Labour & Birth

For some mothers labour is a manageable process, for others it is equivalent to long painful hours. Our Bodies are different and react differently .For few moms if labor is very long and painful it can cause mental stress and this further slows down the process of labor. Hence, you may want to consider some pain relief options. The most favored and popular option is Epidural Analgesia. This is normally administered in the lower back. One of the benefits of epidural would include – pain relief which means that the mom is comfortable and can rest through labor. Epidural is administered when the mom is about 3 cms dilated. It is not given early in labor since at that point labor can take a pause. These pauses can sometimes even extend into days. Also one must not take epidural once you are 8 cms dilated. After this point you will dilate rapidly and labor duration is not long. It is advisable to not take the epidural once you are 8 cms dilated since now you are soon going to be ready to push. Remember that cervical dilation is not pro rate. Early labor is the slowest and the last couple of centimeters can be as short as an hour.

It gives total or partial pain relief hence it can actually be subjective. Which means that in some cases epidural can actually help to speed labor along, because it can help to relax the mother.

There are also some drawbacks to this form of pain relief. The Epidural analgesia is administered in the lower back and makes the lower body numb. Hence this dulls the nerves which carry the sensations to the brain, thus making it difficult for the mother to push effectively. She would need to be instructed on how to push and this may not always be ideal and effective for the mum and baby. Epidurals also cause blood pressure fluctuations and the mother needs to be kept under constant monitoring to ensure all is ok with her. There could also be a possibility of a local infection and in some cases mums also complain of a headache post the birth if the epidural punctures into the spinal fluid. Since it has a numbing effect it reduces mobility and hence can lengthen labor. However since it does not enter the blood stream it does not reach the baby but findings suggest that the baby can be a little lethargic post birth for a short time and this can result in delayed breast feeding. It also results in edema post birth.

If you feel that labor is manageable and you are able to cope with natural forms of pain relief then you can avoid taking the epidural. It is recommended that you decide on whether to take an epidural or not based on your experience during labour. If you feel that labor is long and painful and you cannot manage it, then go ahead and take it. The ultimate decision lies with the Mom.

Wondering what you could expect during labour? Already feeling Jittery about it? What’s the process like? How is it going to pan out? Don’t worry. This article will take you through all that you need to know about labour, contractions and pain relief remedies during labour.

Labor and contractions go hand in hand. Pain is an outcome on account of the contractions. Labour can last anywhere from 12 to 24 hours especially for first time moms. What do contractions mean? Contractions mean that the uterine muscle is contracting and squeezing and while doing so it pulls at the mouth of the cervix thus causing the effacement and the dilatation. By the time most moms realize they are in labor, they are already dilated 3 or 4 cms when they reach the hospital. After you reach the hospital the resident ob/gyn will examine you in order to confirm that you are indeed in labour.

Now let us go through the labour process according to the stages.

Labour stage 1: This is when you would realize that you’re in labor and will be rushed to the hospital because the baby is on its way soon. In this stage the cervix which is also known as the mouth of the uterus effaces (becomes thin) and dilates which means it opens. Normally the cervix has to efface upto 100% and dilate up to 10 cms which is the size of the baby’s head.

Labour stage 2: In this stage the process of actual birth giving takes place. The baby makes its way from the uterus, into the birth canal and outside into the world.

Labour stage 3: In the third stage of labour the placenta is delivered. This happens spontaneously. After the baby is born, and the cord is clamped onto the placenta and the placenta automatically starts separating from the wall of the uterus and is delivered. This is also referred to as “afterbirth”.

Relief from Labour Pain

Our Bodies are different and react differently. For some mothers labour is a manageable process, for others it is equivalent to long painful hours. For few moms if labor is very long and painful it can cause mental stress and this further slows down the process of labor. Hence, you may want to consider some pain relief options. The most favored and popular option is Epidural Analgesia. This is normally administered in the lower back. One of the benefits of epidural would include – pain relief which means that the mom is comfortable and can rest through labor. Epidural is administered when the mom is about 3 cms dilated. It is not given early in labor since at that point labor can take a pause. These pauses can sometimes even extend into days. Also one must not take epidural once you are 8 cms dilated. After this point you will dilate rapidly and labor duration is not long.

It gives total or partial pain relief hence it can actually be subjective. Which means that in some cases epidural can actually help to speed labor along.

