Each Mom should be prepared for childbirth

Childbirth is one of the most beautiful moments in human life, and the due day of your baby is finally near after 9 ½ months anticipation. You may be very excited and eager to see what will happen, and can’t wait to see the face of your beloved baby who you are calling and talking to every day and night. And now the moment is coming unpredictably.

Actually, no one, not even your obstetrician, can predict precisely the date that your labor will begin. If you are calculating from your ovulation day, you will be the one who can guess closely to the actual labor date. It will be normal for any pregnant woman to start labor up to three weeks before, or two weeks after the predicted date. But if it is your first delivery, and you see some signs of labor, it will be the closest time of a real coming labor.

10.1 - Signs of Labor

There are several signs indicating that labor is not far away, and they normally include lightening, bloody show, diarrhea, ruptured membrane, and contractions. It can only be sure that lightening normally happens as the first sign solely in women with their first delivery of their lives. Besides the fact that lightening can happen as the first sign for the first delivery, there is no definite orders of which sign will happen first or which one will happen next of any of those signs. After lightening, either bloody show, ruptured membrane, or contractions could be the first sign of labor for a specific.

Lightening. It occurs a few weeks before your labor in most cases of the first delivery. As explained in Chapter 6, it is an event that the head of your baby drops down to your pelvis to prepare for the later delivery. You will have a released or lightening feeling of the pressure to your lungs and stomach, and thus you will breathe better, eat better and sleep better. But because your baby’s head is pressing your bladder, you will normally feel like urinating more often.

Bloody show. This occurs a few days or hours before your labor. It is an either bloody or brownish looking discharge mixed with mucinous secretion that comes from the mucus plug sealing the cervix of the womb. The mucus plug is functioning as an anti-infection filter, and it is no longer needed in this time. The release of the mucus plug is the result of the early stage of the initial cervical dilation.

Ruptured membrane or water break. This may occur hours before or during early stage of labor, and most of pregnant women go to labor within 12 hours after water break. Only about 10% of women have water breaks before their labors begin. It is the amniotic fluid leak or gush down from the vagina because of the rupture of the amniotic sac. It will be a leak in most of the cases, because the baby’s head will stop further leak out. The amniotic sac and fluid are the protectors of your baby, and the rupture is required for the delivery. But in case the labor does not occur within 12 hours, your obstetrician will need to induce the labor to prevent the possibility of infection.



Contractions. The irregular or practice contractions, known as Braxton Hicks or false labor, often happen in the last few weeks of pregnancy, and have no relationship to delivery. The way to tell the differences from delivery related contractions is that Braxton Hicks will neither go strong nor regular, and they go away easily. And the cause could be just hunger or dehydration as signals that you need to eat or drink.

When the delivery related contractions come, they are normally getting stronger and very regularly, and they will not reduce until the delivery. They are getting more intense and frequent over time, and the intervals are getting shorter between each contraction. The real contractions are required by vaginal birth, and you should try to be relaxed and let it happen by itself. You relaxation will reduce the pain and may reduce the damages during delivery. Once the labor starts, you will feel less pain and have enhanced confidence of the delivery.



Frequent stools or diarrhea. This occurs during the early part of labor. It is induced by a group of hormone like substances called prostaglandins that are secreted by your body to cause the contraction of the uterus, and the dilation and softening of the cervix to facilitate the delivery. But the same group of prostaglandins can also stimulate the bowels to have increased moments and to release stools earlier and softer.

 

10.2 – Caring for the Best

Your family goes through the pregnancy with you and they feel your feelings. They have fears, anxieties, stresses and joys, the same as you do. Now when the delivery time is getting closer, they are as happy and excited as you are. If you can get your partner involved into the time before and during delivery, it will be one of your unforgettable moments. Your partner’s supports will give you strength and enhance your self-confidence of the delivery, which is very important for you to go through the whole process peacefully and successfully. Communication is the key to your partner’s collaboration, and he will not be as informed as you about the delivery because he spends most of his time on family supports. It should be you who actively communicate with him to explain different aspects and steps of the delivery, and prepare him for the event.

If you have kids, they need to be noticed in advance as well. They have paid attentions to your belly in the past, and it is now time to let them know that a new sibling is coming soon. Older kids often have mixed feeling about a newborn baby, and you are the one who should share the truth with them. You can talk to them about the joy, the trouble, and the mess with a newborn; and about that your loves to them will never change because of the new baby. You may get them involved to the preparations of bedding, rooming and clothing of the new baby, and help them to learn how to take care of an infant. When you care about your older children more, they will care about the newborn more as well.

10.3 - During Delivery

There are three stages of each labor, and they are Stage 1, 2 and 3. Stage 1 has three phases as latent phase, active phase, and transition phase.

 

Stage 1:

Latent phase. This is the longest and least intense phase, and thus discomfort is minimal. Contractions are getting more and more frequent, and help the cervix to dilate about 3 ~ 4 centimeters, and to thin out as well. It depends on your contractions, if they are regular, you will be admitted to the delivery room and your pelvic will be examined frequently to determine the dilated centimeters.

Active phase. Contractions become regular and intense, and you will feel pain and pressure to your back and abdomen when they come. The cervix dilates about 4 ~ 7 centimeters, and you may have the urgent feeling to push down. But your obstetrician will request you to hold it until the cervix is fully open.

Transition phase. Contractions are strong and frequent as one minute or so, and the intervals are three to four minutes. The cervix is fully open to 10 centimeters. The pain induced by contractions varies depending on individual feeling, and if you receive adequate delivery training and fully understand the process, you may be relaxed enough and not to feel too much pain. But if you try to use your strength or muscle to against the contraction or pain, you may feel more pain. You need to understand that delivery is a natural process for thousands of years, and you have nothing to be afraid of. You should just let it go, and the contractions are necessary for helping you to deliver your baby.

