Pregnancy, Labor and

BirthBethany Dzivasen

Women’s Health IssuesWorcester State University

February 12, 2013

INSPIRING QUOTE

“We bring to childbirth our histories, our relationships, our rituals, our needs and values that relate to intimacy, our sexuality, the quality and style of family life and community, and our deepest beliefs about life, birth and death.”

Nine Months of Change and Growth

Physical Changes

• Breasts enlarge• Congestion• Frequent Urination• Aches and pains• Shortness of breath• Constipation• Heartburn and gas• Leg Cramps

Emotional Changes

• Hormone levels usually leave mothers to be feeling depressed and under the weather during their pregnancy.

Choosing A Practitioner and Birthplace• Type of Providers to choose from:

Midwives- Midwifery is a health care profession in which providers offer care to childbearing women during pregnancy, labor and birth, and during the postpartum period. They also help care for the newborn and assist the mother with breastfeeding.

Physicians- A family physician is a medical doctor who is trained to provide basic, comprehensive care to people of all ages. Some family physicians provide maternity care and have hospital delivery room privileges

Obstetrician- a physician who specializes in the branch of medicine concerned with pregnancy and childbirth

Maternal-Fetal Medicine Physician- specialists in the obstetrics field who have additional training in complicated obstetrics.

Birthplaces• Home- Home birth is a good option for healthy

women who have healthy pregnancies, a safe and supportive home environment, and easy access to backup medical care

• Freestanding Birth Center- A healthcare facility with midwives and obstetricians and a homelike feel.

• Birth Centers in Hospitals- This is a midwife type of home atmosphere located inside a hospital.

• Hospital- The standard setting for many women who prefer to be close to medical care while giving birth or who intend to use an epidural for pain relief.

Maternity Care • Too few women get adequate prenatal care.• Too many women are exposed to the risks of high-tech

procedures, even when they are healthy and unlikely to benefit from them.

• Too many women are subjected to these potentially harmful procedures without giving informed consent.

• Too few women have the benefit of low-tech supportive care practices that help them safely cope with the demands of pregnancy, labor and birth.

• Too many women end up with physical and emotional health problems after giving birth.

Prenatal Care Your First Visit– As soon as you suspect you're

pregnant, call to schedule an appointment with your obstetrician, family physician, or midwife.

– Even if you've confirmed your pregnancy with a home test, it's wise to follow up with a physical examination so you can start getting prenatal care.

– They will ask about your gynecological health, other health history questions, family medical history and your habits that could impact the fetus.

Fetus at 8 weeks old

Tests During Pregnancy

• Tests that give information about your health: Anemia, HIV-positive or conditions that can be treated.

• Tests for fetal impairments:– Genetic Carrier Tests: test for diseases that can be

inherited by the fetus– Screening Tests: measures the likelihood that your

fetus has a condition but cannot test that the fetus actually has the condition

– Diagnostic Tests: identifies whether the fetus has a particular condition

Special Consideration • High-Risk Pregnancy– Teens– Late 30’s and 40’s– Weight – Abuse or Violence – Sexual Abuse– Disability– Chronic Illness– Addiction– Previous Cesarean Section– Depression or Other Mental Illness

Preparing for Labor and Birth

• Planning for Pain Management: The pain relief methods you choose to use can affect your experience and memories of labor.

• Planning with Confidence, Knowledge, and Flexibility: Learning about our options for coping with labor and working with a knowledgeable support team can help us feel less anxious.

• Preparing for Breastfeeding: Talk with your doctors and midwives about breastfeeding in advance.

Stages of LaborPrelabor

How long will it last? On and off for days or weeks

How dilated will my Cervix be?0 to 3 cm

How strong will the Contractions be?Vary greatly in length and intensity.

What else might be happening?Mucus discharge, backache. It’s hard to tell when you more

from this into latent- phase labor.

Stages of LaborStage 1:Latent Phase

How long will it last? A few hours to a day or more

How dilated will my Cervix be?0 to 4-5 cm

How strong will the Contractions be?Vary widely. Usually short and spaced apart.

What else might be happening?Mucus discharge, backache and upset stomach

Stages of LaborActive Phase

How long will it last? Between 2 and 10 hours

How dilated will my Cervix be?4-5 to 7-8 cm

How strong will the Contractions be?Last about a minute or more, spaced regularly.

What else might be happening?You may feel tired or discouraged, wondering if you can do it.

Pressure in your lower back, need to change position often

Stages of LaborTransition PhaseHow long will it last?

A few contractions to 1-2 hours

How dilated will my Cervix be?7-8 cm to full dilation

How strong will the Contractions be?Occur about every 2 minutes and last at least 60 seconds with

short rest time in between

What else might be happening?Intense emotions and physical sensations. You may feel restless,

irritable, and exhausted. Trembling, nausea, and vomiting are common just before the cervix becomes completely dilated.

Stages of LaborStage 2: Pushing, giving birth

How long will it last? A few contractions to over 3 hours

How dilated will my Cervix be?Fully dilated, 10 cm

How strong will the Contractions be?Powerful contractions about every 3 minutes

What else might be happening?Pain lessens and you may be able to rest for a brief time before

the urge to push becomes uncontrollable. A burning sensation when the baby finally makes it through the birth canal

Stages of LaborStage 3: Delivery of placenta

How long will it last? May last up to 30 minutes or longer

How strong will the Contractions be?No contractions, then one to several strong

cramps

What else might be happening?Provider may massage uterus to cause it to contract

and reduce bleeding; this can be painful

Stages of LaborStage 4: RecoveryHow long will it last?

May last 1-2 hours if birth was un-medicated and not prolonged or difficult

How strong will the Contractions be?Mild or moderate cramps as uterus contracts

What else might be happening?Thick, bloody vaginal discharge that may last 2-4 weeks.

Uterus will tighten to prevent bleeding. Swelling and discomfort if your perineum. Trembling legs.

Discussion Question

What would your birthing plan look like? Where would you want to have your baby? Would you want a doctor or midwife? Would you look for a form of pain relief or would you want to have your baby the natural way?