There are also some drawbacks to this form of pain relief. The Epidural analgesia is administered in the lower back and makes the lower body numb. Hence this dulls the nerves which carry the sensations to the brain, thus making it difficult for the mother to push effectively. She would need to be instructed on how to push and this may not always be ideal and effective for the mum and baby. Epidurals also cause blood pressure fluctuations and the mother needs to kept under monitoring to ensure all is ok with her. There could also be a possibility of a local infection and in some cases mums also complain of a headache post the birth if the epidural punctures into the spinal fluid. Since it has a numbing effect it reduces mobility and hence can lengthen labor. However since it does not enter the blood stream it does not reach the baby but findings suggest that the baby can be a little lethargic post birth for a short time and this can result in delayed breast feeding. It also results in edema post birth

If you feel that labor is manageable and you are able to cope with natural forms of pain relief then you can avoid taking the epidural. It is recommended that you decide on whether to take an epidural or not based on your experience during labour. If you feel that labor is long and painful and you cannot manage it, then go ahead and take it. The ultimate decision lies with the Mom.

If you’re a pregnant mom you probably have hundreds of questions in your mind pertaining to natural birth and C section and are wondering about the circumstances under which a doctor opts for a C section procedure. A baby may need to be delivered surgically for a variety of reasons. We can broadly categorise them as planned C section and emergency C section.

A planned C section is something you would know in advance. It could be due to a maternal or baby health condition or it could be a concern related to the pregnancy, for eg: the placenta is covering the mouth of the uterus or the baby is not in a favorable position for birth. In this situation the doctor will speak to you in advance and ask you to pick a date which is a few days ahead of your actual due date. The reason this is done is to ensure that you do not go into labor which could then become an emergency situation.

At times a mom may go into labor and then certain conditions may need to opt for a surgical birth. Some moms may just not go into labor and be over due, in this case if induction does not work then a C section is the only option. In few cases, a mom may go into labor but the cervix may not open and it is not possible to physically cut the cervix, hence the baby would have to be delivered by a C section. In other cases the mom may go into labor, the cervix would also open but the baby does not move down and that would result in a C section too. Also during the labor process if the baby shows signs of distress or the mom develops a temperature due to an infection or if her blood pressure shoots up, the doctor would go in for a C section procedure. If the condition is not an emergency the doctor will opt for a spinal block which means the mom can be awake and greet her baby at birth. If it is an emergency then the doctor will opt for general anesthesia and deliver the baby asap.

If it is a planned C section then you will be asked to come to the hospital a night prior. The antibiotics are started and you are asked to stay empty stomach for 12 hours. During the surgery itself there will be a drape placed in front of you so that you do not see the actual surgery.Your husband can be present but he will be near your head and he will also not need to see the surgery.

You will feel some tugs and pulls and some vacuum sounds which is normal.
Once the surgery begins the baby is delivered within the first six minutes. Post the birth, the placenta is delivered thru the same incision and the uterus is cleaned out before being sutured. Over all the process can take about 30-45 minutes.
You will also have an IV attached for nutrition and medication as well as a catheter for urination. These will stay in place for 24 hours.

Post the surgery you will be in a recovery room under observation for a couple of hours before you are moved to your room along with the baby. It is a good idea to attempt breast feeding in the recovery room itself.

Giving Birth
Giving birth is a natural process. Towards the third trimester of your pregnancy your body starts preparing for the moment when your baby would enter the world. Labour and contractions take place before the actual process of giving birth as an indication that your baby its on his way. For many first time moms, labor is scary. They will describe their perception of birth as scary, painful, nerve wrecking and so on.

When a mom first realises that she is in labor she will be excited, relieved that she has finally gone into labor. At this time the contractions are mild and far apart and many moms may even sleep through this phase.

As labor becomes more active and the pain becomes a little more, mom starts feeling a little worried. She will start to focus and start practicing her breathing exercises and other coping techniques.

Closer to the birth the contractions are very intense. This is when most moms will feel a loss of control and will probably ask for some pain relief. But there is no point in taking any pain medications at this time as birth is just about to happen.

Once the body is completely ready the mom will feel a strong urge to push and bear down. This can also be compared to passing a hard motion. The sensation is unmistakable and mom will be fully aware of the fact that the baby is now ready to come. As the baby’s head crowns she will feel a burning sensation in her perineum as it stretches to accommodate the head of the baby.

As the baby comes thru the contractions pause and mom will feel intense relief and a huge sense of achievement. She is very excited and over whelmed. She is keen to meet her baby and get breast feeding started and at the same time wants to shout from the top of the world that she is a mom.

Worried about the process of labour and don’t know how your body would react to it? Relax! Giving birth is a normal physiological function of the female body. That means that the body is tuned to know exactly what it has to do provided we leave it alone and not interfere with the natural processes. The human body is intelligent and it knows exactly what it needs to perform.

Expectant mothers, especially first time moms fear the labour process and mentally it’s something that they keep thinking about. Mainly because they have not been through it before and it is the fear of the unknown. Also Labor over the years has been dramatized and hyped up by films, videos, photography and we tend to hear of stories handed down by our parents, grandparents, peers who have gone through their set of experiences. However it is important to remember that labor is not the same for everyone. Human bodies are different and what one person may experience maybe totally different from what another person experiences. In fact labor is unique for each mother and child pair as well. It means that your experience during your first birth can be totally different from your experience in the second time you give birth.

