Pregnancy - Delivery and Labor

Pregnancy - Delivery and Labor    Pregnancy - Delivery and Labor

What is Important to Know about Labor And Delivery?

Very few experiences in your life will match the physical and emotional things you will experience when you go into labor. Many women do not know the signs of labor and do not understand the labor and delivery process.  It can be a very emotional and frightening experience unless you are prepared for it.

Signs of true labor can include contractions at regular and increasingly shorter intervals that also become stronger in intensity, lower back pain that does not go away, your water (amniotic sac) breaks, you experience a bloody, brownish or blood-tinged mucous discharge, and your cervix begins dilating (opening up) and becoming thinner and softer.

It is important to know that you have several labor and delivery options available such as where you will have your baby (home birth, birthing center or hospital), who will assist in the delivery (midwife, doctor, doula, significant other), what kind of delivery you have (vaginal, C-section, episiotomy, water birth), what kind of pain management (drugs, hypnosis, natural) and even post delivery options.

How to Recognize Labor?

Many women think they are in labor when they are not. These false labor contractions are called Braxton-Hicks contractions, or false labor pains. However, if you think you in labor, do not hesitate to call your health care provider, no matter what time of day or night.  It is much better to be safe and call your doctor or midwife if you experience any of the following:

  • Contractions 5-10 minutes apart that come at regular and increasingly shorter intervals.

  • You can no longer walk or talk during contractions.

  • Your water breaks (can be a large gush or a continuous trickle).

  • You experience vaginal bleeding.

  • You have a bloody, brownish or red-tinged mucous discharge.

  • You have lower back pain (back labor) that does not go away.

  • You feel reduced fetal movement

When you are in labor you will have short, regular contractions of the uterus. The frequency and duration of these contractions varies with each individual woman and the onset of these contractions may be very gradual or may occur very suddenly.  These contractions lead to changes in the narrow, outer end of the uterus called the cervix which becomes softer and shorter, thins out, and then opens before birth.

During a typical vaginal delivery, your baby will come through the cervix into the vagina (birth canal).  The baby is most commonly born head-first but in some cases the baby is "breech" meaning either the feet or buttocks are the first to exit the vagina.  In the final stage, the placenta (afterbirth) is expelled. After the birth, the medical condition of the child is assessed with the APGAR score.

For additional information about labor and delivery please visit the page Labor and Birth website Pregnancy And Children.

Birthcenters.org
Back to basics for safer childbirth
March of Dimes: What to take to the hospital

What is Involved by Inducing Labor?

Sometimes, if labor has not started on its own, your health care provider may start your labor through "labor induction". Some women may prefer to have labor induced even without medical need. The March of Dimes (Induction by request) recommends that labor be induced only when the health of the woman or baby is at risk.

The most common reason for labor induction is that the pregnancy has gone 2 weeks or more past the due date. Your doctor might also recommend that labor be induced if you have high blood pressure caused by pregnancy, if you have an infection in her uterus, if your water has broken (the amniotic sac has been ruptured) but contractions have not begun, if you have health problems, or there is a potential problem with the baby.

Your health care provider may use one or more of the following common techniques to induce labor:

  • Separating the amniotic sac from the wall of the uterus: the health care provider gently puts a gloved finger through the woman's cervix and separates the amniotic sac from the uterine wall.

  • Ripening the cervix: the provider places a small tablet or suppository in the vagina up against the cervix.

  • Giving the woman a drug; the most commonly used is oxytocin (Pitocin).

  • Breaking the woman's water: The doctor uses a small instrument to break the amniotic sac that contains the baby.

Like any medical procedure, induction has side effects and risks. The primary risk you face is that if your labor does not start after induction, you might need to have a cesarean section. This risks and other problems with inducing labor are discussed in detail on the page Inducing Labor of the website PregnancyAndChildren.com. You may also want to visit the websites March of Dimes: Inducing labor and Family doctor: Labor induction.

Do-it-yourself techniques to induce labor have not been proven to be both safe and effective. Avoid such "self-help" techniques such as nipple stimulation, castor oil, sexual intercourse, or herbal remedies.

What about a Cesarean (C-section) Birth?

During a C-section, the doctor makes a cut in your abdomen and uterus and removes the baby.  A C-section can save the life of a baby or mother but should be used only when medically needed.

Most healthy pregnant women delivery their babies vaginally but the rate of babies being born by C-section is increasing in the U.S. The  International Cesarean Awareness Network believes that the rise in C-sections is alarming and notes that the World Health Organization estimates that 50% of all U.S. performed cesarean sections are unnecessary. Given the correct support and education it is estimated that 90-95% of women can deliver vaginally.

If you are considering a planned C-section for medical reasons or think you may want to have your baby be delivered by C-section, talk with your doctor. It is important for you to get the facts about C-sections before you go into labor. You should find out the pros and cons of this surgery and understand the reasons why a cesarean birth may be used.  Make sure to carefully consider the risks and benefits.

For additional information please visit the website PregnancyAndChildren.com page Cesarean section.  You may also find the following websites helpful:

March of Dimes: Cesarean birth for medical reasons
March of Dimes: Cesarean birth by request

What is Water Birthing?

In a water birth the woman in labor gets into a tub of water that is between 90-100 degrees Fahrenheit. Some women get out of the tub to give birth. Others remain in the water for delivery. The water helps you to feel physically supported. It also keeps you warm and relaxed which can ease the pain of labor and delivery.

The phenomenon of water birthing is relatively new in this country. Ask your doctor or midwife if you are a good candidate for water birthing. Water birth is not safe for women or babies who have health issues. For additional information about water birthing, visit the following websites:

Natural Child
Childbirth.org
WaterBirth International

What is an Episiotomy?

An episiotomy is a surgical procedure where the skin between the vagina and the anus is cut. This is done to enlarge the vaginal opening so that it will not tear and so the baby can be more easily delivered. When your baby's head is stretching the opening of your vagina, your doctor will make sure the area has been numbed and will then make an incision into the tissue between the opening of your vagina and your rectum (called the perineum).  After delivery, the doctor will put a few stitches in to close up the incision.

In general, the benefits of an episiotomy are that it may result in easier and better repair than a jagged tear and it may shorten the second stage of labor by relieving muscle tightness in this area.  At one time, an episiotomy was a routine procedure but currently there is a great deal of controversy regarding the procedure since it can lead to infection, can increase perineal pain resulting in trouble defecating, and it may cause sex after pregnancy to be painful.

For additional information regarding an episiotomy, please visit the page Episiotomy and Pregnancy and the websites below:

National Institutes of Health: Episiotomy

Where Can I Find Additional Sources of Information?

For additional information about labor, delivery, and the above topics, please visit the website Pregnancy And Children and please visit the link "Ways we can help you".

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