Your questions about c-sections & labor

I received a few questions by email and post comments about labor and c-sections… I thought I’d try to be helpful to everyone and answer them here:

Question: Did I practice any pain management techniques? Do I think they’d be helpful?
Answer: We decided to do the Bradley Method (husband-coached childbirth). But we didn’t take a class, we only read the book (both Steve and I read it). Honestly, we didn’t find it very helpful. It starts by trying to pump you up– like, yea you can do it! And it talks a lot about why it’s the best method or why it works. Then tells you some tips (squatting is best, like sitting on a birthing ball… use abdominal breathing during early labor and later, keep your elbows out and chin down). And of course, the focus is on the husband and how he should talk to me and help me through it. It just didn’t work. Maybe if we had taken the Bradley class?

What I’d try, personally, is hypnobirthing. The at-home kit to teach yourself is like $300, which I thought was ridiculous. But if it works, I’d be willing to pay much more than that after the labor experience I had.

Also, I said the pain was unbearable… but the pain for each woman is different, so don’t let me scare you. It depends on your pain tolerance, your mindset, and the type of contractions. My contractions were focused in my lower belly, like menstrual cramps. Some women have the pain in their lower backs, wrapped all the way around, or just in the belly area.

Question: Do I think a different doctor would have given me a different result?
Answer: Without a doubt. My main OB didn’t start seeing me until I was 20 weeks along anyway (when we moved here) and she never remembered who I was… after she scared us with the “high-risk” and “full-term placenta” stuff we decided to try the 2 other OBs at that clinic because we weren’t too fond of her anymore. They weren’t much better.… but I ended up going back to the original and discussing my birth plan with her. She was actually great about that – saying she wanted my birth to be the experience I wanted. However.… we didn’t end up in labor with her. We got the doctor on call. If you have a doctor who you know will deliver you and she/he is on board with what you want, I think your chances are WAY better of things going how you want. The doctor we had had no idea who we were or what we wanted. She had no attachment to us and didn’t care. I hope to find a new OB that can become, basically, a friend. So that when I am pregnant again, I have someone familiar and friendly on my side.

As for the rest of the hospital staff… I only had the one nurse to deal with the whole time. Day nurse=awesome, night nurse=terrible. But either way, everything they do has to be passed through the doctor. So if you have your doctor on your side, you hopefully won’t have any issues. Plus, you can ALWAYS request a different nurse. I never even thought of it.

Question: How bad was it for Steve and I (without a doula)? What made us start wavering in our decisions? What would have helped us stick to our plan?
Answer: In the moment (exhausted, confused, in pain…) I basically forgot WHY I wanted the things I did. I knew I didn’t want interventions (water broken, pitocin, etc), but WHY? I thought, in hindsight, having a doula would have helped us stick to what we wanted. She would have spoke for us and said NO for us. But I’ve also heard stories where the doula got just as confused and exhausted. It’s just a really hard situation (for anyone) when the doctor starts talking about possible complications and makes you worry for your baby’s safety or your own. Early on I felt I was very strong with the hospital staff in what I wanted (refused water breaking and pitocin 3 times), but after 24 hours of labor and being exhausted (physically and mentally) and just wanting everything to work out… I broke.

Another thing.. Steve and I didn’t start the Bradley Method until pretty late in our pregnancy. I feel like we could have been more prepared. If your husband really doesn’t want a doula (as mine didn’t either), my best advice is to prepare early, and prepare lots (with regard to pain management).

Question: What should you ask your OB about c-sections, pitocin, etc? When should you talk about your birth plan?
Answer: Talk about your birth plan as soon as you’ve made it – trust me, it’s not premature and your doctor should be happy and willing to go over it with you. That way you can be sure your doctor is on board with your wishes (and you have time to switch doctors if needed). Plus, details and more questions will come up as you’re going over it with them.

Ask your doctor their c-section rates and what events may lead to one (if your water breaks/is broken, how long before they’ll want to intervene to prevent infection?; what will they do if you’re “stuck” at a certain dilation for however many hours?; etc). Ask what their max level of pitocin is and what their experience is with its use leading to c-sections. What percentage of births do they use pitocin on? If you get an epidural will you be able to get off the bed at all? (this may be a pointless question if you’re getting an epi regardless).

