BIRTH INTRODUCTION
After 40 weeks of preparing for your baby’s
birth, you may feel like a large bundle of
nervous anxiety and excited anticipation.
You might even feel downright exhausted from
weeks of being somewhat uncomfortable and
not sleeping as well as you would like. But
you can rejoice that soon you will be
holding your baby in your arms.
Rest assure, you will know when actual labor
begins. Remember, that many women mistakenly
think they are in labor when they are not,
but very, very few women don’t think they
are in labor when they are. Be patient, and
know that once labor has started, the
process will go quickly. Be prepared for
hard work and the most wonderful reward in
the world.
VAGINAL BIRTHS
Over 80 percent of all babies are born
vaginally in the United States. Vaginal
birth, in general, is the least medically
complicated birth, with the quickest
recovery time for mothers.
By the 32nd week of pregnancy,
most babies turn head down in the uterus to
prepare for a vaginal delivery. While some
women may not experience any contractions
until the day they deliver, most women will
start to feel mild cramping or contractions
days, and sometimes weeks, before they
actually go into labor. These mild
contractions begin the process of thinning
out (effacing) and opening up the cervix to
allow the passage of the baby through the
birth canal.
About 75 percent of women will go into labor
between the 37th and 42nd
weeks of pregnancy. Labor has several
distinct phases that result in the birth of
the baby.
Early labor,
when your cervix dilates from zero to four
centimeters, can take as long as a day or
more. However, the average first-time mother
is in early labor for about six to twelve
hours. During this phase, you will feel mild
uterine contractions that will slowly become
more regular. These contractions will go
from 15 to 20 minutes apart to about five
minutes apart.
During the next stage, called Active
labor, your cervix will dilate from four
to ten centimeters. Your contractions will
get stronger and last longer through this
phase. Your water may break which will
result in the contractions becoming more
intense.
Other symptoms of active labor include:
backache, trembling legs, nausea, vomiting,
and the urge to push. This phase can last
from four to eight hours. This is the time
to focus on breathing and apply the
relaxation techniques that you have learned
in birthing class. This is also the time to
ask for pain relief if you need it.
Once your cervix has dilated to ten
centimeters, it is time to begin the
Pushing phase. Your contractions may
slow down to every two to five minutes. With
each contraction, you will feel the urge to
push and will be instructed to do so. As the
baby head emerges from the vagina (crowns)
you may feel intense pressure and stinging.
It may be necessary for the doctor to
perform an episiotomy (an incision between
the vagina and rectum, to allow more space
for the baby) to widen the opening of the
birth canal. As you push, your doctor will
guide your baby’s shoulders and body out.
The pushing phase can last between 20
minutes and three hours.
During the final phase, you will continue to
have uterine contractions. These
contractions will help expel the placenta
and amniotic sac that will also be delivered
by the doctor.
CESAREAN BIRTHS
In about one out of every
five births in the United States, a baby is
born by cesarean section. This means that
the baby is delivered through an incision in
the mother’s abdomen and uterus.
There are many medical
reasons that would warrant a cesarean birth.
Some of the main reasons are:
- Multiple pregnancy -
The risks of vaginal birth go up with
the number of fetuses.
- A large baby or small
pelvis
- Breech position of
the baby – The baby is in the buttocks
or feet down position.
- An active case of
herpes that could infect the baby in a
vaginal delivery.
- Placenta or umbilical
cord problems that could cut off the
baby’s oxygen supply.
- Labor that fails to
progress.
During a cesarean birth,
you will first be given an epidural, a
spinal block, or general anesthesia
depending on the specific situation. You
will then be hooked up to breathing, blood
pressure, and heart rate monitors. You will
also be given supplemental oxygen.
Your nurse will prepare
you for surgery by giving you medications to
dry your mouth and airway and reduce acid in
your stomach. Your abdomen will be washed
and any hair between your pubic bone and
navel may be shaved. A catheter will be
inserted into your bladder, and an IV line
will be placed in either your arm or your
hand.
Your abdomen will be
swabbed with antiseptic, and your doctor
will make a four to six inch incision
through your skin and abdomen wall. This cut
may be made either vertically or
horizontally depending on the situation. The
doctor will then spread the abdominal
muscles and cut through the abdominal
cavity. Another cut will then be made into
the uterine wall. The baby is delivered
through the opening created by the
incisions. After cutting the umbilical cord
and removing the placenta, the uterus and
abdominal wall are closed with stitches.
Though not frequent, there
are several risks that can occur during a
cesarean birth. They are infection, blood
loss, blood clots, and injury to the bladder
or bowl.
Continue
to Page 2
