Childbirth

Childbirth can be thought of as both the beginning and the end of something. It's the end of your pregnancy but the beginning of a new life with your baby. Being prepared for childbirth, including labor and delivery, will help make the entire process easier. You've already spent almost nine months being healthy and getting ready for this moment. (Read about "Stages of Pregnancy" "Healthy Pregnancy") Staying healthy is important. Make sure you get enough rest and eat healthy right up until labor begins. Discuss with your doctor before hand if they want you not to eat anything once labor starts.

Preparations

It is, of course, impossible to predict when labor will start so it's best to do some planning ahead. You'll want to decide, with your doctor or midwife, where you will give birth. The decision will depend on a number of factors. You can give birth at home with the help of a nurse-midwife or at a birthing center. Some doctors will also work in alternate locations but most prefer a hospital. The American College of Obstetricians and Gynecologists (ACOG) calls a hospital the safest place to deliver your baby. The National Women's Health Information Center (NWHIC) says that most nurse midwives will not do a home delivery unless you are within 30 minutes of a hospital. NWHIC also says hospitals are recommended for high risk pregnancies.

Here are some other things to do and think about before labor actually starts from ACOG:

• Visit the hospital or birth center before labor so you know where to go when you arrive. (Read about "At The Hospital: For Patients" "At The Hospital: For Visitors")
• Pack a small suitcase for that first trip.
• Pack a larger suitcase that someone can bring later.
• Plan your route to the hospital. Be aware of what traffic conditions will be at various times of the day and know how long it will take. Also, take into consideration possible weather problems, depending on the time of year.
• Discuss with your doctor the timing of when you should go to the hospital and when you should call the doctor or midwife.
• Get an approved child safety seat and learn how to install it prior to bringing the baby home. (Read about "Car Safety")

You may also want to take some childbirth classes. Many hospitals and practices offer classes year round. The classes can help you understand the process you will be going through. Many hospitals require any coach, you plan to have in the delivery room or your husband, to attend childbirth classes.

Contractions

As you approach your due date (Read about "Due Date") you'll be looking for those tell tale signs that the time has come. You may experience what are called Braxton-Hicks contractions or false labor. According to ACOG, it is your uterus cramping. The irregular cramps are normal, most women have them. ACOG says a good way to tell false labor from true labor is to time the contractions from the beginning of one to the beginning of the next. If they are regular and get closer together, they are probably true labor. Braxton-Hicks will be irregular, weak and do not get stronger.

True labor contractions, according to ACOG, will last 30 to 70 seconds, are regular and they don't go away when you walk or move around. In the beginning, they may feel like a lower backache that moves around to the front. A bloody vaginal discharge or spotting may also accompany this. (Read about "Vaginal Discharge") Heavy or menstrual type bleeding should always be immediately reported to your doctor or midwife.

Sometimes however only a pelvic exam can confirm you have gone into labor. Do not be afraid to call your doctor or midwife. Early contractions, more than 4 weeks from your due date, could mean you are in preterm labor. (Read about "Preterm Labor") ACOG says you should contact your doctor or midwife if you have five or more cramps in an hour. Other times to contact your doctor or midwife, according to ACOG include:

• your water breaks or is leaking
• bleeding, more than spotting
• you are experiencing constant pain
• decreased movement of the baby
• greatly increased movement of the baby

Don't be afraid to call your doctor or midwife if you have any questions. It is better to be safe than sorry in these situations.

Labor and birth

Labor is not a short process. It is hard work, which is one of the reasons it is important that you stay healthy and rested during your pregnancy. (Read about "Pregnancy and Nutrition") You can expect your labor to last some 12 to 14 hours, that is the average for first births, according to ACOG. Women having additional births tend to have shorter labor after the first time.

ACOG says there are three stages of labor. The first is also the longest. That's the time when most of the contractions will occur. The cervix is being opened during this part. When it is fully opened or dilated, stage 2 begins. That's when you will be asked to push or bear down during the contraction. This helps to push the baby down the vaginal canal to be born. Once the baby is born, the uterus will continue to contract to push out the placenta. This is stage 3. These contractions are closer together and usually less painful.

Delivery options

Most women deliver their babies through the vagina. But some vaginal deliveries require assistance. For example, the baby's head may not fit through the vagina without tearing it. What's called an episiotomy can be used to keep this from happening. In this procedure, a small cut is made in the perineum (the area between the vagina and the anus) to make the vagina opening larger. ACOG says this is one of the most common procedures in the U.S. However, ACOG stresses that it does not recommend routine use of episiotomies. As with any procedure, there are advantages and disadvantages. You should discuss this issue in advance with your doctor or midwife. Another type of intervention involves the use of forceps or vacuum cups to help pull the baby from the vagina. Again, you should discuss this possibility in advance with your doctor or midwife.

Sometimes, the baby cannot be delivered through the vagina and a cesarean delivery or C-section is used. This is the delivery of the baby through a cut made in the abdomen and uterus. ACOG says the use of a c-section may be indicated prior to labor, depending on the position of the baby in the womb, the mother's own health, and other factors. A c-section may also be used after labor has started if it appears that a vaginal delivery would be dangerous to either the baby or mother. At one time, a woman who delivered a baby with a c-section was advised against future vaginal deliveries. That is no longer the case for all women. Some women may have a VBAC (vaginal birth after cesarean). Not all hospitals can offer this option, and again, every woman is different. You should make sure you discuss all these issues with your doctor or midwife prior to going into labor.

Medications for pain

Each woman experiences childbirth differently. If you are experiencing pain during labor, there are ways to deliver pain relief. You should not be ashamed to ask for pain relief. NWHIC lists some of your options as:

• local or intravenous analgesic, a pain relieving drug
• epidural which is an injection that will numb the lower part of your body
• spinal anesthesia
• pudendal nerve block, which numbs the vulva, vagina and anus

Each of the methods is used at specific times and for specific reasons. (Read about "Anesthesia") You should discuss with your doctor or midwife before hand the options so you are informed and able to make an appropriate decision during labor.

Related Information:

    Pregnancy Resource Center

    Cervical Insufficiency / Incompetent Cervix

    Placental Complications

    Newborn Concerns

    Baby and Young Child Care

    Breastfeeding

    Colic

    Diaper Rash

    Childproof Home

    Crib Toys

    Childhood Illnesses

    Immunizations

    Child Development

    Cleft Lip/Cleft Palate