Everything you need to be equipped and confident for a natural birth without fear.
This amazing process allows for the miracle of baby coming into this world! This is a labor process, and We will help you get prepared and confident. Here's to a healthy Mama and baby. Labor On!
Get in the mindset! Talk about it Talk to women who have done it before Get perspective and get encouragement! Talk to women who have had delivery with and without pain medication Watch movies about pregnancy, labor, and delivery Read books about labor and delivery Laugh about it, cry about it, and get all of your anxieties out in the open Get a birth plan but know that it might change Decisions: Think about staying home once labor begins Think about laboring positions that will make you more comfortable Decide if you want an epidural Decide if you do not want any pain medications Do you want a family in the room? Do you want pictures? Decide on whether you want vaccinations for baby Etc. Tour the hospital labor & delivery unit: Where to park (valet or paid parking) Labor & Delivery Emergency Department first or go straight to the unit Nurse, resident, internist, or on-call doctor may take care of you Pack your bag now! Dad has a Go Bag list too Get car seat ready, and know how to use it.
The mucus plug: Grows in the cervix during pregnancy Present for the protection of the baby Prevents bacteria from entering the cervix, weakening the bag of waters, and rupturing membranes early Will “come out” around week 37 gestation Maybe clear, pink or brown in color You may ask, “Is my labor going to start now that my mucus plug has come out?” There is no correlation between time of mucus plug discharge and onset of labor Loss of the mucus plug is a preparatory phase in late pregnancy as the cervix begins to open (dilate) and thin (effacement)
Also known as... "Are you ruptured?" "Is my bag of waters broken?" "Am I leaking?" "Are my membranes ruptured?" "Is it water or vaginal discharge?" What is a false alarm? The cervix begins to open and the glands secrete watery fluid late in pregnancy This clear watery discharge is normal, but it is not the bag of waters Discharge should not be malodorous, gray, brown, or green Bladder spasms can occur frequently in late pregnancy and cause a gush of urine How to know if your bag of waters has ruptured? You may have a big gush of watery fluid You will then have a continuous leak as the amniotic fluid comes from the baby urinating (peeing) What to do if you feel a big gush or a leak? Make note of the time Empty bladder Change clothes Wait and continue to keep the bladder empty Stay home for 6 to 12 hours until true labor begins *Exception: If you are Group B Strep Positive, then go to the hospital and tell the nurse you need to be treated with antibiotics before a baby is delivered.
Labor occurs for the purpose of delivering the baby through the vagina in a successful and healthy manner for you and your baby. Labor: the uterus contracts (tightens) and causes pain False Labor: irregular uterine contractions *Don’t go to the hospital The uterus is firm and causes cramping No change in cervical dilation Can occur before week 37 gestation Braxton-Hicks contractions (the body practicing labor) Pre Term Labor: true/active labor before week 37 gestation True Labor or Active Labor: regular painful contractions The regular interval from the end of one contraction to the beginning of the next contraction The contraction itself will last approximately 60 to 90 seconds Labor part 1: regular contractions that are 2 to 4-minute intervals for 2 hours Labor part 2: painful contractions that increase in pain for a minimum of 2 hours Labor on!
