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The process that leads to childbirth is called labor and delivery. There are three stages of labor. In the first stage, uterine contractions help thin and open the cervix. The second stage is the actual birth. The third stage is delivery of the placenta.
Your pain relief choices for childbirth may include medical and nonmedical treatments. Medical choices can include I.V. medicines or epidural pain relief. Massage and focused breathing are some of the nonmedical options. Sometimes both kinds of pain relief are used. Knowing your options can help you prepare for childbirth.
You can get ready for labor and delivery by taking a childbirth education class and writing a birth plan. A childbirth class can help reduce your stress both before and during labor and delivery. A birth plan tells others what your wishes are for your labor and delivery.
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Two good ways to prepare yourself for labor and delivery are by taking a childbirth education class and writing a birth plan.
A childbirth education class can reduce your stress both before and during labor and delivery. That's because the class can prepare you to deal with what might happen.
A good time to start the class is in your sixth or seventh month of pregnancy. If your partner or a friend is going to be your labor coach, they can come too.
A birth plan is a document that states your wishes for labor and delivery. It includes who and where you'd like to deliver your baby and what kinds of pain relief you'd like to try. You can give copies of your plan to your doctor or midwife, your support person, and the hospital or birthing center.
A birth plan lets you write down your vision of an ideal birth and share it with your support person, the hospital or birth center, and your doctor or midwife.
Your birth may not go as planned. But the process of making a plan can be a great way to get everyone on the same page about what you think you'd prefer.
Here are some ideas for making a birth plan.
It could be a hospital, a birthing center, or your home. The setting may depend on your level of risk for problems during delivery, and if you're working with a doctor or midwife.
Think breathing techniques, laboring in water, or trying different positions.
Think about pain medicine you'd want, even if you don't think you'll need it. And think about your options if you end up needing a C-section.
Maybe you want family and friends in the room, or maybe you only want the baby's other parent or a support person like a doula.
As you think about your plan, give yourself permission to be flexible. It's hard to know what will happen. The most important thing is to make sure you and your baby are healthy and safe.
Late in your pregnancy, your doctor or midwife will tell you what to do when you think you are in labor. At first, your contractions may not be regular and may happen only now and then.
You may have signs that early labor is not far off.
When you're in labor, the contractions get longer, stronger, and closer together. You will feel them even when you change positions and walk or move around. After a while, it will become hard for you to talk during a contraction. You may have to stop to focus on your breathing.
Call 911 anytime you think you may need emergency care. For example, call if:
Call your doctor now or seek immediate medical care if:
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.
You have many choices to relieve pain during childbirth. These include medical and nonmedical options. You may use more than one of these choices.
Nonmedical options may help reduce pain and help you feel a sense of control during labor. These techniques include:
Other techniques that don't use medicine to control pain include hypnosis and acupuncture.
Your options for pain relief with medicine may include:
Vaginal birth means delivering a baby through the birth canal (vagina). During labor, the uterus tightens (contracts) regularly to thin and open the cervix and to push the baby out through the birth canal. It can take many hours or sometimes days for the cervix to open all the way so you can begin pushing. Most babies are born by vaginal delivery.
Cesarean section (C-section) is the delivery of a baby through a cut (incision) in your belly and uterus. In most cases, you can be awake during the birth and be with your newborn soon afterward. It can take 4 to 6 weeks to recover completely from the surgery.
A C-section may be planned or unplanned. In most cases, doctors do cesarean sections because of problems that arise during labor.
Vaginal birth after cesarean (VBAC) means delivering a baby through the birth canal after having had a C-section for a previous birth. In the past, if you had one baby by C-section, you had to have your next babies by C-section. But now you may be able to try for a vaginal birth. It depends on the reason for the first C-section and the type of incision that was made.
There are three stages of labor that can occur over many hours or even a few days. The first stage is labor. During the second stage, you deliver the baby. The final stage is delivering the placenta.
The first stage of labor is divided into three phases: early labor, active labor, and transition.
Early labor is often the longest part of the birthing process, sometimes lasting 2 to 3 days. Contractions:
It's common for women to go to the hospital during early labor and be sent home until they are in active labor or until their "water" (amniotic sac) breaks.
Active labor starts when the cervix is about 5 cm (2 in.) to 6 cm (2.4 in.) dilated. This stage is complete when the cervix is fully effaced and dilated and the baby is ready to be pushed out.
During this phase, contractions get stronger, are more frequent (every 2 to 3 minutes), and last longer (50 to 70 seconds). Now is the time to be at or go to the hospital or birthing center. If your amniotic sac hasn't broken before this, it may now.
You may be restless and excited, and you may feel the need to shift positions often. This is good because it improves your circulation.
As your contractions get stronger:
Transition is the end of active labor. As the baby moves down, contractions become more intense and longer and come even closer together. Delivery isn't far off.
During transition, you may be self-absorbed, focused on what your body is doing. You may want others nearby for support but be annoyed or distracted by their attempts to help. You may feel more and more anxious, nauseated, exhausted, or fearful.
A woman who's delivering for the first time may take up to 3 hours in transition. A mother who has had a vaginal birth before will usually take no more than an hour. Some women have a very short and intense transition.
