When the office is closed call If you get no answer, you can call Labor and Delivery at If you call us during office hours, we may ask you to come in to the office for a labor check. If the office is closed, your call will be forwarded to the answering service at Saint Agnes Hospital, who will take your name and number. Please ensure to provide the operator with a number that you can be reached at. Whichever doctor is on call will answer you call as quickly as possible. If you have not heard from anyone in twenty minutes, call again.
On nights and weekends, we will send you to the hospital for a labor check. You will need to go to the front entrance of the hospital and then proceed to the Admissions desk. On Labor and Delivery the nurse will have you change clothes and provide a urine specimen. The nurse will also check your blood pressure, place you on the fetal monitor and check your cervix.
Your nurse will then call us and inform us of your condition. The hospital doctor may also be asked to evaluate you if we feel this is necessary. With the first baby, labor is usually between 12 and 24 hours. It takes a variable amount of time to progress from 0 to 5 centimeters. After that, your cervix will usually dilate one centimeter per hour. When you get to 10 cm, you begin the second stage, or "pushing. You can expect us to be there by the time you are 5 cm, or earlier if you desire an epidural or have any problems.
If you are not planning to "go natural" and you need something for pain in early labor, we would administer narcotics through an I. Later in labor, we cannot give narcotics because there would not be enough time for the baby to clear the drugs from its circulation before birth. Later in labor, if you need medication for pain we would recommend an epidural. You will meet with the anesthesia team at the hospital upon your admission to discuss your pain management options, if you so desire.
Typically, we try to avoid giving an epidural until labor is well established so we like to wait until you have a strong contraction pattern. We prefer our patients have an IV in place for any emergency situation that may develop. The IV is indicated for any abnormal fetal heart pattern, maternal dehydration, trial of labor after cesarean sections, epidural and IV pain management. We prefer continuous electronic fetal monitoring during the active phase of labor. Prior to this point, fetal monitoring for at least twenty minutes every two hours is routine.
If all is going well, and you wish to walk around the rest of the time, the on call provider will discuss whether you may remain of the monitor during this time. If you need Pitocin or you have meconium stained amniotic fluid, you must be monitored continuously. It does not usually cause any problems to the woman. However, it may be a cause of urinary tract infection or cause of vaginitis. If a newborn comes in contact with the GBS bacteria, the baby may develop a severe infection.
We screen all our OB patients between weeks for presence of this bacteria. If it is present, we treat with antibiotics in labor to avoid transmission of the bacteria to the baby during delivery.
Episiotomy : This is not routine. You may feel the baby drop, or you might notice that there is now space between your breasts and abdomen. The good news here is that you may get some relief from the shortness of breath you've been experiencing, since this shift takes pressure off your diaphragm.
The bad news is that it puts more pressure on your bladder, so you may be visiting the bathroom more than you ever thought possible.
Some mothers feel more pressure on their pubic bones or can even see in the mirror that their belly has lowered after lightening; others may be unaware of any difference. Your cervix -- the lower, narrow end of the uterus that protrudes into the vagina -- softens as it's preparing for labor.
This process, known as "ripening" or effacement, usually begins during the last month of your pregnancy. By the time the big day rolls around, your cervix will have stretched from around 1 inch in width to paper thinness. Your doctor or midwife may start checking for gradual effacement during your last two months of pregnancy with internal exams during your prenatal visits. Effacement is measured in percentages: Zero percent means no effacement; percent means you're fully effaced.
As your baby's birthday approaches, your cervix begins to dilate, or open up. Dilation is checked during a pelvic exam and measured in centimeters cm , from 0 cm no dilation to 10 cm fully dilated.
Typically, if you're 4 cm dilated, you're in the active stage of labor; if you're fully dilated, you're ready to start pushing. Your health practitioner will probably check for dilation and fill you in on your progress during your prenatal visits in the later stages of your pregnancy.
It's not as gross as it sounds, nor as bloody. Although it's termed the "bloody show," this telltale sign of impending labor occurs when the thick plug of mucus that seals off your cervix and prevents bacteria from entering the uterus during pregnancy gives way. Despite its name, the "mucus plug" doesn't resemble a cork there will be no popping sound! It's more like thick or stringy discharge that you may pass in a clump into the toilet or your underwear.
The discharge can appear as pink, brownish, or slightly bloody in color. The bloody show usually debuts either a few days before your labor starts or at the very beginning of labor, although many women go into labor before it appears.
Not everyone will have the dramatic "Oh my God, my water just broke! The fact is, when the sac of amniotic fluid that surrounds and protects your baby during pregnancy breaks, it's more likely to leak from your vagina in a gentle trickle than it is to break the floodgates.
The so-called "rupturing of the membranes" can happen at the very start of labor or during the first stage of labor. Usually the doctor, midwife, or nurse will break your water before you become completely dilated, if it hasn't broken by then. This allows them to learn if you have any problems that would impede the baby's safe delivery.
Contractions usually become much more intense after your water breaks, and the labor goes faster. Your physician or midwife should evaluate you and your baby as soon as possible after your water breaks. That's because the baby is at risk of developing an infection in the uterus once the protective fluid is gone. In preparation for delivery, the cervix thins out effacement and opens up dilation to allow the baby to pass through the birth canal.
Keep reading to learn more about cervix dilation and effacement, and how to check whether it's happening to you. Cervical effacement happens when your cervix thins and stretches to prepare for vaginal delivery. It's caused by the baby's head dropping into the pelvis and pressing against the tissue. Doctors track cervical effacement through percentages: A cervix that is percent effaced has gone from the shape of a thick-walled cone to that of a flat, thin cup beneath the baby's head.
If you're 50 percent effaced, that means you're halfway there, says Laura Riley, M. Thanks to Braxton Hicks contractions , by the final weeks of pregnancy, your practitioner may pronounce you to be 50 percent effaced or more. Dilation is characterized by an opening of the cervix, which helps the baby pass through the birth canal. There's no set time frame for dilation; it can start weeks, days, or hours before labor. Your contractions will gradually open your cervix to that magical dilation measurement of 10 centimeters.
When your cervix has dilated to that point about the width of your hand , your midwife or obstetrician will tell you that it's time to push and deliver your baby. Can you feel your cervix dilating? Usually not, says Ashley Brichter, founder and CEO of Birth Smarter , which offers in-person and virtual childbirth classes for expectant parents.
However, you might notice the following cervical dilation symptoms.
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