NORMAL LABOR / NORMAL DELIVERY
Labor is a physiologic process during which the products of conception (ie, the fetus, membranes, umbilical cord, and placenta) are expelled outside of the uterus. Labor is achieved with changes in the biochemical connective tissue and with gradual effacement and dilatation of the uterine cervix as a result of rhythmic uterine contractions of sufficient frequency, intensity, and duration.
Labor is a clinical diagnosis. The onset of labor is defined as regular, painful uterine contractions resulting in progressive cervical effacement and dilatation. Cervical dilatation in the absence of uterine contraction suggests cervical insufficiency, whereas uterine contraction without cervical change does not meet the definition of labor.
A vaginal delivery is childbirth that happens when the baby is pushed down the birth canal and delivered through the vagina. Every labor and delivery is different. How long labor and delivery lasts and how it progresses varies depending on previous births, the position of the baby’s head, and the size of the baby and the birth canal. There are, however, general stages of labor and delivery that Dr. Monica uses to decide whether it is progressing normally for a vaginal delivery. The 3 stages of labor are:
- First stage: The cervix opens and thins to full dilation. The average woman in her first labor may dilate about 1 cm per hour during the active phase of labor. If you have had a baby before, the cervix usually dilates faster.
- Second stage: The baby moves through the birth canal and is born. This stage of labor usually lasts 15 to 75 minutes but may last as long as 2 or 3 hours.
- Third stage: The placenta (afterbirth) passes through the birth canal and is delivered. This usually happens within 30 minutes after the birth of the baby.
No one can predict with certainty when labor will begin — the due date your doctor gives you is merely a point of reference. It is normal for labor to start as early as three weeks before that date or as late as two weeks after it. The following are signs that labor is probably not far away:
- Lightening – This occurs when your baby’s head drops down into your pelvis in preparation for delivery. Your belly may look lower and you may find it easier to breathe as your baby no longer crowds your lungs. You may also feel an increased need to urinate, because your baby is pressing on your bladder. This can occur a few weeks to a few hours from the onset of labor.
- Bloody show – A blood-tinged or brownish discharge from your cervix is the released mucus plug that has sealed off the womb from infection. This can occur days before or at the onset of labor.
- Diarrhea – Frequent loose stools may mean labor is imminent.
- Ruptured membranes – Fluid gushing or leaking from the vagina means the membranes of the amniotic sac that surrounded and protected your baby have ruptured. This can occur hours before labor starts or during labor. Most women go into labor within 24 hours. If labor does not occur naturally during this time frame, doctors may induce labor to prevent infections and delivery complications.
- Contractions – Although it’s not unusual to experience periodic, irregular contractions (uterine muscle spasms) as your labor nears, contractions that occur at intervals of less than 10 minutes are usually an indication that labor has begun.
Postpartum is the time after the birth of your baby when your body is changing back to normal. It lasts about 6 weeks or until your uterus returns to its normal size. If you are not breast-feeding, you may start having menstrual periods 3 to 10 weeks after delivery. If you are breast-feeding, you may not get your period again until you stop breast-feeding. During this time, you will need to take steps to adjust to your body’s changes and life with a new baby.
- We will give you a list of your medicines when you leave the hospital.
- Know your medicines. Know what they look like, how much should take each time, how often you are to take them, and why you take each one.
- Take your medicines exactly as we tell you to.
- Carry a list of your medicines in your wallet or purse. Include any non-prescription medicines and supplements on the list.
- We may prescribe medicine to:
- Treat pain
- Treat or prevent an infection
- Soften stool and reduce straining with a bowel movement
- Reduce swelling in the area of your rectum
- To relieve the pain in the vaginal area and keep the area clean you can sit in a warm bath, put cold packs on the area, or put warm water on the area with a squirt bottle or sponge.
- To relieve tension headaches that many women develop in the first few weeks after delivering their baby, lie down with a cool damp cloth on your forehead or try relaxation techniques, such as meditation.
- To relieve breast pain and discomfort after your milk comes in (2 to 4 days after childbirth):
- Wear a well-fitting support bra
- If you are breastfeeding, maintain a regular breastfeeding schedule
- If you are not breast-feeding, put ice packs on your breasts and do not stimulate your nipples
- Follow Dr. Monica’s instructions for follow-up appointments for you and the baby.
- Keep appointments for any routine testing you or the baby may need.
- Talk with Dr. Monica about any questions or fears you have.
- Follow the treatment plan Dr. Monica prescribes.
- Follow activity restrictions, such as not driving or operating machinery, as recommended by us, especially if you are taking pain medicines.
- If you had a normal delivery without any problems, you can get back to doing most of your normal activities right away.
- Do not do any heavy lifting or otherwise strain the belly muscles for 4 to 6 weeks.
- Exercise as recommended.
- Get plenty of rest while you’re recovering. Try to get at least 7 to 9 hours of sleep each night. You may find it helpful to try to sleep while the baby sleeps.
- Drink enough fluids to keep your urine light yellow in color, unless you are told to limit fluids.
- Eat a healthy diet.
- Avoid diets which cause you to lose weight very quickly.
- Eat foods rich in fiber to prevent constipation.
- Eat meals on a regular basis.
- Avoid drinks that contain a large amount of caffeine
- If you are breast-feeding, eat at least 1800 calories a day.
- To help prevent bladder infections:
- Practice good hygiene and wipe from front to back after urination and bowel movements.
- Urinate regularly and avoid long waits between the times you empty your bladder.
- Talk to Dr. Monica about methods of birth control you can use after the birth of your baby. You may still be able to get pregnant even if you do not have a period.
- Do not put anything in the vagina, including tampons, or have sex until your provider says it is okay.