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Read about giving birth and take a childbirth class
Choose a support person to be with you during labor and delivery
Write a birth plan that explains what you want and helps you to think about possible complications
Talk to your doctor about:
Ways to contact her after hours and when you should call
Steps you should take when in labor
Whether you want pain relief during labor
Perineal massage—The perineum is the area between the anus and the vagina. Massaging it may help to reduce your chance of trauma to that area.
How you will travel to the hospital
Arrangements for home and work
Be aware of the signs of labor, which include:
"Water breaks" (amniotic fluid that surrounds the baby leaks out through the vagina)
Slight vaginal bleeding
True Versus False Labor
Before "true" labor begins, you may have periods of "false" labor. These are irregular contractions of your uterus, called Braxton Hicks contractions. They are normal but can be painful. They are usually also felt in the stomach and not the back.
Timing the contractions is a good way to tell the difference between true and false labor. Note how long it is from the start of one contraction to the start of the next. Keep a record for an hour. If the contractions are getting closer together, longer, stronger, and are being felt in your back, then it may be true labor. If you think you are in labor, call your doctor.
During this process, you will prepare to deliver your baby.
At the beginning of labor, the uterus (where the baby grows during pregnancy) will begin to contract, moving the baby down the vagina (birth canal).
The cervix, the opening of the uterus into the vagina, will slowly enlarge to a diameter of about 10 centimeters. This will allow the baby to pass through and be delivered through the opening of the vagina.
This process usually takes a while. However, if you have delivered vaginally before, labor can be very quick.
Labor can cause severe pain, but keep in mind that every woman's labor is different. Everyone experiences pain differently. While planning the delivery, talk to your doctor about your options for pain relief.
In the early stages of labor, techniques like rhythmic breathing,
may be helpful. Some women do not require any other pain control.
There are many medical options for pain control.
All treatments to relieve pain during labor have risks and benefits. Make sure you discuss these with your doctor:
Pain medications by IV or muscle injection:
Given when contractions become stronger and more painful
Once the cervix is fully dilated (opened) and the baby seems to be heading down the birth canal, the nurses will help prepare you for delivery. Your legs may be draped with cloths. Some doctors will clean the area around the vagina with an antiseptic solution.
You may put your legs into holders, especially if you have an epidural. The nurses and your support people may hold your legs in a comfortable position. This will help you to push. Your doctor may encourage you to find a position that is right for you. Each time you have a contraction, you will be instructed to push. This involves you bearing down, like you are trying to have a bowel movement.
"Crowning" is when the baby's head is seen at the opening to the vagina. When this happens, you may be asked to slow your pushing. Depending on your delivery plan, the doctor may massage your perineum to gently stretch it. An episiotomy is not routinely done, but in some cases, it is necessary.
Once your baby's head is out, you will be asked to stop pushing. The doctor will check to make sure that the umbilical cord is not around the baby's neck. Then, you will be able to push the rest of the baby out. If the baby appears healthy and is breathing well, the baby may be placed on your stomach. The umbilical cord will be clamped and cut. Within the next 20 minutes, the placenta will be delivered.
Having a baby will change you physically and emotionally.
Physically, you might have the following:
Sore breasts—Your breasts may be painfully engorged when your milk comes in. Also, your nipples may be sore.
—You may not be able to move your bowels until the third or fourth day after delivery.
Stitches may make it painful to sit or walk.
—Hemorrhoids are common. They may make it painful for you to move your bowels.
Hot and cold flashes—This is due to your body trying to adjust to the change in hormones and blood flow levels.
or fecal incontinence—During delivery, your muscles were stretched. This may make it hard for you to control your urine and bowel movements for a short period of time after delivery.
"After pains"—The shrinking of your uterus can cause contractions. These can worsen when your baby nurses or when you take medication to reduce bleeding. It is normal to have this after delivery.
Vaginal discharge—This is heavier than your period and often contains clots. The discharge gradually fades to white or yellow and stops within two months.
Weight—Your postpartum weight will probably be about 10 pounds below your full-term weight. Water weight drops off within the first week as your body regains its salt balance.
Emotionally, you may be feeling:
"Baby blues"—About 80% of new moms have irritability, sadness, crying, or
anxiety. This begins within days or weeks of giving birth. These feelings can result from hormonal changes, exhaustion, unexpected birth experiences, adjustments to changing roles, and a sense of lack of control over your new life.
(PPD)—This condition is more serious and happens in 10%-20% of new moms. It may cause mood swings, anxiety, guilt, and persistent sadness. Your baby may be several months old before PPD strikes. It is more common in women with a family history of depression.
Postpartum psychosis—Postpartum psychosis is a rare, but severe condition. Symptoms include difficulty thinking and thoughts of harming the baby. If you feel this way, call your doctor right away.
Sexual relations—You may not feel physically or emotionally ready to begin sexual relations right away. In most cases, you will feel more interested in sex in a few weeks.
Ways to Take Care of Yourself
When your baby sleeps, take a nap.
Set aside time each day to relax with a book, or listen to music.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
Get plenty of exercise and fresh air.
Schedule regular time for you and your partner to be alone and talk.
Make time each day to enjoy your baby. Encourage your partner to do so, too.
Breastfeeding is encouraged unless your doctor tells you otherwise
Clean less and have easier meals. Take a break from having visitors if you feel stressed.
Depression during and after pregnancy. Office on Women's Health website. Available at: ...(Click grey area to select URL) Updated July 16, 2012. Accessed August 14, 2014.
Epidural anesthesia. American Pregnancy Association website. Available at: ...(Click grey area to select URL) Updated July 2014. Accessed August 14, 2014.
Obstetrics: Normal & Problem Pregnancies.
3rd ed. New York, NY: Churchill Livingstone; 1996.
Spinal block. American Pregnancy Association website. Available at: ...(Click grey area to select URL) Updated January 2014. Accessed August 14, 2014.
2/5/2009 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Beckmann M, Garrett A. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2009;CD005123
12/4/2009 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Marín Gabriel M, Llana Martín I, López Escobar A, et al. Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn. Acta Paediatr. 2009;99(11):1630-1634.
4/29/2011 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Hjelmstedt A, Shenoy ST, Stener-Victorin E, Lekander M, Bhat M, Balakumaran L, Waldenström U. Acupressure to reduce labor pain: a randomized controlled trial. Acta Obstet Gynecol Scand. 2010;89(11):1453-1459.
12/9/2013 DynaMed's Systematic Literature Surveillance ...(Click grey area to select URL) Hodnett ED, Gates S, et al. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2013;7:CD003766.
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