A Labor of Love

Through each step of pregnancy, you’re not only mothering your growing baby, you’re preparing emotionally and physically for the final, most challenging leg of pregnancy’s marathon: labor and delivery. Wondering what to expect?

            First, discuss any anxieties or fears you may be experiencing about labor and delivery with your health care provider.

            “They have seen it all and can often offer a lot of reassurance,” says Dr. Tara Chettiar, OB/GYN, who delivers babies at Saint Luke’s South Hospital. “Remember that you’re going into this as a team and everyone has the same goal: healthy mom and healthy baby.”

            Considerations before labor. A written birth plan can be a helpful way to think through your preferences and choices surrounding the birth of your baby. Discuss your plan with your provider, as well as any circumstances that might necessitate a medical intervention like an induction or cesarean section.

            Also decide where you’re going to have your baby. Kansas City’s expectant parents are fortunate to have multiple choices of birth centers and prestigious hospitals with highly trained, experienced medical staff.

            “Consider delivering at a hospital with an experienced labor and delivery team, including nurses, physicians and neonatal nurses who may care for your infant if difficulties should arise,” says Dr. Peter Caruso, OB/GYN, Saint Luke’s Hospital.

            How do I know I’m in labor? Many women feel Braxton-Hicks contractions throughout their pregnancies, especially beginning around the 20th week. These contractions are more of an uncomfortable nuisance than painful. They’re also characterized as more erratic than active labor, tending to last 10 to 20 seconds every 10 to 15 minutes.

            If you’re bothered by Braxton-Hicks contractions, make sure you’re getting enough fluids.

            “The most common cause of false labor is dehydration, and pregnant women get dehydrated much easier than non-pregnant women,” Dr. Chettiar says.

            Hot baths and showers also can provide relief.

            “Heat is a natural muscle relaxant, so a heating pad on your back—not your belly—is a great option,” Dr. Chettiar advises.

            The first stage of labor. Some signs of early labor include your water breaking (which is the rupture of the amniotic membranes), backache, blood-tinged discharge, menstrual-like cramps and low abdominal pressure. Stay close to home, try to rest and be prepared to head to the hospital as the time between contractions decreases.

            If you choose to deliver your baby in a hospital, one of the first people you’ll meet will be a labor and delivery nurse who will guide you through the process, review your health history and learn about your birth plan. The staff also will check your blood pressure and monitor your baby’s heartbeat using a Doppler or fetal monitor.

            Once you’re in active labor, contractions are more painful and rhythmic in nature, lasting 30 to 60 seconds and occurring every five minutes for at least one hour. During this stage, expectant moms feel a wide range of emotions from anxiety and fear about the labor process to excitement that they’ll soon be cuddling their long-awaited baby.

            To stay comfortable, try natural pain relief like intermittent walking (unless you’ve dilated beyond 7 cm), sitting on a labor or peanut ball or asking your partner for a gentle massage on your lower back.

            “Listening to music for distraction and shallow breathing techniques are (also) helpful,” Dr. Caruso says.

            Genna DeBrabander, an Olathe Health labor and delivery nurse, suggests activities like slow dancing, imagery and visualization, as well as changing positions from one side of your body to the other for pain relief.

            “Another great option for pain control would be an epidural,” she says.

            If you plan to get an epidural, the health care staff will hook you up to an IV.

            Time to push. Active labor has advanced to transitional labor when the intensity of your contractions increases and the cervix dilates from 7 to 10 centimeters.

            At this point, you’ve entered the second stage of the labor process, which can last as few as 15 minutes to as many as three hours. During this stage, you’ll start to push.

            Shallow breathing techniques during the first part of a contraction and pushing at the peak of a contraction can help you manage any pain or pressure you’re feeling. Dr. Caruso also recommends a squat bar to help ease pain during the pushing phase.

            Your emotions may run the gamut too.

            “There are many emotional challenges, such as despair, hopelessness, inadequacy, elation and a sense of accomplishment,” DeBrabander says.

            While this is the most physically and emotionally taxing part of the labor process, by the end of all of your hard work you’ll be rewarded with a baby in your arms.

            Almost done. The last stage of labor is the delivery of the placenta. You may barely notice these contractions after giving birth to your baby.

            The placenta develops during pregnancy, attaches to the uterine wall and is connected to your baby’s umbilical cord. This organ supports your baby throughout her time in your uterus, providing oxygen and nutrients and removing waste products like carbon dioxide. If you plan on keeping your placenta, let your doctor know.

            After the delivery of your placenta, you may experience cramping as your uterus contracts and some perineum pain and swelling.

            “Topical medications, oral medications and ice packs are great to aid these discomforts,” DeBrabander says.  

Before Labor

• Schedule tours of the birth facilities where your provider delivers.
• Learn about the facility’s labor and delivery policies and procedures.
• Discuss your preferences with your physician.
• Write a birth plan to bring with you to the hospital.
• Be aware of your options and plan for the unexpected.

Freelance journalist Christa Melnyk Hines resides in Olathe with her husband and their two sons. Christa is the author of Confidently Connected: A Mom’s Guide to a Satisfying Social Life.

As always, if you have any questions or concerns, please consult your health care provider.