Pregnancy Lounge

Tag: birth

  • The Second Stage of Labor

    During the second stage of labor, your cervix is fully-dilated to 10 centimeters and as your baby makes his or her way down the birth canal, your contractions may actually space out to about 2-4 minutes apart and become more regular. This may allow you to rest and take a breather briefly between contractions. Although it may be difficult, rest and save your strength for pushing.

    Pushing and Delivery

    At this point, the pressure on your rectum increases and the urge to push becomes overwhelming, as your baby descends. You may feel more in control once pushing begins, as well as a sense of relief to be able to play a more active role in the birth process. You may also experience a burst of renewed energy as delivery draws ever-so-close. The urge to push usually feels the strongest at the peak of a contraction, then fades toward the end.

    Positioning and breathing will impact your pushing. Unless you are making significant progress, you may be advised to change positions about every half hour, which may enhance progress. Allow your partner (or support person) to help you into a semi-sitting or a semi-squatting position, which allows gravity to work for you, not against you. Squatting utilizes gravity, helping your pelvis to open up and make more room for your baby. It can also take some pressure off your back. Some hospitals even have squat bars that you can hold onto, or you can use your partner for added support.

    The side-lying position may also help ease back pressure, if you are experiencing “back labor” during pushing. For this position, you or your partner may hold up your top leg. A common position for pushing is having your feet in stirrups, while lying on your back. This position is most convenient for your doctor or midwife if you need an episiotomy, although gravity doesn’t help you out much while using this position.

    Whatever position you choose when pushing, take a deep breath, hold it in, bear down and concentrate. Curl into the push as much as you can, rounding your shoulders, putting your chin to your chest, allowing all of your muscles to work to help ease your baby into the world. Don’t be alarmed if you pass small amounts of urine or feces during the pushing stage, because many women do and it’s completely normal. It can even mean you are pushing effectively. Remember, every push brings you that much closer to holding your baby in your arms.

    Birth

    Some women want to use a mirror to see their baby’s head and may want to touch it as well. Seeing or feeling your baby’s head crown may give you added inspiration to keep pushing. Just before your baby is born, you may feel a burning, stinging or stretching sensation at the opening of your vagina. This often happens as your perineum widens to allow your baby’s head to descend (often called “crowning”) and your baby to pass through the birth canal.

    As your baby’s head emerges, it typically turns to one side to allow the shoulders to align. Once your baby’s head is delivered, you may be asked to stop pushing, so his or her airway can be cleared of excess mucus, by suctioning your baby’s nose and mouth. After that’s done, your doctor or midwife may assist the rest of the body out, usually with one last push. Congratulations! You have a brand new baby!

    Back to Labor Stages

  • Signs of Labor

    It’s not known what brings labor on, but it’s believed that hormones such as prostaglandins stimulate uterine activity and trigger oxytocin release, softening and thinning the cervix. Your body goes through a series of changes when it’s preparing for labor. Although the signs vary from woman to woman (as well as from pregnancy to pregnancy), once your labor has begun, the strong, painful contractions will ultimately give you a clue that it’s time for your little one to be born.

    At first, especially if this is your first pregnancy, you may not know the difference between true labor and false labor signs, making you unsure of what exactly you are experiencing. Becoming familiar in advance with the signs of labor will help you to distinguish the difference when the time comes. If you think you may be going into labor, don’t feel embarrassed to call your doctor or midwife to ask questions, no matter what time of day or night, or go to the hospital.

    Diarrhea, Nausea, Increased Energy

    Labor can start out with signs as simple as experiencing frequent diarrhea and nausea/upset stomach. Some women find themselves suddenly flooded with energy, when the nesting instinct kicks in full-force. Lower back pain and abdominal cramping aren’t uncommon either.

    Rupture of Membranes

    If you’re water breaks, that’s a definite sign that your time is drawing near of holding your little one. When your membranes rupture, it can feel like a little trickle or a big gush of fluid. This is the amniotic fluid that has surrounded your baby in the amniotic sac for nine months. Many times, your water won’t break until later stages of labor, or may even have to be broken manually by your doctor or midwife at the hospital. If you think your water has broken, call your doctor or midwife, because they will most likely want you to come to the hospital. The longer between when your water breaks and when delivery occurs, the greater chance of infection. Use a towel or pad to make you feel more comfortable, never use tampons while pregnant.

