IMPORTANT

IMPORTANT: If at any time you feel a significant pressure to push, you should get to the hospital immediately, and forget the leisurely labor at home!

If you can feel a bulge or firm protrusion between your legs at the mouth of your cervix, you should not try to make it to the hospital. Have someone call 911 and get yourself comfortable on your bed with extra clean towels or a clean (old) comforter underneath you. Or, if you are more comfortable on the floor, be sure you have plenty of clean padding underneath you and relax and breathe until the ambulance and EMTs arrive.

When you are ready to go to the hospital, don’t try to go alone if you can help it. Have someone take you, call a cab or call an ambulance if you must. When you get to the hospital on the day of delivery, be sure you ask if they have a copy of the birth plan. If not, have another copy ready to give them, and repeat your primary and most important requests then and there so that you remind the staff of what you want.

During labor your cervix will become thinner and more open. If you are a first time mother, this may take 10 hours or more. If you have already had a child it may take only 2-3 hours. Your doctor will refer to this dual process as ‘effacing’ and ‘dilating’, and he will use your progress to determine how soon you may give birth.

The thinning of the cervix (effacement), is noted as a percentage. If you are 25% effaced, you are only ¼ of the way there.

The widening of the opening in your cervix (dilation) is noted in centimeters or sometimes in ‘fingers’. When your cervix is fully dilated it is about 10 centimeters across. Or your doctor may say you are ‘2 or 3 fingers’ dilated, meaning your cervix is dilated by about 3-4 centimeters and still has a way to go.

As your labor progresses, contractions will get more intense and you will have shorter breaks between these contractions. But even at the longest point of your labor, these contractions never last more than 1.5 min. and you will typically have at least 30 sec between contractions. Each contraction occurs in three stages:

o The Increment Phase (or start-up)
o The Acme Phase (the height of the contraction)
o The Decrement Phase (the contraction slows to a halt)

And you will get a brief rest in between each cycle.

The discomfort of labor is primarily from the pressure and weight of the baby’s body putting pressure on your organs and body and traveling down through the birth canal, causing the hips to widen and the head and body to push against the cervix.

Stage 1 Labor - The upper half of your uterus becomes more dense and the lower half thinner so that it push against your baby to propel him/her down into the birth canal. Every time you have a contraction during this stage, your baby will move down and then come back up a little as it progresses through the narrow change in your pelvis.

Stage 2 Labor – Begins as soon as your cervix and uterus have completed their effacing and dilation processes. This stage is considerably shorter than the first stage and may last 20-60 minutes. Unless you are heavily medicated or you have had an epidural, she will feel like you MUST start pushing your baby out.
Try to resist this urge unless and until your doctor tells you to go ahead. And if you are going to push, try to control the ‘when’ on your own schedule, gently pushing with breathing in between so that you can go with what your body is telling you to do.

Because the uterus does most of the work, you may not have to push much at all and what doctors call the ‘valsalv maneuver’ or the ‘purple push’ will raise your blood pressure and tire you more quickly.

So, if your doctor asks you to push, ask him to do it on your own count as you are ready. Your baby will born within the same time period and you and the baby will both be less stressed.

Once your baby is born your doctor will snip the umbilical cord (the umbilical cord is about 22 inches long, and looks rather like a spiral tube with a white membrane
covering it), and your baby will become its own independent entity, no longer dependent on your body though certainly dependent on you as her new mother in this brave new world!

The doctor will then take the baby for a moment to clean out her mouth and record her vital statistics (weight, length, etc.). You will probably get a chance to hold the baby right after he has finished his work.

Remember that babies arrive on their own schedule, so your labor may be shorter or longer than someone else’s. In most cases, this is just what is normal for you and for THIS baby – not necessarily what will happen in any subsequent births.

Before we finish talking about labor, we should note that you have one more thing to do before your delivery is over.

You have to expel the placenta (the amniotic sac that has nourished and cradled your baby while he/she has developed in your uterus).

During your pregnancy, the placenta is attached to the wall of your uterus with slender threads or roots and it gets its nourishment for your baby from your body.
It stores carbohydrates, minerals, protein, and fats and feeds them to your child through the umbilical cord, and it is the conduit for oxygen to your baby’s body.
It also carries away waste matter and carbon monoxide which is then washed through your kidneys and out of your system.

At the time of your baby’s birth, the placenta will be about 6-8 inches in diameter, about 1 inch thick and about one pound in weight.

After your baby is born, the placenta will detach itself from the uterine wall so you can ‘deliver’ it through the same channel from which your baby was born.

If you see the placenta while your doctor is delivering it, you will notice its rich red, kidney bean color and a texture that is squishy and sponge-like.

Your doctor will put the placenta in a bowl and examine it to be sure that it is intact and there are no fragments missing that may still be attached to the uterine wall.

Within hours after delivery, your uterus will shrink, reverting to almost normal size within ten days after your baby is born.

For about six weeks after delivery, you will experience some bleeding as your uterus cleans out the remaining fluid and other artifacts of your pregnancy. If this discharge has a foul or strange odor, call your doctor and let her know.

A few months after ‘house keeping’ activities are completed, your ovaries will release another egg, and you are once again ready to ‘make a baby’.

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