| Labor & Delivery |
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You probably feel as if you have been pregnant forever. Nine months feel more like nine years. But the time has finally come to have your baby. What will labor be like? Where will you give birth? What methods of pain control do you want to use? Have a birth plan prepared before your baby is due so there is no last minute deciding and scrambling. WHAT TO EXPECTIf this is your first baby, you are probably worried what it will be like. You have probably heard horror stories about the pain and duration of labor. Each delivery is different and every woman experiences labor pain differently. Unforturately it is impossible to tell you what labor will be like. There is no such thing as a textbook delivery. Each one is unique. Just because your friend was in labor for 72 hours does not mean that you will be too. Remember that your pain is worth it and that you will have a beautiful baby when it is all done. PLACES TO GIVE BIRTHSeveral types of facilities are available now for birthing. Where you deliver will depend on personal preference and what your insurance will cover. Hospital- This is the most common place to deliver. Check out the hospitals in your area before you are due to see what their rooms are like. Find out the following things: Do they have separate labor and birthing rooms? Will you have to share a room with someone else? Can your baby stay in your room with you? Will your partner be allowed to stay with you? When can your family visit? Is the staff friendly? Once you have determined all of these factors, you will have to decide which hospital suits you best and where you can feel the most relaxed. Home- Home births are becoming increasingly popular. You and your partner will need to be well educated in the process of labor and delivery if you plan to give birth at home. Many women will have a midwife present during the event. Just remember that there is always the risk for complications during birth. If you are at home, medical intervention (such as an emergency c-section) will not be available. Birthing facility- Many areas have birthing facilities. Many birthing facilities will offer not only quiet birthing rooms, but also the option for water birth. Unlike hospitals, birthing centers do not offer pain control and they will require that you go home within a few hours after the delivery. These centers are also not equipped to handle any kind of complications that may arise during the birthing process. CHANGES IN YOUR BODYAs you approach your due date, several things will be going on to tell you that your body is preparing for birth. Not all women experience all of the symptoms. Here is a list of things to watch for: Dropping (lightening)- When your baby has "dropped" your baby will look and feel lower in your abdomen. This can occur up to a few weeks prior to delivery. You may find this uncomfortable since the baby is now putting even more pressure on your pelvic muscles, nerves and cervix, and you will probably need to use the bathroom even more (if that is possible!). Weight maintenance- Many women will find that they are no longer gaining weight during the last week of pregnancy. Mucous plug- Within a few days prior to birth, your cervix will pass a mucous plug. This plug has remained in your cervix throughout your entire pregnancy. Its purpose is to protect the uterus and baby from infection. You may notice this waxy plug in the toilet when you use the bathroom. Bloody show- As the cervix begins to dilate, blood vessels on the cervix begin to bleed. When this occurs, you should go into labor within a day or two. Stronger Braxton-Hicks contractions- You may find that your normal Braxton-Hicks contractions have become more regular and more painful. Increased pressure in the pelvis & rectum- As your baby drops, she puts more pressure on your pelvic muscles and nerves, causing you to feel more uncomfortable. FALSE LABORIt can be very difficult to tell the difference between true and false labor sometimes. You can experience quite a bit of pain with false labor, but your contractions should not occur in regular intervals. The contractions also should not increase in frequency. Your cervix will not dilate during false labor either. If you are unsure, call your doctor. It is always better to be safe than sorry. THE REAL THINGHere is a list of signs that may indicate that you are going into labor: Contractions- As you begin to go into labor, your contractions should occur in regular intervals. The intensity and duration of the contractions should increase and become more frequent. Some women experience most of the pain in their lower backs, while others experience it primarily in their abdomen. Some will experience it equally in their backs and abdomen. Mucous plug- If you have not already passed this plug in the last few days, you will definitely pass it now as you go into labor and your cervix begins to dilate. Bloody show- You may be spotting a pink-colored or bloody discharge. This indicates that your cervix is beginning to dilate. Ruptured membranes- This occurs when the amniotic sac that surrounds your baby ruptures and releases the amniotic fluid. Most women expect this fluid to be clear, but it is not. This is a definite sign that the baby is coming. WHEN TO HEAD FOR THE HOSPITALYou want to head for the hospital once your contractions occur regularly every 5 minutes. If you live far away from the hospital or birthing facility, you want to leave when your contractions are 6-9 minutes apart. You will also want to head for the hospital if your membranes rupture, regardless of how far apart your contractions are. There are some instances when your pregnancy may become complicated. If you see any of the following symptoms, head to the hospital immediately.
