You may have read up on the subject of labor and delivery, but there are still things that can happen that patients are not expecting. The most important thing to remember is to expect the unexpected. It is good to have an idea of what you would like and outline it in your birth plan, but remember to be flexible since no birth ever goes exactly according to our plans.
Early labor is when you are having contractions but your cervix is not changing. This can last for two to three days, so you might get sent home from the hospital and asked to return when the contractions are closer and stronger.
If you are choosing an induction, it may take one to two days to get you into active labor. This can vary greatly and depends on many factors. Some moms come to the hospital for an induction and expect to be holding their baby in a few hours. You just need to be realistic about how long an induction could take and if it is safe.
When you are in labor, a nurse will usually be with you for a 12-hour shift, so you may have more than one nurse during your labor. Your doctor or midwife will usually have an on-call provider that will handle your delivery, so it might not be your specific provider. The provider may also have other responsibilities during your labor and won’t be in the room the entire time.
Midwives try to provide more one-on-one labor support. A team of experienced nurses will monitor you during your labor and will notify the provider when it’s time to deliver.
You will usually need 30 minutes to get IV fluids, and the epidural will usually take about 30 minutes to start working. If a patient is ready to push the baby out, it’s probably too late for the epidural.
You will usually know it’s time to start pushing because you will feel like you have to poop. Patients are always worried about this but the muscles you use to push your baby out are the exact same ones you use to poop. If you actually have a bowel movement, it’s not a big deal to us, and your nurse will just clean it up.
First time moms can push for two to three hours. Moms who have delivered before can push for one to two hours but sometimes it can be much quicker. There is no way to estimate how long this will take.
It’s hard to predict if someone will have vaginal tears. If you do, stitches will be placed that will dissolve, eliminating the need for removal. We usually try not to cut an episiotomy unless there is a reason to do so. You may also have swelling of your labia (lips of vagina) and ice packs work very well to help numb the area and decrease the swelling.
After the cord is clamped and cut, you will still need to deliver the placenta. It usually will happen within a few minutes of your delivery but can take up to 20 to 30 minutes. You will be given Pitocin to help your uterus firm up and your nurse will need to massage your uterus to make sure it stays firm. You can see the placenta if you would like. Many women are interested to see where their baby was living for the previous nine months.
The shakes are caused from the immediate hormonal shifts that occur after delivery. They are normal. If you try to stop yourself from shaking, it usually makes it worse. They will usually go away in a few minutes.
Most moms don’t discuss these things because after the blood, sweat and tears that are all part of childbirth, they have their baby in their arms, amnesia sets in and all the bad is forgotten. Talk with your provider for any additional questions you may have about the labor and delivery process.