Planning Labour and Delivery
Since no labor or delivery can be fully anticipated or planned in advance, be flexible. Your experience once labor begins may be totally different from what you expected. If an emergency or urgent situation arises, your birthing plan may be changed for your own or your baby''s safety. You may still be allowed to share in some decisions, but your choices may be limited.
When writing your birthing plan, first consider the location of your delivery, who will deliver your baby, and whether you want continuous labor support from a designated health professional or a doula, a friend, or family members. If you haven''t already, this is also a good time to decide whether you''ll attend a childbirth education class, starting in your sixth or seventh month of pregnancy.
Once you''ve set the stage, think through your preferences for comfort measures, pain relief, and medical procedures and fetal monitoring, as well as how you want to handle your first hours with your newborn.
During your prenatal visits, talk with your health professional about what you would like to happen during your labor. Consider writing up your labor and delivery preferences in a birthing plan, either in a childbirth education class or on your own.
Coping with Labour
Labour is indeed hard, painful work. However, there are multiple things that you can do to make the experience a better one.
Here are a few non-medical options that should help calm you down and reduce labour pain.
Which hospital will you be delivering the baby at? Go with the advice of your gynaecologist. If your gynaecologist works at or suggests more than one hospital or nursing home, you may need to make the decision yourself.
Speak to friends and families who have delivered at various places, and get their opinion. However, don't make the final decision without visiting the hospitals or nursing homes yourself.
Once you have made a decision, visit the hospital again to take a good look at the room and bathroom. Familiarising yourself with the place you will be giving birth removes some of the stress associated with the unknown. Take a look at where the room is, how far is it from the delivery room etc.
You may feel more comfortable in your own nightclothes than in a hospital gown. Speak to your gynaecologist beforehand to find out if this is permissible.
What position will you be in when pushing? Many doctors will have you lying down on your back, with your knees propped up and pushing. This position however doesn't receive any help from gravity. You may want to be in a crouching or squatting position when pushing. It is easier to push down, than it is to push forwards. Also, avoid pushing between contractions. Give your muscles a chance to stretch slowly. This may help avoid an episiotomy.
Urinate frequently. What happens sometimes is mothers may notice a sudden urgent need to urinate when pushing. As a result, they don't push as hard as they should. Empty your bladder every hour. You may find the need to pass stools more frequently as well. Your bowels are cleaning up in preparation for labour, so do visit the bathroom as often as necessary. Taking a shower or a warm bath may help ease the pain.
Some swear that drinking a small cup full of ghee helps with the delivery. There seems to be no scientific basis to this, and the only evidence supporting this theory is people's experiences. One cup of ghee when going in for delivery will not hurt, so if you want to give it a shot, go ahead.
Drink plenty of fluids during your pregnancy and during labour. Your body requires more fluids when you are pregnant to prevent constipation and dehydration. There is also increased pressure on your kidneys as your baby grows, and drinking more water keeps your kidneys functioning well. Dehydration can also cause premature labour, so drink up.
As far as possible, try to walk between contractions. Walking may not be easy depending on the stage of labour you are in, and you will need more and more support as your labour progresses. In addition, it encourages steady contractions. It also keeps your pelvis floor moving, and helps position the baby for delivery. Discuss all this with your gynaecologist.
You may feel a sudden burst of energy a day or two before going into labour. This is nature's way of preparing you for the hard work you will have to do, so be careful not to use up all this energy! Don't overexert yourself and spend the entire day running around the mall, just because you feel so energised. Save some of that energy - you will need it.
Comfort measures may include:
- Nonmedication pain management ("natural" childbirth), such as focused breathing, distraction, massage, imagery, and continuous labor support, which can reduce pain and help you feel a sense of control during labor.
- Acupuncture and hypnosis are also low-risk ways to manage pain that work for some women.
- Laboring in water, which helps with pain, stress, and may also help prevent slow, difficult labor.
- Walking during labor, including whether you prefer continuous electronic fetal heart monitoring or occasional monitoring. Most women prefer the freedom to walk and move around, which helps improve discomfort, but a high-risk delivery would require constant monitoring.
- Eating and drinking during labor. Some hospitals allow you to drink clear liquids while others may only allow you to suck on ice chips or hard candy. Solid food is often restricted because the stomach digests food more slowly during labor. An empty stomach is also best in the rare event that you may need general anesthesia.
Playing music during labor.
- Birthing positions during pushing, including sitting, squatting, or reclining or using a ball, whirlpool, or birthing chair, stool, or bed.
Labour pains are a major damper in the joy of having a baby. The thought of the pain that you have to go through makes you ill. Pictures of pregnant women, screaming in pain, that you have seen in hundreds of films, flash through your mind. You can not get all those horror stories that you have heard out of your mind. This fear is very real, yet very normal.
Labour pains are a fact of life that cannot be avoided. There is no point dreading it and working yourself up. Sometimes, the pain is easier to bear when you understand what is happening to your body. Taking up childbirth education classes and read up on the subject will certainly help. Prepare yourself physically by faithfully following a regimen of breathing and toning exercises. Remember that the pain is not going to last forever. With every successive contraction, you are that much closer to the end of the ordeal.
Prelabour and Engagement
Prior to labour, the cervix undergoes a process, sometimes called ripening, in which it becomes thinner (effaced), more pliable and slightly dilated. The beginning of cervical effacement and dilation is known as prelabour. This can precede labour by a full month or even just a few hours if it is your second pregnancy. In your ninth month, the doctor looks out for certain signs of imminent labour. These are signs that you might even be able to see for yourself.
What is "engagement" (sign of prelabour)?
In first time pregnancies, the foetus begins its descent into the pelvis, two or four weeks before the onset of labour. This is ‘engagement'. In subsequent pregnancies, this could take place just a couple of hours before real labour begins. Besides this, your breathlessness will considerably decrease as the foetus moves down, away from the lungs. You will automatically feel an increased pressure in the pelvis and on the rectum.
You won't gain much weight after this. In fact, some women have been known to even lose a couple of pounds. You will find a marked change in your energy levels. Some women get increasingly tired because of the excessive weight and others experience a sudden spurt of energy in preparation for the arrival of the little one (called the ‘nesting instinct').
What is "lightening" or "dropping". Is it the same as engagement?
Lightening or dropping is the descent of the baby into the pelvis in the latter weeks of pregnancy. This is not the same as engagement where the baby's head (unless it is breech, in which case it is the buttocks) moves down to the level of the ischial spines and gets "engaged". Lightening is accompanied by less shortness of breath, decreased pressure in the stomach, and the feeling that the baby has "dropped". It also increases pressure in the pelvis and backache, leads to more frequent urination and constipation, the initial appearance or aggravation of haemorrhoids and varicose veins in the legs. Many women also complain of swelling of the legs and feet, and possibly more difficulty in walking.
The term for the foetus moving into the birth canal is known as "engagement". In a first time pregnancy, this engagement takes place 2 or 3 weeks before delivery. In subsequent pregnancies, it may occur just before the onset of labour. If this is your first pregnancy, then it is quite possible that engagement might have occurred without your realizing it. Your doctor will be checking for this engagement through an internal examination. Since engagement and dilatation of the cervix can occur anytime over a few hours or even a few weeks, not having your baby's head engaged in the cervix is not indication that you will go past your due date.