    Loss of Mucus Plug

    You may experience the loss of your mucus plug or “blood show” at the onset of labor, although it can occur as early as 2-3 weeks before delivery. This mucus-like discharge may be thick, bloody and stringy. This “plug” is the barrier that seals the opening of your cervix throughout pregnancy, preventing infection. Sometimes it dislodges as your cervix begins to thin and dilate (open). Make sure to let your doctor or midwife know if this happens, especially if it’s heavy and bright red, which could indicate something serious.

    Contractions

    Labor contractions start out similar to Braxton-Hicks contractions, beginning mild and relatively painless. But unlike Braxton-Hicks, they progressively get stronger and longer in duration. Also, true labor contractions will not let up by changing positions or resting, which false labor contractions tend to do. They continue and don’t go away, no matter what you do, they may even get stronger and intensify with activity. When you are really in labor, your contractions gradually become more regular and typically develop a pattern. They commonly begin in your lower back and radiate forward, like waves. False labor contractions are usually just centered in your abdomen and stay there. Your abdomen will feel very hard (usually much harder than Braxton-Hicks), like a basketball during these contractions, which you can feel by placing your hand on your belly. And unlike false labor contractions, real contractions will dilate and efface your cervix.

    Back to Labor Stages

  • Stages of Labor

    Every woman’s labor is different, following it’s own pattern (even from pregnancy to pregnancy) and there are some things that can’t be anticipated. Although every labor and birth is unique and your labor will unfold in a very special way, the process is remarkably and beautifully constant. You can expect a sequence of events, when everything goes smoothly.

    Labor is typically divided into three distinct stages. The first stage being when your cervix softens, dilates and thins out (effacement), ending in full dilation.

    The first stage can be divided into three “phases”: the early (or latent phase), the active phase and the transition phase. The second stage of labor is when your baby passes through the birth canal and is born. During the third stage, the placenta (afterbirth) is delivered.

    —Signs of Labor
    —Preterm Labor
    —Preterm Complications
    —Preterm Labor Causes
    —Preterm Prevention and Treatment
    —First Stage: Phase I
    —First Stage: Phase II
    —First Stage: Phase III
    —Second Stage
    —Third Stage
    —Induction of Labor
    —Induction of Labor Procedures
    —Labor Induction Risks
    —Do It Yourself Labor Induction

  • The First Stage of Labor – Active Labor

    During the second part of the longest stage of labor, your cervix really opens up, continuing to dilate from about 4 centimeters up to 8 centimeters. Your contractions continue to become more intense, more regular and last longer, as your labor progresses. They get closer together, eventually about 3-5 minutes apart and may last over a minute each, as your baby gets in position for birth. Read more on labor below:

    Active Labor

    Physically, you may be feeling increasing pressure and pain in your back. You may be much less comfortable than the earlier phase, as your labor pains intensify and become more frequent. During this phase, you may feel more fatigue, leg discomfort and increasing mucousy discharge (bloody show), as well as diarrhea. If your water didn’t break earlier, it will now or your doctor or midwife may choose to rupture your membranes sometime during this phase. During active labor, some women request an epidural or other pain medication.

    Emotionally, you may feel increasingly restless and anxious, especially if this phase lasts a long time. Your mood may become more serious and your initial excitement may begin to wane as your pain gets worse. You may find it very difficult to concentrate, while dealing with contractions and your support person can help keep you focused.

    At this point, you will be headed for the hospital or there already. To reduce your growing discomfort, try breathing exercises and relaxation techniques (the ones that you may have learned in childbirth class), if you feel like doing them. Concentrate on resting and relaxing, because the more relaxed you are, the easier and quicker your labor may be. Soaking in a warm bath or taking a shower, may be helpful at this time. Experiment with different positions to find ones that are more comfortable. Discomfort can often be helped by positions that allow gravity to speed dilation, including walking, squatting or rolling on a birth ball. If you are confined to bed, try lying on your side.

    If your doctor or midwife agrees that it’s alright to do so, drink clear liquids or suck on ice chips to keep from becoming dehydrated and also to keep your mouth from becoming dry. If you become hungry, you can ask if it’s okay to have a light snack, such as Jell-O, although many hospitals won’t allow you to eat anything during labor. In between contractions, get up and walk around, if possible. Take this time to use the bathroom, because urinating regularly will allow your baby’s head to move down more easily into the birth canal. A gentle massage from your partner (or support person) may be welcomed, although some women prefer not to be touched during this phase of labor.

