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Vaginal Birth is the most common. The
uterus opens at the cervix while the baby descends through the vagina,
and the baby’s head emerges at the vaginal opening (crowning). After
the head is out, the nose and mouth are cleared of any secretions with a
bulb syringe by the doctor. With another contraction, the shoulders and
the rest of the body will be born. The baby will drag behind the
umbilical cord which still is delivering oxygen to the baby until it is
cut or the placenta detaches.
Cesarean Section is used if there
might be a difficult vaginal birth or when the well-being of the mother
or baby is at risk. An incision is made in the mother’s abdomen and
through other layers of tissue until the doctor reaches the uterus.
Making another incision into the uterus and taking special care to
protect the baby, the doctor delivers the baby through the opening. This
takes about 1-5 minutes.
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During the second stage of labor when the
cervix is 10 centimeters or completely dilated, the baby begins the
journey down the vagina. With each contraction the baby is pushed by the
force of the uterus and your pushing effort. Much of the progress at
this point is up to you. Obtaining a good position for pushing makes
this stage of labor shorter. Practice several pushing positions.
Start: in a reclining position,
flexing your knees and lifting your feet off the bed. Pull back your
knees gently toward your shoulders; you can hold your ankles or your
shins. Make sure your elbows are pointed outward when you push —
as if rowing a boat. If you hold your ankles you can rest your arms
on top of your legs. Now curl your body up, with your chin almost
touching your chest. Relax and bulge your perineum, bear down and
push as if have to use the bathroom. You will do this 3 - 4 times
during one contraction.
Another good position is lying on
your side. Flex both your knees up close to your tummy. During a
contraction raise your upper leg and pull it back toward your
shoulder, curl your body over your tummy and bear down.
Squatting is good if you have the
strength to hold yourself up. Simply obtain a squatting position and
then curl your body over your tummy and bear down and push.
I don’t recommend pushing during
practice. Years ago when the couples were practicing this exercise in
one of my classes one of the women broke her water with an explosive
effort. Mother and baby did fine, but the dad-to-be sitting across from
them never came back to class — I still think of him.
This is an incision made in the perineum
(the skin tissue between the vagina and the rectum) as the baby's head is
crowning. This allows for a faster delivery of the baby if needed or to
prevent the vaginal tissue from tearing. The nerve fibers in the pelvic
floor are stretched and disbursed during crowning, so if an episiotomy is
made during a contraction when the baby's head is pushing against the
skin, you may not feel the incision being made—even without medication.
The body
is a fine thing!
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These deliveries are not used
routinely for birth. They are used for maternal exhaustion and poor
pushing effort when the fetal head is crowning or near crowning. More
commonly, these are used when the mother has had an epidural, because of
the diminished effort with pushing. Your doctor has a preferred method
when or if a time comes to assist with this type of delivery.
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After the baby’s birth, the uterus will
continue to contract until the placenta spontaneously detaches from the
uterus. This takes about 5-10 minutes, and sometimes longer.
Oxytocin may be added to your IV or a shot may be given to assure that
you will not have excessive bleeding. The uterus will be at the
umbilicus immediate after delivery. It should feel and be about the size
of a grapefruit. The nurse may rub the fundus (the top of the uterus) by
massaging your abdomen to prevent bleeding. Your nurse may show you how
to massage your own fundus by touching your finger tips to your abdomen
and pressing down until you feel the firm small uterus. This will
prevent unnecessary bleeding. The placenta site will take about a month
to heal. The contractions that follow the birth are called afterbirth
pains. They are usually more noticeable if you have had a baby before.
They may also be stronger during breastfeeding since this releases your
own oxytocin that stimulates uterine contractions. These afterbirth
pains usually subside after a day. Ask for pain medication if needed.
Oxytocin is the hormone that contributes to the shrinking of the uterus
to its pre-pregnant size. Oxytocin remains working hard after the birth
as well as another hormone called prolactin. Prolactin and oxytocin are
responsible for the production and the release of milk from the breast.
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Dads, don’t rush right out of
the birth room after the birth and tell the family about the
baby until the doctor or midwife finishes and the nurses tidy
the room or your wife is taken to her room. Mom may want to
share the news with her family and friends. I encourage you to
touch, look and cuddle with your baby after birth. Some
mothers that have had a long labor or an unusually heavily
medicated labor may have delayed emotions. Everyone is excited
about the birth of the new baby and may want to inquire about
your labor and baby. Most hospitals have adopted policies that
do not allow the staff permission to give out information to
visitors and family in the hospital or to those who call the
hospital. These policies are to protect your confidentiality.
Family and Friends are almost always
welcome when the new mother feels ready. This is a joyous time for new grandparents, aunts, uncle, cousins, and family friends. Everyone will
want to hold, cuddle and "take a peak" at the baby. Take
special care that everyone has washed their hands and keeps the baby
warm. Mom may want to breastfeed in private or may be tired and want to
sleep. This is a recovery time and visitors need to leave after a short
visit. If you do not want visitors, you may want to hang a "No
Visitors, please check at the nurses desk" or a "Do Not
Disturb, mom and baby are sleeping" sign on the door. These are
easy to make. Enjoy your baby!
During the recovery period the nurse will
monitor your vaginal bleeding, blood pressure, and pulse for about an
hour or until you are stable and things are going smoothly. The nurse
might massage the uterus to assess for vaginal bleeding. This is also
the time you might be feeding your baby for the first time. The nurse is
there to assist you any way she can.
