Labor Articles

Article / Updated 09-03-2021

Whether you’re in labor, being induced, or having a cesarean delivery, you need to be admitted to the hospital’s labor floor. If you preregistered earlier in your pregnancy (ask your practitioner about the process), your records are already on the labor floor when you arrive, and a hospital unit number is assigned to you. When you arrive at the hospital or birthing center, you go through an admission process and are assigned to a room. You settle into your hospital room, following a fairly standard routine: You change into a gown. A nurse asks you questions about your pregnancy, your general health, your obstetrical history, and when you last ate. If you think water has broken or you’re leaking fluid, let your nurse know. A nurse, midwife, resident, or other practitioner performs an internal exam to see how far along in labor you are. Your contractions and the fetal heart rate are monitored. A nurse may draw your blood and start an IV line in your arm (for delivering fluids and possibly medications). You’re asked to sign a consent form for routine hospital care, delivery, and possibly cesarean section. You sign the consent form when you’re admitted in case you need an emergency cesarean during labor and you don’t have time to sign consent forms. Signing a consent form doesn’t mean you’re limiting your care options. You may want to hand over any valuables you have with you to your partner or another family member (or simply leave them at home). Most hospital rooms include some standard features, so the room you’re placed in probably includes all of the following: A special bed: In a room used for both labor and delivery (also known as a birthing room), the bed is specially designed to come apart and be turned into a delivery table. Some hospitals have rooms where you labor, deliver, and even remain for your postpartum recovery. These rooms are called LDR (an acronym for labor, delivery, and recovery) rooms or LDRP rooms (the p stands for postpartum). Doppler/stethoscope: Your practitioner or nurse uses these portable tools to listen periodically to the fetal heartbeat instead of using the continuous fetal monitor. Fetal monitor: This machine has two attachments, one to monitor the baby’s heart rate and one to monitor your contractions. The fetal monitor generates a fetal heart tracing, which is a paper record of how the baby’s heart rate rises and falls in relation to your contractions. Infant warmer: This device has a heat lamp to keep the newborn’s body temperature from dropping. IV line: This tube is connected to a bag of saline (salt water) containing a glucose mixture to keep you properly hydrated. It also provides access for medications in case you need pain control or have an emergency. Rocking chair or recliner: The extra chair is for your partner, your coach, or another family member.

Article / Updated 09-03-2021

It’s one thing to know, plan for, and write a birth plan based on a scheduled cesarean birth; it’s quite another to get into labor — sometimes nearly all the way to the end — and then find out you need to have a C-section. Most of the time, an unscheduled cesarean isn’t an emergency. In that case, you have a chance to ask questions and make your wishes known about who will be in the operating room with you and whether you want to have your baby with you right after birth (as long as neither you nor the baby has life-threatening complications requiring immediate care). When your doctor says she wants to do an unplanned caesarian delivery, consider asking these questions before she wheels you down to the operating room: Why are you recommending a cesarean now? Although you probably already have some idea, you’ll feel better if you get your doctor’s input firsthand. Make sure she discusses both the pros and the cons. Can we try any other options first? These options can include getting in a different position, walking up and down the hall, simply giving labor a little more time, augmenting your labor to strengthen your contractions, turning the dose down (or off) if your baby appears to be stressed, or waiting for your epidural to wear down a little. Is my baby in immediate distress? In most cases, if your baby is in distress, you’ll know it by the flurry of activity in your room. If your room is still fairly quiet, ask your practitioner what she feels the risk to your baby is at this time. Am I in danger? If the danger isn’t immediate, ask your doctor for an explanation of why a C-section is the best option for you right now. What kind of anesthesia will I have for the surgery? The anesthesiologist may talk to you about the pros and cons of putting a higher dose of medication in your epidural for the surgery versus putting in a spinal. One benefit of using the epidural is that you can use it for pain medication after your surgery. Can I hold my baby right after the surgery? If your baby isn’t in immediate distress, this should be an option. Who can come into the operating room with me, and where will they be? Hopefully, you decided ahead of time (and put in your birth plan) your first choices. But if you’ve been in labor for a while, you may have a clearer idea of who’s a good choice and who isn’t. How long will the surgery take, and what type of incision will I have? Keep in mind that the incision on the uterus and the incision on the skin may not be the same. The baby is usually out within five to ten minutes, but putting everything back together again can take up to an hour.