The second stage is the actual birth, when the baby is pushed out by the contractions. This pushing stage can be as short as a few minutes or as long as several hours. You are more likely to have a fast labor if you have given birth before.
In the second stage:
You may feel a burning pain when your baby's head comes through the vagina (crowns). You can have a mirror positioned so you can watch your baby's head crown.
If the baby is coming quickly, your doctor or midwife may ask you not to push with every contraction. This may give the perineum a chance to stretch without tearing.
Then after a final push, your baby is born, and you get to hold and look at this new person for the first time. But your body still has some work to do: stage three, delivery of the placenta.
The third stage of labor is when the placenta is delivered. You will still have contractions. They make the placenta separate from the inside of the uterus, and they push the placenta out.
The third stage can be as quick as 5 minutes. But in most cases, the placenta is delivered within 30 minutes. Your contractions will continue until after the placenta is delivered, so you may have to focus and breathe until this uncomfortable process is complete.
Your care provider will help you during this time. If the placenta doesn't fully detach, your doctor or midwife may remove by hand what's left inside. You'll also be watched for any problems, such as heavy bleeding, especially if you have had it before.
You may be given medicine after the placenta is delivered. Oxytocin (such as Pitocin) is used to make the uterus shrink and bleed less. (This is the same medicine that is sometimes used to make contractions more regular and frequent during labor.) Breastfeeding right away can also help the uterus shrink and bleed less.
In most cases, you don't have to lie in bed while you're in labor. Your nurse or doctor may have you stay in bed or in a certain position if there are problems with your baby or your health. Or you may need to be in bed if you have an epidural.
If you don't need to be in bed, you can choose whichever position feels most comfortable. You may want to walk, sit on a big rubber ball, or kneel. The position that feels best for you may change as you move through labor.
Moving around and changing positions during labor may help you feel more comfortable.
During early labor, walking can help ease discomfort or pain. Some people walk during much of their labor.
Leaning forward during each contraction can help ease discomfort or pain.
Sitting backward in a chair and leaning over the back of a chair is a comfortable position that lets you rest while staying upright. You can place a pillow between your belly and the chair back. Leaning over the back of a chair is also a good position for receiving a back rub.
Squatting opens the pelvis, especially when you hold onto something stable and stretch away from it. This position can be used for pushing during contractions and for delivering the baby.
Kneeling over a chair, ball, or cushions is good for active labor and for when you need to rest. This position is easy to move into and out of when you feel the need to change position. You may find it eases back labor.
Kneeling on your hands and knees can be used to reduce the intensity of contractions and to try to turn a posterior-facing baby. You may find that kneeling eases back labor.
Lowering yourself from hands-and-knees can help ease the physical and emotional intensity of labor. It is also used to take pressure off of the back and may help shift a baby to a more favorable position. You may find that it eases back labor.
Lying on your side can give you needed rest during a long labor. Take care to prop up your upper leg and head.
Birthing positions for pushing include squatting, reclining, and using a birthing chair, stool, or bed. You may find that certain positions are more comfortable than others during the pushing stage. Speak to your doctor or midwife about different birthing positions before your labor begins.
Some exams and procedures are normally done during labor. Others are used as needed.
These are done to check how much your cervix has thinned and opened.
Your baby's heart rate will be checked during labor. The heart rate is a good sign of how your baby is doing. Fetal heart monitoring may be done at set times (intermittent) or all the time (continuous).
Measures may be taken to start (induce) labor. This may be done by breaking (rupturing) the amniotic sac. Or medicine may be used to soften the cervix or cause contractions. These measures may be needed if labor doesn't start on its own and the baby needs to be delivered soon. They may also be used if active labor starts on its own but contractions slow or stop.
You will be given antibiotics if you tested positive for group B strep during your pregnancy.
In some cases, a woman may need medical help to give birth.
Forceps delivery or vacuum extraction can be used to assist a vaginal delivery. This may be needed at the pushing stage if labor is stalled. It may also be done if the baby shows signs of distress and needs to be delivered quickly.
An episiotomy is a cut (incision) to widen the perineum. This is sometimes done to deliver the baby's head more quickly, when there are signs of distress.
Sometimes what starts as a routine vaginal birth may end in a cesarean delivery (C-section). This may be done to make sure the mom and baby are safe.
You may have shaking chills right after delivery. This is a common reaction in the hours after delivery. A warm blanket may help you feel more comfortable.
During the first hours after the birth, your health professional or a nurse will:
Close physical contact helps you bond with your baby and helps your newborn feel secure. One special way to bond with your newborn is "kangaroo care." This simply means holding your baby to your chest, skin to skin. Talking to, reading to, and caring for your baby also help to form a bond.
It's best to start breastfeeding within 1 hour of birth. For each feeding:
Breastfeeding doesn't always come easily at first. But it gets better with practice. Be patient. Talk to your doctor, midwife, or lactation specialist if you have problems.
Current as of: July 11, 2023
Author: Healthwise StaffClinical Review BoardAll Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Current as of: July 11, 2023
Author: Healthwise Staff
Clinical Review BoardAll Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
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