Tuesday, September 22, 2020

Labor and Delivery: How to Plan Your Childbirth

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Labor and Delivery Options

As an expectant mother, you have the option to give birth where and how you want. There are number of different options on giving birth. Options largely depend on your personal preference, the recommendation of your doctor and your overall health.

Hospital Births

Hospital births are often considered to be the best option for delivery due to the best medical technology available to take care of you and your baby throughout labor and delivery. Hospitals have easy access to machines, well-trained nurses, well-trained doctors and are capable of handling medical emergencies that can arise during birth.

Home Birth

While not too common in the United States, home births are common practices in many parts of the world. If you have had a trouble-free pregnancy, a home birth can be just as safe as a hospital birth. Home births allow you to have the comforts of your own home along with familiar faces to help support you. Home births are not recommended for individuals prone to high blood pressure, diabetes and heart problems.

Birthing Centers

Birthing centers often provide more personalized levels of attention as well as modern technology to help ensure your safety as well as the safety of your baby. Many birthing centers have nurse midwives who have had certified training in child birth. Birth centers often encourage natural births and are often not recommended for high-risk pregnancies. In the event of an emergency, some birthing centers are equipped to handle problems while others may transport you to the nearest hospital.

Midwives Clinics

Midwives clinics are run by certified nurse midwives. These centers often have a home-like feel to them and are more relaxed than hospitals.

Methods of Giving Birth

There are multiple options when it comes to giving birth. Some moms-to-be may opt for more traditional options, while others opt for more modern methods of delivering their babies.

Vaginal Birth

Vaginal births are the most common method of giving birth to a child. Women who give birth vaginally often have an easier time breastfeeding and spend less time in the hospital. There are also fewer risks associated with a vaginal birth compared to a c-section. With a large number of pain medications available, doctors are able to make vaginal births a more comfortable experience.

Water Birth

Water births are a less common method of giving birth, but are believed to be more comfortable for mom during labor. Due to an increase in popularity, many birthing centers and even hospitals are choosing to have birthing tubs on sight. You can also rent a birthing tub if you choose to give birth at home. When you begin to go into labor, you will enter a tub filled with water ranging in temperature for 90-100 degrees. Your baby’s condition will then be monitored using a special Doppler device. You can give birth under water or above the surface of the water.

Caesarean Section

A caesarean section (or C-section) is a surgical method of child birth that involves your doctor making an incision in the abdomen and the uterus to remove the baby. C-sections are recommended for women who are at risk for complications as well as birth defects, having multiple births, with health conditions and during an emergency. C-sections require a longer recovery time than vaginal births.

Commonly Used Obstetrical Anesthetics

There are a number of commonly used forms of anesthesia to help make childbirth more comfortable. Here are some of the most commonly used obstetrical anesthetics:

Local Anesthesia: Local anesthesia is a series of injections that can help reduce discomfort in a certain area of your body. Local anesthesia may be used following childbirth for the placement of sutures should you need them.

Sedation: Narcotics or tranquilizers may be administered as an injection or through an IV. These medications can help to reduce labor pains and ease anxiety that is sometimes associated with the delivery process.

Pudendal Block: A pudendal block is a form of regional anesthesia. The vaginal area is injected with local numbing agents to help reduce pain in the vaginal area felt during childbirth.

Epidural: Epidurals are local anesthetic delivered through a small tube known as a catheter placed in the small of the back, just outside the spinal canal. An advantage of the epidural is that it allows most women to fully participate in the birth experience relieving most, if not all, of the pains of labor.  Women are able to feel touch and pressure. In many cases, the anesthetist will start the epidural when cervical dilation has reached four to five centimeters. Under certain circumstances, it may be desirable to place the epidural earlier at the discretion of the physician and anesthesiologist.

Spinal Anesthesia: This form anesthetic is very similar to an epidural, but because it is administered with a needle directly into the spinal canal, the effects of spinal anesthesia are felt much more quickly. You may feel numb and need assistance in moving your legs during the delivery. Spinal anesthetics are sometimes used for delivery by cesarean section or forceps are needed to help remove the baby.

Warnings regarding spinal and epidural anesthesia:

  • When mom is on blood thinners or has a bleeding disorder.
  • Is hemorrhaging or in shock.
  • Has a back or blood infection.
  • Has an unusual anatomic condition or spinal abnormality.
  • If there is no time.

Considerations when discussing anesthesia options with your doctors:

  • The last time you ate or drank.
  • History of difficulty breathing after anesthesia or complications with anesthesia in the past.
  • Lower back pain, injury or a history of back problems.
  • Family history of high fevers.
  • Respiratory problems including asthma, bronchitis, pneumonia, or if you are currently experiencing the flu, a cold or a sore throat.
  • Underlying medical conditions such as cardiac disease, diabetes or asthma.

Labor and Delivery Complications

Pre-term labor or pre-mature birth: Pre-term labor is one of the greatest dangers a child can face while entering this world. If a child arrives when its body systems are not mature enough, survival can be compromised. For instance, if the lungs are not fully developed the baby may not be able to breathe properly.