First Stage: the onset of true labor to 10 cm dilated cervix Early Phase: Make a note when labor begins Don’t go to the hospital Stay comfy at home or walk Practice breathing techniques Drink water and eat small snacks Sleep between contractions (5 - 30 minutes) Active Phase: Go to the hospital as active labor begins to turn into the transition phase Transition Phase: This phase is hard, but it is the shortest You may experience hot flashes, chills, nausea, vomiting, or gas Second Stage: 10 cm dilated cervix to delivery of the baby Pushing Phase: You will experience an overwhelming sensation to push if you do not have an epidural An epidural causes numbness and difficulty in feeling when to push The nurse will prompt you to push if you are not sensing when to push Begin to push when you feel a contraction starting: Take a deep breath Tuck your chin Begin to push (hold your breath as you push like you are having a bowel movement) Keep pushing until the contraction ends Take a deep cleansing breath and rest until the next contraction Third Stage: delivery of the placenta Your healthcare provider may push on your belly to make sure all of the placentae are delivered You get to hold the baby while this is occurring! Fourth Stage: skin-to-skin This phase is all about bonding, nursing, and resting
Why is the Caesarean Section performed? Repeat C-Section: Mamas that have had a C-Section in the past Failed Labor (arrest of labor): Mama cannot deliver vaginally How is the Caesarean Section performed? Performed by a surgeon Surgery will last approximately 20 minutes to 2 hours Anesthesiologist or nurse anesthetist will monitor pain relief during surgery What are the types of Pain Relief? Regional anesthesia (epidural or spinal): numbness from chest to feet General anesthesia: Mama goes to sleep What will happen after the surgery? Recovery room for 1 to 3 hours Transferred to the postpartum room for 2 to 5 days (average of 3 days) Anesthesia will wear off The nurse will remove the Foley catheter and help Mama get up to walk What pain relief will be provided during recovery? Narcotics Over The Counter NSAID (non-steroidal anti-inflammatory): Ibuprofen or Advil Prescription NSAID: Toradol How to care for surgical incision? Soap and water sponge bath Allow skin to be exposed to air Monitor for infection: redness, malodorous drainage, bleeding, fever, chills *Follow up with your healthcare provider within one week of discharge.
First Stage: the onset of true labor to 10 cm dilated cervix Early Phase: Contraction feels like a menstrual cramp Make note of when labor begins Don’t go to the hospital Stay comfy at home or walk Practice breathing techniques Drink water and eat small snacks Sleep between contractions (5 - 30 minutes) Active Phase: Contractions increase in intensity Transition Phase: Cervix dilates to 10 cm ("fully dilated" or "complete") The phase is painful, but the shortest before the pushing phase You may experience hot flashes, chills, nausea, vomiting, or gas Second Stage: 10 cm dilated cervix to delivery of the baby Pushing Phase: Overwhelming sensation and need to push, just like you need to poop Begin to push once you begin to feel a contraction: Take a deep breath Tuck's chin Hold your breath as you push like you are having a bowel movement (poop) Push until the contraction ends Take a cleansing breath and rest until the next contraction Stinging sensation as the baby delivers known as the "Ring of fire" Third Stage: delivery of the placenta Your healthcare provider may push on your belly to make sure all of the placentae are delivered You get to hold the baby while this is occurring! Fourth Stage: skin-to-skin Bonding, nursing, and resting
Tools: Birthing ball (exercise ball) Relaxing playlist Essential oils (lavender, frankincense, clary sage) Husband Legs Labor on!
You are a capable woman with wisdom. We are here to inform and help you learn to cope with labor pain using: Meditation Breathing techniques Relaxation techniques Comfortable positions for rest Our beliefs about Labor & Delivery: Pain during childbirth is normal Birth is a natural and healthy process You have the right to your preferences during childbirth With preparation, you can avoid pain medication Staying home as long as possible will help to decrease interventions and risk of C-Section Preparation is important for labor pain even if you want an epidural
Rhythmic breathing techniques, also considered abdominal or diaphragmatic breathing is for active concentration and relaxation during labor and delivery. During Labor: Walk, rest, or be in the position of your choice during each contraction Tune into your breath Concentrate on the exhale (out-breath) Breathing is low, easy, relaxed Pain builds, peaks, eases Relax face, shoulders, arms, legs Concentrate on normal breathing during contraction as tendency will be to breathe fast and shallow Start and end each contraction with a cleansing breath (blow out slowly) *You may experience an urge to push before the cervix is 10 cm (complete). This can cause swelling of the cervix and problems with delivery. Don't push until nurse says you are ready. Push with contraction (work with normal feeling to push) Breathe in gently when a contraction begins Tuck's chin Bare down towards your bottom Push like you are pooping Let the breath escape through lips (don’t blow out during pushing) Blow out your breath once contraction ends Take a deep cleansing breath *Alternate between pushing and blowing the breath out as baby's head begins to emerge (to control the speed of delivery).
