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Old 11-14-2007, 04:24 PM
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Default labor and delivery information

Okay, I will try and break it down the best I can... remember, I'm not a labor and delivery nurse, but I think I have enough knowledge there to maybe help some of you with some questions you might have.

This will be a generalized break down of what you can expect. I'll try and explain some phrases or terms you may hear them say..etc.

A full term pregnancy is considered to be 38 to 40 weeks. Of course you can go over the 40 week mark as well. I've never seen anyone go past 42 weeks... most deliveries are just shy of the 40 week mark.

Most people that go into labor on their own tend to progress through the stages because their body is ready to labor. Those that have to be induced can sometimes take longer to get into a normal labor pattern because it is being coaxed by medication such as pitocin. Other drugs they use to help start labor are some cervical thinnning drugs called cytotec and cervadil. Cervadil looks a little like a miniature tampon. They insert it up near the cervical opening and leave it in place until the cervix begins to thin out.

Here's some terms:

EFFACED: They often use this term when they are describing how thin your cervix is becoming. Oddly enough they refer to it as the "ripening" or "softening" of the cervix. Ripening just sounds so ewwww...lol.

DILATION: This is the phase where your cervix begins to "open". You start with "closed" and then go to "thick" and you might hear them say a "fingertip". The fingertip means that they can literally fit a fingertip in your cervix. Everyone dilates at different rates of speed. MOST gravida 1's (first pregnancy) tend to dilate a centimeter every hour to two hours. You might also hear them say a "loose" 3 or whatever number from 1-10. That just means that technically you're further than a 3 but not a 4 yet. In order for you to deliver.. you must be 100% effaced and at 10 centimeters. If you hear them say you have a "bloody show" don't panic.. it's just a term they often use to describe a small amount of blood tinged mucus or discharge that often occurs as your cervix begins to open up.. it's okay, nothing to worry about if you're full term and ready for birth. The only time that phrase is cause for worry is if you are premature because it can be a sign you are going into labor early.

STATION: is a term used to describe the descent of the baby into the pelvis. An imaginary line is drawn between the two bones in the pelvis (known as ischial spines). This is the "zero" line, and when the baby reaches this line it is considered to be in "zero station." When the baby is above this imaginary line it is in a minus station. When the baby is below, it is in a "plus" station. Stations are measured from -5 at the pelvic inlet to +4 at the pelvic outlet. So, if you hear them say your baby is at -4 station.. it simply means your baby is still high up in the pelvis.

In the begining.. your contractions won't be so bad, you might even think "hmmm.. this isn't bad at all" But don't let that fool you. Take advantage of the not so bad contractions and get some much needed rest. You will need to muster up every ounce of energy you have to push that baby out and it's hard work. Imagine yourself running a marathon AFTER you've been up for 18 hours and did all your spring cleaning and laundry you had piled up... are you gonna feel much like running a marathon.. I would say not. So... PLEASE get as much rest as you can and conserve that energy for when you will need it most.

There are 3 stages of labor. The first stage of labor is broken down into 3 phases. The first part is the "oh gosh, I'm in labor!" phase. Also known as "early labor" Some people hardly even know they're having contractions during this phase. This is when your cervix starts to thin out and you start to dilate. Your contractions may be anywhere from 5 to 15 even 20 minutes and can last 30 to 60 seconds. This part of labor is usually the longest part. The second phase of the first stage is "active labor". This is where you become more uncomforatable with the contractions. They can last 45 seconds to a minute maybe even longer than a minute and they're more severe with the intensity. You can expect them to come every 2 to 4 minutes or so. This is where your body will shift into a good labor pattern and you'll make more cervical changes. You might start to feel some pressure in your lower back area. The last phase of the first stage of labor is the "transition" phase. This is usually the quickest part of the first stage of labor but don't let that fool you... it's the hardest part. This is where your cervix finishes up dilating and thinning out. The contractions are severe and can feel like they're happening one on top of the other. This is where the pressure is strong in your back, vaginal area as well as your rectum. You might get sweaty and then be cold... this is very normal. Some people even vomit right when they are "complete" and being complete means you are ready to push.

Okay, I will have to continue the next part because this is getting too long and it might not let me post it if it's too long.
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Old 11-14-2007, 04:46 PM
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Okay, the second stage of labor is the actual delivery of the baby. This is where you need to pay attention to your labor nurse and your doctor. I can't emphasize enough how you have to be able to focus during this part. When it comes time to push they will break down the bed and put the stirrups on and you will have to scoot your bottom to the edge of the bed. They will help you do this if you've got an epidural in and have numb legs. They will tuck a big plastic bag like thing under the edge of your bottom to catch the "stuff" that comes out. Okay, this is where it gets a little graphic.. so if you don't want to read about it then stop now..lol.

Pushing can take a few minutes or a couple of hours. In reality.. if it's been well over an hour or two and you haven't pushed your baby out.. most likely you will be headed for a c-section. If you listen to what I am about to tell you and do it... you most likely will be able to push your baby out in a shorter amount of time. Now keep in mind that even the best pushers can still end up with a c-section of the baby is too big to pass through the pelvis.

Okay, once they get you set up to push this is where your hubby or your birth coach needs to step in and keep you on track. The contractions at the end of your labor can last 90 seconds at a time with a lot of intensity. This is your uterine muscle contracting and literally pushing the baby down and out. When they tell you to push. You need to take your chin and tuck it down to your chest and roll your upper body around your abdomen... almost like your tucking into a ball. Grab the back of your knees at the same time and allow your legs to drop to the side.. rather than squeezing them together. When you allow them to drop to the side it enables the pelvis to open more and makes things a lot easier.

