Classes
Questions about Class 3: Labour and Birth
Question 1 -
How do we know it is time to go to the hospital?
Most new mothers worry that they won't know when to go to the hospital. Sometimes it can be hard to judge, as each labour is different, but here are a few guidelines. In the Calgary Health Region, most caregivers advise expectant mothers to go to the birth centre when:
- contractions have been 5 to 7 minutes apaprt for one hour, if this is your first baby. If it is not your first baby, go to the birth centre when your contractions are 7 to 10 minutes apart.
- contractions are becoming stronger and you're no longer comfortable at home.
- your membranes have ruptured.
- there is a decrease in your baby's mvements.
- there are abnormal signs such as vaginal bleeding or signs of preterm labour.
Trust your instincts!
Question 2 -
I thought labor always starts with the water breaking. That seems to be how it happens on television shows
Water breaking, or "rupture of membranes," occurs as a first sign of labor in only 10-12% of births. It usually happens much later - in active labor. In fact, it may take so long that your caregiver might propose the option of rupturing the membranes for you!
Question 3 -
I'm really excited about becoming a new Dad, but I'm completely freaked out about getting her to the hospital at the right time. Is it possible to get there too early?
On television, we get the impression that we should race to the hospital after her first contraction. In actual fact, research has shown that being at the hospital before she's in solid active labor is associated with significantly higher chances of having a C-section. If your doctor has given you specific guidelines about when to come in, follow those. But, if she's had a normal, low-risk pregnancy and your doctor has not given special instructions for when to come in, these are some additional guidelines that many doulas and midwives find apply to most laboring women in solid active labor:
- She can't walk or talk during a contraction
- She's not concerned about her appearance, and less concerned with modesty
- Between contractions, she's not experiencing pain, but she's quiet and focused - not into chatting
NOTE: If you notice that she's grunting or "bearing down" during a contraction, phone 911. This is a precaution. In all likelihood, she will still make it to the hospital to deliver her baby.
Question 4 -
I'm feeling really worried that I won't be able to handle the pain of contractions. Why do they have to hurt?
While few mothers would argue that contractions can be rather painful, understanding what causes them and knowing that they are a natural and necessary part of this "bodily function" and can help. The sensations associated with contractions are related to three main sources:
- The contracting, or shortening, of uterine muscle fibers as they "pull up" and dilate (open) the cervix. The calf cramps you may be experiencing at night are very similar - it really hurts, but you know it's not damaging you.
- The pressure of the baby's head on the cervix as the uterus pushes the baby down. This is essential to help the cervix thin out. Without that pressure, the labor will take much longer!
- The pressure on the pelvic bones and strain on the ligaments around the pelvis as it opens to make more space for the baby. The hormone "relaxin" has been at work in your body for months loosening your ligaments so that they can safely stretch.
Try to remember that contractions aren't the enemy - something to be feared or to fight against. Welcome each contraction, and hope that it's strong! A strong contraction means that the positive work of labor is being done, and you'll meet your baby sooner.
Question 5 -
I've heard that women sometimes have a bowel movement when pushing. How common is that?
Giving birth feels a lot like having a rather large bowel movement! This makes sense because the rectum is located right behind the birth canal and the baby's head puts pressure on it. In fact, for many women the first sign that the 2nd stage is starting is the sensation of needing to have a bowel movement. While a small amount of stool may be expelled when some women are pushing, remember that many women experience frequent loose bowel movements when labor begins. Your body cleans itself out in preparation! Even if it does happen, your caregiver will take care of it quickly and no one will notice. The bottom line is that worrying about it might make your pushing efforts less effective - you can't tighten the muscles in your bottom without also blocking baby's exit!
Question 6 -
I read that the birth canal is only 4 cm long. Why does it take so long to move the baby that short distance?
Unlike other mammals, the human birth canal is curved, and requires some maneuvering on the part of the baby. The baby enters the birth canal with his chin tucked. As he descends, he turns his face toward Mom's tail bone, and tips his head back as he comes around the corner. Once emerged, he turns his head back to align with his body for the birth of his shoulders. It's interesting to note that if you're laying on your back, the "corner" turns into a "hill". You and your baby must both work against gravity to get the baby up the hill and out. Also, the ligaments around your pelvis have loosened to allow for more opening, and also to allow the tailbone to act like a "trap door" as the baby's head moves past. Can it swing open if you're laying on it? Can you think of other positions that might make the job easier for both of you? You may feel the urge to be in a particular position, or if you're not sure, your caregivers can help you get into "gravity enhancing" positions that help the baby move through the birth canal with greater ease. Positions that involve squatting can create as much as 15% more space in the pelvis. You may also find changing positions frequently helpful.
Question 7 -
How long will I have to wait before I can hold my baby?
That depends on a number of factors. If the baby has experienced distress during the labor, the medical team may like to take the baby for closer observation as a precaution. You'll be reunited as soon as possible. In other cases, Mom may not be ready to hold the baby right away due to being very tired, or receiving stitches, for example. (NOTE: In these circumstances, Dads or others can provide an excellent "second best"!)
In most cases, however, Mom and baby are both ready to begin interacting immediately. Studies have repeatedly shown that mothers and babies do best when routine medical procedures are delayed and they spend time together right after birth - especially when they are skin to skin. Babies warm immediately to just the right temperature, and their heart and breathing rates become regular and stable. They cry very little, if at all. Mothers' vital signs also stabilize nicely when the pair is in skin to skin contact. The baby will instinctively look for the breast, and when she suckles, Mom's body will be stimulated to release oxytocin. This will help expel the placenta and stop any excessive bleeding.