WHAT TO BRING TO THE HOSPITALMake sure to bring these items with you to the hospital: Account of your contractions- When they started, how far apart, etc. Insurance card Hospital pre-registration forms- Most hospitals and birthing facilities will allow you to pre-register before the birth of the baby so there is no last minute scrambling. You don't want to have to deal with filling out forms when you are in labor. Books or magazines to read- Bring books or magazines for any children that may be present or to help you pass the time and keep your mind pre-occupied during the first stages of labor. Stereo- Music can be relaxing and can help take your mind off of the pains of labor. Phone numbers of relatives and friends- Have a list ready to take with you to the hospital of all the people you want to call when the baby arrives. Pajamas- Bring warm, comfortable pajamas. You may even want to bring a robe so you're not wandering around in just your pajamas. Change of clothes- Bring loose, comfortable clothing. You probably won't be wearing any of your pre-pregnancy clothes home. Toiletries- Just bring the basics. No need to bring makeup or perfume or any other unnecessary items. You will be too tired for these types of hassels anyway. Clothing to bring your baby home in- Do not go for frilly clothes, even though you want your baby to look her best when you bring her home. Pick out an outfit with snaps that will be easy and less stressful to put on your baby. Baby blanket- Bring a soft, hypoallergenic blanket. Try to avoid wool or down-filled comforters. Wool blankets can be itchy to your newborn's sensitive skin and down can cause allergic reactions. Camera if you wish to take pictures- Have the film pre-loaded so there's no last minute scrambling. VAGINAL DELIVERYThis is the type of delivery that scares women the most. How can a 7 pound baby fit through there? Believe it or not, your muscles in your cervix and vagina are designed to stretch that big. If you deliver vaginally, your will go through three stages during the birth of your baby. • First stage Early or latent labor- Your contractions should be regular, occurring every 5-20 minutes and last about 30-45 seconds each. Your back will hurt, your abdomen will feel crampy, you will have a bloody show and you may feel nauseous. Your membranes may have ruptured and your cervix will dilate from 0-3 cm during early labor. This stage can last anywhere from 2-12 hours. If you have had a previous baby, each subsequent birth should progress quicker. Try to keep active and moving during this stage. Many laboring women prefer to walk to keep their minds occupied and their labor progressing. Contact your caregiver when you start this stage of labor. By the end of this stage you should definitely be on your way to the hospital or birthing center. Active labor- Your contractions should occur every 3-5 minutes and last about 45-60 seconds. Your contractions will feel stronger and more painful. You may become very irritable and anxious during this stage. Try to remain active during this stage if your caregiver will allow it. Walking slowing or trying different positions may help ease the discomfort of labor. If the pain becomes severe, you may start your epidural or other method of pain control during this stage. Your cervix will dilate to 7 cm. This stage can last 2-4 hours. Transition labor- This is the most intense part of your labor. Your contractions will occur every 2-3 minutes and last about 60-90 seconds. Luckily, this stage does not last very long, typically between 15-60 minutes. You will feel increased pressure in your back and throughout your pelvis, your legs and thighs may ache tremendously and you may shaky and nauseous. This is usually the stage when you become the most irritable. You feel uncomfortable no matter what. By the end of this stage you will be fully dilated to 10 cm. • Second stage The second stage is when you start pushing. This stage typically lasts 30-90 minutes. Your contractions may not feel quite as bad but they will still be occurring in 3-5 minutes intervals. You may feel an uncontrollable urge to push. If not, your caregiver will instruct you when to push. This can be a very exhausting experience. Allow your partner to support you during this stage. Once you are able to see your baby's head emerge, you may feel a sense of renewal as you continue to push and give birth to your baby. Once she is born, the umbilical cord will be clamped and her nose and mouth will be suctioned out. Once this is done, your caregiver may allow you to hold your baby for the first time. Holding your baby and looking into her eyes for the first time will be one of the most memorable experiences of your life. • Third stage The third stage is the delivery of the placenta. This can occur up to 45 minutes after the birth of your baby. You will be bleeding quite heavily at this point and may continue to have minor contractions. These contractions assist the delivery of the placenta. INDUCED LABORSometimes your caregiver will want to induce labor. Reason for induction include:
To induce labor your caretaker will do one of three things: Administer drugs- There are several drugs that your caregiver can use to help stimulate your body to go into labor. He may use special vaginal suppositories of Prostaglandin E that act to ripen and dilate the cervix. Or he may use hormone therapy such as Pitocin or oxytocin, that will promote uterine contractions. Artificially rupture your membranes- Your caregiver will rupture your membranes with a special medical tool. If your cervix has begun to dilate, this procedure should not be painful. If you have not begun to dilate, this procedure can be very uncomfortable. Once your membranes have been ruptured, your body should be stimulated to go into labor on its own. If not, your caregiver will intervene with another method to induce you, most likely with the use of drugs. Use cervical dilators- Cervical dilators are natural or synthetic materials that are placed in the cervix. These dilators absorb water and expand, causing your cervix to dilate. Once your cervix has begun to dilate, your body will be stimulated to go in to labor on its own. CESAREAN SECTIONIn a cesarean section, your doctor will deliver your baby