Normal Delivery

You can choose who you would like to be with you during labor and delivery. You will need to take into consideration the guidelines of your hospital or birthing center. Most hospitals and birthing centers encourage women to have a support person. Your birth assistant should be focused on helping you by guiding you through relaxation and comfort techniques during labor. Your partner or support person should also know how you feel about the use of medications and invasive procedures, so your wishes can be communicated even if you are too preoccupied to speak for yourself. During the birth, you may appreciate having your support person encourage you, sponge your forehead, or support your legs or shoulders.

A nurse will be your primary caretaker for the whole time you are in the hospital or birthing center, and your doctor or midwife usually arrives when you go into active labor. So that you will know what to expect, you should talk with your midwife or doctor about when they will be with you during labor and birth. In some hospitals, there are also student nurses and doctors who may ask to help with the birth. You can let your nurse or doctor know if this is okay with you.

once your cervix is completely dilated (open to 10 cm), you will be encouraged to start pushing. If you have not received pain medication, the urge to push is usually strong. Pushing will give you a burst of energy. For most women, it feels better to push than not to push. Pushing is done instinctively and as hard as the mother feels necessary.

If you have had an epidural, you will be numb from most pain experiences, but you will still feel pressure. You may or may not have the urge to push. Your muscle coordination will be a little more difficult to organize into effective pushing. You may have to rely on your nurse, nurse-midwife, or doctor to help guide your pushing efforts. Most women with epidurals push very effectively and will not need the assistance of forceps or a vacuum extractor to deliver their babies. If you are very numb, sometimes the nurse or doctor will encourage you to rest comfortably while the uterus continues to push the baby downward. After a while, the epidural will be less powerful, you will feel more able to push, the baby will be further down the birth canal, and delivery can proceed.

To push effectively, you will need to take a deep breath and hold it in your lungs, put your chin on your chest, and pull your legs toward your chest while bearing down. The same instructions apply if you are squatting. Women use the same muscles to push out a baby as they do to push out a bowel movement. Those particular muscles are very strong and effective in helping deliver a baby. If they are not used, it can take considerably longer to deliver.

Some women are afraid of accidentally passing some stool if they use these muscles to push. This is a frequent occurrence and you should not be embarrassed if it happens. The nurse will quickly clean it up. After all, everything else has to get out of the way to allow the birth of the baby.

The time it takes to push the baby through the birth canal, under the pubic bone, and to the vaginal opening depends on a number of factors. It can take a woman anywhere from a few minutes to hours to push your baby. The timing varies depending on the factors discussed below.

The first variable is whether this is your first vaginal delivery (even if you have had a cesarean section before). Your pelvic muscles are tight when they have never been stretched to accommodate the birth of an infant. The process of your muscles stretching to accommodate the birth can be slow and steady. It usually will not take as long to push the baby out during subsequent deliveries. Some women who have had a few babies may push only one or two times to deliver the baby because the muscles have been stretched before.

The second factor is the size and shape of the mother’s pelvis. Pelvic bones can vary quite a bit in size and shape. A nice, large round opening is ideal. Some pelvic openings may be large and some small, but infants can navigate most of them well. While rare, some openings are too narrow for even a small infant to get through. If you have been told you have a small pelvis, you will be encouraged to labor and give your pelvis a chance to stretch as the infant starts the descent to the pelvic opening.

The third factor is the size of the infant. Infants have skull bones that are not fixed in a permanent shape. These bones are able to shift and overlap during the delivery process. When this happens the infant will be born with a somewhat elongated head, affectionately referred to as a “cone-head.” The head will return to a round shape within a day or two. An infant’s head may be larger than the mother’s pelvis can accommodate, but this is not usually apparent until vaginal delivery has been attempted. Most mothers are given the opportunity to delivery vaginally first, depending on any projected complications. Also, if a woman has had a cesarean birth before, there is a greater risk for rupture of the uterus. Some physicians may recommend another cesarean delivery instead of a vaginal birth.

A fourth factor is the position of the baby’s head within the pelvis. For normal vaginal delivery, the baby should be in position to exit the womb headfirst. Facing back toward the tailbone is the ideal situation. This is called ananterior position. When the baby is facing up toward the pubic bone (called aposterior position), the labor may be slower and the mother may feel more back pain. Babies can be delivered facing upward, but sometimes they need to be rotated to an anterior position. Pushing usually takes longer when the baby is in a posterior position.

The fifth factor is the force of the labor. Forcerefers to how strong the contractions are and how hard the mother pushes. Contractions help the cervix to dilate and if they have been strong enough to dilate the cervix completely, they should be strong enough to help you birth your baby. With good pushing and a good balance of the other factors, the infant will most likely deliver within an hour or two of pushing. It can happen sooner and it can take quite a bit longer. Don’t be discouraged-keep working!

