Articles
Labor & Delivery
The word Labor can create a mix of emotions. First comes the excitement signaling the end of your pregnancy which is then almost immediately followed by anxiety. The term labor can be defined as physical work, which is exactly what you are going to experience. The best way to go into this stage of your pregnancy is to be prepared and find out as much as you possibly can about what happens during labor and delivery. That knowledge will make the occasion much more relaxed; you will feel more in control and may actual enjoy this incredible miracle that is "birth".
Recognizing Labor
Throughout your pregnancy you might have experienced cramping and “pre-labor” pains that can be associated with Braxton Hicks. As with most medical terms, Braxton Hicks was named after the doctor who first identified the contractions. This is an important stage that your body goes through, especially in the last trimester, as it gets ready for the impending birth of your child. Braxton Hicks aren’t true contractions but rather “practice” ones that soften and thin your cervix so that your baby’s head can settle into your pelvis. The actual feeling can be described as a tightening or cramping sensation in your abdomen. Usually you can alleviate this uncomfortable sensation by moving around, lying down or just deep breathing. If your Braxton Hicks contractions don’t go away, and when timing them, if they are actually getting closer together then you should contact your obstetrician and make sure that you aren’t actually in labor.
There are some signs that you look for which let you know that labor is approaching. It is important to note that sometimes these signs show up weeks earlier and for others it is just days before labor. No one can accurately determine exactly when your baby is going to come, so these are just guidelines in terms of the approximate time in which they occur.
- Engagement: Also known as “dropping” and can be referred to as the point in which your child has descended into the pelvis. You will definitely know when this happens as you will feel like you can breathe easier and your heartburn should cease. As the baby moves into this position, the pressure higher up in your stomach has stopped so it is actually an easier time on the mother. This usually occurs a few weeks before labor begins but can also occur during labor when it is a subsequent pregnancy.
- Pressure in your pelvis:As noted above, your baby will descend into your pelvic area as you enter the last phase of pregnancy. Unfortunately this will also bring an increase in uncomfortable sensations, like having to constantly use the washroom. It is common for a mother to wake up many times during the night-time to urinate. Please remember that this is actually a good sign as your baby has moved into position for delivery.
- Increase in Vaginal Discharge: As your cervix softens and prepares for birth, you may find an increase in the amount of vaginal secretions you have. Usually the color is white and/or soft pink, so if you see any other color or even a foamy color you should speak to your doctor or midwife.
Signs that labor is impending
- Bloody Show: The dreaded “Bloody Show” scares more early pregnant women than it should. It is just a term that explains the process of your mucus plug being released from your body. The mucus plug is the “plug” that has sealed the cervix for most of your pregnancy. And the “show” is really just the progression of it being dislodged. As the cervix softens and you begin to dilate, the mucus plug is released. It is important for you to contact your doctor if this happens so that they are aware of your stage of early labor and can assist if labor doesn’t naturally begin shortly after.
- Membranes Rupturing: This is simply the process of your water breaking. The water meaning the fluid in which is in your amniotic sac. For some pregnant woman, this stage never actually happens until they are already in the hospital in labor and yet for others it is the main sign that you are in the throes of labor and that you should get mentally prepared for the labor process. In either situation, the rupture of your membranes means that your little one is almost here!
- Contractions: Contractions can confuse some women as they have already experienced them with Braxton Hicks. However these labor contraction are the ones that don’t go away. There is no way for you to move positions and or walk around in order for them to cease. Once your contractions have a steady pattern or last for a longer period of time, you will know that you are indeed in labor. As a side note, if you are experiencing a lot of back pain at this point, you should head immediately to the hospital so that your healthcare provider can look at the position of your baby.
Keep in mind that once your contracts have been happening for over an hour and are increasing in length and in shorter intervals, you should head to the hospital. It is also important to note that subsequent babies arrive in half the time as the first. In any case, if you are unsure with what is happening, there is no shame in contacting your doctor or midwife to consult with them. There is nothing to be embarrassed about.
Stages Of Labor
First Stage
The first stage of labor is the one described above. It is the early time in which uterine contractions work to fully dilate the cervix so that your baby can exit the birth canal. This stage can take an hour or several hours, it is important to note that all pregnancies are different and all labors are different as well. Your doctor and nurse will be able to check you at each point and tell you how many centimeters you have dilated.
