Labor and Delivery (Giving Birth)
How will I know when my labor and delivery begins? That is sometimes a difficult question because each woman and each pregnancy are different. Maybe this is your first child, and you are confused by friends and relatives who tell you that labor will be the toughest hours of your life or that it will not be so bad. Perhaps you have already borne a child and you expect this labor to be similar to your previous one. Whatever you expect, expect the unexpected.
Every labor is slightly different. But there are some good indicators that labor is beginning or about ready to begin.
1. A few days or hours before labor actually begins, you may have what is called "bloody show." This is the discharge of a small amount of blood-tinged mucus. Actually, it is the mucus plug that formed the barrier between your uterus and your vagina during your pregnancy.
2. The membranes that surround the amniotic fluid may rupture at the beginning of labor or as the labor progresses. If the membranes fail to rupture during labor, the physician ruptures them. When your membranes (sometimes called "bag of waters") rupture, you may feel a gush of fluid from your vagina or simply a slow trickle.
3. Contractions may or may not be a sign that you are in labor. Throughout pregnancy, you may have noticed your uterus contracting. These are called Braxton Hicks contractions, and they usually do not cause discomfort until the last weeks of pregnancy. Many women then have these contractions and believe they are in labor. It is often difficult for pregnant women to distinguish between these Braxton Hicks contractions (false labor) and those of real labor.
As a rule, the contractions of real labor occur at regular intervals. The period between contractions slowly begins to get shorter, and the contractions become longer and more intense. The pain usually begins high in the uterus and then radiates down the abdomen and to the lower back. If walking makes the contractions stop, they are generally false labor.
If you have any of these signs, notify your physician. Your physician may want to examine you to see whether your cervix is dilating and thinning (effacing), signs that the baby is getting ready to be born. If your membranes rupture, your physician probably will want you to go to the hospital immediately.
How long will I be in labor? That is a common question and one that is impossible to predict with any accuracy until your physician can determine how quickly your cervix is readying itself. As a rule, labor usually is longer with first babies. The uterus and birth canal of a first—time mother are less flexible, and as such it takes longer for labor and birth. A first-time mother generally can expect about 13 hours to pass between the time she goes into active labor and the birth of her baby. Some women, however, are in labor much longer. For a woman who has previously given birth, the average time is between 4 and 8 hours. There are three stages of labor.
During the first stage your cervix opens so that the baby can pass into the birth canal. Think of the uterus as a large, upside down, elastic bottle. When labor begins the cervix is about 1/2 inch long and almost closed. It would be impossible for a baby to pass through such a small opening, so somehow the cervix has to open. Contractions cause the cervix to open by creating pressure within the uterus. This force is tremendous and is directed against the uterus in two ways. During a contraction, the infant is subjected to an intense pressure that forces it against the cervix. These repeated attempts eventually will stretch the cervix open. The cervix is said to be fully dilated when it is open to a diameter of 4 inches. At the same time, the contractions cause the cervix to become thinned (effaced) or to merge with the uterine walls.
During the first stage of labor, your contractions will become more frequent and last longer. You may be attached to a machine that monitors your infant’s heart rate and charts the onset and cessation of each contraction. Your physician or a nurse periodically will do a pelvic examination to determine how you are progressing. When the contractions are not forceful enough to open the cervix, a drug may be given to make your uterus contract. Some women go through the entire labor with no pain medication. These women usually have taken classes in prepared childbirth and learned breathing techniques. Many women find that they need some pain relief, however, particularly as they get closer to full dilation. If you need something for the pain, do not be afraid to ask your physician.
The second stage of labor is when your baby is born. Your cervix is now fully dilated and effaced. This is the baby's signal to start the 5—inch journey down the birth canal. Now that the cervix offers no resistance, each contraction serves to propel the infant downward. You may feel a tremendous urge to push, almost as though you want to have a bowel movement. You must wait, however, until instructed to do so by your physician or nurse. Sometimes this urge to push comes before the cervix is fully dilated. Push only when you are having a contraction. In this way two forces that of the contraction and your pushing combine to move the baby, which conserves your energy.
Both the first and the second stages of labor are longer for first time mothers. On the average it takes about 1 to 2 hours to push a first baby out, whereas women who have previously given birth complete the second stage in anywhere from 15 to 40 minutes. As you push and the baby begins to move, the vaginal opening becomes more and more dilated and begins to bulge. At this point you might be moved from the labor room to the delivery room. In some hospitals, all stages of labor and delivery occur in specially equipped rooms called birthing rooms. If the vaginal opening does not provide adequate room for the baby to be born and it appears that your tissues may tear, your physician may give you a local anesthetic and then make an incision (an episiotomy) at the opening of the vagina. This will create a larger opening for delivery of the infant. After you have pushed the baby’s head out, you will be instructed to stop pushing for a moment while your physician clears the baby’s airway. A few more pushes and your baby is born. The umbilical cord that connects the baby to the placenta is cut and your baby is examined, weighed, and cleaned.
The third stage of labor is delivery of the placenta. Your uterus will continue to contract to expel it, but you should not feel any great pain.
Pregnancy Week To Week 1- 40