through a small incision in your lower abdomen. A c-section may be necessary if the baby is too large to deliver vaginally, if the baby is breech or if there are complications with the health of the baby or with the birthing process. Cesarean sections will take longer to recover from than a vaginal birth. It is also a myth that once a cesarean, always a cesarean. Many women who have their first baby with a c-section go on to deliver healthy babies vaginally. WATER BIRTHWater birth is used as a natural way to help women to relax during birth. Some people speculate that the birth is less traumatic for the baby when it is born in warm water. Most physicians, however, feel that birth underwater is not safe. Sitting in a warm tub until the moment of birth is acceptable, but the laboring woman should get out of the tub at the last minute and give birth outside the water. If a baby is born underwater, there is a risk that your baby could inhale water into her lungs which could lead to respiratory problems. Discuss water birth with your caregiver if you are interested in delivering this way. PAIN CONTROLThis is something you want to discuss with your caregiver before your baby is due. There are a few options available that can help you feel more comfortable during the birthing process. Just remember that pain medication will slow down your labor which can increase your risk for complications. Here is a list of the most common methods of pain control: Epidural- This is probably the method you have heard about the most. With an epidural, the anesthesiologist will inject pain medication into the sheath that surrounds your spinal cord. It should make the lower half of your body numb. As a result, walking around and urinating will be difficult. It may also slow your labor. Injectable narcotics- There are several narcotics that your anesthesiologist can use that can help to relax you and diminish the sensation of pain. These will be given intravenously or intramuscularly. Narcotics can affect the baby and may cause breathing difficulties. Local anesthetic- There are several methods of local anesthetic that can help ease the pain. Injections may be given locally in the cervix, vagina or perineum to help diminish the sensation of pain. The most commonly used form is in the perineum when an episiotomy is needed. This type of pain control only lasts about 45 minutes. EPISIOTOMYAn episiotomy is an incision made in your perineum, the space between your vagina and your rectum. This is done to aid the birth of your baby and to prevent you from ripping. Ripped tissue has a much harder time healing than cut tissue. Not all women have to have an episiotomy. Your caretaker can numb you first before the procedure is done. The incision should take about two weeks to heal. During that time, you will need to be careful when you use the restroom, you cannot have intercourse and you will need to care for your incision to prevent infection. Your caregiver may have you use sitz baths to soak your incision and aid in healing. PREMATURE BIRTHYour body may go into labor prematurely for many different reasons. Listed below are the most common reasons why women go into premature labor:
Drugs can be given by your doctor to help prevent delivery if you go into preterm labor. If the drugs are unsuccessful and you deliver early, you will be faced with a variety of financial and emotional decisions. With all of our medical advances, babies can now be delivered as early as 24 weeks. If your baby is under 38 weeks, she may need to spend time in a neonatal intensive care unit (NICU). This is where your baby will be kept alive and cared for until she is strong enough to go home. Sometimes it may be for a short period of time, other times it may require months of hospitalization and enormous costs. Having a premature baby can be emotionally exhausting, but will pay off when she is able to go home. If your baby is born over a month early, you will need to accept the risk that she may not make it. Your doctor will be able to discuss the risks and complications that may occur with your premature baby. HOW YOU WILL FEEL AFTER BIRTHYou will feel extremely exhausted once the baby has arrived. Try to get as much sleep as you can while you are in the hospital and have someone to help you with the baby. Once you get home, your baby may not sleep through the nights for a while and your sleep will suffer. If you had a c-section, your incision will be very sore when you move and your recovery time will be longer. If you delivered vaginally, it will be uncomfortable to use the bathroom for about a week following the delivery. You doctor may require that you and your partner avoid intercourse for up to six weeks after the birth of your baby to give your body adequate time to recover. Some women experience what is called postpartum depression. Sometimes this is caused by a feelings of inadequacy. Some women feel they are not good mothers or that they no longer have time for themselves. Other times the depression is unexplained. Experiencing this for a week or two can be common, but if it persists longer seek professional help. BREASTFEEDINGMany women prefer to breastfeed because it is natural and helps to provide the baby with needed antibodies to protect her from illness and disease. Sometimes a medical condition or personal beliefs lead to bottle feeding instead of breastfeeding. Remember this decision is up to you. You are not a bad mother if you decide you do not want to breastfeed. If you decide you want to breastfeed, talk to your caregiver while you are at the birthing facility. Most postpartum floors have a nurse dedicated to teaching women how to breastfeed their babies. If you decide that breastfeeding is not right for you, there are several nutritionally-balanced formulas on the market. Talk to your doctor to see which is the best for your baby. SUDDEN INFANT DEATH SYNDROME (SIDS)As the name denotes, Sudden Infant Death Syndrome is very sudden and unexpected. Unfortunately, the cause of SIDS has yet to be discovered. This is something that all mothers worry about. Unfortunately there are no warning signs that this may occur. There are a few things you can do to help lower the risk.
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