

Here is the important statistic, though: 60% of birthing parent deaths are preventable. Understanding the disparities and providing equity in healthcare access can decrease maternal mortality. To help increase awareness for maternal health, the American College of Obstetricians and Gynecologists (ACOG) recognizes Maternal Health Awareness Day every January 23.

We’ve gathered some of our favorite resources for expectant parents to improve maternal health outcomes. Let’s walk through them!

Routine Prenatal Visits are Vital for Your Birthing Parental Health and Baby’s Health

ACOG recommends that you schedule a visit with a care provider as soon as you know you are pregnant. Then, go to all of your visits, even if you feel fine. A prenatal care provider can include an OB/GYN, a family care doctor, a nurse practitioner, or a midwife.

The March of Dimes has an extensive guide to prenatal care visits and what to expect.

Understanding Pregnancy Helps Support a Healthy Pregnancy

Our belief is that education, collaborative provider partnership, and unwavering nonjudgmental support can make pregnancy and childbirth one of the most fulfilling and transformative experiences of your life. Understanding pregnancy can help people know what to expect, what to look out for, and how to stay as healthy as possible. For example, preeclampsia is a leading cause of birthing parental mortality, but many people may not know their risk factors.

The American College of Obstetrics and Gynecology (ACOG) has an infographic with preeclampsia basics and an FAQ about staying healthy before and during pregnancy. At Doulas of Baltimore, our Childbirth Education Classes help you feel informed and make confident decisions.

Postpartum Care Should Be an Ongoing Process to Support Birthing Parental Health

While a lot of focus is placed on the time leading up to childbirth, ACOG has recognized that the postpartum period is important. For parents, this should mean planning and thinking about healthcare, feeding, care, and important decisions (link to last blog) before baby arrives. ACOG believes that postpartum care should be an ongoing process that is individualized for each birthing person. This is especially true for people who have other health conditions that may impact their postpartum health. March of Dimes has an overview of what to expect during postpartum healthcare visits.

Each pregnancy and birth is unique. By helping parents understand childbirth and the postpartum period, we can create change for healthier families and babies.

RSV Vaccine during Pregnancy | The Evidence

Pregnancy

We all want to keep our newborn babies safe. When looking at common illnesses, RSV is a frequent concern amongst new parents. The latest recommendation? Recieve the RSV Vaccine during pregnancy. If your doctor has made this suggestion you may be curious how it works. Let’s take a look at what RSV is and what you can do before your baby is even born to protect them from it.

What Is Respiratory Syncytial Virus (RSV)?

Respiratory syncytial virus (RSV) is a leading cause of hospitalization in infants, responsible for 58,000–80,000 annual hospitalizations in children under 5 in the U.S. Babies under 6 months are especially vulnerable, as RSV can lead to severe lung infections like bronchiolitis and pneumonia. We’ve done a deep dive on the specifics of RSV in babies, you can check that out here!

It’s important to remember that while RSV is dangerous for infants and the immunocompromised, it can present as a common cold in healthy individuals. This means even if someone’s only symptom is a runny nose, they could spread the illness.

How does getting the RSV vaccine during pregnancy work?

The Abrysvo vaccine, approved by the FDA and recommended by the CDC, is given to pregnant individuals between 32 and 36 weeks of gestation. It works by transferring protective antibodies to the fetus, providing passive immunity that shields infants during their most vulnerable early months.

Is it safe and effective?

Yes! Clinical trials show impressive results:

81.8% efficacy against severe RSV within the first 90 days of life.
69.4% efficacy through 6 months of age.

Safety data from over 7,000 participants revealed no significant risks to pregnant individuals or babies. The most commonly seen side effects are mild such as injection site pain or fatigue and they were reported to be short-lived.

What else should I know about the RSV Vaccine during Pregnancy?

Timing: CDC recommends vaccination at 32–36 weeks, ideally before RSV season (typically fall/winter).

Who should get it? Most pregnancies without contraindications. This could be something such as an allergy to the vaccine’s components.

Alternative option: For those unable to receive the vaccine, there is an option that can be given to infants post-birth.

The American Academy of Pediatrics (AAP) and World Health Organization (WHO) endorse RSV vaccination during pregnancy as a safe, effective way to reduce infant complications due to RSV.

Take Action

The most important thing you can do when considering healthcare decisions is to talk to your trusted healthcare provider. You can practice using the BRAIN acronym during your prenatal visit by asking the following questions:

Benefits – What are the benefits of recieving the RSV vaccine during pregnancy?
Risks – What are the known risks? What are the risks of RSV to a newborn?
Alternatives – What alternatives do I have?
Intuition – What am I feeling now that I know the science-based answers to my questions?
Nothing – What happens if I do nothing about RSV?