C-sections are something my OB and I never even discussed because I was so sure I wouldn’t have one. I just figured that if I ended up with one, it’d be an emergency… that’d it’d be absolutely necessary. And I was wrong – so definitely discuss it.

Please let me know if you have any other questions!

Electronic Arts Reports 1Q Results

Wireless News July 29, 2011

Wireless News 07-29-2011 Electronic Arts Reports 1Q Results Type: News

Electronic Arts announced preliminary financial results for its first fiscal quarter ended June 30.

This was another solid quarter driven by both digital and packaged goods,” said John Riccitiello, Chief Executive Officer, in a release dated July 26.

We saw strong digital revenue growth over the prior year. On packaged goods, NCAA is off to a great start and pre-orders for Battlefield 3 are tracking extremely well.”

EA is well positioned for the year ahead and reaffirms its fiscal 2012 non-GAAP EPS guidance,” said Eric Brown, Chief Financial Officer. “And we are increasing non-GAAP digital revenue guidance to a range of $1.100 billion to $1.150 billion for fiscal 2012.”

Selected Operating Highlights and Metrics:

–Trailing twelve month non-GAAP digital revenue $854 million, up 35 percent year-over-year.

–First quarter fiscal 2012 non-GAAP digital revenue $209 million, up 11 percent year-over-year.

–Trailing twelve month console non-GAAP digital revenue increased 91 percent year-over-year.

–First quarter fiscal 2012 smart phone non-GAAP revenue up over 75 percent year-over-year.

–Nucleus registered users 125 million at the end of first quarter fiscal 2012.

EA held five of the top ten paid games on Verizon, two of the top ten paid games on the iPhone, and two of the top ten paid games on the iPad in June 2011.

–Portal 2 sold in over two million units in the first quarter. On catalogue, Crysis 2 sold in approximately three million units life to date; Dead Space 2 and Dragon Age 2 have both sold in over two million units life to date.

EA was the #1 publisher in Western markets with 16 percent segment share in the June quarter.

–For the quarter, EA had four of the top 20 selling games in Western markets: Portal 2, Crysis 2, FIFA 11, and Tiger Woods PGA Tour 12: The Masters.

–Life to date, including digital and mobile downloads, FIFA 11 sold in nearly 15 million units and Battlefield: Bad Company 2 sold in over nine million units, demonstrating strong cross-platform results

EA Games Label and EA Sports garnered 148 award nominations and 19 wins at E3. Winners included Mass Effect 3, Battlefield 3, Star Wars: The Old Republic, FIFA 12, SSX, Need for Speed The Run, Kingdoms of Amalur: Reckoning, Madden NFL 12, and NHL 12.

EA’s E3 Game Changers press conference was viewed by more than two million people on Spike TV’s broadcast and live webcasts on several consumer sites.

–On July 12, EA announced an agreement to acquire PopCap Games, a provider of games for mobile phones, tablets, PCs and social network sites. With blockbuster titles like Plants vs. Zombies, Bejeweled, and Zuma, and a proven ability to create new hits, PopCap is a leader in the fast growing market for casual digital games. The acquisition is expected to be completed in August 2011. The PopCap acquisition is expected to be neutral to fiscal 2012 non-GAAP and GAAP EPS, at least $0.10 accretive to fiscal 2013 non-GAAP EPS and $0.10 dilutive to fiscal 2013 GAAP EPS. web site dragon age 2 characters

Q1 FY12 Financial Highlights:

Non-GAAP net revenue of $524 million was at the upper end of our updated guidance of $500 million to $525 million. Non-GAAP loss per share of ($0.37) also was at the upper end of our guidance of ($0.40) to ($0.37). As expected, non-GAAP net revenue in Q1 fiscal 2012 was lower as compared to Q1 fiscal 2011 due to a reduced title slate, which went from six major titles in Q1 fiscal 2011 to four in Q1 fiscal 2012. This was somewhat offset by our continued digital revenue growth.

Second Quarter Fiscal Year 2012 Expectations — Ending Sept. 30,

GAAP net revenue is expected to be approximately $675 to $725 million.

–Non-GAAP net revenue is expected to be approximately $925 to $975 million.

GAAP diluted loss per share is expected to be approximately ($1.03) to ($0.87) as compared to previous guidance of ($1.10) to ($0.97).