Sometimes, the baby needs extra help in getting out. Even though you may be pushing with all the strength you can muster, your energy may have waned, and because of fatigue, your pushing may not be strong enough to deliver the baby. Alternatively, it may be a tight fit or the baby may need to be rotated to a better position in order to squeeze out. After two to three hours of good pushing, your nurse or doctor may opt to guide the baby out with an instrument while you continue to push.

The instruments that may be used in these situations are the forceps and the vacuum extractor. They should not be used unless the baby can be seen and reached easily. Your doctor will not “pull” the baby out. The baby will be guided while you continue to push.

An episiotomy is a cut at the base of the vagina to make the opening for the baby larger. In the past, doctors believed that every woman needed an episiotomy to deliver a baby. According to Sutter Health, the national episiotomy rate for first-time mothers is less than 13 percent. However, nearly 70 percent of women giving birth for the first time experience a natural tear. At present, episiotomies are performed only in certain cases, including:

when the baby is having distress and needs help getting out fast
when there is tearing of the tissues upward into sensitive areas such as the urethra and clitoris
if after pushing for a long time, there is no progress in stretching or toward delivery
No one can predict whether or not you will need an episiotomy. There are some things you can do to help decrease the chances that you will need an episiotomy. However, there are certain factors you cannot control, such as the size of your baby.

Eating a well-balanced diet and periodically stretching the vaginal area during the four weeks before your due date can lower your changes of needing an epistomy. Your doctor may apply warm compresses to your vaginal opening or warm mineral oil, which can soften your skin and help your baby come out more easily.

Small skin tears may be less painful and heal faster than an episiotomy. In some cases, an episiotomy may not be performed, but the mother may still need a few small stitches.

For repair of an episiotomy or tears, doctors use sutures that dissolve so that they won’t need to be removed. You may also experience itching as the skin heals.

When the cervix is fully dilated (about ten centimeters), contractions help the baby begin to move from the uterus into the vagina. The vagina leads from the cervix to the outside of your body. The inside of your vagina has many folds, called rugae, which unfold as the baby passes through.

In fact, most women do poop during labor. It can happen more than once while you’re pushing, but it’s most common right before the baby crowns. The bottom line: Don’t worry about it. It’s all in a day’s work for a labor room pro, who will clean it up with some gauze or a clean towel.

If you’re a first-time mum, active labour may take about eight hours. This is an average, though, and it could be much shorter or longer than that. It’s unlikely to last more than 18 hours. Once your cervix has dilated to 10cm, it could take you an hour or two hours of pushing before your baby is born.

Yes, childbirth is painful. But it’s manageable. In fact, nearly half of first-time moms (46 percent) said the pain they experienced with their first child was better than they expected, according to a nationwide survey commissioned by the American Society of Anesthesiologists (ASA) in honor of Mother’s Day.

Early real labor contractions could feel like strong menstrual cramps, stomach upset or lower abdominal pressure. Pain could be in the lower abdomen or both there and the lower back, and it could radiate down into the legs.

10 Simple Ways To Prepare Your Body For A Smooth Vaginal Delivery
You can prepare your body for a smooth vaginal delivery by being mindful of a few things:

Labour is a long and arduous process, but if the body and mind is prepared for it, vaginal birth need not be a stressful and traumatic experience. Here are some tips to ensure you have a smooth birthing experience.

1. Start early. Ensure healthy eating habits for both spouses for 3 to 6 months prior to conception. Get a complete checkup done to ensure all nutrient levels are normal. Women can take a multivitamin and a folic acid supplement three months prior to conception. Men should also take a multivitamin supplement which has a higher zinc content.

2. Make sure you complete all your prenatal visits and tests as scheduled.

3. Follow a healthy diet even during pregnancy. A fit body will be able to handle the rigors of labour a lot more easily.

4. Exercise regularly. Do check with your doctor before you begin. A walking program is easy to follow and, if possible, register for a prenatal exercise class.

5. Relaxation and meditation will not only help you be calm during pregnancy, but can also be a great pain-management tool during labour. Practise various relaxation techniques along with your spouse through the pregnancy.

6. The fetal position is very important to the birthing process. If the baby is malpositioned then a vaginal birth can become difficult or impossible. Be alert and aware of your baby’s position. Your baby should be in the head down position by about Week 32. If the baby is not in the right position then you may need to do some optimum fetal positioning sessions.

7. Be Positive. This one is very important. Negative thoughts will only hamper your plans for a vaginal birth. Staying positive and surrounding yourself with people who help you stay upbeat and happy will definitely help.

8. Avoid Information overload. You do need to have the right information, but not an overload of information. Discuss your queries with your doctor or you prenatal coach. A good prenatal class will help you with customised information and query resolutions.

9. Do not be passive during labour. Walk and move around and try to be in an upright position for as long as possible.

10. If you are comfortable, avoid pain medications. These can confine you to the bed and make you lose mobility. Instead, practise the relaxation techniques you learned in your prenatal classes for pain management.