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Labor & Delivery

Labor & Delivery

Welcome Baby Home

This is the time you’ve been waiting for! It is very normal to have some apprehension about labor. I’d like to give you some information on what will be happening so that we can discuss any questions or concerns you might have. Hopefully by discussing what normally occurs during labor, it will lessen some of the expected anxiety. Remember, women have been having babies for hundreds of years, so try to relax and enjoy the experience!

Birth Plans

Some of you may be going to birthing classes in which they ask you to write a birth plan. For the most part, I don’t feel birth plans are very helpful and in many cases, can set you up for disappointment. Many times, it is difficult to determine exactly how your labor will progress. So when things don’t go according to the preset birth plan, some women may be disappointed or have a sense of failure. It is a good idea, however, to think about your options and what you would like to experience in ideal circumstances. Keeping an open mind and going with the flow of your labor will help you to enjoy this time and provide a memorable experience for you and your family.

Pain Management

Pain management will vary for each individual. What may be right for one woman may not be the right choice for another. You are in charge of your own pain management in labor. You may use hypnosis, breathing techniques, IV sedation or an epidural.

If you decide on an epidural, talk with your anesthesiologist as to what you would like. It is a good idea to be able to move your legs during labor, as this will assist with pushing during the second stage. In some cases, a complete motor block (inability to move your legs on your own) may lengthen the second stage of labor. An epidural may also increase your risk of vacuum, forceps, or c-section if you are unable to push effectively. This does not mean that you need to have pain during labor, but that ideally, it is easier to push if you are able to feel pressure. Discussing with your anesthesiologist your desire to be able to feel pressure during the pushing stage may make it easier for you.

If you decide on IV sedation, please note that this will dull, but not completely take away the pain during labor. IV sedation may be all that some women with shorter labors require. In some cases, the intensity of the second stage (or “pushing stage”) is greater without an epidural. In these cases, it is important to stay focused and remember that the pressure will end once the baby is delivered. Steady and focused pushing efforts may decrease the need for an episiotomy or vaginal repair. We do not automatically or routinely perform an episiotomy unless it is necessary. Women who have given birth previously are less likely to need an episiotomy or repair.

Indications for Vacuum, Forceps or Cesarean Section

Most women will have a spontaneous vaginal delivery! Indications for a c-section would be fetal distress, malpresentation, and failure to dilate or descend with pitocin. Indications for vacuum or forceps would be fetal distress or inability to push a baby out spontaneously. Vacuum and forceps are safer than a c-section when used appropriately.

Remember, most women are going to have a spontaneous vaginal delivery! Our goal for you is a healthy baby, healthy mom and a memorable birthing experience. These are some of the highlights of what to expect during this special and exciting time. We will be happy to discuss any issues with you at your next visit.

Go to the Hospital for the following:

  • Rigid Abdomen that is painful and does not relax.
  • Heavy Vaginal Bleeding.
  • Lack of Fetal Movement, even in labor your baby should move some.
  • Your bag of water breaks.
  • You experience sudden swelling in hands and face with blurred vision.
  • Painful regular contractions, in “true” labor contractions increase in frequency and strength, they are not relieved by activity or position and would require pain management.