ABOUT Labor Delivery

Stages of Labor and Occasional Complications

 

Congratulations! Your baby’s time has come! This is an experience you will remember forever, whether it is your first or a later one!

First, be assured that you can do this fine! This is a very natural process. Countless women through time have done this successfully. You are no different. So just allow your body to do what it already knows how to do. The whole thing will be over in a matter of hours, or perhaps a day in some cases. It may be challenging emotionally and physically – or not.  In either case, it will pass over and then you can rest.

Everyone is different in how they respond to labor and delivery. Indeed, it varies from pregnancy to pregnancy in the same individual.

The first event is when your water breaks. This is fluid from the “amniotic sac”, the fluid inside that surrounds your baby. Usually labor begins shortly thereafter, so that is when you want to call the midwife or go to the hospital where you plan to have your baby.

In the off chance that labor doesn’t start within hours, it is ok to just wait. As time goes on, however, there is an increasing chance of infection, so most doctors will want to induce labor within 18 or maybe 24 hrs (practices vary around the world).

A simple way to do this is to use our module to be found at eremedyonline.com/module/28/labor-delivery/. You will be asked some questions on your computer or cellphone (or perhaps your midwife or nurse or family member can ask you). Answers to these questions leads the expert system to choose the correct eRemedy in your unique case. Then you play this audio file according to the protocol recommended directly on your cellphone or computer. We expect that to initiate a strong labor right away.

 

Stage 1: Early labor and Active Labor

Labor begins with contractions. These are muscular actions that gradually push on your baby to move him/her down the canal and to dilate the opening of the uterus so the baby can pass through.

Here is a diagram to give you a visual image of the process:

 

You see the baby with head down inside the uterus. The opening at the bottom of the uterus (and at the top of the baby’s head) is closed in this image – it is called the “cervix”, and the small opening is the “cervical os.” This opens into your vagina. Other structures toward the back are the rectum and spine.

The goal of labor is for the uterine muscles to push the baby’s downward, to dilate the cervical os so that the baby’s head can pass out of the uterus and into the vaginal canal. The vagina has huge capacity to stretch, so you need not worry.

This first stage of labor is the longest. It begins with Early Labor during which contractions are irregular at first and then settle into a rhythm. Usually they are mild and do not stop you from doing  simple household chores, taking a walk, or even napping. Contractions are usually 30 to 90 seconds long and eventually become less than five minutes apart. This phase can last six to twelve hours for first moms and can be only a few hours with more experienced moms. Be sure to stay hydrated and pace your energies.

If this process becomes either too slow (too weak contractions) or too rapid and intense, there are eRemedies that can normalize the process rapidly. For this help, go to eremedyonline.com/module/28/labor-delivery/ .

The risk of too slow development of contractions is not serious, just exhausting. After membranes rupture, there can be an increased chance of infection.  On the other hand, too rapid or too intense progress can lead to tears in the vagina, and too intense pressure on the baby’s head. 

Progress at this stage is measured primarily by “cervical dilation” which is determined by the doctor or midwife’s palpitation by a gloved hand. It is measured in percentage; 100% is called “complete effacement.”

 

Second stage: Vaginal delivery

Once the cervix is fully effaced, contractions push the baby’s head into the vagina. There can be a little discomfort at this stage because the vagina has a lot of sensory nerves. However, the usual experience is that there is so much adrenaline and effort with contractions that this discomfort is not an issue.

The baby’s head is gradually pushed through the vaginal canal to the pelvic opening.

As the baby’s head widens the vaginal opening, called “crowning”, there is a spontaneous urge to use abdominal muscles to push downward along with the contractions. Helpers will urge you to do this with all your might. This effort usually does not last very long but does involve effort.

 

The baby at birth

Once the baby is out, the umbilical cord is still attached from the baby’s abdomen to the placenta inside the uterus. During pregnancy, vessels in the umbilical cord supply all the nutrients and oxygen to the baby. After birth, these vessels spontaneously close off. The doctor or midwife will put two clamps a half inch or so apart to finish this closing off, and then cut between the clamps. This separates the baby from the mother. This triggers the baby to take his or her first breath – an exciting moment for everyone in the room!

Once the baby has a first breath, and usually a cry, his/her color turns from purple-blue to pink showing that there is good oxygenation. The baby is also covered with a protective cheesy waxy substance called “vernix.” Most of this is wiped off, so the baby looks clean and healthy!

