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Labor and Delivery

Labor and Delivery

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Labor and Delivery

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  1. Labor and Delivery

  2. Stages of Labor • The stages of labor are often thought to be a mystery. In all honesty it is a mystery in many ways. Each woman will have a different labor and yet many parts are the same.

  3. Stages…1-4 • Stage 1-Labor ends by being fully dilated. • Stage 2- Pushing, and the birth of your baby • Stage 3- Birthing the placenta. • Stage 4-Postpartum

  4. First Stage –three phases • 1. "Yippy! I'm in labor!" The early phase of labor may be spent wondering "Is this really labor?" The contractions are usually very light and may be 20 minutes or more apart in the beginning, gradually becoming closer, possibly up to five minutes apart. The key to this stage is to go about your normal schedule or if it's the middle of the night go back to bed! Most women will be very comfortable during this stage and with a few exceptions those having a hospital birth will not be in the hospital at this point.

  5. First Stage-phase 2 • Active Phase • "This is hard work." The active phase of labor is where many women are getting serious and withdrawing to do the hard work of labor. Contractions generally are four or five minutes apart and may last up to 60 seconds long. Remember this still gives you a big break in between • For woman who desire medications in labor they will usually go to the hospital in this stage of labor, while those desiring little or no medications will go towards the end of this stage or the beginning of transition, again, with a few exceptions. Mobility and relaxation are the key to getting through active labor.

  6. First Stage- phase 3 • Transition Phase • "Okay, I'll go home and come back tomorrow!" This is one of the shortest parts of labor, but definitely one of the hardest. Your contractions may be two or three minutes apart, lasting up to a minute and a half. Some women will shake and may vomit during this stage. This is normal. Remember that this stage usually doesn't last more than an hour or two. When this phase is done you will be completely dilated! Some women will have a small break of no contractions after becoming fully dilated, and yet not feeling the need to push yet.

  7. Stage 2 • “I can push?" • Pushing usually feels better for most women. They have spent the first stage of labor relaxing and letting their body do all the work, now they can actually do something to help. This stage can last three or more hours, but for many women will not. The length of this stage is dependent upon the positioning of the mother (upright = faster), the positioning of the baby, whether medications have been used, etc. The contractions will usually space out a bit, going back to about four minutes apart. This stage ends with the birth of your baby!

  8. Stage 3 • Birthing the Placenta • After you are holding your beautiful baby, you may be asked to push again after some point, and you might be puzzled. Oh yes, the placenta! Don't worry this one has no bones and is much easier to push out. Nursing your baby after he or she is born will help the uterus to contract and expel the placenta, but most come within an hour after birth, usually within a few minutes.

  9. Stage 4 • Fourth Stage • "I asked for this?" • No real contractions to speak of, but postpartum is generally accepted as the fourth stage of labor. Your body is going through many changes now that the baby has been born. Not to mention the large changes your family is going through adding a new person to your family. Be sure to ask for help. Your body will slowly change and become more like your pre-pregnancy self, but not exactly.

  10. Recap • Stage 1-Labor ends by being fully dilated. • Stage 2- Pushing, and the birth of your baby • Stage 3- Birthing the placenta. • Stage 4-Postpartum

  11. Labor Positions • • Hands-and-Knees Positions • These childbirth positions, which include the "crawl" and the "full moon", are beneficial for back labor, turning a posterior baby, and for birthing a large baby. • Sitting Positions • Sitting positions let you combine the helpful force of gravity with relaxation.  You can use a birth ball, rocking, or toilet sitting to rest while gravity helps labor progress. • Squatting Positions • Squatting positions are helpful in opening the pelvis to allow a baby to find the optimal position for birth.  Squatting can be performed through use of a birth companion or a tool such as a squatting bar. • Side-Lying Positions • Side-lying positions are beneficial for resting during a long labour, promoting body-wide relaxation, and minimizing extra muscular effort.  They are best used in the latter stages of labor since gravity isn't able to speed the process. • Upright or Standing Positions • Upright positions for childbirth use gravity to the mother's advantage.  They help the baby drop into the pelvis and prevent pressure from being concentrated in a particular spot.  They also allow the birth companions to apply other comfort measures easily.  They represent the most underused birth positions.

  12. Important Terms • Breech- breech birth is the birth of a baby from a breech presentation. In the breech presentation the baby enters the birth canal with the buttocks or feet first as opposed to the normal head first presentation. • Ruptured Membranes-Amniotic Sac ruptures • Cesarean Section- known as C-section or Caesar, is a surgical procedure in which incisions are made through a mother's abdomen and uterus to deliver one or more babies. It is usually performed when a vaginal delivery would put the baby's or mother's life or health at risk, although in recent times it has been also performed upon request for childbirths that could otherwise have been natural • Epidural/Spinal- short for epidural anesthesia, a form of anesthesia involving injection of drugs through a catheter placed into the spinal cord. • Episiotomy- incision through the perineum made to enlarge the vagina and assist childbirth. The incision can be midline or at an angle from the posterior end of the vulva, is performed under local anesthetic and is sutured closed after delivery.

  13. Birthing Options •

  14. C-Section •

  15. C-Section • Cesarean Section • •

  16. Water Birth •

  17. Assisted Delivery • • When delivery is assisted with either forceps or vacuum extraction, some form of anesthesia is administered before the forceps or vacuum is applied. Assisted deliveries should be discussed with your physician or midwife, however, a physician performs assisted deliveries. • ForcepsForceps are instruments that are placed on the baby's head to turn the baby and/or assist the mother with delivery. Forceps are most commonly used when the baby is in the lower portion of the vaginal outlet (low forceps delivery). Only on rare occasions would forceps be applied in a higher position. If forceps marks (small reddened areas on the baby's cheeks) appear, they tend to fade quickly. • Vacuum ExtractorSuction is applied to the baby's head to help turn his head and/or assist with delivery. The baby may have a bruise on the area in which the suction cup was attached. This bruise will gradually fade.

  18. Doula • A doula is someone experienced in helping women cope with labor, birth and the postpartum period. A doula is generally not medically trained, and so she will not examine you or perform any medical or clinical tasks. She will, however, support you throughout your labor and birth, helping you to breathe, helping you to manage your pain. • A doula can also offer your partner or others supporting you during labor suggestions on how to help comfort you. • Doulas are also available for a while after your birth to make sure that you are comfortable, that you have everything you need and to help you get started nursing.

  19. Midwife • A midwife may deliver your baby in your home or in a hospital. This depends in part upon her credentials. Midwives can be accredited or non-accredited. Accredited midwives generally have the option of performing hospital or home births, whereas non-accredited midwifes traditionally practice only within the home. • Most certified midwives have accreditation that includes schooling and apprentice. A certified nurse midwife usually also requires an RN and BSN degree, though there are exceptions to the rule. Depending on a midwife’s credentials, they may deliver your baby in a hospital or in your home.