1. Stages of Labor

2. The Beginning of Labor Lightening occurs pressure on upper abdomen is now reduced

3. Early Signs “bloody show”: losing your mucus plug Plug of mucus seals the cervix Before birth mucus begins to liquefy Woman may notice few drops of blood or pinkish staining

4. Early Sign “Her water broke” Trickle or sometimes a gush of warm fluid from vagina Membrane holding amniotic fluid has broken When it breaks woman should note the time, amount of fluid and color/odor. Once broken, baby normally delivered within 24-48 hours

5. Early Sign Contractions: tightening and releasing of the muscle of the uterus Uterus gets shorter and harder like any other muscle Painful but bearable because of resting time

6. False Labor If contractions are: Not regular or rhythmic Become increasingly stronger Ending when woman walks Contractions should be timed, how frequently they are occurring,

7. Stages of Labor First Stage: contractions open cervix Second Stage: baby is born Third Stage: placenta is expelled

8. First Stage Contractions prepare body for birth Each time uterus contracts, muscles pull up on cervix thinning and opening it Contractions get stronger and longer (60 seconds 5-6minutes apart) As cervix opens, baby moves down into lower pelvis “breech presentation”: feet or buttocks enter into pelvis first

9. First Stage Transition=ending of first stage Cervix is now fully dilated Contractions even stronger, longer and more frequently Most difficult part of labor

10. Second Stage Crowning: top of head appears at the opening of birth canal Head emerges: head has changed shape to fit through passage of birth canal, shoulders follow, then rest of baby

11. Equipment Used Forceps: special surgical steel tongs that guides movement Vacuum extraction: suction applied to babies head during contractions

12. Baby’s Body Skull is soft and flexible – Consists of five separate bones that overlap to allow head to fit through pelvis and vagina

13. Mother’s Body Pelvis – Bones are joined by ligaments that are very stretchy at the time of delivery – Helps pelvis stretch open Vagina stretchy – Relaxin: hormone that makes this happy Episiotomy: widen the vaginal opening with a surgical cut

14. Third Stage After baby is born mother gets a short period of rest Urge to push because of contractions Very little discomfort Placenta detaches from wall Placenta is delivered If placenta remains, bleeding or infection can occur

15. Cesarean Birth Delivery of baby by making a surgical incision in the mother’s abdomen. Mother and baby remain in hospital for 3 days Some medications allow mother to remain awake during surgery

16. C-Section Incisions

17. Placenta Previa Placenta grows in lowest part of uterus covering the cervix The placenta can move as the uterus grows and stretches Almost all women require a C-section to avoid severe bleeding Can be fatal for mom and baby

18. Epidural Most popular method of pain relief in labor Epidurals block the nerve impulses from the lower spinal segments. Decreased sensation in the lower half of the body. Arch back, a needle then inserted into back, a small tube (catheter) is threaded through needle into back, needle removed, medicine injected.

19. Natural vs. Drugs Natural: unmedicated approach to labor Drugs: using medication as a pain reliever Advantages and Disadvantages to both…?

20. Epidural Natural vs drugs