    Back to Labor Stages

  • More on Episiotomies (continued)

    Many recent studies have shown that routine episiotomies shouldn’t be performed, because they are not helpful to the majority of women, although there are certain circumstances when they are needed. Having an episiotomy can increase pain during the postpartum period, leading to a longer recovery time. In addition, women who have episiotomies may have weaker pelvic floor muscles as well as more pain when resuming intercourse postpartum.

    Episiotomy rates have declined over the years, but the number still remains high. Despite all the evidence against routine episiotomy use, close to 50- 80% of first time moms end up with an episiotomy in the U.S. The majority of women having them done are young white women, who have private insurance, according to a recent study.

    There are a few situations when an episiotomy may be medically necessary. If there is a sign that your baby is in distress while in the birth canal, such as slowing of your baby’s heart rate, an episiotomy may be unavoidable for the sake of your baby’s well-being. If your baby’s shoulders get stuck, if your baby has a very large head that cannot fit through the vaginal opening or if delivery happens too quickly for the skin of your perineum to stretch naturally, you may need an episiotomy.

    Perineal message helps reduce the chance of tearing during birth and the need for an episiotomy. It can make the perineum more flexible and increase elasticity, in preparation for birth. It’s a good idea to start doing perineal massage around the 34th week of pregnancy or before. To perform perineal massage, wash your hands thoroughly (or your partner). Place K-Y jelly, vitamin E oil or another mild lubricant on one or two fingers and gently stretch the lower part of the vagina until you feel a slight burning sensation. Hold the pressure steady for about 2 minutes or so. Repeat this daily for about 8-10 minutes.

    Warm compresses during labor (especially during the pushing stage) encourage the stretching and relaxing of the perineum. Make sure they are only warm, but not hot, which can cause some swelling. Positioning during labor and birth may contribute to whether you need an episiotomy or not. Squatting can help reduce tearing. Avoid laying directly on your back, if possible and keep changing positions if you can. Talk to your doctor or midwife early about your feelings regarding episiotomies, especially if you wish to avoid one.

  • Episiotomy

    A small incision during delivery is an episiotomy. Right before your baby’s head emerges during delivery, in the pushing stage of labor, you may be given an injection of local anesthetic and your doctor or midwife may make a small incision in the skin between your vagina and anus (your perineum). This is called an episiotomy. An episiotomy is usually a second degree cut in both the skin and muscle of your perineum made for the purpose of enlarging your vaginal opening to assist in delivering your baby. The incision is closed with stitches after your baby and the placenta have been delivered. It is one of the most common medical procedures performed on women and also one of the most controversial.

    There are two main types of cuts: a midline (the most common), which is a cut directly towards the anus and a mediolateral, which is a diagonal cut toward the side. The most common are second degree and the least common are fourth degree cuts.

    Many doctors believe that an incision heals more easily than a tear. Other claimed benefits of episiotomy include prevention of possible third or fourth degree lacerations, lacerations that reach the anus, incontinence later on, damage to the pelvic floor and injury to the baby, as well as shortening the pushing stage; leading to a quicker delivery. Some doctors say that episiotomies are preferred, because they are simply easier to repair.
    <<click here for the rest of the article on episiotomies.>>

  • Pregnancy and Depression

    Pregnancy is supposed to be a joyful time, one of the happiest in a woman’s life, but for many women it’s a time of sadness and even bouts of depression. Depression can be described as an on-going and impairing feeling of sadness, hopelessness, unhappiness or being consistently down-in-the-dumps. Many people get the blues at one point in their lives or another, but clinical depression is considered a mood disorder in which these feelings interfere with day to day life for an extended period of time. Depression is common, with symptoms affecting as many as 70% of pregnant women and about 15% of those will suffer from major depression. Depression is one of the most common complications during pregnancy, even more common than postpartum depression is after delivery.

    Often, depression during pregnancy (or “prenatal depression”) is overlooked, ignored and left untreated, due to the fact that some normal pregnancy changes cause similar symptoms and happen about the same time. This can easily confuse symptoms of depression with typical symptoms of pregnancy.