*You have the right to push and give birth in the position that is most comfortable for you. *Mamas with epidurals cannot get out of bed to labor or push. Your healthcare provider may help you get into the lithotomy, recumbent, or lateral position to push. *Mamas without epidurals benefit from the upright positions during the second stage of labor (pushing) as this provides benefits such as a lower risk of abnormal fetal heart patterns, decreased use of vacuum, forceps, and episiotomy. Lying Down Lithotomy: back lying in supine with hips and knees flexed, thighs apart, and legs in stirrups or pulled up to abdomen by thighs Recumbent and semi-recumbent: lying on back or in a semi-sitting/lying position with the head of the bed raised up ("C Position") Lateral: side-lying position with one leg raised Upright Hands-and-knees Sitting on a birth seat Squatting Standing supported by a partner or prop
The second stage of labor and delivery begins once your cervix has dilated to 10 cm and you begin to push. Pushing time: Primip/Nullip (first-time mama) average: 2 to 3 hours Multip average: 1 to 2 hours Cords and wires: Monitor for baby’s heart rate and your contractions Internal scalp electrode to better monitor baby Intrauterine pressure catheter to better monitor uterine contractions IV fluids such as Lactated Ringers (“IV Gatorade”) Epidural pump Caput! (head crowning): It takes time to deliver the head, but the rest of the body delivers very quickly A vacuum may be applied to baby’s head or forceps may be used to guide the head out of the vagina if the baby has a low or high heart rate (used for a small percentage of women) Episiotomy: a surgical cut at the opening of the vagina (most healthcare providers do not perform episiotomy) Tissue may tear during delivery Baby is born: Baby and Mama bond with skin-to-skin Labor nurse will stimulate baby and check airway and breathing Cord clamped and cut (Dad can cut the cord to be involved!) Healthcare provider will drain the umbilical cord to collect a blood sample to identify the baby’s blood type Placenta delivered (2 to 15 minutes) The provider will manually remove placenta if it does not deliver spontaneously Labor nurse will initiate uterine compression and massage to decrease the risk for bleeding (uncomfortable but necessary) Healthcare provider will repair tissue tear with dissolvable sutures Labor nurse will administer intravenous (IV) Pitocin (Oxytocin) to help the uterus contract and prevent bleeding Cytotec (Misoprostol) may be administered to help uterus contract if Pitocin does not decrease bleeding sufficiently Labor nurse will assist you in cleaning up once you are stable *The delivery process has ended and your postpartum period will begin!
Childbirth is the most beautiful process! You were made to do this. Maybe you are set on having an epidural, and maybe you want to try to deliver without pain medicine. Whatever you choose, be confident in your abilities. I want to give you some words of encouragement and help you find your story.
That was quite the journey! Now people are about to ask 100 different questions and do 100 different things. Be prepared to write information down, or ask your husband to take notes and answer questions. What is the nurse doing to my baby? Measuring weight, length, and head circumference Recording body temperature Cleaning umbilical cord stump and giving the baby a bath Inform nurse beforehand if you don’t want your baby to have a bath Applying antibiotic ointment to eyes to treat for STI gonorrhea and chlamydia Inform nurse beforehand if you choose to decline Administering Vitamin K to help blood clot Inform nurse beforehand if you choose to decline Administering Hepatitis B vaccination Inform nurse beforehand if you choose to decline Be informed with CDC Vaccine Schedule Collecting baby’s footprints and applying identification bands to wrist and leg What happens in the postpartum room? Hospital stay: Vaginal delivery with no complications: 2 days Cesarean delivery with no complications: an average of 3 days Baby will “room-in” with Mama You can ask the nurse to take your baby to the nursery Ask for ibuprofen, water, juice, food, etc. Epidural Medicine will wear off The nurse will remove the Foley catheter and assist you to the restroom Ask for help if you want to shower (fainting is common after delivery) Ask for the lactation consultant to assist with breastfeeding Record baby’s poops, pees, and feedings The lab technician will draw your blood to check hemoglobin and hematocrit Heel-stick blood test to screen your baby for metabolic disorders The pediatrician will examine the baby within 24 hours of delivery Hearing screening for baby Cord stump care education Circumcision Birth certificate paperwork Discharge class covering how to care for the baby at home