The agony and the ecstasy
The lowdown on labor and delivery
Should I Stay, Or Should I Go?
When to go to the hospital will depend on how your labor is progressing. In general, according to Burch, you should go when the contractions have become strong enough to take your breath away and are coming regularly, at five- to 10-minute intervals. At this point, the cervix is usually 3–4 centimeters dilated and completely effaced.
Some childbirth experts believe it is unwise to go into the hospital too soon. “Many studies have shown that a woman is better off, and requires less medical intervention, when she stays home and remains in contact with her doctor or midwife by telephone until she’s further along in labor,” says Marsden Wagner, M.D., a Washington, D.C., reproductive-health research scientist who spent 15 years as director of women’s and children’s health for the World Health Organization.
If you choose not to go to the hospital right away, call your health practitioner to inform her that you think labor has begun. Rest and keep your strength up by eating a snack, because it’s likely to be a long time before you can eat again, says Giselle Genillard, a licensed midwife in Santa Fe, N.M. She suggests light, nutritious foods such as yogurt and toast.
Although physicians used to ask women to report to the hospital as soon as their water broke, opinions on the subject currently run the gamut. “Some doctors will have women wait 12 hours to see if labor starts, while others will give you 24,” says Burch. “Others, like myself, prefer to check the woman out in the office and put her on a fetal monitor for 20 minutes to make sure everything is OK. Find out your health care practitioner’s policy on this before you go into labor.”
Q: I’ve read that it is good to walk around during delivery, but I’ve heard that as soon as you get to the hospital, they strap on a baby monitor. What should I do?
A : Baby-monitoring policies vary from hospital to hospital. Some hospitals require intermittent monitoring, which allows a woman to walk around until the last part of labor, while others require constant monitoring, which prevents this. Check with the hospital where you plan to deliver regarding its policy on the matter.
Q: What’s the best position for delivery?
A: Doctors vary on what they will allow for delivery, so inquire before labor begins. The most common position is propped up on one’s back, with knees open wide and high.
Squatting is considered one of the best positions because it helps open up the pelvis. You can squat with support from a partner or hang onto a birthing bar, which is hooked onto a birthing bed. This type of bed allows you to squat in bed and then lean back in between contractions. Birthing beds also break down and become what looks like a delivery table so the woman can push and deliver the baby without being moved.
Birthing chairs are often used by midwives. They are helpful for a woman having trouble getting the baby down the birth canal. Sitting in a birthing chair helps open up the pelvis wider than in a birthing bed.
Delivering while lying on one’s side works well, opening the pelvis, as does all-fours delivery, which works particularly well for women experiencing back labor.