Pregnancy Labor and Delivery

So your little one is finally ready to come out. Hopefully you've planned in advance. You've drawn up a plan of how you will get to the hospital in a safe and timely manner. You've packed your bag full of basic supplies you and your partner might need, such as a comfortable change of clothes, toothbrush, nonperishable ready to eat snacks, and a camera.

More importantly, you should know what to expect from labor. If you've taken classes, you already know, but if you haven't you should educate yourself about the stages of labor. For some women, labor starts and finishes very quickly, while for others it can be a long, drawn out affair and last days. If it's your first labor, chances are, it will be on the long side. Although every labor is different, assuming there are no complications, most of them follow a similar pattern.

Your doctor will be checking for signs that labor is imminent by looking at cervix dilation, and effacement. This should be able to tell you when you are getting very close to labor. You may get something called a bloody show, where the mucus plug comes out, and there is a vaginal discharge with a small amount of blood in it. Even if you get this, you could be several days or even a week away from labor. Sometimes, the membranes rupture, also known as your water breaking. If this happens, you need to see your doctor right away.

You've probably been getting Braxton Hicks contractions for a while now. As you get closer to your due date, these contractions will become stronger, and sometimes painful. To determine if the contractions are actually the first sign of going into labor, you should:

-Figure out the time from the beginning of one contraction to the beginning of the next. If the contractions are getting stronger and have shortening time intervals, there is a good chance it is labor. If the contractions come at least every 5 minutes, it is probably labor, but if they are irregular, it may be a false alarm.

-Figure out how long the contractions last. Real contractions tend to last 30 seconds or longer, and get progressively longer and stronger. If labor is false, it will usually vary in length and strength.

-Try lying down, going for a walk, or changing your body position. If you can stop the contractions by changing your position or activity level, then it probably isn't true labor.

-Pay attention to where the pain is coming from. With real contractions, it usually comes from the abdomen, affecting the entire abdomen and even the lower back. If it's just Braxton Hicks contractions, you will likely only feel the pain in the lower abdomen.

The first stage of labor is divided into early labor and active labor. In early labor, the cervix effaces and starts to  dilate. During this stage, you should stay well hydrated and urinated frequently. You should also try to rest and get naps in between contractions if possible. Once in active labor, the dilation becomes more rapid, and the contractions become longer, stronger and more frequent. Once you go into active labor, you need to get to your doctor's hospital as soon as possible, or if you are doing a home birth, then contact your midwife.

When you arrive, you will be changed into a hospital gown, and you will lie down on a special bed for delivery. You will have special equipment attached to you to monitor the heartrate of your baby and the strength and length of the contractions. If you want it, you will be given oxytocin or an epidural to manage the pain.

Towards the end of active labor, you reach a point called the transition period. This is the point when many women start feeling the urge to push and you enter the second stage of labor.

The pushing begins in the second stage of labor. The pushing typically feels like you are trying to make a bowel movement, because you use the same muscles. The pushes will be timed to coincide with the contractions, and your doctor will help you time them. Eventually, the baby's head will become visible, known as "crowning". Then the head will pop out, and your nasal passage and mouth will likely be suctioned to make breathing easier.

Once the shoulders come out, the baby slides right out, and right after the umbilical cord is cut and baby is dried off and cleaned up a bit, and Apgar scores are recorded, he or she will likely be placed in your arms.

After this, comes the third stage of labor, which is very short. The contractions begin again, and you deliver the placenta. Now you have completed the job and you can relax and recuperate for a while. You also may want to try breastfeeding for the first time.

The above description applies to a typical labor process. However, there are many other scenarios, such as if there are complications in the pregnancy. If you go into labor preterm, there may be all kinds of special procedures followed and your baby may be put into a neonatal intensive care unit. If you are overdue by around 10-14 days, labor will likely be induced. If your baby is breech (not facing head down), he or she may be turned in your tummy from the outside by a doctor, or a caesarian section may be performed. Many births now are done through caesarian, which is a lot easier than labor, but the recovery process is painful and long.