When they say "push" you take a big deep breath and hold it. Don't scrunch your face all up or cry. If you're making noise.. you're not pushing effectively. You have to take all that energy you've conserved because you've gotten some rest, right? Anyway... take that deep breath, hold it, and push like your trying to have a bowel movement. You may feel like you're crapping all over the place... but don't worry about that. If there's anything up in your colon.. sorry to say it, but it will most likely come out when you push. DO NOT WORRY ABOUT IT. Everyone worries about pooping during labor and it causes them not to push as hard. What's a little poop?? It's nothing.... and it usually happens to the ones that eat a bunch of food before labor. You just push like you've never pushed before. Hold that push steady and strong for a count of ten. Then you will have just enough time to take another deep breath and do it again. You might do this 3 or 4 times before you get to take a break for a minute or so... then you're right back at it again. It is physically and emotionally exhausting.

Once the baby's head is crowning.. you might feel the ring of fire. That is when your perineum is stretching to accomodate the birth of the head.. which is the biggest part. It can sometimes burn and feel like your crotch is on fire. I promise you it's not.. it just feels that way. Hopefully your perineum will stretch nicely. If not.. sometimes they will do an episiotomy to prevent tearing. It's better to be cut than tear. And sometimes they do it just to make more room if you're having trouble getting the baby out. If you hear them say you have a 1 degree or 2 degree laceration... don't sweat it.. you'll be sore but it'll be okay. It just means you ended up tearing a little. What you don't want to hear is a 3rd or 4th degree laceration because you might be really sore. You can often avoid those lacerations if you pay attention to your doctor and stop pushing when they tell you to. And sometimes it just happens because the baby is too big and the skin can't accomodate the head and it ends up tearing. But it's all able to be repaired.. you'll heal.. and you'll have your beautiful new baby to hold and love on. If you do happen to tear or have an episiotomy.. make sure you use your sitz bath afterward and don't forget to take it home with you. So many people leave it behind at the hospital and it really helps with the discomfort. If you need more information about that just let me know and I'll explain it further. Hopefully you won't have to worry about it.

Okay, i'll break here and continue.. geez.. I didn't think there would be this much to say..lol
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Old 11-14-2007, 04:54 PM
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Okay, the head is out. This is when they will unwrap the cord if it's around the neck at all. They also bulb suction the baby's mouth and nose out. Then they'll tell you to give one more big push and the rest of the baby just slides on out. The cord is cut.. some doctors place the baby on mom's abdomen and start the bonding process immediately.. others hand it off to the nurses to dry and stimulate under a radiant warmer. If the baby is okay.. and you want the baby on your abdomen right after birth, make sure you tell them. We tend to get the baby from the doctor and bring it over to the radiant warmer and dry it there. The midwives tend to place the baby on the abdomen. It's your birthing experience.. you make the decisions as long as the baby is following the program too.

Now you have to deliver the placenta. It can take 5 to 10 minutes... sometimes up to a half hour. It's nothing like you just went through. Some may argue it feels like delivering another baby.. but I can't even remember delivering mine. I was so enthralled with my new baby I could care less about what else was going on.

I think I've pretty much touched base on most things. If you have any other questions I have not answered just ask. I'd be happy to answer them for you and if I don't know the answer I know plenty of people that might.

If you want to know what to expect as far as the OB part after you have the baby... just let me know and I can shed some light on that as well.. I used to work the OB floor a while back.
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Old 11-14-2007, 04:55 PM
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Hey, how did this get stickied?? That was weird.. I went to go see if my post was there and it's up the top... hmmmm..
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Old 11-14-2007, 05:38 PM
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The sticky Gods have been shining down on you Nancy
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Old 11-14-2007, 05:57 PM
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**ahh episitomy**

The thought of that freaks me out like you don't even know.

other than that, COOL! I think being a midwife or a delivery nurse would be cool. If i fail at filmmaker and teaching, i'll look into that.
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Old 11-14-2007, 06:13 PM
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This is an excellent post Nancy and explains it really well. I am one of those women who do not want the baby laid directly on me. I have been covered in birthing fluids from horses and goats and the only thing magical about them is that there aren't enough paper towels in the world to soak it all up.
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Old 11-14-2007, 06:21 PM
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This is some great information, thanks Nancy!
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Old 11-14-2007, 06:22 PM
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Good post Nancy. I hope you don't mind but I would like to add some stuff.

If you have been getting enough rest before you go into labour, try walking around throughout as much of the labour as possible. If you feel tired, lay down and get some rest. Walking will get your baby into position and you may progress quicker.

Also, with the placenta, you can opt out of having a managed third stage and instead, have a physiological third stage. This means that you can ask not to have medicine (oxytocin). Being injected with oxytocin will help to deliver the placenta more quickly. Having the baby laying on your skin or breastfeeding also helps to deliver the placenta. After 30 minutes, if the placenta has not been delivered, it is considered to be retained. 30 minutes or less to deliver the placenta is considered the norm, but it doesn't mean it can't take longer. Some women deliver it very quickly while for others it may take a while. The time between birth of the baby and delivery of the placenta is a rest break for you and your body and it also gives you time for you the two of you to bond.
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Old 11-14-2007, 08:16 PM
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Where were you 50 years ago Nancy !! LOL !! Another thing that I've never seen anyone mention , is that when you start to nurse , you can feel your utereus contract . Helps clean you out . TMI for some . I had an episiotomy with me first and no one told me about sitz baths . One day after I got home ,. I went in to pee and when I pulled the pad down , it was stuck to the stitches !!! OUCH!!!! Yes, I was rushing and boy was I sore after that !!
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