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Know what to expect before the big day.
From the moment you find out you're going to have a baby, you feel a mixture of
excitement and apprehension about what's to come. Concerns about labor and
delivery are common, especially among first-time mothers. Although it's
impossible for anyone to predict what will happen, because no two childbirth
experiences are the same, educating yourself about the process should help lessen
your fear of the unknown and ease your worries. Finding a care provider you can
trust is also crucial. Whatever unexpected turns your delivery may take, try to
keep things in perspective and remember that the health of you and your baby is
what matters in the end. Here are answers to the most frequently asked questions
about labor and delivery.
- How will I know if I'm in labor?
There are three key signs that indicate
the start of labor: regular contractions, the bloody show, and the breaking of
your water. While mild, irregular contractions (known as Braxton Hicks) are often
felt in the weeks or even months prior to labor, real labor contractions are
stronger, longer, and closer together, says Cheryl Coleman, R.N., B.S.N., a
certified childbirth educator and past president of the International Childbirth
Educators Association. If you pass the "bloody show," a pinkish, blood-tinged
mucous discharge, it usually means that labor will begin within the next 24
hours. Likewise, if your water breaks (which could produce either a gush or
continuous trickle of amniotic fluid), you'll most likely go into labor within a
day, if you haven't already.
While it sounds clear-cut, these signals can be quite difficult to distinguish,
and most women find themselves wondering "Is this it?" Rule of thumb: If you
experience any of these symptoms, or you're not sure what's happening, call your
care provider for advice.
- How long does labor generally take?
The average duration of first-time deliveries is about 14 hours, Coleman says.
However, the childbirth process can also take much longer (20 hours or more) or
be considerably shorter (fewer than eight hours). For women who have given birth
before, labor and delivery average about eight hours.
- What if my doctor wants to use forceps or a vacuum?
In about 10 percent
of vaginal births, a physician chooses to use either forceps or a vacuum to
assist with delivery, says Michelle Sang, M.D., an obstetrician with Portland
Obstetrics and Gynecol- ogy in Portland, Oregon. If your baby is showing signs of
distress or is stuck in the birth canal, or you aren't able to push him or her
out fast enough, these instruments can help save your baby's life and prevent you
from having to undergo a C-section.
When handled properly by an experienced professional, the risk of injury
associated with forceps and vacuums is relatively small, says Charles Lockwood,
M.D., chair of the department of Obstetrics, Gynecology and Reproductive Science
at Yale University School of Medicine. However, injury to either you or your baby
can occur even when the tools are used correctly. "They aren't without risk, but
the risk-benefit ratio is often in favor of their use," Lockwood notes. In
general, forceps may be slightly less risky for the child, while vacuums tend to
be less traumatic for mom.
- Why is Pitocin used?
Pitocin is a synthetic form of oxytocin, a hormone that causes the uterus to
contract, Coleman explains. It may be used to induce labor if you're one to two
weeks past your due date, if labor isn't progressing, if your unborn baby isn't
thriving, or if the placenta or uterine environment isn't functioning optimally.
Given intravenously, it tends to bring on more powerful and frequent contractions
within 30 minutes. Because it can cause overstimulation of the uterus, mother and
baby are monitored electronically during the process.
- Will I need an episiotomy?
Episiotomies are performed in about 28 percent of vaginal births, according to
the American College of Obstetrics and Gynecologists. Once used routinely to
prevent vaginal tears and hasten delivery, the incision between the vagina and
the anus (the perineum) is now being made much less readily. Why? Research shows
that women who undergo episiotomies may feel more pain, take longer to heal, and
be more likely to suffer serious lacerations near or through the rectum than
women with vaginal tearing. However, an episiotomy may be warranted in some
situations, such as if the second stage of labor takes too long or your baby is
in distress. Discuss the benefits and drawbacks of episiotomy with your
caregiver, and ask about ways to relax or stretch the perineum to help avoid
tearing.
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Six Signs of Preterm Labor