 

Third stage: Delivery of the Placenta

Once the baby has been delivered, there are natural reflexes causing the uterus to clamp down on the empty space and in the process to expel the placenta. There may be some bleeding associated with this process, yet not enough to pose a problem. Expelling the placenta is very similar to expelling the baby, even involving further contractions.

Once the placenta is expelled, the uterus clamps down on itself. This stops further bleeding.

 

Complications of Labor and Delivery

Once again, having a baby is a very normal process. Everything follows in sequence automatically. Every woman is capable of the process, so feel confident.

Nevertheless, even such a natural process can have glitches. These are easily managed by an obstetrician or midwife. They are trained to recognize these situations and what to do about them. For many of these, eRemedies can be a useful assistance. This module can be found at eremedyonline.com/module/28/labor-delivery/. Just answer preliminary and followup questions, followed by playing the eRemedies on cellphone or computer according to the recommended schedule.

Delayed or weak labor, as well as too rapid or intense a labor, have been mentioned as part of the Stage 1 description.

One fairly common complication can be “malpresentation” in which the baby’s position is not normal. Usually the baby’s head comes down into the pelvic canal first.

 

 

Sometimes the baby’s head will have what’s called a “posterior presentation” in which the face is facing forward. This can be trickier but usually not a big problem.

If the baby is aligned with butt down first, this is called a “breech presentation.”

 

This can present obvious difficulties,  so the midwife or obstetrician will use manual massage techniques to try to turn this around. An eRemedy can also be helpful in this specific situation – found at eremedyonline.com/module/28/labor-delivery/. It is possible to do a breech delivery in normal fashion, but this does involve special training and technique. Sometimes the option will be to do a Caesarean section (“C-section”), which is surgery done through the abdomen in sterile conditions.

During some of these presentations, or if the canal is tight for the size of the head, the midwife or obstetrician may use simple instruments called forceps to grasp the head and help pull the baby out. This is a safe procedure.

In any of these complications, there might be tearing, bruising, and swelling of tissues around the vagina and the opening to the vagina.  Suturing may be required to help the tissues heal in a normal configuration. Healing does occur with time and nearly always leaves no later difficulties. Bruising and swelling can be helped by eRemedies at eremedyonline.com/module/28/labor-delivery/. Rarely, the pelvic wall can be weakened by childbirth causing prolapse of the uterus or leakage of urine with exertion (called “stress incontinence”). These can be helped by exercises called “kegels” and by a mechanical device called a “pessary.” Sometimes surgery may be needed, but this is not usual.

Sometimes the baby can have distress after birth. The cord may be wrapped around the neck at birth, too much mucous might obstruct airways, or even infection may cause the “meconium” (birth mudous) to be breathed into the lungs. Commonly these problems are dealt with immediately with lasting problems, but occasionally the newborn might need to spend some time in a hospital Newborn Intensive Care Unit. Most difficulties involving breathing or shock-like reactions can also be helped by eRemedies found at eremedyonline.com/module/28/labor-delivery/.

Another complication that can happen can be “retained placenta.” In this case, the placenta doesn’t come out properly, or fragments may be left inside. This can lead lead to excessive bleeding and sometimes even infection after some time. It is urgent to finish this process, so the midwife or obstetrician may reach inside with a gloved hand to scrape out the remaining placenta. Very rarely, surgery could be required. Again, there are eRemedies that can help with this condition – found at eremedyonline.com/module/28/labor-delivery/.

Even without retained placental fragments, bleeding can continue for days and rarely weeks after delivery. There are various possible causes for this. If it is not excessive bleeding, the usual recommendation is to just wait it out. eRemedies can help in this circumstance. They can be found at eremedyonline.com/module/28/labor-delivery/.

There can be vaginal discharge lasting days or weeks after delivery, sometimes foul-smelling and/or blood-tinged. This can represent local infection, though rarely does it require antibiotics. There are eRemedies that can bring about rapid relief at eremedyonline.com/module/28/labor-delivery/.

 

Finally, and of significant urgency, you might get what is called “puerperal fever.” This is a generalized infection spread throughout the body that can become quite serious if not treated immediately. Definitely a doctor should be consulted if available. Antibiotics and perhaps hospitalization will be required. Meanwhile, eRemedies can be a help – found at https://www.eremedyonline.com/module/28/labor-delivery/.