Labor and delivery
In this section you'll read about what to expect during labor and the
delivery of your baby:
Signs that you're in labor
The birth process starts when you go into labor. You'll begin to feel strong, regular contractions as the uterine muscles tighten to push the baby out during birth. You'll know labor is progressing if you have:
- Contractions throughout your entire uterus
- Contractions that get stronger instead of weaker
- Regular contractions (about every 5 minutes) that get more painful
- Pink or blood-streaked discharge from your vagina
- Breaking of the "bag of waters." This may be a trickle or a gush from
your vagina.
Your doctor will give you instructions on when to call him or her and when to go to the hospital or birthing center. Be sure to call your doctor if you have questions or concerns about how your labor is going.
False labor
Some women have signs of labor before it actually begins. If you go to the hospital before your labor is progressing actively, you'll likely be sent home to wait. You're probably not in active labor if your
contractions:
- Are not regular or strong
- Occur only in the lower part of your abdomen
- Subside when you walk or change position
How to be more comfortable
Labor becomes more painful as it progresses, but there are some things you can do to feel more comfortable.
- Change position often: sit, lie on either side, lean forward on a stack of pillows, kneel on all fours.
- Urinate frequently.
- Use a cool (or warm) washcloth on your face and neck after a contraction.
- Suck on ice chips, popsicles or sour lollypops between contractions for dry mouth.
- Lightly massage your abdomen during a contraction.
- Have your partner put firm pressure on your lower back during contractions.
- Don't be afraid to ask for medication if the pain is unmanageable.
At the hospital
When you get to the hospital, a nurse will examine you to see how close you are to giving birth. If you are in active labor, you'll go to a labor and delivery room. A nurse will be there to help you before, during and after delivery.
- Your nurse will take your pulse, temperature and blood pressure.
- You'll probably have an external fetal monitor attached.
- A pelvic examination will determine how much your cervix has effaced (thinned and opened) in preparation for birth.
Most women have a partner or chosen friend or relative with them for support during labor. This person can encourage you, help you remember to breathe correctly or hold your hand if you need it.
Vaginal birth
When your cervix is thinned and opened enough, you'll transition to the pushing stage of labor. You may need a small incision called an episiotomy. This enlarges your vaginal opening so the baby's head can pass through more easily.
After birth, your baby will be wrapped in a blanket given to you to hold for a few minutes. A nurse will then take the baby for measurements:
- Length and weight
- Heart rate
- Temperature
- Breathing check
- Blood pressure
You'll be taken to a room for recovery after you:
- Deliver the placenta.
- Receive stitches if you've had an episiotomy
Cesarean birth
About one in five women in the U.S. delivers by cesarean birth, or surgical delivery through an incision in the abdomen and uterus. Reasons for cesarean birth include:
- Previous cesarean birth
- Baby is too large to pass safely through the vagina
- Baby is in breech (buttocks or feet first) or transverse (sideways) position
- Placental problems
- Labor that has not progressed
- Umbilical cord prolapse (umbilical cord slips into the vagina)
- Multiple pregnancy (especially triplets or more)
- Maternal problems (infection, diabetes, heart disease, high blood pressure)
- Fetal distress, such as a slowed heart rate
If your cesarean birth is an emergency, general anesthesia may be used and you'll be asleep during delivery. If epidural or spinal anesthesia is used, you'll be awake, with no sensation from your waist to your feet.
Cesarean birth takes longer to recover from than a vaginal birth. Plan to spend two to four days in the hospital. Full recovery usually takes four to six weeks.