There are many ways in which you can deal with the pain for this stage of labor. Especially towards the end of the first stage of labor where you are dilating from 8-10cm and will probably experiencing a lot of pain. It is important to report your pain level to your healthcare provider as it could mean that your body needs extra oxygen or nourishment. Just like when you are exercising, hard work (and labor is definitely hard word) requires nutrition to keep the muscles working. It is not a big deal for the nurse to give some oxygen to assist you during this part of labor. An important part of your preparation with your healthcare provider is for you to discuss and inform him/her of exactly what you wish/expect to happen in labor in terms of pain control.
Ways in which you can control labor naturally
- Positioning: Try moving your body into different positions to see what is most comfortable. Going on all fours, leaning against a wall, lying down or being supported with cushions are all ways that can help with the pain control. Every woman is different so you should try whatever you think will work.
- Massages:Sometimes kneading can help with the tension and help relax you through contractions. Your partner may feel helpless at different points in labor and be frustrated that they can’t assist you, so this might be a way in which they can help.
- Breathing Exercises: It is always smart to take a prenatal course prior to delivery since healthcare providers different ways to breathe during labor. Having a good supply of oxygen is important because without it you produce more lactic acid which causes more pain. As mentioned above, breathing (and oxygen) is important in all forms of hard work/exercise, and this is no different.
Second Stage
This stage is also known as the “pushing” stage. It usually only takes about an hour but can be as short as 5-10minutes. It is important to note that this stage of labor can be lengthened significantly if anesthetic is given. Many women prefer this stage of labor to the first (more lengthy) stage. It gives them a sense of purpose and a feeling of “it’s almost over”. Some women report that bearing down makes some of the pain cease since the compression of nerves serves as a form of anesthetic itself. There are still contractions at this point in your labor but they are usually every 2-4 minutes and you can slow them down by lying in a knee-chest position.
If your doctor or nurse gives you the ok to push then it is because your baby is almost here. You may have felt the urge to push before they say you can, but it is important to wait until they give you instructions. They are the experts and can give your baby out in the easiest and fastest way possible. When your baby’s head appears at the entrance to your vagina, you will feel a burning feeling and a huge pressure on your rectum.
As your baby is being born, pushing in a slow, controlled way is best to allow the perineum to stretch gradually and prevent tears. This is also the point where doctors may speak to you about an episiotomy. If you can, try to do this stage of pushing without an episiotomy as many studies have shown that a natural tear is easier, smaller and heals much faster than a larger, straight cut made by an episiotomy. Your doctor will advise you on the best route for your specific labor.
After your baby is born, his/her umbilical cord is clamped in two places and then cut in between. Often the new father is asked to cut the cord to allow him to feel more involved in the delivery process. It is an important symbolic gesture.
Third Stage
After your baby has been delivered, the pediatrician and/or doctor will take the baby to be looked at. It is also the point in which you will enter the last stage of labor, which is the delivery of the placenta. For most deliveries, this is the stage that requires the least amount of effort.
Further contractions will evacuate your uterus and then it will be examined to check that fragments of it haven’t been broken off and left inside during labor and delivery. If there are pieces broken off, they will be manually taken out.
After the placenta is removed from you, it is time for you to welcome your little one in your arms and thank your blessings for the gift of life.
Special Types of Delivery
Breech
Breech babies means that the baby’s legs/bum is closest to the cervix. This position can make things a lot more difficult on the mother and the child during delivery. This is because the baby’s head is the largest part of the body and can get trapped when it goes through the cervix. Usually your doctor can pick it up at 3rd Trimester ultrasound and can sometimes be massaged into the correct position for birth. If the baby cannot be maneuvered, your doctor may suggest the need to deliver by a C-section as a way to protect both the safety of the mother and the baby.
Posterior
A Posterior baby is one who descends into the birth canal with his/her head down but his back towards his mother’s spine. This type of delivery may result in a greater amount of back pain and longer delivery. Often your doctor will try and encourage the baby to rotate during the pushing phase.
Multiple Births
While it may seem that delivering multiple babies that the birth process will be longer and more painful, often it is not the case. Many women can give birth to twins (or more) vaginally faster than with single babies. You will definitely have an anesthesiologist standing by in case the babies need help and the delivery goes into a cesarean birth. There are also cases where the first baby can deliver vaginally without any problem but the second baby needs assistance. Your doctor can assist with Pitocin (which speeds up delivery) or even with forceps if needed.
It is important to note that most triplets are delivered by C-Section, so that it is a controlled setting where a multitude of nurses and doctors can assist in case of a problem.