By vaccinating during pregnancy, you’re offering your baby a strong first defense against a potentially serious illness.

Group B Strep: What is GBS?

Pregnancy

If you’re pregnant it’s likely you’ve heard of Group B Strep (GBS), probably as one of the required tests for pregnant individuals. What is it and why does it matter? While GBS is common, (1 in 4 pregnant individuals have it present!) if left untreated it can pose serious health risks. Today we’re taking a look at what GBS is, treatments and testing, and the bottom line so you can make informed and empowered decisions for you and your baby.

What Is Group B Strep (GBS)?

GBS is a common bacterium (Streptococcus agalactiae) that naturally exists and is typically harmless in adults. It resides in the digestive, urinary, and reproductive systems. While the bacteria may be present (colonization) it often doesn’t lead to infection.

If a bacteria has colonized, it simply exists. It’s when it gets out of control that it can cause infection in the body. Even if one is asymptomatic, infection could be present and is very dangerous for newborns which is why testing is so important. An estimated 20-25% of pregnant individuals have GBS present.

Remember: levels can vary over time.

Why Is Group B Strep a Concern During Pregnancy?

Risks to the Pregnant Person:
Those who have GBS present generally are unaffected. Rarely, they can encounter complications such as Urinary Tract Infections (UTIs), infection of the amniotic fluid or infection of the uterus once the baby has arrived.

Risks to the Baby:
The risks of GBS are generally for the baby. Transmission of the bacteria to the baby during childbirth can lead to early-onset (first week) or late-onset (weeks 1–3) disease. Complications from contracting this bacteria include sepsis, pneumonia, meningitis, long-term disabilities, or even mortality.

Though this can sound scary, please keep in mind that these are rare complications, only affecting 1 or 2 babies out of 100 if the laboring person doesn’t receive antibiotics during labor. Though rare, it’s vital to understand the facts.

Risk Factors for Transmission:
Your baby may be at a higher risk for contracting GBS if you experience preterm labor, prolonged rupture of membranes (greater than 18 hours), a fever during labor, or a prior GBS-positive baby. Your baby is also at risk if you test positive on your routine GBS testing.

How Is GBS Tested for in the United States?

The United States takes a broad approach to testing using a Universal Testing model that requires a routine vaginal/rectal swab at 36–38 weeks. This will typically be done at your OBGYN or Midwife’s office. This swab is then cultured and evaluated to determine if GBS bacteria are present. If yes, the results will be communicated to you along with options for treating and intervention.

This testing is done between 36-38 weeks to ensure accuracy (remember, this bacteria varies in levels present) and avoid overuse of antibiotics.

Urine testing can also detect GBS earlier in pregnancy. Typically a positive result won’t prompt any action by your care provider but if heavy colonization is indicated, this could require antibiotics during pregnancy.

You might be surprised to find that countries around the world vary in their approaches. Canada, for instance, aligns with the US perspective of Universal Testing whereas Nordic countries such as Sweden and EU countries such as the UK prefer a Risk-Based approach where testing is only done if requested or indicated. Regardless, it’s important to ask questions and follow the recommendations of your trusted healthcare provider.

What Are the Options If I Test Positive for GBS?

Intrapartum Antibiotics:
The gold standard for care is IV penicillin administered during labor at least 4 hours before delivery. This helps ensure efficacy of the antibiotic prior to baby passing through the birth canal. The timing is important!

Special Scenarios:
If labor is rapid it can limit the efficacy of the antibiotics. Antibiotics will still be given but baby will likely be monitored more closely. In the event of a Cesarean section delivery, antibiotics won’t be needed if labor hasn’t begun and your water hasn’t broken.

What Else Should I Know About Group B Strep?

Prevention Strategies: There are no preventative measures that can be taken to eliminate GBS bacteria in the body. This bacteria occurs naturally. Once detected, prompt antibiotic treatment reduces neonatal risk by ~80%.

Newborn Care: It’s important to monitor the baby for fever, lethargy (difficult to wake), or breathing struggles. These can all be signs of infection and should be addressed as soon as possible by a medical provider. The baby’s pediatrician should be the first call. Antibiotics are the standard treatment.

Postpartum Care: Mind the birthing person’s temperature and symptoms alongside baby’s, paying attention to any changes and seeking care if they’re noted.

Emotional Support: Addressing parental anxiety and connecting with support groups.

Future Pregnancies: Retesting will be required for all subsequent pregnancies, however, a positive test isn’t a guarantee. Group B Strep can be a transient bacteria that recedes, eliminating the risk to the birthing person and their baby.

Are There Myths About GBS?

Yes! There are many myths about GBS that can feel scary or leave you feeling confused. The main ones are:

GBS is not a sexually transmitted infection. It is a naturally-occurring bacteria that exists within the body and a common one, at that.

