Birth Control

managing labour painIts important to master your chosen pain relief method, and familiarize your birth assistant with the technique, before you go into labour. If special equipment is required, make sure it is available at home or in hospital. One method alone may not be enough – you may need a combination for complete relief.

Positions

Walking around, leaning against your partner or the wall, and rocking your pelvis will probably feel much more comfortable than lying on your back in bed. There are also certain positions that you will find more comfortable than others, because these will relieve the pressure on your back. Read the rest of this entry »


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Birth Control

When you arrive at the hospital, the midwife will prepare you for the birth. There are certain routine examinations that you will have to undergo.

While consulting your notes, the midwife will ask you questions about your labours progress — whether your waters have broken and how often your contractions are coming.

You will be asked to undress and put on a hospital gown or your own T-shirt or nightdress.

You will then be examined; the midwife will palpate your abdomen to feel the baby’s position; she will listen to the fetal heartbeat, take your blood pressure, pulse and temperature and give you an internal examination to see how jar your cervix has dilated.

You will be asked to give a urine sample to test for the presence of protein and sugar.

You 11 be asked when you last had a bowel movement and it may be suggested that you have an enema or a suppository (although this is no longer routine in many hospital).

You then have a shower or bath and are shown to the first stage labour room. If you have any questions or you want to make your feelings known to the staff, now is the time to remind them of your birth plan.

Every woman’s experience of labour is unique, and the time span can’t be predicted. However, an average labour lasts about 12—14 hours for first-time mothers, and about seven hours for subsequent labours. If your first labour lasts longer than 12 hours, or in subsequent labours nine hours, your obstetrician may intervene.

The first stage of labour can be regarded as having three separate phases. The early, or latent, phase is the longest, lasting about eight hours for first babies, during which the cervix is softening and you will feel contractions occurring with increasing frequency and length. Try to conserve your energy during this time.

The next, active phase when the cervix is dilating, is shorter, lasting from three to five hours, and this is when your contractions become more painful, and you may want pain relief. The final phase of dilatation (sometimes called transitional) is the shortest and most intense, usually lasting under an hour, and comes just before you begin to push.

Your Cervix Dilates

The normally tough cervix must be stretched thin and opened wide before your baby`s head can pass through. The contractions of the first stage of labour achieve this.

Before labour

Your cervix is normally thick and closed, but has been softened by hormones during pregnancy.

Early (Latent) phase

Your cervix begins to thin (efface) before it can stretch and dilate.

Active dilatation

When your cervix is about 5cm (2in) wide, it is halfway to full dilatation and delivery.

End of the first stage

Your cervix is fully dilated when it is about 10cm (4in) wide. Now the head can descend.


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Birth Control

Although fetal monitoring may confine you to bed, lying on your back for delivery can have many disadvantages:

- you have to work harder pushing the baby uphill;

- pain may be greater in this position than in a vertical one;

- the tissues of the birth canal may be slow to open and be stimulated by the descending baby, thus possibly prolonging labour;

- there is a greater need for an episiotomy;

- there may be an increased chance of a forceps delivery;

- it inhibits spontaneous delivery of the placenta;

- there is a greater possibility of lower back strain.

Slow Deliveries

What is considered to be the normal length of labor varies from hospital to hospital— and it is the marrying of what is right for you with what is normal for the hospital that causes problems. Procedures that are more likely to be used when the medical staff wishes to hurry you include:

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Birth Control

Some types of pain relief will only be available in large or teaching hospitals, others are widely available in all hospitals. Your midwife will also be able to offer you certain types during a home delivery.

Medication

Regional anaesthetics

These remove sensation from part of your body by blocking the transmission of pain from nerve fibres. Caudal anaesthesia is administered by an injection into your spinal area around the sacrum, and numbs your vagina and perineum. This may be used for short-term relief if the birth involves a vacuum extraction or forceps delivery.

To administer a pudendal block, anaesthesia is injected straight into your vagina near the pelvic region, blocking the pudendal nerve. This numbs the lower part of your vagina, and may be used if you have an episiotomy.

The most widely used form of this type of anaesthesia is the epidural block. Most mothers who have a Caesarean have an epidural instead of a general anaesthetic, which allows them to stay awake throughout the birth.

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