Labor and Birth - What to Expect
Soon, you'll experience the amazing process of childbirth! Find out the signs of labor and learn about your options for giving birth. Once you reach the third trimester, you should talk to your doctor about labor and delivery. Learn your options for pain relief. Find out how to reach her if you go into labor. And ask her at what point in labor should you call. Before you reach the last few weeks of pregnancy, you should visit the hospital or birthing center. Find out if you can pre-register so that your insurance information is already in the computer when you arrive.
Signs of Labor
Many women, especially with their first babies, think they are in labor when they're not. This is called false labor. Do not feel embarrassed if you go to the hospital thinking you're in labor, and then you get sent home.
If you think you are in labor call your doctor. Call your doctor if you experience any of the following :
- Contractions that come at regular and increasingly shorter intervals. Contractions will become stronger over time.
- You have persitant lower back pain. You might also feel cramps as if you were premenstrual.
- Your water breaks in a large gush or a trickle.
- You have a brown or red-tinged mucous discharge. This is most likely your mucous plug. Losing your mucous plug usually means your cervix is dilating and becoming thinner and softer. Labor could start right away or could be a few days away.
Choosing Where to Deliver
Many women carefully choose the kind of environment in which to deliver her baby. Not all insurance companies will cover birth at a birth center and even less will cover planned homebirths. The three ways women can choose to deliver are at a hospital, birth center or at home. Most hospitals and birth centers offer birthing classes and breastfeeding support.
Laboring in a Hospital
If you have health problems, pregnancy complication,s or are at risk for problems during labor and delivery, you should give birth in a hospital. Hospitals offer the most advanced medical equipment and highly trained doctors for labor and deliver. In a hospital, a doctor can do a cesarean section if needed. Epidurals or many other pain relief options are also available.
Only certain doctors have admitting privileges at each hospital. So before you choose your doctor learn about their affiliated hospital. When choosing a hospital you might consider:
- Is it close to your home?
- Is an anesthesiologist on staff at the hospital 24-hours a day?
- Do you feel comfortable in the labor and delivery rooms?
- Are private rooms available?
- How many people can you have in the room with you?
- Does it have a neonatal intensive care unit in case of serious problems with the baby?
- Can your baby stay in the room with you?
Laboring in a Birth Center
Healthy women who are at low-risk for problems during pregnancy, labor and delivery may choose to deliver at a birth or birthing center. Birth centers give women a more relaxed, home-like environment in which to labor and give birth. A birth center will focus on making labor and delivery a natural, family-focused process. Usually certified nurse-midwives deliver babies at birth centers.
Birth centers do not do any routine medical procedures which means you will not automatically be hooked up to an IV when you are in labor. You also will not have an electronic fetal monitor around your belly the whole time. Instead, the midwife or nurse will check in on your baby from time to time with a handheld machine. When your baby is born, all examinations and care for the baby will occur in your room. You cannot receive an epidural at a birth center although some pain medicines may be available. If a cesarean section becomes necessary,you will be moved to a hospital for the procedure. Basic emergency care can be done on a baby with problems while they are being moved to a hospital.
Many birthing centers have showers or tubs in their rooms for laboring women. They also tend to have comforts of home like large beds and rocking chairs. Birth centers usually allow more people in the delivery room than do hospitals. A birth center can be affiliated with a hospital, inside of hospitals, or completely separate facilities.
Homebirth - Labor at Home
Healthy pregnant women with no risk factors for complications during pregnancy, labor or delivery can consider a planned homebirth. Some certified nurse midwives and physicians will deliver babies at home. If you are considering this choice you should ask your insurance company about their policy on homebirths and if they cover costs.
Homebirths are common in many parts of Europe, but in the United States, planned homebirths are still controversial. If you are considering a homebirth, you should fully research the pros and cons. The main advantage is that you will be able to experience labor and delivery in the privacy and comfort of your own home. Since there will be no routine medical procedures, you will be in complete control of your experience. The main disadvantage of a homebirth is that in case of a problem, there is not immediate hospital/medical care in the event of an emergency. Care would have to wait until a transfer to a hospital. Women who deliver at home have no options for pain relief.
To ensure your safety and that of your baby, you must have a highly trained and experienced midwife to assist you. If you live far away from a hospital, homebirth may not be the safest choice. Your midwife must be experienced and have the necessary training and supplies to perform emergency care for you and your baby if need be. Your midwife should also have access to a physician 24 hours a day.
Who Should Deliver Your Baby?
Women can also choose what type of health care provider they would like to deliver their baby. An obstetrician is a medical doctor who specializes in the care of pregnant women and in delivering babies. Obstetricians also have special training in surgery so they are capable of doing episiotomies and cesarean sections. Women who have health problems or pregnancy complications should see an obstetrician.
A certified nurse-midwife (CNM) and a certified professional midwife (CPM) specialize in prenatal care, labor, and delivery. Either one can offer a different care choice for healthy women at low-risk for problems during pregnancy, labor, or delivery. A CNM does not need experience delivering babies in home settings. Most CNMs practice in hospitals and birth centers. A CPM is required to have experience delivering babies in home settings because they deliver in homes and birthing centers. Both should have a back-up arrangement with an obstetrician in case of a problem or emergency.
Some women also choose to have a doula assist with labor and delivery. A doula is a professional labor coach who gives physical and emotional support to women during labor and delivery. The doula offers advice on breathing, relaxation, and positioning. Doulas also give continuous emotional support and comfort to women and their partners during labor and birth. Doulas and midwives often work together during a woman's labor. Check with your health insurance company to find out if they will cover the cost of a doula.
Managing the Pain
Virtually all women worry about how they will cope with the pain of labor and delivery. Childbirth is different for everyone. So no one can predict how you will feel. The amount of pain a woman feels during labor depends partly on the size and position of her baby, the size of her pelvis, and the strength of the contractions.
Natural Pain Relief During Labor
Many women choose to deliver their babies without using medicine for pain relief. Things women do to ease the pain include:
- use breathing and relaxation techniques
- take warm showers or baths
- receive massages
- have the supportive care or a loved one, nurse, or doula
- find comfortable positions while in labor (stand, crouch, sit, walk, etc)
- use a labor ball
- listen to music
- Building a positive outlook on childbirth and managing fear may also help some women cope with the pain. Labor pain is caused by contractions of the uterus that are pushing your baby down and out of the birth canal.
- Take a childbirth class. Call the doctor, hospital or birthing center for childbirth class information.
- Get information from your doctor. Write down your questions and talk about them at your regular visits.
- Talk about your fears and emotions with friends, family and your partner.
More and more women in the United States are using water to find comfort during labor and delivery. In waterbirthing, a woman in labor gets into a tub of water that is between 90 and 100 degrees. Some women get out of the tub to give birth while others remain in the water for delivery. The water helps women feel warm and relaxed which helps to ease the pain of labor and delivery for many women. It is also easier for laboring women to move and find comfortable positions in the water.
Waterbirthing is relatively new in this country which means there is very little research on its benefits. However, many women say giving birth in the water is faster and easier. Waterbirthing may be gentler for your baby as it can ease the baby's transition from the womb to the new world. The baby is born into an environment that is similar to the womb it inhabited for 9 months. Make sure you discuss waterbirthing with your doctor or midwife to see if you are a good candidate for waterbirthing. Water birth is not safe for women or babies who have health issues or a woman in a higher risk pregnancy.