1. Labor and Delivery

2. People there during pregnancy:
Midwife- an individual trained to delivery babies at home (not a doctor) may have Rn degree
Gynecologist (OBGYN)- medical doctor trained in women’s reproductive health, labor & delivery.
Doula- an individual trained to assist the woman in having a positive experience during pregnancy, labor & delivery.
Anesthesiologist- a medical doctor trained to administer pain medication, epidurals, etc.

3. Epidural Pain Relief During Pregnancy
Epidural – needle goes between the vertebrae of the lumbar spine used as an anesthetic
Numbs from the waist down
Takes mins. to work
Given about 5cm dilated
May diminish ability to push
Cannot cause permanent damage to the spine

4. Pre-labor: Lightening – “dropping of the fetus in the pelvis”
Passage of Mucus Plug
“Bloody Show” – pink or bloody discharge from the vagina caused by passage of mucus blood and dilation of cervix
Membranes rupture – “water breaks” (contractions may start before this or after

5. Mucus Plus -> Bloody Show -> Water breaks

6. Stages of Labor and Delivery
Stage 1 – Dilation and Effacement of the cervix (basically the worst part )
Early labor (cervix 0-3cm)
Active labor (cervix 4-7cm)
Transition (cervix 8-10cm)
Stage 2 – “Pushing Phase” - Birth of the Baby
Stage 3 – Expulsion of the Placenta (after birth)

7. Stage 1 – Dilation and Effacement of Cervix
Longest stage Averaging 12 hours
Cervix effaces or thins out
Cervix dilates or opens up to 10 cm
Effacement & dilation may occur at the same time or separately

8. Stage 1 – Early Labor Cervix dilates 1-3cm
Contractions (intense menstrual cramps) last less than a minute every 5-20 mins.
Woman can still continue with light eating and activities

9. Stage 1 – Active Labor Cervix dilates 4-7cms
Stronger contractions last at least 1 minute and are about 3 minutes apart
Stage last about 2-4 hours
Go to hospital!!!

10. Stage 1 - Transition Cervix dilated 8-10cms (fully dilated finally!!)
Intense contractions last seconds and occur 2-3 minutes apart
Phase lasts about 15 minutes to an hour
Usually the shortest phase of stage 1

12. Stage 2 – Birth of the Baby
Often referred to as the Pushing Phase
Averages 1-2 hours in length
Contractions are approximately 1 minute apart
Crowning Occurs: When baby’s head is visible from the vaginal opening

14. Stage 3 – Expulsion of Placenta
Placenta is often called the Afterbirth
Usually takes 5 minutes to ½ hour
Mild contractions lasting 1 minute or less
Placenta weights on average 2 pounds
Breastfeeding or a shot of oxytocin will stimulate the uterus to contract strongly to stop blood flow.

15. Labor and Delivery Terminology
Episiotomy - An incision made to perineum to allow baby’s head to pass through
Perineum - skin located between the vaginal opening and the rectal opening

16. Cesarean Section
A cesarean section is the delivery of a baby through a cut (incision) in the mother’s belly and uterus.
1 out of 4 birth are C-sections
A woman can be awake during birth
Incision is made across belly on “bikini” line. Causes a scar.
Epidural or spinal anesthesia will be given to numb belly and legs
Can be risky
Recovery Time Necessary

17. C-Section

18. Reasons for an unplanned C-Section
Labor is slow and hard or stops completely.
The baby shows signs of distress, such as a very fast or slow heart rate.
A problem with the placenta or umbilical cord puts the baby at risk.
The baby is too big to be delivered vaginally.

19. Reasons for a Planned C-Section
The baby is not in a head-down position close to your due date.
You have a problem such as heart disease that could be made worse by the stress of labor.
You have an infection that you could pass to the baby during a vaginal birth.
You are carrying more than one baby (multiple pregnancy).
You had a C-section before, and you have the same problems this time or your doctor thinks labor might cause your scar to tear (uterine rupture).