As you approach the last few weeks of your pregnancy, the baby starts taking the position for birth automatically. What is this position? Gravity helps by pulling the baby’s head which is the heavy part towards the pelvis. Also the baby naturally finds it comfortable to find space for his head in the pelvic cavity. The pressure on the cervix increases as the baby’s head descents downward thus making the cervix shorter and thinner.

Your abdomen at this point in times moves down lower from your rib cage zone thus creating pressure in the pelvis area. At this stage it is also normal to feel an increase in the number of Braxton-Hicks contractions since this is a sign that your body is practicing for the big day. Also when you visit your doctor at this stage, they would be able to ascertain with a physical examination if the mother’s body is ready for the birth process.

Most times mother do not even notice these internal changes but here are some signs you could look out for – The frequent urge to empty her bowels, spasmic lower back pain. You would also notice a sudden rush of energy. You may feel like to want to clean the house, or go shopping, cook and in general would be really pumped up.

The above mentioned are just some signs and does not mean you are already in labour but make sure you are prepared if it were to happen anytime soon. Make sure your hospital bag is packed; your loved ones are in town and wait for the process to begin?

Into the last week of your Pregnancy and can’t wait for the little bundle of joy to come into the world and into your lives? This excitement can be quite overwhelming. You must however ensure that you are prepared for the big day a few weeks in advance. Labour can start anytime once you are in week 37 and when you do feel the contractions you do not want to scramble around or stress about your hospital bag. Of course most hospitals will provide everything for the mother for use during labour and even gowns for the stay, so do not worry. Check with the hospital if they will be providing the items for the baby and pack accordingly. Some hospitals insist that the baby items should be from the hospital whereas others will insist that you bring all baby requirements and also arrange to have them washed from home.

Here’s a quick checklist for you:

1) Toiletries- Personal articles like hair brush and tooth brush, mums creams and lotions, undergarments and any other personal effects.

2) Maternity Pads- Mom should also pack maternity pads which are especially designed for post partum bleeding and also help the stitches to breathe.

3) Warm socks- For use during labor the mother will need massage tools, warm socks to help her feet stay warm especially during pushing and birth,

4) Chapstick- to keep her lips from getting dry with all the special breathing that she needs to do during labor contractions,

5) Others – Camera, wash cloths for hot and cold compresses, an exercise ball if possible to practice labor positions, some music to help relax her and anything else she feels will make her comfortable.

Make sure you complete this checklist and you should be good to go!

Before we begin talking about labour signs, let us first make you ponder upon one small question. What time of the day do you think most women go into labour? Ponder upon this……Here is your answer… It’s at night! And the main reason behind this is that the human body is in the most relaxed and rested form while sleeping at night. One of the main rules of labor is that the more relaxed a mom is the faster labor progresses, hence, in most cases labor would start when a mom is most relaxed which is in her sleep. Giving birth is a normal physiological function of the female body. That means that the body is tuned to know exactly what it has to do provided we leave it alone and not interfere with the natural processes. The human body is intelligent and it knows exactly what it needs to perform

For most mothers if early contractions start at night, they may go unnoticed and will take place while the mum is in her sleep. Early labor contractions feel like mild menstrual cramps. Usually mums feel them in their lower or upper abdomen, she may feel them like spasmic lower back pain or she may even have a feeling of overall weakness which comes and goes. It is imperative however for the mom to take notice if the amniotic fluid is leaking or if she finds herself spotting. In these cases she should immediately head to the hospital as she may actually be further along in labor than she actually feels.

There are 3 main areas that you should keep a check on to determine your labour stage- Frequency, Duration and Leaking. Let’s take you through what these actually mean.

Frequency

Frequency means how far apart your contractions are. This is timed from the start of one contraction to the start of the next contraction. The closer the frequency of your contractions, the closer you are to delivering your baby.

Duration

Duration means the actual length of the contraction. This is measured as the time taken from the start of one contraction to the end of the same contraction. The longer the duration of your contraction, the closer you are to labour. You could request your husband or close family of friends to time these for you so you know the progress in labour.

Leaking

Leaking refers to the amniotic fluid. This is your baby’s sterile environment and if you are leaking then it means that they baby is also susceptible to infections. Contact your doctor immediately if you’re leaking and inform them so that you can get to the hospital and the doctor can probably induce labor and deliver the baby.

Once you are on your way out to the hospital, pick your hospital bag and do not forget to pack in all the reports as the doctor may need to refer to the same.

Amniotic fluid is transparent and straw colored. If the fluid is brownish or greenish then your baby has passed stools and you should rush to the hospital immediately. Else you would have about 24 hours to deliver the baby. If your contractions have not started the doctor will administer medications to help induce labor. For most women the bag of waters breaks once labor starts.