Labor and Delivery
Labor and Delivery – What You Should Know
There are two main stages of labor. The first occurs when the amniotic sac tears releasing the amniotic fluid, the cervix widens and the contractions gradually become continuous and grow shorter apart. After this is when the second stage of labor comes in: The actual baby delivery. Of course, one naturally follows the other, so there’s no real way to tell when the first stage is over and the second begun. This changes from birth to birth.
Women differ in their approach to childbirth. Some will experience more pain than others. For some, labor takes many hours, whilst for others, it’s all over in two or three! Also, the post-natal outcomes will differ for each mother and child. According to statistical data, seventy five percent of women who carry the baby until the end will have a normal labor of approximately twelve hours, while two percent of these will undergo labor for more than one full day!
In the second stage of childbirth, contractions are continuous with short break between two. This is where all the practice you did in your Lamaze class comes in. Use both techniques for breathing that you have learnt: for the duration of the contraction as well as that for the resting between the contractions.
At this stage, everything the mother takes is passed on to the child through the placenta, so any drugs and pain medication are disapproved of, because they might reduce the baby’s heart rate and affect its ability to breathe.
Many women take analgesics, which may be useful but also tend to lead to a faster heartbeat and nausea in the pregnant mother. Another appropriate pain relief technique is the use of the regional block, which alleviates pain but does not affect the mother’s capability to push. Regional block doesn’t work with all women. The use of hot pads, ice packs, slivers of ice to suck on and having a hand to hold during the worst times: all these can help block or shut out the pain.
Meet up with your physician in advance and prepare a plan of action to take care of all possible occurrences!
Transition, the last stage of delivery where the cervix dilates to the maximum, shows that childbirth is now imminent. It causes the most powerful and repeated contractions, but rarely lasts for more than a few minutes. Again, this is the ideal time to practice the breathing method you have learnt and have a hand to hold to help you keep calm and focused.
For breathing at rest, take in long and deep breaths. When you’re pushing, take short, sharp ones. And when you’re in transition, use only shallow short breaths! Focus on your breathing, for this helps you to shut out the pain as well as maintain correct oxygen levels in your blood.
The second stage of vaginal delivery starts properly as the baby’s head moves into the vagina, or the birth canal. Contractions are now very close together, with only three to four minutes interval between them. Then, at the zero station, the head moves lower until it is at a position with the lower pelvic bones. Then, it will move lower to position 1, then 2, then 3 until the head is finally visible.
The excitement at this stage increases, and the mother is all out to finish the labor and see her baby! Although most mothers at this stage are almost asleep with exhaustion, the adrenalin flowing through their bodies helps them complete the baby delivery! And then, it’s over and the mother finally sees the precious bundle hidden in her for nine long months! It’s her baby!
You’re In Labor, Now What?
There are various signs of labor that can inform you that labor has started. One of this is the ‘breaking of your water’. Basically, this happens when the baby is ready to leave the uterus and thus exerts pressure on the amniotic sac of the uterus, breaking it open and releasing the amniotic fluid, which is essentially, what is meant by ‘water’! So when you feel the fluids leaking out of your vagina, call up your partner.
The time of labor varies from person to person, which is why not even your doctor will be able to pinpoint the amount of time it takes from your first contraction to the actual birth. After the breaking of water, contractions will start (about half a day later). Some women proceed to deliver their baby in three hours, others take twenty four. There’s just no telling!
When you feel that first gush, wash it off and clean up the vagina to prevent infection (but not by taking a bath). Watch for any signs of green or rust-colored fluid called meconium, which is actually from the baby’s bowel movement. If you spot it, call your doctor immediately, since it signals fetal stress. Make a note of the time.
Your contractions will start shortly after this.
Remember, your uterus is just a big muscle whose job during childbirth is to contract, forcing the baby out into the birth canal. Thus, contractions are caused by the uterine muscle tensing and relaxing. Before the contraction starts, you’ll feel a dull pain in the pelvis and back. When these contractions have been in place for more than one hour, and are longer than half a minute, then you can consider yourself in labor!
To prevent yourself from a false alarm, try to ascertain that you’re actually in labor by shifting body position and moving about. See if the contractions continue at the same pace. Watch the clock. Timing is everything in labor.
Also, if you’re a first-time expectant mom, you should know that your labor is going to take longer. Don’t panic and rush. Keep calm. When you see that the contractions are spaced out at intervals of five minutes for the past hour, start moving to the hospital. If you’re not sure about the timing, head out anyways. Always, always err on the side of caution!
If you’re in serious pain rather than the usual pain of labor, then it’s a sign of complications. It can be either placenta previa or placenta abruption. Placenta previa is a case whereby the placenta blocks the exit of the baby from the uterus, while placenta abruption is the detachment of the placenta from the uterine wall, affecting the oxygen supply of the baby. Place a call to your physician immediately! If necessary, page him!
More than ninety percent of all labors progress without complications. All you need to do is remember to stay calm and fortify your mental state for delivery. You’ll make it!
What To Expect From The First Stage Of Labor
As your labor starts, you’re going to have to get your mental state in readiness for the process of childbirth that is looming ahead of you. For women who have already been through one or more births, this is easy. However, for women who are pregnant for the first time, the process of natural childbirth seems to be an unimaginable ordeal.
The best method to relieve yourself of the tension surrounding this process is to research and know what to expect for the final hour!
As labor starts, the cervix will expand to 1.5in (4cm) whereas the contraction will last for thirty to sixty seconds with five minute intervals between. This stage of labor can go on for almost the whole day, during which eating is not advised, so you might have to go hungry if it does! At this point, the head of the fetus is located at the inner edge of the cervix.
As this stage of labor moves along, the dilation of the cervix will increase to double its width from the start of contractions (8cm), whilst the interval between contractions decreases to about two minutes. Right. It’s time for you to start using all the training that you gained from the Bradley and Lamaze classes! Breathing techniques will enable you to oxygenate your muscle cells as well as help you to block out the pain.
The dilation of the cervix enables the baby’s head to move lower into the birth canal. In the hospital climate, a feeling of cold may pervade your body, but this is more because of the hormonal changes within your body than the external hospital environment. You may also be scared about your feelings of helplessness, but remember, you’ve got the one person you love right beside you offering comfort!
Your doctor will keep monitoring your status, as well as that of the baby. Apart from the heart rate which helps to determine if everything is in the right place, the hospital will also place a fetal heart monitor which will monitor the baby’s heartbeat to determine the baseline against which to measure the changes that will occur during birthing.
Sometimes your doctor may decide to monitor the changes internally if the membranes have already broken. In this case, they’ll insert a catheter into the uterus for measurement of contractions, as well as a small electrode into the vagina. This is, however, very safe for you and the baby, so there’s no need to worry!
Hospitals always tend to monitor continuously cases which have complications. In any case, talk to your doctor beforehand about the possibility of removing the devices as fast as possible for your peace of mind.
In this final stage, the baby will lower completely into the birth canal as your abdomen is said to ‘drop’. This stage is also called ‘lightening’ because you will immediately feel lighter, as you can now breathe more easily with the baby’s weight no longer against your diaphragm! Then, your doctor will tell you that you’re a hundred percent effaced, where your cervix is finally 10cm wide. The contractions are much longer now, and coming one on top of the other.
And finally, it’s time to push!