–Non-GAAP diluted loss per share is expected to be approximately ($0.13) to ($0.03) as compared to previous guidance of ($0.15) to ($0.05).

–For purposes of calculating second quarter fiscal year 2011 loss per share, the Company estimates a share count of 331 million.

–Expected non-GAAP net loss excludes the following from expected GAAP net loss:

–Non-GAAP net revenue is expected to be approximately $250 million higher than GAAP net revenue due to the impact of the change in deferred net revenue (packaged goods and digital content);

–Approximately $50 million of estimated stock-based compensation;

–Approximately $25 to 30 million of acquisition-related expenses;

–Approximately $5 million of restructuring charges;

–Approximately $5 million from the amortization of debt discount; and

–Non-GAAP tax expense is expected to be $43 to $56 million higher than GAAP tax expense.

Fiscal Year 2012 Expectations — Ending March 31, 2012

GAAP net revenue is expected to be approximately $3.825 billion to $4.025 billion as compared to our previous guidance of $3.725 billion to $3.950 billion.

–Non-GAAP net revenue is expected to be approximately $3.900 billion to $4.100 billion as compared to our previous guidance of $3.800 to $4.025 billion.

GAAP diluted earnings (loss) per share is expected to be approximately a loss per share of ($0.10) to earnings per share of $0.21, as compared to previous guidance of ($0.04) to $0.26.

–Non-GAAP diluted earnings per share are expected to be approximately $0.70 to $0.90.

–For purposes of calculating fiscal year 2012 earnings (loss) per share, the Company estimates a share count of 330 million for loss per share computations and 334 million for earnings per share computations.

–Expected non-GAAP net income excludes the following items from expected GAAP net income (loss):

–Non-GAAP net revenue is expected to be approximately $75 million higher than GAAP revenue due to the impact of the change in deferred net revenue (packaged goods and digital content);

–Approximately $175 million of estimated stock-based compensation;

–Approximately $85 to $95 million of acquisition-related expenses;

–Approximately $28 million of restructuring charges;

–Approximately $15 million from the amortization of debt discount; and

–Non-GAAP tax expense is expected to be $121 to $147 million higher than GAAP tax expense.

Amortization of Debt Discount on the Convertible Senior Notes. Under GAAP, certain convertible debt instruments that may be settled in cash on conversion are required to be separately accounted for as liability (debt) and equity (conversion option) components of the instrument in a manner that reflects the issuer’s non-convertible debt borrowing rate. Accordingly, for GAAP purposes, we are required to amortize as a debt discount an amount equal to the fair value of the conversion option as interest expense on the Company’s $632.5 million of 0.75 percent convertible senior notes that were issued in a private placement in July 2011 over the term of the notes. Electronic Arts’ management will exclude the effect of this amortization when evaluating the Company’s operating performance and the performance of its management team during this period and will continue to do so, when it plans, forecasts and analyzes future periods. here dragon age 2 characters

Change in Deferred Net Revenue (Packaged Goods and Digital Content). Electronic Arts is not able to objectively determine the fair value of the online service included in certain of its packaged goods and digital content. As a result, the Company recognizes the revenue from the sale of these games and content over the estimated online service period. In other transactions, at the date we sell the software product we have an obligation to provide incremental unspecified digital content in the future without an additional fee. In these cases, we account for the sale of the software product as a multiple element arrangement and recognize the revenue on a straight– line basis over the estimated life of the game. Internally, Electronic Arts’ management excludes the impact of the change in deferred net revenue related to packaged goods games and digital content in its non-GAAP financial measures when evaluating the Company’s operating performance, when planning, forecasting and analyzing future periods, and when assessing the performance of its management team. The Company believes that excluding the impact of the change in deferred net revenue from its operating results is important to (1) facilitate comparisons to prior periods during which the Company was able to objectively determine the fair value of the online service and not delay the recognition of significant amounts of net revenue related to online-enabled packaged goods and (2) understanding our operations because all related costs are expensed as incurred instead of deferred and recognized ratably.