    Common symptoms include: appetite changes (eating too much or too little), decreased interest, motivation or pleasure in activities that used to be enjoyed, change or disturbance in sleep patterns, excessive fatigue or lack of energy, difficulty focusing or concentrating, extreme restlessness and irritability, persistent feelings of guilt or worthlessness, extended periods of sadness, as well as significant weight gain or weight loss. Also, crying a lot, withdrawal from family and friends, stronger emotional reactions and excessive worries about a woman’s health or the health of her unborn baby can also be symptoms of depression. Recurring thoughts of suicide, death and feelings that life isn’t worth living anymore are more severe symptoms, which a woman shouldn’t hesitate to seek help for immediately. Any of the symptoms mentioned previously that last longer than 2 weeks or more at a time can’t be blamed on normal mood changes caused by pregnancy.

    << rest of the article on depression during pregnancy >>

    << Postpartum Depression >>
    << Depression After Delivery >>

  • Depression During Pregnancy (continued)

    Possible triggers for prenatal depression include: family or personal history of depression, relationship problems or martial conflict, living alone, unplanned pregnancy, financial troubles, a complicated or high-risk pregnancy, being confined to bed rest, fertility treatments, previous pregnancy loss (fear that something may happen to this pregnancy), stressful life events (such as a recent death in the family, divorce, separation or job loss), being young at the time of pregnancy, history of substance abuse, limited support from family and friends as well as past history of being abused either emotionally, sexually or physically. There may be a number of reasons why a woman may get depressed during pregnancy, although at other times, the cause isn’t quite as clear.

    Depression during pregnancy can be dangerous, since when it’s severe, it may result in decreased ability for women to care for themselves or their unborn baby, along with interference with prenatal bonding. Women may not eat properly, get adequate rest or receive prenatal care. Depression can also put women at risk for increased use of substances such as tobacco, alcohol and drugs. Women with severe depression may be at a much higher risk of suicide, if the depression is left untreated. Depression during pregnancy is linked to premature delivery, low birth-weight and possibly even depression and behavioral problems later on in the child.

    In addition, depression during pregnancy is one of the strongest predictors of postpartum depression after delivery. About 50% of women suffering from depression during pregnancy go on to develop postpartum depression. The good news is treatment during pregnancy can reduce that number dramatically.

    Many women suffer needlessly because they don’t seek help. Depression can be treated and managed during pregnancy, but the first step of seeking out help and support, is the most important. Treating depression is just as important as treating any other health concern during pregnancy. Without proper treatment, depression can get worse or be harmful to the baby or mother.

    If you suspect that you are becoming depressed, it’s important to talk to your doctor or midwife about how you are feeling. He or she may want to prescribe anti-depressant medication and/or refer you to a therapist who can provide you with some much-needed support, if your depression is moderate to severe. Besides medication and therapy, alternative approaches include light therapy, support groups as well as self-help approaches that may help you feel better. These include: building a support network that can help with such things as household responsibilities, preparing meals and other daily tasks to help keep you from feeling fatigued, exercising, which can be very beneficial, especially walking and stress management. Make sure to take plenty of breaks, get adequate amounts of sleep and eat a well-balanced diet. Talking things out with your friends, partner and family may also be very helpful.

    << Postpartum Depression >>

  • Leg Cramps in Pregnancy

    Leg Cramps in Pregnancy

    When your enlarging uterus places pressure on certain nerves (as well as a shortage of calcium), you may experience leg cramps or pains, which are more common in the last half of pregnancy.

    • Elevate your feet whenever possible and avoid crossing your legs.
    • You may try massaging and stretching your calf muscles before bed.
    • Add more calcium and potassium to your diet to prevent leg cramps.
    • When a cramp hits, straighten your leg and gently massage it until the pain lets up.
    • Apply a heating pad or a hot water bottle to the sore area.

    Call your doctor or midwife if it doesn’t get better, because the cramping could be a symptom of something more serious.

    more Pregnancy Discomforts

    –Backaches
    –Constipation
    –Hemorrhoids
    –Fatigue
    –Headaches
    –Heartburn and Indigestion
    –Itchy Abdomen
    –Dizziness and Fainting
    –Swelling
    –Varicose Veins
    –Breast Discomfort
    –Urinary Problems
    –Sleep Trouble
    –Leg Cramps
    –Nausea and Morning Sickness
    –Increased Discharge
    –Pelvic Pressure
    –Hand Numbness
    –Braxton Hicks Contractions

  • Pregnancy Contractions

    Contractions are when your uterus starts practicing and preparing for labor (as early as the second trimester), you may experience some discomfort, as your uterus briefly tightens and relaxes. They are typically mild and painless and may quiet down if you change positions.

