Trying to get pregnant? Make sure you know the bottom line on baby-making—what you don't understand can affect your bub-to-be's health.
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Last week I answered Samantha's question about finding a good doctor and hospital and mentioned that both she and Natalie thought their questions were trivial. No they're not. They're the stuff we all think about. Thank you for asking. Believe me, you're only one of about 4 million women wondering the same thing. So, as promised, here's my answer to Natalie's question.
What do you do if you won't go into labor or your labor has stalled? What do you do if your baby has decided never to be born? What if your water has been broken for 24 hours and you still haven't had a contraction? How about if you've been 5 cm for 8 hours and your doctor is talking Cesarean? What do you do? Sounds like it's time for some vitamin P. That's Pitocin—the synthetic version of oxytocin. Oxytocin is the hormone that runs around your body to make your uterus contract. Under ideal circumstances, you'll make enough to squirt that baby out on your own.
Not all my time at the hospital is spent delivering babies. Sometimes I'm on "pad-patrol." That's nurse-speak for postpartum mother/baby care. Go ahead—guess what kind of pad I'm talking about. Sometimes I "do outpatients"—pregnant ladies who need medical attention but aren't necessarily in labor. A whole lot of outpatients come to the hospital with an Unidentified Foreign Leak. My job is to "Name That Leak." Most of the time it's pee. I know what you're thinking: "How could they not know they've wet their pants?" They just can't, that's why.
From the moment you discover you’re pregnant, decisions await you. Fortunately, many of them, such as what color to paint the nursery and whether to use cloth or disposable diapers, are not life-changing (though they may seem so at the time). But the big-picture decisions—questions like where your baby will be born, who will deliver her and whether or not you should schedule the birth—can have a profound impact on your pregnancy and delivery, often making the difference between a joyous experience you can’t wait to repeat and a traumatic one you’d rather forget.
1) Should you wait to push? If asked whether they’d like to prolong labor, few pregnant women would say yes. But in some circumstances, waiting to push may be a wise thing to do. Women who receive epidurals may have less complicated deliveries if they delay pushing until after the cervix is completely dilated to 10 centimeters, research indicates. Here’s why: Waiting a few hours before pushing allows the continuing contractions to help propel the baby into the pelvis.
Lisa Hickey never expected to give birth in a 1993 Toyota Camry on an on-ramp to Interstate 90, but that’s what happened. Early on a July morning in 2003, Hickey, 31, of Natick, Mass., went into labor with her second child. Her husband drove her and her 22-year-old sister, who planned to watch the delivery, to the hospital in Boston. When Hickey’s doctor found she was only 4 centimeters dilated, he estimated that the baby wouldn’t arrive for a long time and sent them home.
Almost every pregnant woman portrayed on television wakes up in the middle of the night and says, “It’s time!” And within 20 minutes (on a half-hour show), she delivers the baby.
The frustrating truth is that the onset of labor is rarely predictable. But there are signs that it has started — or soon will. Here are a few of them.
Most first time mom to be are naturally apprehensive and curious about labor and delivery. Concerns include: How will I know when I’m actually in labor? Will it hurt, and how much? When should I go to the hospital? Will I lose control and scream like a banshee, embarrassing everyone in the room?
Compared with the slow, quiet days of pregnancy, labor—with its minute-to-minute changes —can be both disconcerting and exhilarating. While each woman’s labor and delivery is different, we can address some of the more common questions and concerns.
What is Labor?
The first meeting of mother and child can only be described as magical. Both stranger and close confidant, your baby blinks and stares at you as though he’s surprised to finally meet you, as you are to meet him. After waiting 40 weeks for this moment, you’ll be understandably anxious for some quality time together. But your baby’s caregivers will be equally eager to make sure your child is healthy. Luckily, doctors have found a way to make everyone happy.
My birth plan when I was pregnant with my son, Truman, was this: I had no plan. I knew I wanted a hospital delivery, so I selected one that had a birth center known for family friendliness and an OB-GYN with a reputation for erring on the side of safety. Beyond that, I just packed my iPod in my hospital bag, let my doctor know that I'd rather skip the C-section, thank you, and trusted that somehow the process of giving birth would take care of itself.
The length of a hospital stay after delivery tends to be one-size-fits-all: 48 hours for a normal vaginal birth and 96 hours for an uncomplicated Cesarean section. But a study suggests that moms should be discharged based on individual factors, not simply how long they've been in the hospital. Henry Bernstein, D.O., and colleagues at New Hampshire's Children's Hospital at Dartmouth examined the decisions to discharge more than 4,000 mothers after childbirth. They found that 17 percent of mom-baby pairs were not ready to go home.