Loss on Lease Obligation and Facilities. During the second quarter of fiscal 2010, Electronic Arts completed the acquisition of its headquarters facilities in Redwood City, California pursuant to the terms of the loan financing agreements underlying the build-to– suit leases for the facilities. These leases expired in July 2009, and had previously been accounted for as operating leases. The total amount paid under the terms of the leases was $247 million, of which $233 million related to the purchase price of the facilities and $14 million was for the loss on our lease obligation. In addition, Electronic Arts recorded a tax benefit of approximately $31 million, consisting of approximately $6 million related to the loss on our lease obligation, and a $25 million reduction in our valuation allowance due to the acquisition. As a result of this lease obligation and facility acquisition, on an after-tax basis, Electronic Arts incurred a positive net income effect of $17 million. Electronic Arts’ management excluded the effect of this transaction when evaluating the Company’s operating performance and when assessing the performance of its management team during this period and will continue to do so, when it plans, forecasts and analyzes future periods.

Loss on Licensed Intellectual Property Commitment. During the fourth quarter of fiscal 2009, Electronic Arts amended an agreement with a content licensor. This amendment resulted in the termination of our rights to use the licensor’s intellectual property in certain products and we incurred a related estimated loss of $38 million. This significant non-recurring loss is excluded from our non-GAAP financial measures in order to provide comparability between periods. Further, the Company excluded this loss when evaluating its operating performance and the performance of its management team during this period and will continue to do so when it plans, forecasts and analyzes future periods.

Loss (Gain) on Strategic Investments. From time to time, the Company makes strategic investments. Electronic Arts’ management excludes the impact of any losses and gains on such investments when evaluating the Company’s operating performance, when planning, forecasting and analyzing future periods, and when assessing the performance of its management team. In addition, the Company believes that excluding the impact of such losses and gains on these investments from its operating results is important to facilitate comparisons to prior periods.

Restructuring Charges. Although Electronic Arts has engaged in various restructuring activities in the past, each has been a discrete, extraordinary event based on a unique set of business objectives. Each of these restructurings has been unlike its predecessors in terms of its operational implementation, business impact and scope. As such, the Company believes it is appropriate to exclude restructuring charges from its non-GAAP financial measures.

Stock-Based Compensation. When evaluating the performance of its individual business units, the Company does not consider stock– based compensation charges. Likewise, the Company’s management teams exclude stock-based compensation expense from their short and long– term operating plans. In contrast, the Company’s management teams are held accountable for cash-based compensation and such amounts are included in their operating plans. Further, when considering the impact of equity award grants, Electronic Arts places a greater emphasis on overall shareholder dilution rather than the accounting charges associated with such grants.

Income Tax Adjustments. The Company uses a fixed, long-term projected tax rate of 28 percent internally to evaluate its operating performance, to forecast, plan and analyze future periods, and to assess the performance of its management team. Accordingly, the Company has applied the same 28 percent tax rate to its non– GAAP financial results.

Electronic Arts is a provider of digital interactive entertainment.

((Comments on this story may be sent to newsdesk@closeupmedia.com))

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9 comments to Your questions about c-sections & labor

  • Whitney

    I used the Bradley Method with great success. 2 day labor and no pain meds. I did attend the classes and thought they were awesome and provided SO much info concerning birth. But as you said-every woman’s labor pain is different and each woman has to decide what’s best for HER in labor. My friend used Hypnobabies (check for it on diaperswappers.com-might be cheaper) and it did not work for her cause she had an intense, quick labor. I think it’s be awesome to try-very cool concepts. Ultimately, you have to do what works for YOU. Thank you for sharing your birth story. I know it was a hard experience for you. I’m so blessed to have had the birth I wanted. Keep up the good work on being a Mamma!!

    [Reply]

  • Thank you! We’re going to do at least two classes together (probably Lamaze and Hypnobabies or Lamaze and Bradly) and talk to our OB about these things monday! Great responses!!!

    [Reply]

  • Thank you so much for answering these questions! I’m definitely glad we are starting classes early. Thanks again for sharing your experience — it is truly appreciated, and helpful!

    [Reply]

  • Miracle Pending

    I just wanted to add something about requesting a different nurse. I had a similar situation: one good nurse, one horrible. The first nurse I had was bad enough that we wanted to file a complaint. We discussed our disappointment with the nurse supervisor and she proceeded to tell other nurses on staff about our complaints. Our second nurse didn’t like that we had any complaints to start with and defended the first nurse wholly. My point is that you shouldn’t be surprised if asking for a different nurse results in defensiveness. At the end of they day, they’re coworkers and will probably share the same views on a lot of issues.

