Chapter 6.1. The Beginning of Labor Early Signs of Labor “Show” or “Bloody Show” – few drops of blood or pinkish vaginal stain that occurs when the mucus.

Labor and BirthChapter 6.1

The Beginning of LaborEarly Signs of Labor

“Show” or “Bloody Show” – few drops of blood or pinkish vaginal stain that occurs when the mucus that plugs the uterus during pregnancy dissolves May occur as early as a few days prior to birth

“Water has Broken” – trickle or gush of warm fluid from the vagina. Amniotic Sac around the baby has broken

Contraction – the tightening and releasing of the muscles around the uterus When the uterus contracts, it shortens and closes,

pushing the fetus against the cervix. Then the uterus relaxes before the next contraction. In early labor, they are further apart. In later labor,

they become more rapid.Fetal Monitoring – Watching of an unborn

baby’s heart rate for stress Done during labor and birth Usually done with ultrasound

Premature LaborWhen the fetus has been developing in the

womb from 37 weeks or less.Warning signs:

Contractions every 10 minutes or lessFeeling a constant, dull, backacheLeaking fluid or blood

Sometimes doctors can give medicine to stop premature labor

False LaborThree signs:

Contractions are not regular or rhythmicContractions do not get stronger over timeContractions end with light exercising such as

walking or stretchingCan occur hours or days before real labor

occurs

Inducing LaborDoctors can induce labor by artificial meansCan be done by using medication or

puncturing the amniotic sacOften induced for medical reasons or in

emergenciesIf the baby was slow developing or still in the

womb after 42 weeks, the doctor may choose to induce.

Also done if the amniotic sac has broken but labor has not begun

Inducing labor does not change the labor process

The Stages of LaborStage 1 – Contractions open the cervix

Stage 2 – The baby is born

Stage 3 – The placenta is expelled

The First StageBegins when the contractions are coming at

regular intervalsContractions increase in strength, length, and

frequencyIn the beginning of this stage, contractions are

approximately 30 seconds long, and up to 20 minutes apart.

Active labor – when contractions are 60 seconds long and only two to five minutes apartMost hospitals do not admit women until they are

in active labor

Woman becomes focused, and needs support from her partner

Using coping techniques – walking, breathing exercises, etc.

This stage is when the mother would receive pain medication (epidural) if wanted

As the cervix dilates, the baby moves lower into the pelvis

Most babies enter the world head-firstIf feet first, it is called breech presentation.

These babies may have a hard time moving through the pelvis, so the doctor will determine if a normal delivery is possible

The end of this stage is called “transition”The cervix becomes fully dilated to a

diameter of about 10 centimeters (4 inches)Strong contractions that last up to 90

seconds and are two to three minutes apart occur at this point

Difficult part of laborA woman needs encouragement and

reassurance from her support partner at this time

End of Stage 1 – “Transition”

The Second StageContractions during the second stage are more

productive, pushing the baby through the pelvis and out of the vagina, or birth canal.

It is safe for women to push at this pointWhen she pushes, she uses her muscles to expel the

babyDuring labor, the hormone called relaxin, allows the

ligaments in the mother’s pelvis to stretch like a rubber band.This stretching moves apart the pelvic bonesIt also makes it possible for the walls of the vagina to

stretch so that that baby can pass safely through

The baby’s body is designed for this journeyA soft skull lets the baby’s head become longer

and narrower than usualIf the opening of the mother’s body is too

small to accommodate the baby’s passage the doctor may widen it with a surgical cutEpisiotomy – Surgical cut from the vagina to

the anusAs the baby’s head emerges, the doctor or

midwife provide gentle support to help guide the baby outThe head is followed by one shoulder and then

the otherThe rest of the body follows quickly

Sometimes the doctor uses surgical tongs called forceps, to grasp the baby’s body and guide it’s movement.

A vacuum extractor that applies suction to the baby’s head once it appears may be used if the baby needs to be moved through the birth canal quickly.

The Third StageAfter birth, the mother may rest briefly, and

then may feel a few contractions and a desire to pushUsually not painful contractionsFor the purpose of pushing the placenta out

Once the placenta is out, the birth process is over

The new mother may now begin to bond with her child

If needed, the doctor or midwife will stitch up the episiotomy or tears that may have occurred during birth

The final stage is brief but importantScientists have discovered that cord blood

contains stem cells.The stem cells can be used to treat many

serious blood related illnesses in the baby or other family members

Parents can arrange to have the cord blood stored in case there is a future medical need.

It also can be donated for use by others

Coping with LaborMedication

Anesthesia Some injected into veins or muscles

Make women and baby sleepy Epidural – lower back

Numbs the lower half of the body

Childbirth ClassesTeaches breathing and relaxation techniques

Often called Lamaze classes, but that is only one approach to childbirth education

Cesarean BirthIf complications arise during pregnancy or

birth a C-section may become necessary. Performed for several reasons:

Lack of normal progress during laborDiscovering the baby is in distressDiscovering the baby is turned in the wrong

directionMultiple births (twins or more)

Special parenting classes if C-section is planned

Pain medicationEpidural – women remain awake during the surgeryGeneral anesthesia – puts women to sleep

Father or support person may be present with permission

SURGERYHas risks, but can relieve stress on the baby and speed

up the deliveryDoctor has more control of the birth process

Mother may or may not be able to hold baby immediately afterwards

Mother taken to recovery room for a few hours afterEncouraged to stand up or walk with assistance to speed

up recoveryUp to six weeks to recover fully

Premature Birth5-6% of all babies are born prematurelyBorn before reaching 37 weeks of

developmentWeighing less than 5 pounds, 8 ouncesThe earlier the baby is born, the less

developed the organs are and the lower their birth weight

Why does premature birth happen?No one knows for sureMothers more likely to give birth to

premature baby:Women who have given birth to a premature

baby beforeWomen who have medical problemsTeen mothersMalnourished mothers

You can help prevent premature births by eating well and getting proper prenatal care

Special Care for PreemiesThey need:

Controlled body temperatureControlled breathingControlled feeding

Baby usually put in an incubatorSome may be able to breast feed or feed from a bottleSome will have lifelong health-related problemsMany premature infants will reach development

milestones in the first year a little later than the average child.By the time they are toddlers it is often impossible to

know if a child was born prematurely.