Chapter 6.1

LABOR AND DELIVERY

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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