You will notice how alert your baby is. He will even search for your face when you talk. Babies recognize the voices they heard regularly in the womb! If you and your baby can't be together right away, don't fret. As soon as you're able to hold your baby, remove her blankets and snuggle skin to skin. You can still experience this special bonding, even if it's delayed.
Most new mothers worry that they won't know when to go to the hospital. Sometimes it can be hard to judge, as each labour is different, but here are a few guidelines. In the Calgary Health Region, most caregivers advise expectant mothers to go to the birth centre when:
- contractions have been 5 to 7 minutes apaprt for one hour, if this is your first baby. If it is not your first baby, go to the birth centre when your contractions are 7 to 10 minutes apart.
- contractions are becoming stronger and you're no longer comfortable at home.
- your membranes have ruptured.
- there is a decrease in your baby's mvements.
- there are abnormal signs such as vaginal bleeding or signs of preterm labour.
Trust your instincts!
Water breaking, or "rupture of membranes," occurs as a first sign of labor in only 10-12% of births. It usually happens much later - in active labor. In fact, it may take so long that your caregiver might propose the option of rupturing the membranes for you!
On television, we get the impression that we should race to the hospital after her first contraction. In actual fact, research has shown that being at the hospital before she's in solid active labor is associated with significantly higher chances of having a C-section. If your doctor has given you specific guidelines about when to come in, follow those. But, if she's had a normal, low-risk pregnancy and your doctor has not given special instructions for when to come in, these are some additional guidelines that many doulas and midwives find apply to most laboring women in solid active labor:
- She can't walk or talk during a contraction
- She's not concerned about her appearance, and less concerned with modesty
- Between contractions, she's not experiencing pain, but she's quiet and focused - not into chatting
NOTE: If you notice that she's grunting or "bearing down" during a contraction, phone 911. This is a precaution. In all likelihood, she will still make it to the hospital to deliver her baby.
While few mothers would argue that contractions can be rather painful, understanding what causes them and knowing that they are a natural and necessary part of this "bodily function" and can help. The sensations associated with contractions are related to three main sources:
- The contracting, or shortening, of uterine muscle fibers as they "pull up" and dilate (open) the cervix. The calf cramps you may be experiencing at night are very similar - it really hurts, but you know it's not damaging you.
- The pressure of the baby's head on the cervix as the uterus pushes the baby down. This is essential to help the cervix thin out. Without that pressure, the labor will take much longer!
- The pressure on the pelvic bones and strain on the ligaments around the pelvis as it opens to make more space for the baby. The hormone "relaxin" has been at work in your body for months loosening your ligaments so that they can safely stretch.
Try to remember that contractions aren't the enemy - something to be feared or to fight against. Welcome each contraction, and hope that it's strong! A strong contraction means that the positive work of labor is being done, and you'll meet your baby sooner.
Giving birth feels a lot like having a rather large bowel movement! This makes sense because the rectum is located right behind the birth canal and the baby's head puts pressure on it. In fact, for many women the first sign that the 2nd stage is starting is the sensation of needing to have a bowel movement. While a small amount of stool may be expelled when some women are pushing, remember that many women experience frequent loose bowel movements when labor begins. Your body cleans itself out in preparation! Even if it does happen, your caregiver will take care of it quickly and no one will notice. The bottom line is that worrying about it might make your pushing efforts less effective - you can't tighten the muscles in your bottom without also blocking baby's exit!
Unlike other mammals, the human birth canal is curved, and requires some maneuvering on the part of the baby. The baby enters the birth canal with his chin tucked. As he descends, he turns his face toward Mom's tail bone, and tips his head back as he comes around the corner. Once emerged, he turns his head back to align with his body for the birth of his shoulders. It's interesting to note that if you're laying on your back, the "corner" turns into a "hill". You and your baby must both work against gravity to get the baby up the hill and out. Also, the ligaments around your pelvis have loosened to allow for more opening, and also to allow the tailbone to act like a "trap door" as the baby's head moves past. Can it swing open if you're laying on it? Can you think of other positions that might make the job easier for both of you? You may feel the urge to be in a particular position, or if you're not sure, your caregivers can help you get into "gravity enhancing" positions that help the baby move through the birth canal with greater ease. Positions that involve squatting can create as much as 15% more space in the pelvis. You may also find changing positions frequently helpful.
That depends on a number of factors. If the baby has experienced distress during the labor, the medical team may like to take the baby for closer observation as a precaution. You'll be reunited as soon as possible. In other cases, Mom may not be ready to hold the baby right away due to being very tired, or receiving stitches, for example. (NOTE: In these circumstances, Dads or others can provide an excellent "second best"!)
In most cases, however, Mom and baby are both ready to begin interacting immediately. Studies have repeatedly shown that mothers and babies do best when routine medical procedures are delayed and they spend time together right after birth - especially when they are skin to skin. Babies warm immediately to just the right temperature, and their heart and breathing rates become regular and stable. They cry very little, if at all. Mothers' vital signs also stabilize nicely when the pair is in skin to skin contact. The baby will instinctively look for the breast, and when she suckles, Mom's body will be stimulated to release oxytocin. This will help expel the placenta and stop any excessive bleeding.
You will notice how alert your baby is. He will even search for your face when you talk. Babies recognize the voices they heard regularly in the womb! If you and your baby can't be together right away, don't fret. As soon as you're able to hold your baby, remove her blankets and snuggle skin to skin. You can still experience this special bonding, even if it's delayed.