    Unlike real labor contractions, Braxton-Hicks will subside. You may want to try relaxing, by soaking in a warm bath or by taking a nap. If they start coming at regular intervals, are accompanied by back pain or become painful, contact your doctor or midwife.

    more Discomforts

    –Backaches
    –Breast Discomfort
    –Braxton Hicks Contractions
    –    Constipation
    –Dizziness and Fainting
    –Fatigue
    –Hand Numbness
    –Headaches
    –Heartburn and Indigestion
    –Hemorrhoids
    –Increased Discharge
    –Itchy Abdomen
    –Leg Cramps
    –Nausea and Morning Sickness
    –Overheating
    –Pelvic Pressure
    –Sleep Trouble
    –Swelling
    –Urinary Problems
    –Varicose Veins

  • Constipation in Pregnancy

    When digestive muscles begin to loosen (due to certain hormones) and the last half of pregnancy when your growing uterus puts added pressure on your bowels, you may experience irregularity.

    To overcome constipation, eat foods that are fiber-rich. Fresh fruit and vegetables, whole grain products and prune juice are all good choices.
    Increase your fluid intake and make sure you are getting at least eight 8-ounce glasses of water a day to help soften your stool and keep food moving along in your digestive tract.

    Regular exercise is especially helpful in dealing with constipation. Don’t take enemas, laxatives, or home remedies unless recommended by your doctor or midwife.

    more Discomforts

    —Backaches
    —Breast Discomfort
    —Braxton Hicks Contractions
    —    Constipation
    —    Dizziness and Fainting
    —    Fatigue
    —    Hand Numbness
    —    Headaches
    —    Heartburn and Indigestion
    —    Hemorrhoids
    —    Increased Discharge
    —    Itchy Abdomen
    —    Leg Cramps
    —    Nausea and Morning Sickness
    —    Overheating
    —    Pelvic Pressure
    —    Sleep Trouble
    —    Swelling
    —    Urinary Problems
    —    Varicose Veins

  • Pregnancy Complications

    Despite the fact that most women have normal, uncomplicated pregnancies, with only minor discomforts, pregnancy complications are not that uncommon. Hundreds of thousands of women have pregnancy complications every year. Among women who become pregnant in the United States each year, at least 30% have a pregnancy-related complication.

    Every year in the United States, approximately 875,000 women experience one or more pregnancy complication, about 467,200 babies are born prematurely, close to 307,000 babies are born with low birth weight and over 154,000 babies are born with birth defects. It’s predicted that this year, 1,050,000 women will develop hypertension, 420,000-840,000 will experience abnormal bleeding, 380,000 will go into labor too early, 210,000 will come down with viral infections, 139,000-420,000 women will have babies with intrauterine growth retardation, 126,000-504,000 will have gestational diabetes and 42,000 will have too much amniotic fluid.

    The majority of problems are relatively mild, but some carry significant health risk to both you and your growing baby. Complications can range from minor (morning sickness, leg cramps, edema, etc) to more serious complications that may need medical intervention including ectopic pregnancy, miscarriage, incompetent cervix, bleeding in pregnancy, intrauterine growth retardation (IUGR), placenta previa, placental insufficiency, placental abruption, premature rupture of membranes (PROM), low or excessive amniotic fluid, preeclampsia, (pregnancy-induced hypertension) and eclampsia.

    If your doctor or midwife identifies a potential problem, they may refer you to a perinatologist, who is a specialist that handles pregnancies that are at higher-than-normal risk for complications. Under certain circumstances, a neonatologist may be called in to advise about problems that occur (or are expected to occur) shortly after delivery. A neonatologist is a pediatrician who works exclusively with newborns, specifically those born premature, have a serious injury, illness, infection or a birth defect.

    There are several specific tests done during the first trimester of pregnancy, and a few screenings later in pregnancy to help prevent certain complications, or spot them early. Your doctor or midwife can provide you with a schedule for prenatal tests. Every woman can minimize her risk of experiencing complications by maintaining a healthy lifestyle, particularly by eating well and refraining from non-prescription drugs, including alcohol and tobacco, as well as receiving regular prenatal care. It’s important to follow your doctor or midwife’s advice, to lower your risk for complications and to heighten your odds of delivering a healthy baby.