Prior to Procedure
During pregnancy you should:
- Be sure to go to all prenatal care visits with your doctor
and drink plenty of fluids.
Get as much
- Read about giving birth and take a childbirth class.
- Choose a support person to be with you during labor and delivery.
- Write a birth plan that explains what you want and helps you to think about possible complications.
Talk to your doctor about:
- Ways to contact her after hours and when you should call
- Steps you should take when in labor
- Whether you want pain relief during labor
- Perineal massage—The perineum is the area between the anus and the vagina. Massaging it may help to reduce your chance of trauma to that area.
- How you will travel to the hospital
- Arrangements for home and work
Be aware of the signs of labor, which include:
- "Water breaks" (amniotic fluid that surrounds the baby leaks out through the vagina)
- Back pain
- Slight vaginal bleeding
True Versus False Labor
Before "true" labor begins, you may have periods of "false" labor. These are irregular contractions of your uterus, called Braxton Hicks contractions. They are normal but can be painful. They are usually also felt in the stomach and not the back.
Timing the contractions is a good way to tell the difference between true and false labor. Note how long it is from the start of one contraction to the start of the next. Keep a record for an hour. If the contractions are getting closer together, longer, stronger, and are being felt in your back, then it may be true labor. If you think you are in labor, call your doctor.
During this process, you will prepare to deliver your baby.
At the beginning of labor, the uterus (where the baby grows during pregnancy) will begin to contract, moving the baby down the vagina (birth canal).
The cervix, the opening of the uterus into the vagina, will slowly enlarge to a diameter of about 10 centimeters. This will allow the baby to pass through and be delivered through the opening of the vagina.
This process usually takes a while. However, if you have delivered vaginally before, labor can be very quick.
Labor can cause severe pain, but keep in mind that every woman's labor is different. Everyone experiences pain differently. While planning the delivery, talk to your doctor about your options for pain relief.
In the early stages of labor, techniques like rhythmic breathing,
may be helpful. Some women do not require any other pain control.
There are many medical options for pain control.
All treatments to relieve pain during labor have risks and benefits. Make sure you discuss these with your doctor:
Pain medicines by IV or muscle injection
- Given when contractions become stronger and more painful
- Can cross into the baby's bloodstream
- Epidural block
- Liquid pain medicine injected near spinal cord
- Given in small amounts by an anesthesiologist (a doctor who specializes in anesthesia)
- Does not cross into baby's bloodstream
- Decreases pain and feeling in your lower body
- Provides good pain relief and allows you to continue with delivery
- Can cause headaches and drop in blood pressure, as well as changes in baby's heartbeat
- Liquid pain medicine injected into spinal fluid
- Used for pain relief during delivery, especially if forceps or vacuum extraction is needed
- Often used for C-section
- Numbs lower half of the body and reduces your ability to push
- Provides good pain relief and works quickly
- Can cause headaches after delivery and drop in blood pressure during labor and delivery, as well as changes in baby's heartbeat
- Injected into vagina or surrounding area
- Used if an
episiotomy (cutting near the vagina)
- Also used when vaginal tears are stitched
- Does not relieve pain of contractions during labor
Description of the Procedure
Once the cervix is fully dilated (opened) and the baby seems to be heading down the birth canal, the nurses will help prepare you for delivery. Your legs may be draped with cloths. Some doctors will clean the area around the vagina with an antiseptic solution.
You may put your legs into holders, especially if you have an epidural. The nurses and your support people may hold your legs in a comfortable position. This will help you to push. Your doctor may encourage you to find a position that is right for you. Each time you have a contraction, you will be instructed to push. This involves you bearing down, like you are trying to have a bowel movement.
"Crowning" is when the baby's head is seen at the opening to the vagina. When this happens, you may be asked to slow your pushing. Depending on your delivery plan, the doctor may massage your perineum to gently stretch it. An episiotomy is not routinely done, but in some cases, it is necessary.
Once your baby's head is out, you will be asked to stop pushing. The doctor will check to make sure that the umbilical cord is not around the baby's neck. Then, you will be able to push the rest of the baby out. If the baby appears healthy and is breathing well, he may be placed on your stomach. The umbilical cord will be clamped and cut. Within the next 20 minutes, the placenta will be delivered.
Copyright © Nucleus Medical Media, Inc.
Sometimes the baby's head does not move as expected through the birth canal. If this happens, your doctor may use forceps or vacuum extraction to move the baby.
Average Hospital Stay
The usual length of stay for a vaginal delivery is 1-3 days. Your doctor may choose to keep you longer, however, if complications arise.