Article / Updated 09-03-2021

Most delivery rooms are sterile-looking places because, in fact, they have to be germ-free. However, that doesn't mean that you can't do something to enhance the atmosphere while you're delivering your baby. You won't be allowed to light candles in a hospital, but you can tape some photos to the wall, bring a boom box to play some background music, and even spray a favorite scent into the air. By placing your mark on your surroundings, both of you feel more in control of the situation. While the delivery room may never be what you would call a romantic setting, you can enhance the romantic aura with a little planning. Playing it safe In the attempt to create a greater sense of intimacy during the birthing process, some couples choose to have their babies at home. If something does go wrong during the birthing process — and it can — you want to be as close to an operating room as possible. If you can be quickly wheeled into the operating room, most of the time doctors can right whatever goes wrong. However, if you have to wait for an ambulance and then drive to the hospital, it may be too late. Because many couples would prefer a more homey setting, some hospitals do have labor rooms that are decorated to look just like a bedroom. Of course, if an emergency develops, the operating room is just around the corner, so they offer the comforts of a home delivery with the safety of a hospital. If you want this type of experience, see whether your doctor is affiliated with a hospital that has such rooms. Be forewarned that even if this is a possibility, you may end up in a normal delivery room if many women give birth on the same day. Enduring labor day You can't predict how long labor will last. Some women give birth in a few hours; others take a few days. The longer the process takes, the more uncomfortable you are going to be. In addition, as the hours of discomfort continue to mount up, you're going to become crankier, also. You can't take your frustration and pain out on your doctor or the nurses, so who's likely to bear the brunt? Your husband. To lessen the impact this stressful time can have on your relationship, you have to talk about what to expect ahead of time. If you're both aware that labor may be long, grueling, and tense, he'll have an easier time shrugging off your bad mood, and you'll be more likely to recognize the cause of your griping and apologize before doing it again. One of the reasons this can be such a frustrating experience for both partners is that most men are natural fixer-uppers. If you tell a man there's a problem, chances are that he's going to look for a solution. In this case, there's nothing he can do other than to give you some ice chips and tell you to breathe properly. When you scream at him "Make this stop!" he's going to want to do exactly that, even though you are only venting your own frustrations. Moreover, if this behavior has been going on for hours, you're both going to be tired and your tempers will fray. In the "good old days," men were left to pace in the waiting room, and such interaction between husband and wife didn't occur. Before that, husbands waited outside the house while midwives ministered to their wives. The father-to-be is now the birthing coach, and, right after the delivery you go back to being husband and wife. With those facts of life in mind, you're both wise to forgive and forget any words or acts delivered at the most emotional moments of this wonderful process.