A full-term pregnancy last between 38 to 40 weeks. If you are having labor contractions before 37 weeks, you are considered to be in preterm labor. A baby born before 37 weeks of pregnancy is considered to be a premature baby. Premature babies are at risk for complications such as immature lungs, respiratory distress, and digestive problems.

Prolonged Labor (or failure of your labor to progress): While rare, a small percentage of women, mainly first-time mothers, can experience a labor that lasts too long, sometimes referred to as “failure to progress.” Both the mother and the baby are at risk for several complications, including infections, especially after mom’s water has broken.

Abnormal Positioning of Your Baby: In the weeks before your due date, the fetus usually drops lower in the uterus to prepare for birth. The ideal position for labor is with the baby  positioned head-down, facing the mother’s back, with its chin tucked to its chest and the back of the head ready to enter the pelvis. In this position, the smallest possible part of the baby’s head leads the way through the cervix and into the birth canal. This normal presentation is called vertex or head down position. Unfortunately, this is not always the case and abnormal positioning of the baby can make labor more difficult.

  • Frank breech. In this position, the baby’s buttocks lead the way into the mother’s pelvis; the hips are flexed, the knees are fully extended.
  • Complete breech. In a complete breech, both knees and hips are flexed, and the baby’s buttocks or feet may enter the birth canal first opposed to the head like in a regular birth.
  • Incomplete breech. In an incomplete, footling or breech, one or both feet lead the way out of the birth canal.
  • Transverse lie. This is a rare birth complication. From time to time a baby may lie horizontally in the uterus, referred to as a transverse lie, which indicates the baby’s shoulder will lead the way into the birth canal rather than the head. This can make birth more painful.

Premature Rupture of Membranes (abbreviated PROM): In a normal birth that is free from complications, the membranes surrounding the baby in the mother’s uterus break and release amniotic fluid either right before or during labor. This is commonly referred to as your water breaking. Premature rupture of membranes indicates that the membranes have ruptured too early in pregnancy. This exposes the baby to a high risk of infection as the mother.

Umbilical Cord Prolapse: The umbilical cord is very important in helping to keep your baby alive and developing while in your uterus. You pass oxygen and other vital nutrients from your body to your baby through means of the umbilical cord and placenta.

On occasion, before or during labor and delivery, the umbilical cord can slip through your cervix before your baby enters the birth canal. The cord can occasionally protrude from the vagina — this creates  a dangerous situation. The blood flow of the umbilical cord can be stopped. You will likely know if this has occurred because you can feel the cord in the birth canal if it prolapses and may see the cord. This a medical emergency and you should seek emergency medical care.

Preeclampsia: Preeclampsia is a complication of pregnancy involving high blood pressure may develop in the end stages of your pregnancy or immediately following delivery. This condition can cause premature detachment of the placenta from the uterus.

Uterine Bleeding or Postpartum Hemorrhage: After your baby is delivered, excessive bleeding may occur from the uterus. This is condition is known as postpartum hemorrhaging and can be a major concern for a new mom. Excessive bleeding can occur when contractions during delivery are impaired and affect the surrounding blood vessels.

Labor and Delivery Tips For Your Partner

Mom-to-be is not the only individual affected by the labor process. As a dad-to-be, partner or labor coach, preparation can help make the labor and delivery process easier for all of those involved. Preparation can help ensure safety throughout the entire process. Preparation can also help provide comfort for mom-to-be in a less-than-comfortable situation.

  • Know what to expect. Read the pregnancy, labor and delivery books in the months leading up to the delivery, not during the delivery. Consider attending childbirth or parenting classes with mom-to-be as well. You’ll be coached on basic skills as well as what to expect. You can also talk to other spouses and how they are planning to prepare for the event.
  • Learn the signs of early labor, learn how to count contractions and know when it is time to go to the hospital.
  • Be ready to go. Have a bag ready to go and gas in your car at all times. Since it is not realistic to be with the mom-to-be at all times, have your phone on and charged so that you are easily able to be reached when the moment comes.
  • Be prepared for the emotions. A woman may be very irritable during labor and delivery. Do not take anything personally she may say to you. Just be there to comfort her.
  • Ask questions. Ask the doctors and nurses questions if you don’t understand something.
  • Be her advocate. If she needs something don’t be afraid to ask for it. If she wants her doctor or her pain isn’t under control, ask the nurses to page your doctor or anesthesiologist.
  • Know your own limits. If you are uncomfortable at any point (such as cutting the umbilical cord) speak up. If you need to stay at her head, do so. No one is requiring you to watch the birth of your son or daughter.
  • Be there for her. The best thing you can do is be present and try to comfort her. Labor can be an uncomfortable process as well as a stressing time, be there to help make it easier for her.
  • Make preparations for your other children. Have your parents, her parents, relatives or close family friends available to care for your other children – especially if they are too young to sit in a hospital waiting room by themselves. Have them stay at home with a relative or friend or at a relative or friend’s house. Bring your other children to the hospital later on to see their new brother or sister.

Resources:

Jonathan
Medically trained in the UK. Writes on the subjects of injuries, healthcare and medicine. Contact me jonathan@cleanseplan.com

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