    [Reply]

  • Hypnobabies Home Study is only $150, the live classes are usually in the $350 range. I did it for my VBAC. It really worked and was very easy.

    Natural Birth Download is another hypnosis program that is cheaper. I haven’t used it, though.

    http://​www​.birthdownload​.com/

    I definitely recommend Hypnobabies and a doula. Most doulas don’t say no for you, but they will help you remember what you wanted, why you wanted it and help you stall to think about things and speak for yourself. My VBAC was so fast and my birth team was so supportive, I didn’t have any problems, like that, but it was still great to have my doula. Her presence was just so reassuring that I was able to just let my body go.

    If VBAC is something you are interested in the future, you can definitely do it.

    http://​cairomama​.blogspot​.com/​2​0​0​9​/​0​3​/​h​o​w​-​t​o​-​p​l​a​n​-​y​o​u​r​-​v​b​a​c​-​v​a​g​i​n​a​l​-​b​i​r​t​h​.html

    [Reply]

  • Hi there!

    I’m following you on twitter and I think it’s great that you took this opportunity to talk about your experience. I’m sorry you didn’t end up with the experience you hoped and planned for. It is always difficult when this happens, and I hope you are healing both physically and emotionally.

    I just wanted to jump in as a Bradley Method instructor and say that I tell students that Husband Coached Childbirth (by Dr. Robert Bradley) is a great introduction to the Bradley method. It’s got a lot of the “whys” but not really a lot of the “hows.” It’s also nice for dads to understand the importance of their role in the birth process. It was written by a doctor who started his practice in 1947, and it shows in his language and attitudes, but the basic premises and methods ring true 60+ years later. For more nuts-and-bolts of how to use the method, for your future births, may I humbly recommend Natural Childbirth the Bradley Way (by Susan McCutcheon), just for starters. I would also recommend Gentle Birth Choices, Ina May’s Guide to Childbirth, and The Thinking Woman’s Guide to a Better birth, to name a few. One I haven’t yet read (shamefully!) but that would probably be of great help to you is The VBAC companion.

    All of this being said, a Bradley class series gets WAY more in depth than either of the Bradley books, and gives couples a chance to practice techniques hands-on. If your Bradley instructor is also a doula (as mine was and as I am), this can help dads feel more comfortable and confident in the idea of a doula, knowing that a good doula rooted in the Bradley method (and really, any good doula) would never overstep the father and take over his role but supports the couple. Especially if planning a VBAC would I recommend a doula. My husband did not want to hire a doula at first, but we ended up hiring our Bradley teacher, whom we had come to know and feel comfortable with.

    Best wishes to you, your husband, and your sweet little one. Happy breastfeeding!

    [Reply]

  • I used HypnoBabies and I loved it. I won’t say labor was pain-free, but HB worked wonders to keep me calm and when your whole body is tensing up with contractions being able to relax through them makes a huge difference. I was in the transition part of labor and the doc walked in and inquired about my epi (which I hadn’t taken). He assumed I must have had one to be so calm and quiet! This was after hours of awful back-labor too. I will definitely use HypnoBabies again. If you search online you can usually find 20% off coupons for the home study course.

    [Reply]

  • Heidi J

    I’m so sorry that things ended up the way they did. I hope your able to successfully have a VBAC in the future. Was a forceps/vacuum delivery ever discussed? I’m just curious as I had a very long labor (25 hours) that came very close to ending in a c-section, but they tried forceps as the last resort before that and it worked. I also had an epidural that may contributed to my labor being so long, but I also don’t regret it. I needed to rest and it allowed me to sleep.

    Background: I was planning giving birth at a birth center, but had a hospital birth due to being mildly pre-eclamptic, but I had both my birth center midwife and a doula in addition to my husband there with me. They were all great.

    [Reply]

  • I’m going to be a broken record and say that next time, I think you’d love a Bradley class. They are 10 weeks long and there’s just SO much information that is empowering so that you know what to expect and what a HUGE range ‘normal’ is. We did read the book as a class (although I skipped a lot of it) but still felt completely informed and prepared for birth. I can’t imagine having only read a book and trying to stay strong in labor. That must have been hard!

    Blessings!

    [Reply]

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