Antibiotics during labor do not harm the baby. While it is true that the antibiotics could have a small impact on baby’s microbiome, these effects have not been studied at length. Preliminary studies with limited data suggest that the impact is short-term and the effects can be mitigated to some degree by choosing to breast or chestfeed.

Positive status doesn’t guarantee infant infection! Even if you do test positive and aren’t able to recieve antibiotics quickly the number of newborns that get sick from GBS are few. While the illness is a very serious one and shouldn’t be taken lightly, it is still rare.

No proven remedies are known to exist besides antibiotics during labor. There are many online suggestions such as Hibiclens or Garlic to change the bacteria levels. There are no scientific studies to prove any of the alternatives work to keep your baby safe.

Wrapping it all up

If you’ve found yourself here because you have tested positive for GBS, don’t panic. Remember, GBS is a bacteria that naturally exists within the body. There is nothing you could do that would change that. If you test positive for GBS at your routine screening, remember that it is manageable with proactive care.

Antibiotics reduce both neonatal and postpartum risks for baby and parent and can be simply administered during labor.

As with everything, remember to ask questions and follow the guidance of your medical care provider. With early intervention, proper treatment, and consistent care you and your baby will not experience any ill effects from GBS.

Early Labor | What Should I Do?

Childbirth Education, Doulas of Baltimore, Pregnancy

Early labor can often leave us with the question of, “When do I head to the hospital?”. Clever reminders like “511” remind us that contractions should be 5 minutes apart and 1 minute long for 1 full hour before you head in. As doulas, we are huge advocates for distraction through early labor. Often, when you focus on distractions you’re able to discern when you can’t ignore labor anymore.

When your pregnancy is healthy and labor is going normally, we love to encourage clients to try to make their contractions go away. True labor won’t stop just because you put your feet up! In addition to staying hydrated, eating nourishing food that feels good to you, and laying down for a bit, here are a few of our favorite ways to enjoy a distraction during early labor.

Schedule an Appointment

An excellent way to relax and distract yourself is to get yourself to a self-care appointment. Book a pedicure, a prenatal massage, or find a salon near you that does blow outs. These appointments are wonderful for distraction but they also help create a flow of oxytocin in your body. Oxytocin is a wonderful pain relief and also calming hormone and it can be stimulated by skin-to-skin contact. Be sure you’re in contact with your birth team and consider having someone else drive (just in case!)

Warm Shower or Bath

The warmth of a shower or bath can ease tension and relax your muscles, helping you stay comfortable as early labor progresses. Water has a calming effect and can provide gentle relief, especially for back pain or cramps. Sitting or standing under a warm shower allows the heat to target your back and abdomen, while a bath can create a more immersive, weightless experience that helps you relax between contractions.

Safety Note: Be sure to keep the water at a comfortable, warm temperature (not hot) and stay hydrated if you’re soaking for a while.

Movement and Gentle Exercise

Moving around can be surprisingly effective in early labor. Gentle stretches, walking, a prenatal yoga video, or using a yoga ball can help release muscle tension, encourage a more optimal baby position, and may even help labor progress. Slow dancing with a partner or swaying your hips in a figure-eight motion can bring comfort and connection, grounding you through each contraction.

Tip: If you have a yoga or birth ball, sit and gently rock your hips, move them in a figure 8 motion, or bounce lightly to ease any pressure in your lower back or hips.

Create a Calming Environment

A soothing environment can make a big difference in how you feel. Dim the lights, play calming music or sounds, and use soft, cozy blankets or a favorite pillow. Try lighting a candle that has a soothing scent to create a spa-like atmosphere if you’re interested in aromatherapy. Choose things that bring you comfort and help you feel safe.

Tip: Make a playlist with a mix of calming and upbeat songs. The calming ones can help you relax, while the upbeat tracks can lift your mood if you’re feeling restless.

Mindful Distractions

Early labor is the perfect time to engage in activities that keep your mind occupied without draining your energy. Simple activities like reading a favorite book, watching a comforting movie, or doing a craft project can keep your focus off contractions while still allowing you to relax. Some people enjoy adult coloring books, knitting, or easy puzzles that bring a sense of calm.

Tip: Make a list of short, enjoyable tasks you can do easily and stop anytime, so you’re prepared with options if labor progresses quickly or you start needing to focus more on your contractions.

These techniques can help you stay comfortable and relaxed at home as labor begins. Remember, there’s no right or wrong way to experience early labor; do what feels best for you. Take things one contraction at a time, stay connected to your body, and know that each step brings you closer to meeting your baby.

Unsure if it’s really labor? Check out our blog “Am I actually in labor?”