Labor and Delivery: First Stage
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Buy a Snoozer Pillow
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Labor and delivery in layman's (or laywoman's) terms.
Due Date
The baby is expected to come during the 40th week of pregnancy. Your due date marks the end of the fortieth week. You've got that date circled on the calendar in red...or pink...or blue. But what are the chances baby will really come on that day? Guess what? Some babies do actually come on their due date...but only 3% of them. The rest, yours is probably part of that 97%, do not. Don't get hung up on making it to that date. It's great to make it to forty weeks, but any baby born between the 37th of 42nd weeks is considered full term. What should you be watching for as you approach that starred off date on the calendar?
Contractions
Been having Braxton-Hicks contractions? Think these will feel like that? Well, they may start out similarly, but they do not go away and they gradually intensify. Not sure what to expect? Think of early contractions as menstrual cramps, really intense ones. At the beginning of labor, that's what many women are reminded of. By the end, they won't remind you of anything other than what they are. Labor pains! Intense, mind-numbing ones. Eventually, there's no mistaking them.
Contractions are the muscles in your uterus working to push baby through the birth canal out into the world to meet you. You may feel like your abdomen is being squeezed painlessly at first, or you may feel actual cramping. Either way, baby is on its way.
The onset of contractions should not send you running to the hospital, unless you live very far away. Once contractions begin, call in your friends and family for reinforcement and try to relax. Laboring at home is preferable to laboring in the hospital in the early stages. Read, walk around a bit (not too far, of course), take a shower (but not a bath), spend some time with older children, nap if possible. When contractions come regularly and have intensified significantly, it's time to ring up the doctor.
Back pain
Sometimes contractions are masked as very bad back pain, called back labor. If you have not regularly been experiencing back pain or if back pain is so distracting that you cannot focus on other issues, you may be in labor. Call in reinforcements just in case.
Cervix dilating and effacing
The opening at the bottom of your uterus which baby must pass through is normally closed. Your doctor may have been checking it for changes. In order for baby to pass through, the cervix must soften and thin out (efface) and open up (dilate) ten centimeters so that baby's head (shoulders, knees, and toes...) can pass through. You may efface and dilate slightly weeks before birth, but the majority of changes will happen while you are in labor. You will be checked periodically during your labor for changes to the cervix via internal examinations. Once you are completely thinned out and dilated to ten centimeters, you will be ready to deliver baby.
Water breaking
When the uterus contracts, it puts pressure on the baby, pushing it downward. It also puts pressure on the amniotic fluid and the membrane which surrounds it. When the membrane ruptures as a result of this pressure, amniotic fluid will begin to exit the uterus through the vagina. Sometimes it comes out in a rush, as in the image so many women have of standing in a pool of fluid. Other times it trickles out continuously, and a woman may be unsure of whether or not her water has actually broken. If you suspect your water has broken, it's time to call the doctor.
If during labor, your water does not break on its own, your doctor may elect to rupture the membrane with a device that looks like a crochet hook. It is a painless procedure, really just a feeling of pressure and is perfectly safe. Ruptured membranes (naturally occurring or doctor assisted) mean baby is fast approaching.
Induction
If a woman goes past her due date or if baby would be better off outside the uterus than in for medical reasons, doctors may induce labor, coaxing labor to begin. This is done through the use of medication. A date is chosen, mother enters the hospital, pitocin, a man-made hormone which emulates the naturally occurring hormone oxytocin, is administered to start contractions, dilation and effacement. In some cases, a topical medication will be applied to the cervix, as well.
Epidural
Pain medication may be administered directly into the body at the spine by an anesthesiologist if a mother requests it. The procedure lasts a few minutes, and the medication takes the edge off pain, allowing mother to rest between contractions. Pain medication will be reduced before pushing so that pushing is as effective as possible.
Pitocin
If labor does not progress as quickly as a doctor feels it should, he or she may choose to administer pitocin, a man made hormone which stimulates contractions.
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