1. Labor and Delivery
Chapter 6.1

2. The Progression of Labor
Giving birth is a powerful and emotional experience!
Leaves most new mothers feeling both exhausted and exhilarated
Giving birth, or labor, occurs in two basic parts: the beginning of labor and the stages of labor

3. The Beginning of Labor
During last few weeks, time often seems to slow down for expectant mother
Many women become anxious for baby to be born
During this time they may feel lightening
This occurs when the baby settles deep in the pelvis near the time of birth
Because the baby has moved down, the pressure on the women’s upper abdomen is reduced, or lightened

4. Early Signs of Labor Many signs that the baby is on its way
“Show” or “bloody show”
Few drops if blood or a pinkish vaginal stain that occurs when the mucus that plugs the uterus during pregnancy dissolves
Water breaks
When women feel a trickle or gush of warm fluid from the vagina
This indicates that the membrane, or amniotic sac, holding the fluid around the baby has broken
Contraction
Tightening and releasing of muscles of the uterus
When the uterus contracts, it shortens and closes, pushing the fetus agains the cervix
The uterus relaxes before the next contraction

5. Premature Labor Full-term pregnancy usually lasts 40 weeks
Giving birth a week or two earlier is still normal
Premature, or preterm, labor occurs when the fetus has been developing in the womb for 37 weeks or less

6. False Labor
Some women feel what is called false labor hours or days before their real labor starts
They begin to feel strong contractions and believe that labor may have begun
Doctors look for three signs that may indicate false labor
Contractions that are not regular or rhythmic
Contractions do not get stronger over time
Contractions end with light exercise, such as walking or stretching

7. Inducing Labor
If necessary, the doctor can induce, or start, labor by artificial means
This can be done by using medication or puncturing the amniotic sac
Often induced for medical reasons or in emergencies
If the baby has been slow to develop or is still in the womb after 42 weeks, the doctor may decide to induce labor
Also if the amniotic sac has broken and labor does not begin on its own

8. Stages of Labor Three basic stages
Stage 1 Contractions open the cervix
Stage 2 The baby is born
Stage 3 The placenta is expelled
During these stages, the baby makes its way out of the mother’s womb and into the world
The amount of time it takes to give birth depends on the mother and the baby
Often takes longer for a mother’s first
6-18 hours for first
2-5 for a later child

9. The First Stage
Officially begins when contractions are coming at regular intervals
Contractions in the uterine muscle pull up on the cervix, slowly softening and thinning it allowing it to open
Contractions increase in strength, length, and frequency
Mother will use coping techniques with the help of their partner such as breathing techniques or exercises
This is the stage the mother would receive medication if she wanted

10. The First Stage
As the cervix dilates, the baby moves into the lower pelvis
The first stage ends with a period called transition
When the cervix becomes fully dilated to a diameter of about 10 centimeters (4 inches)
This is the most difficult part of labor

11. The Second Stage
Contractions during the second stage are more productive, pushing the baby through the pelvis and out of the vagina, or birth canal
During this stage, it is safe for the woman to push
When pushing, uses her muscles to expel the baby

12. How can a baby fit through such a narrow space??
Ligaments, or connective tissue, join the bones of the mother’s pelvis
During labor, a hormone called relaxin allows this tissue to stretch like rubber bands
Stretching moves apart the pelvic bones
Also makes it possible for the walls of the vagina to stretch so the baby can safely pass through

13. The Second Stage Baby’s body is designed for this journey
Soft skull lets the baby’s head become longer and narrower than usual
Skull consists of five separate bones that move together and allow for the baby’s head to fit through the pelvis and vagina
Sometimes opening of the mother is too small to accommodate baby’s passage so doctor may widen it with a surgical cut called an episiotomy

14. The Third Stage
After birth, the mother may be able to rest briefly, and then may feel a few contractions and a desire to push
Usually not painful and helps the placenta, the organ that develops in the mother and helps supply oxygen to the fetus, separate from the uterine wall
Once the mother pushes the placenta out of her body, the birth process is complete

15. Cesarean Birth Not all births progress through the stages of labor
If complications arise during pregnancy or labor, a cesarean birth or c- section may become necessary
Delivery of a baby through a surgical incision in the mother’s abdomen
Performed for several reasons
Lack of normal progress during labor
Baby is in distress or turned in the wrong direction
Often planned for multiple births
Because it is a surgery, it carries some risks
Women who have had a cesarean birth may need up to six weeks to fully recover

16. Premature Birth Between 5-6% of all babies are born prematurely
Babies born before 37 weeks of development and weighing less than 5 pounds, 8 ounces
The earlier babies are born, the less developed their organs are and the lower their birth weight
Mothers who have had other premature births, are carrying more than one baby, or have other medical problems are more likely to have premature babies
Women can reduce their risks by eating well and getting proper prenatal care

17. Premature Birth Premature babies, or preemies, require special care
They are not ready to live outside their mother’s body
Their systems for controlling body temperature, breathing and feeding are not yet mature
To help control the undeveloped body systems, a premature baby is usually placed in an incubator
Special enclosed crib where the oxygen supply, temperature, and humidity can be closely controlled