LABOR & DELIVERY

The Beginning of Labor Lightening- occurs when the baby settles deep into the mother’s pelvis. Lightening may occur days or weeks before labor depending on the pregnancy. Lightening typically occurs closer to delivery with every pregnancy each mother has.

Early Signs of Labor “Show” or “Bloody Show” – refers to as loosing the mucus plug. Throughout the pregnancy the mucus plug seals the Cervix: the lower part of the uterus. This mucus helps prevent bacteria from moving up the vagina into the uterus where it might cause infection. As birth gets closer, the mucus begins to liquefy- the woman may notice a few drops of blood or a slightly vaginal staining. This “show” may come as early as a few days before labor begins.

Early Signs of Labor In some women, the onset of labor is signaled by a trickle- or sometimes a gush- of warm fluid from the vagina. We commonly refer to this as the “water breaking.” Occurs when the membrane holding the amniotic fluid surrounding the baby has broken. For most, this membrane does not rupture until she is at the hospital in active labor.

Early Signs of Labor Once the water has broken, mother should take notice of: The time Amount of fluid Color & odor of fluid She should contact her doctor immediately & report this information. The doctor usually will want to deliver the baby within 24 to 48 hours- to protect baby from infection.

Early Signs of Labor Contractions: the tightening and releasing of the muscle of the uterus. When the uterus contracts, it gets shorter and harder- like any other muscle. With each contraction the uterine muscle , shortens and harden- holds the hardness for a short time, and then relaxes and rest for a few minutes. This is the clearest sign that labor has begun.

False Labor Some experience “false labor” hours or even days before they begin real labor. They begin to feel strong contractions and believe that labor has begun. Doctors look for these 3 signs to determine if labor is false: Contractions are not regular or rhythmic. They do not become increasingly stronger. They end if the woman walks around.

Before labor begins- the cervix is normal size and shape.

The 1st Stage Contractions prepare the mothers body for birth. With each contraction the uterus pulls up on the cervix, slowly thinning and opening it. Contractions get stronger & longer- lasting about 60 seconds. They also get closer together- 5-6 minutes apart.

The 1st Stage As the cervix opens the baby moves into the lower pelvis. Normally, the baby is head down. Sometimes baby is “breech”- meaning that they are feet or buttocks first. This stage ends with a period called “transition”- when the cervix becomes fully dialated. Contractions become very strong lasting longer- up to 90 seconds. Contractions become more frequent- 2 to 3 minutes apart.

Contractions make the cervix dilate- or widen. Cervix becomes thinner- this is called effacing.

Completes the work of the 1st stage. The cervix becomes fully dilated to a size of about 4 inches (10 cm). The baby’s head begins to slip out of the uterus into the birth canal.

The 2nd Stage Contractions at this stage are working to move the baby down the birth canal. This stage is when pushing begins The hormone “Relaxin” is released by the body to allow the ligaments in the pelvis to stretch like rubber bands. The baby’s skull is soft and flexible so that the head can slide through the pelvis.

The 2nd Stage If the doctor determines that the fit between mother and baby is not adequate they may perform an “Episiotomy”- widening the vaginal opening by making a surgical cut. The doctor provides gentle support as the head is delivered. Sometimes the doctor uses forceps- special tongs that are designed to fit the shape of the baby’s head. These are used to help the baby emerge more quickly.

First the top of the head appears at the opening of the birth canal.

Baby’s head emerges first Next the shoulders follows. Then the rest of the baby slips out easily.

The 3rd Stage After the baby is born, the mother often experiences a period of rest. Then followed by another spell of contractions and an urge to push. These contractions are different from the others- they do not typically cause as much discomfort. They help the placenta separate from the uterine wall. Once the mother pushes and delivers the placenta, the birth process is complete.

The woman gives birth to the placenta, no longer needed by the baby.

Cesarean Birth Not all births progress through these 3 stages of labor. If complications arise during pregnancy or during labor it may be necessary to perform a Cesarean Birth- the delivery of a baby by making a surgical incision in the mother’s abdomen. With the use of certain medications, mother is able to stay awake to see the delivery of her baby.

Cesarean Birth After surgery, mother and baby stay in the hospital for about 3 days. Woman who have had a cesarean need about 6 weeks to recover from birth sense they are also getting over major surgery.

The Newborn The newborns head is large and wobbly. It may appear strangely lopsided or pointed due to the passage through the birth canal. With time it will return to normal. The baby’s head has 2 fontanels- open spaces where the bones have not joined yet. One of these “soft-spots” is just above baby’s forehead- the other toward the back of the skull.

The Newborn Some babies have fine downy hair called “lanugo” over their forehead, back, and shoulders. This will disappear. To protect baby’s skin it is covered with a rich creamy substance called “vermix.” After birth some vermix may be found in the creases of the skin- it can be removed with warm water and a washcloth.

The Newborn Some babies also have tiny white bumps scattered over their nose and cheeks. These bumps are called “milia.” They are simply plugged oil ducts. The milia will disappear in a week or two.