Breastfeeding can be done by most women
even though most women don’t think so. It doesn’t come naturally. It
is an art taught and passed down from woman to
woman, generation after
generation. But somehow a few generations forgot how! The first two
weeks seem to be the most difficult for inexperienced mothers. Sometime
during your pregnancy find a breastfeeding group in your area. It’s a
fine thing!
Lochia is the bright red vaginal
discharge after the birth and will be like a heavy period the first 3-5 days. You may even see some clots in the first day or so,
especially if you have been lying down for a long time and then get up.
The lochia gradually deceases in amount and turns to a darker red color
then eventually to a whitish discharge as the placenta site heals. The
bleeding may last as long as six weeks.
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The appearance of the baby may be
different from what you may envision. The baby is wet with amniotic
fluid. The head may be bloody from the passage through the birth canal
and take the shape of the mother’s pelvis (cone head or a bottle neck)
due to molding as the baby fit through the birth canal. This usually
disappears within a few days. The baby will appear bluish at birth and
the skin will be covered with a white, creamy substance called vernix.
Don’t be surprised if your baby does not cry right away: it’s OK.
The baby is still attached to the umbilical cord which is giving the
baby needed oxygen until he/she takes their first breath. When the baby
does start crying, the tiny sacs in the lungs fill with air and baby
quickly becomes pink, but the hands and feet may remain blue for several
days—all these things are normal. The baby is dried to prevent loss
of body heat; as most babies cannot regulate their body temperature for
the first few weeks due to an immature central nervous system. When
their temperature drops, they breathe faster and use more oxygen to try to
raise their temperature. It is important to keep the baby swaddled in a
blanket during the recovery time so they will stay warm . A cap may be
placed on the baby’s head for warmth.
Apgar Score is a method of evaluating
baby’s well-being and condition immediately after birth. Scores are
done at 1 and 5 minutes of age. The infant is scored in five categories,
and given a 0-2 rating in each category: a total of 10 being the best. A score
of 7 or greater is remarkable!
I.D. bands are applied to mother, baby and
sometimes the father after the birth. Security is an issue that is in
the forefront of most new parents minds, and hospitals go out of their
way to protect babies. Having matching ID bands for mother and baby has
proven to be successful in identifying babies to their mothers. Two
bands are placed on baby and one band on the mother. All have matching
numbers. Some hospitals will also have a band for dad. With today’s
technology electronic security has been developed. Hospital’s have
installed electronic security devices on the baby units.
This device comes as a bracelet or can be
attached to the umbilical cord clamp. If it is removed by someone
unauthorized to remove it or if baby is taken past the electronic
doorway, an alarm will sound throughout the nursing unit. While still
other hospitals have put a "code word" in place, which is given
to the parent’s after the birth. Whichever one your hospital uses, it
will be explained to you when you’re admitted.
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Weighing and measuring your baby is an
exciting thing. An infant scale is used, and this is the legal weight
that will be documented on the birth certificate. Next the baby is
measured. This is done in the birth room, but sometimes is done in the
newborn nursery. |
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Shots can be very upsetting for new
parents to watch. I like to prepare parents for the these treatments
after babies are born. |
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Vitamin K is given after the birth. This
is the vitamin that helps our blood clot. Vitamin K is made from the
component that come from our food intake. Up until the baby’s birth,
baby relied on mom for this. It takes about 24 hours for baby to make
their own vitamin K from their own food intake. |
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Hepatitis B vaccine is part of childhood
immunizations. Hepatitis B is given in three parts. The first shot may
be given to the baby before leaving the hospital and the other two are
given over the next several months. |
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Eye treatment with antibiotics is required
to prevent infection from some commonly transmitted diseases passed to
baby during the birth. |
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Blood test to check baby’s blood sugar
are sometime necessary when babies are born to a mother with diabetes
(gestational or juvenile) or if baby is large for gestational age. Blood tests on newborns are done with a heel stick. |
Umbilical cord
The umbilical cord stump needs to be
treated until it falls off, somewhere around two to three weeks of life.
Some physicians will order an antiseptic (blue in color) to be applied
to the umbilical cord after the baby is born. While other physicians
will treat with rubbing alcohol after every diaper change. Your nurse
will instruct you on how to care for the baby’s cord at home.
Circumcision is a common procedure on
baby boys in the United States. Even though it is an option and considered
cosmetic surgery, there is no medical indications for it, but most
parents desire it. When a baby is circumcised the foreskin is removed
from the head of the penis. As several dads have told me over the years
"why break a 2000 year tradition". But other groups feel passionate about this procedure and feels it
should never be done.
During pregnancy is the time to give
serious consideration of who will be caring for your baby after birth. Most hospital will require your baby to be seen by a doctor after birth
and every day you and your baby remain in the hospital. You may have to
refer to you insurance carrier for a recommendation or you can ask your
doctor, friends, or relatives for one. If your doctor is a family
practice physician, they can care for your baby. But if your doctor is
an obstetrician, you will need to find a pediatrician or family practice
physician to care for your baby.
You can make an appointment to meet with
a prospective doctor. Make sure both of you participate when you go.
This is a good thing for dads to do to attach to the baby prenatally.
Mostly you will decide if you are
comfortable with the doctor. This is important because you will be at
the baby’s doctor often over the next three years. You will see the
doctor for all your baby’s childhood immunizations, and also for the
times the baby is sick. It’s a kindly thought to remember the baby’s
doctor and staff with goodies every now and then.
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