Article / Updated 09-02-2021

More and more women are expressing interest in nontraditional or alternative birthing methods, and more and more options are available. Certainly, the following options aren't for everyone, but knowing what's possible can be helpful. Delivering without anesthesia Natural childbirth usually refers to giving birth without any medications or anesthesia. (It's probably not the best terminology, because using pain medication doesn't make the birthing process unnatural.) The theory behind natural birth is that childbirth is an inherently healthy and natural process and that women's bodies are made to handle childbirth without the need for medications. Natural childbirth allows you to have a great deal of control over the childbirth process and your own body. It emphasizes having you choose which positions are comfortable, how mobile you want to be, and which techniques you want to use to be as comfortable as possible. Natural childbirth can be practiced in a hospital setting, in a birthing center, or even at home. Some practitioners aren't comfortable with every aspect of natural childbirth because they don't want to be limited in doing what they feel is medically necessary and important. Discuss with your practitioner what he feels comfortable with so your delivery can be as great of an experience as possible. Giving birth at home For some women, a home birth provides an ideal environment to deliver their baby. Common reasons for choosing a home birth are the desire for a low-intervention birth; a desire for control over the birth process; a desire to give birth in a familiar and comfortable environment, surrounded by family and friends; living in a rural area with lack of access to a hospital; and economic, cultural, or religious issues. Typically, a midwife usually attends a home birth, and an obstetrician is on call in case problems arise. Home births are certainly more appropriate for women who are at very low risk for complications. Although some studies demonstrate that home births are associated with greater risks for both the mother and baby, others show that home births are at least as safe as hospital births for healthy, low-risk women. Home births are still relatively uncommon in the United States, with fewer than 1 percent of women choosing to deliver at home. Although respecting the right of women to make medically informed decisions about where they want to deliver, the American Congress of Obstetricians and Gynecologists, in agreement with the American Academy of Pediatrics, believes that hospitals and birthing centers are the safest settings for births and has published the minimum criteria for planning a home birth, which include the following: A singleton pregnancy with the fetus's head down No medical or obstetrical conditions No contraindications to vaginal birth A licensed obstetrical caregiver to administer the prenatal, labor, birth, and postpartum care A backup hospital within 15 minutes of the home In addition, and of prime importance, is that women completely understand that although the absolute risk of home births is low, home birth is still associated with a two- to threefold increase in neonatal death when compared with planned hospital births. Also, home births aren't legal in all states. Using a doula A doula may be a friend, relative, or trained companion who provides nonmedical, continuous support during labor and delivery. Doulas often meet with prospective moms before delivery so they get to know each other. During labor, they provide both emotional support and physical support — helping to get moms into comfortable positions, massaging their back or legs, getting water or ice chips, and so forth. Some studies have shown that labors attended with doulas may actually be shorter in length, although there is no effect on cesarean delivery rates. Women who used doulas also seemed to have a slightly better overall birth experience and were more likely to rate their labor and delivery as "very good." Immersing yourself in a water birth In a water birth, much of labor is spent immersed in water, and the baby can even be delivered in the water. Water births usually take place in a birthing center with the help of a midwife, although some hospitals may provide birthing pools or baths. The water temperature is kept about the same as the body temperature, and the woman's temperature should be monitored throughout labor. A recent review of randomized trials found a somewhat lower rate of anesthesia when water immersion was used in the first stage of labor. Interesting, prolonged immersion for more than two hours may actually slow down labor by decreasing the production of oxytocin. Although some professionals in the medical community feel that a water birth is a safe procedure, others have more serious concerns about its safety for both the patient and newborn. Water immersion during the second stage is not well studied. There have been a few cases reported of water aspiration and snapped umbilical cords, difficulty regulating body temperature, and infections in the newborn. Also, not all facilities are equipped for water births.

Article / Updated 09-02-2021

One of the best ways to get yourself ready for childbirth is by exercising during your pregnancy. Anyone who tells you that childbirth is a breeze isn't being very honest with you. Childbirth is hard, and you don't want to approach it without being physically ready. Having a less complicated delivery Several research studies have shown that women who exercise have fewer complications during delivery, including instances of fetal intervention because of abnormal fetal heart rates, forceps deliveries (in which a large tong-like tool helps the baby come out), and cesarean deliveries (in which the baby is surgically removed from the uterus). Women who exercise during pregnancy also tend to need fewer drugs for pain relief. Spending less time in labor According to a study by Dr. Clapp, labor is significantly shorter (by about one-third) for women who exercise regularly during pregnancy than for a control group made up of physically active women who didn't continue exercising during pregnancy. Also, babies of women who exercise regularly throughout pregnancy are born about five days earlier than those of women who don't exercise, making pregnancy that much shorter (and five days is a really big deal when you're in your third trimester).

Cheat Sheet / Updated 03-27-2016

A birth plan is a document you create to communicate your wishes and requests to your medical practitioner, the birth team, and your support team. How do you put your hopes and dreams for a perfect birth down on paper? Pinpointing what kind of labor and delivery you want isn’t as overwhelming a task as it may first seem. Here are some ideas to help you get started.