Pregnancy Lounge

Tag: childbirth

  • 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

  • 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 >>

  • Reasons for Cesareans

    There are many reasons for cesareans and they vary with the individual woman, as well as the individual pregnancy. The chance of needing a cesarean depends on how your pregnancy is progressing and what complications may arise as your due date draws near. Sometimes cesareans aren’t the only option and the reasoning is questionable, while other times there are legitimate medical reasons making a cesarean unavoidable. In some situations, cesareans can be life-saving for mothers and babies.

    Occasionally, an emergency arises when your baby may need to be delivered within a matter of minutes. An emergency cesarean may be caused from such things as: a prolapsed cord (when the umbilical cord comes through the cervix before the baby’s head, preventing blood flow and oxygen from reaching the baby), which occurs in close to 4% of births, placental abruption (when the placenta separates from the uterine wall before birth), placenta previa (when the placenta is low and covers the cervix either partially or completely) and uterine rupture (when the uterine tissue tears).

    Fetal distress is another cause for the need of a quick delivery leading to a cesarean. This happens when there are concerns about the baby’s health during labor. Changes in the baby’s heart rate (when it’s very fast, very slow or irregular) may signal a problem such as he or she is not responding ideally to contractions or is not getting enough oxygen, either because the umbilical cord is being compressed (pinched or wrapped around something) or the placenta isn’t functioning properly.

    If the baby is mal-positioned (not in a good position for vaginal birth), a cesarean may be recommended, although sometimes babies can be turned or can be delivered vaginally anyway. Some common positions include: transverse (lying sideways) and breech (feet or bottom first). Breech positions account for between 12- 15% of all cesareans.

    << click for the rest of the article on reasons for cesareans >>
    << Avoiding Cesareans >>

  • Cesarean – When is a Cesarean Delivery Necessary

    When pregnant women think about childbirth, they rarely envision having a c-section. Most assume they will deliver vaginally, although with the United States’ cesarean rate at an all-time high, the odds are good that you may, in fact, have a c-section. If you’ve had a previous cesarean, you are much more likely to have another, with a decline in vaginal birth rates following previous c-sections. A recent study found that 47% of moms who’ve had a previous c-section aren’t even considering a vaginal birth the next time. Also, pre-planned or “elective” c-sections are becoming more and more common, when many times there is no identifiable medical reason. Cesareans are the most common surgery performed and it’s believed that between 25- 50% are unnecessary. More below:

    If you live in the United States, there is about a one in four chance your baby will be delivered by cesarean, which is a very steep rise since 1970, when only 5% of all deliveries were by cesarean. In the late 1980s and early 1990s, there was an overall decline in the number of cesarean deliveries in the U.S.

    In the mid 1990s, the rates began to increase rapidly. From 1999 through 2001, the percent of “elective” c-sections grew from about 1.56% to 1.87%, which is a 20% rise. In 2002, cesarean deliveries increased by 67% among low-risk women. Low-risk, first-time moms who were 40 and older were more than five times more likely to have a c-section than first-time moms between the ages of 20 and 24. In 2002, the number of vaginal deliveries was less than 3 million, while the number of cesarean deliveries were about 1.1 million (approximately 634,000 were first time c-sections and 409,000 were repeat c-sections). Now the rate has jumped to well over 27% of all deliveries in the United States, which translates to about 27 c-sections for every 100 births. Some hospitals have a staggering cesarean rate of over 50%!

    Why the increasing cesarean rates? It is believed that the rates of c-sections among women in the United States are on the rise for a number of reasons including: increasing age of pregnant women, more underlying conditions such as diabetes and hypertension, for convenience purposes, fertility treatments yielding more twins and triplets, improved fetal monitoring (which has made it easier to tell if the baby is stressed), as well as liability reasons for doctors and hospitals, who may feel as if their risk of being sued is greater if complications occur during a vaginal delivery.

    << Reasons for Cesareans
    << Avoiding Cesareans