It's your big day! Now what?
The anxiety that comes with anticipating your delivery day is normal, which is why it helps to be prepared for it. Whether you're having a natural birth or getting a C-section, knowing what to expect can help quell the nerves that's typical of first-time mommies (and daddies). To help you get a grip on what you can expect on D-day, here are some pointers:
Know the different phases of labor.
This is the longest stage of labor and it can span several hours and last up to several weeks. The cervix will dilate to three centimeters and it undergoes effacement (thinning out). Typically, your contractions will last an average of 30 to 45 seconds, with five to twenty minutes spaced between each one. Your back will ache and some cramping will occur. This is also when your discharge will be blood-tinged mucous or bloody.
The best thing to do during this phase is to just relax. Save your strength for the more intense phases. If you're able to, try to get some sleep. If not, keep yourself busy by cooking some meals that you can later bring to the hospital, start preparing an overnight bag, or even go for a walk which can help induce contractions and speed up the whole process. If you get hungry, eat a light snack, but be sure to avoid fatty foods.
During this phase, you'll experience stronger contractions, which would come every three to four minutes and will last up to 40 to 60 seconds. By now, you should be at the hospital. Your cervix will dilate to seven centimeters.
As in phase one, remember to keep relaxed and comfortable. Remember to urinate regularly and to keep yourself hydrated. At this point, a nurse or midwife should be with you to take your blood pressure, take note of the spacing between each contraction, and observe the baby's position with an electronic fetal monitor. If you plan on taking an epidural, now would be the time to ask for it.
This is the shortest, albeit most intense phase which can last anywhere from 15 to 60 minutes. Your cervix will dilate from seven to the full ten centimeters. You'll experience stronger contractions which will be 60 to 90 seconds long. There will be pressure in your lower back and rectum. You may also experience nausea, fatigue, tightness in your throat and chest, some shakiness, and more blood-tinged mucous discharge.
Ask your doctor for guidance. Do not push until your cervix is fully dilated as this may lead to swelling of the cervix, which can cause complications.
The main event
Now that you're through the three phases, it's time to push! This can take anywhere from a few minutes to several hours. Currently, there are two schools of thought when pushing: the coached pushing or the spontaneous pushing. Here are their differences:
- Coached pushing is most widely used in hospitals. This happens when you're fully dilated at 10 centimeters and is done by a labor and delivery nurse.
- You're coached to push at regular intervals, three times with each contraction for a count of 10 seconds.
- Do not push with your upper body, this can strain your face and lead to black or bloodshot eyes and bruises.
- It's also known as physiological pushing or mother-led pushing, when you follow your body's natural urge to push.
- Pushes are shorter but more frequent during a contraction.
- Spontaneous pushing is more intuitive and is assisted by a midwife.
What happens during a caesarean section?
A caesarean section or C-section is when a woman delivers her baby through a surgical incision in her abdomen and uterus.
Nowadays, C-sections can be scheduled in advance for many reasons, namely:
- Placenta previa (a low placenta that covers the cervix)
- An obstruction that makes vaginal delivery impossible
- You’re carrying more than one baby
- You’ve had a previous C-section which increases the risk of your uterus rupturing during delivery
- Your baby is in breech (feet first) or transverse (sideways) position
- You’re HIV-positive and have a high viral load
- Your baby has a malformation or abnormality making vaginal delivery dangerous
- Your baby is very large
Reasons for an unplanned C-section:
- Your cervix stops dilating or the baby stops moving through the birth canal
- A prolapsed cord (when the umbilical cord slips through the cervix)
- Placenta separation from the uterine wall or placental abruption
- Your baby's heart rate slows down
- You have a genital herpes outbreak during delivery or when your water breaks
The C-section process:
After you're give anesthesia and it takes effect, your belly will be cleaned with an antiseptic and the doctor will make a small, horizontal incision above your pubic bone.
The doctor will then cut through the underlying tissue. He'll separate your abdominal muscles and spread them to expose what's underneath. When he reaches your uterus, he'll make a horizontal incision in the lower section called a low-transverse uterine incision.
He'll then reach in and pull out the baby. After the umbilical cord is cut, he'll show you your baby then hand her off to a nurse for examination and cleaning. When this is through, they'll hand over the baby to your partner or place her beside you while you get stitched up.
Stitches are removed from three to seven days later, or they may dissolve on their own. After you're done, you'll be moved to a recovery room where you'll be monitored for a few hours. But don't worry, your baby will be with you and you'll be free to snuggle and kiss her all you want.