Normal Labor and Delivery

Your caregiver must first be sure you are in labor. Signs of labor include:

  • You may pass what is called "the mucus plug" before labor begins. This is a small amount of blood stained mucus.

  • Regular uterine contractions.

  • The time between contractions get closer together.

  • The discomfort and pain gradually gets more intense.

  • Pains are mostly located in the back.

  • Pains get worse when walking.

  • The cervix (the opening of the uterus becomes thinner (begins to efface) and opens up (dilates).

Once you are in labor and admitted into the hospital or care center, your caregiver will do the following:

  • A complete physical examination.

  • Check your vital signs (blood pressure, pulse, temperature and the fetal heart rate).

  • Do a vaginal examination (using a sterile glove and lubricant) to determine:

  • The position (presentation) of the baby (head [vertex] or buttock first).

  • The level (station) of the baby's head in the birth canal.

  • The effacement and dilatation of the cervix.

  • You may have your pubic hair shaved and be given an enema depending on your caregiver and the circumstance.

  • An electronic monitor is usually placed on your abdomen. The monitor follows the length and intensity of the contractions, as well as the baby's heart rate.

  • Usually, your caregiver will insert an IV in your arm with a bottle of sugar water. This is done as a precaution so that medications can be given to you quickly during labor or delivery.

NORMAL LABOR AND DELIVERY IS DIVIDED UP INTO 3 STAGES:

First Stage

This is when regular contractions begin and the cervix begins to efface and dilate. This stage can last from 3 to 15 hours. The end of the first stage is when the cervix is 100% effaced and 10 centimeters dilated. Pain medications may be given by

  • Injection (morphine, demerol, etc.)

  • Regional anesthesia (spinal, caudal or epidural, anesthetics given in different locations of the spine). Paracervical pain medication may be given, which is an injection of and anesthetic on each side of the cervix.

A pregnant woman may request to have "Natural Childbirth" which is not to have any medications or anesthesia during her labor and delivery.

Second Stage

This is when the baby comes down through the birth canal (vagina) and is born. This can take 1 to 4 hours. As the baby's head comes down through the birth canal, you may feel like you are going to have a bowel movement. You will get the urge to bear down and push until the baby is delivered. As the baby's head is being delivered, the caregiver will decide if an episiotomy (a cut in the perineum and vagina area) is needed to prevent tearing of the tissue in this area. The episiotomy is sewn up after the delivery of the baby and placenta. Sometimes a mask with nitrous oxide is given for the mother to breath during the delivery of the baby to help if there is too much pain. The end of Stage 2 is when the baby is fully delivered. Then when the umbilical cord stops pulsating it is clamped and cut.

Third Stage

The third stage begins after the baby is completely delivered and ends after the placenta (afterbirth) is delivered. This usually takes 5 to 30 minutes. After the placenta is delivered, a medication is given either by intravenous or injection to help contract the uterus and prevent bleeding. The third stage is not painful and pain medication is usually not necessary. If an episiotomy was done, it is repaired at this time.

After the delivery, the mother is watched and monitored closely for 1 to 2 hours to make sure there is no postpartum bleeding (hemorrhage). If there is a lot of bleeding, medication is given to contract the uterus and stop the bleeding.