Stage 2:

Once the cervix is fully open, Stage 2 begins. You will receive an OK instruction from your doctor to start pushing down. Your pushes and contractions will propel the baby through the birth canal. The soft spots or called fontanels on the head of your baby will help the head fit to the narrow canal, and the head eventually crowns in the vaginal opening.

Once the head is fully coming out, you will need to hold your pushing for a few seconds, because the doctor will need to suck and remove any liquids like amniotic fluid, mucus and blood from the baby’s nose and mouth to allow the baby to breathe easily. And then your job will be pushing continually and slowly to deliver the baby’s shoulder and the whole body. When the delivery is done, the umbilical cord will be clamped and cut, and removed. The cut wound will be well sterilized and covered to allow the wound to recover naturally, and to prevent infection.

The important thing to do in stage 2 is that you follow the instructions given by your obstetrician for the speed of the delivery, either too fast or too slow is not good for you and the baby. If you push too hard, it is unnecessary and will make more than necessary damages to your birth canal; if your push is not hard enough, it will slow down the delivery and will be not good for the baby. It happens that you may feel eager to push harder, but you really need to control your feeling to fit to the need of the delivery. So the key is to follow the instructions from your experienced doctor, and to do what you are told.

Stage 3:

Once the baby is delivered, you are in the stage 3 of labor to deliver the placenta that nourishes the baby in the past months. And if any stitch is needed to seal the wounds inside or outside of your vaginal and its opening, it will be performed in this stage under anesthesia and sterilized procedures.

The total time spent by you for your labor will be unique and different from others, and if this is your first time of pregnancy, it will probably last about 12 ~ 14 hours from the beginning of stage one. And the length of time will be shorter for any subsequent delivery in the future of your life.

The level of pain will be also different individually, and the position, size of baby, and your relaxation will influence the pain level. You can learn from prenatal training classes for how to relax yourself, and to reduce the pain level during delivery. If you can manage to relax those muscles that are not needed for delivery, you will be able to reduce pain and limit it to the maximum level. Those women who can handle this will feel almost no major pain during the delivery.

There are many non-drug options for pain relieving like relaxation skills, hypnosis, acupuncture, and body position adjustment during delivery. You will need to have special training during your pregnancy by attending prenatal classes for delivery muscle training and pain reduction training. You may choose one or more of these options to assist your labor to reduce pain and the use of pain relief medication, and to help your delivery to be easier.

But if you feel that you need pain relief medication, you can always ask your doctor. There are different types of pain relief safer for you and your baby, but the less use of these medications will be better, because any medication will come with potential of side effects.

Recovery from your delivery.

This is your happy time, and it will take several steps towards your fully recovery. There are many foods, herbs, teas and home remedies can help you to recover sooner, and you may check online and pick those that work for you. One of the North American traditions is drinking coca-cola, and it has been confirmed by many moms that it really works for your utero and your body to recover earlier. No one knows why it works, and it is probably those herbs and ingredients that it contains play their effects on your body. Some physical symptoms may happen to you in recovery period, and each of you will feel differently, depending on your prenatal and postnatal exercises and your nutrition status.

Hot or cold flashes. Immediately after birth, you may have some rare feelings like a sudden warm or cold, or even chilling. These symptoms come from hormone adjustments and blood flow changes that your body makes to fit to a new situation of post-delivery. They will disappear within a few hours.

Irregular contractions. You will feel contractions for a few days more, and they are irregular and necessary for your utero to go back to its normal size. The contractions themselves are helping your utero to shrink gradually back to its normal situation before the pregnancy. Your breast feeding of your baby will enhance these contractions, and this is one of the reasons that breast feeding will do both you and your baby good. In case your contraction is not strong enough, your obstetrician will need to use medications or other methods to help your utero to recover earlier.



Vaginal discharge. You will experience a heavy bloody discharge right after birth, and the amount is more than the one of regular period. The discharge will decrease and eventually becomes yellow, and then white, and stops within a couple of weeks to two months. This is a normal procedure that your utero and vaginal are recovering. All you need to do for this discharge is to keep your perineal area clean and dry to prevent any possibility of infection, which is similar to regular menstrual period, but lasting a bit longer time.

Pain at the episiotomy site. During the delivery, in case that your vaginal opening is not big enough for your baby’s head, your obstetrician may need to perform an episiotomy in the perineum area between the vagina and the anus, to enlarge the vaginal opening. When the situation is required, this small surgery is necessary to help the baby to be delivered safely, to prevent tearing your vaginal tissues, and to prevent heavy bleeding. The cut wound and other wounds caused by the delivery will be sterilized and stitched appropriately right after birth, but you will have minor painful feeling while these wounds are recovering. The pain or uncomfortable feeling will be probably more obvious when you walk or sit, or when you cough or sneeze. But they will disappear within a few weeks.

Sore breasts. Three to five days after the delivery, your breasts and nipples will be harder, swollen and painful for a few weeks as your breasts are producing milk for your baby. Your milk of the first several days and a few weeks are most important to your baby because it contains the highest concentrations of antibodies and other components required by your baby’s growth. So these uncomfortable feelings will be well paid back.

Abdomen pain or constipation. Your bowel will also experience hemorrhoids, episiotomies and sore muscles, and when they move around to digest foods, you may have uncomfortable or minor painful feelings for the first few days. You may also feel uneasy when you try to release stools due to the painful feeling in the vaginal area and the slow moving bowel, or even have symptoms of constipation. In this case, you may need to ask for helps from your obstetrician, and avoid using too much strength because the strength may slow down the recovery of your vaginal area. These feeling will be gone sooner after the delivery.

Urinary and fecal incontinences. During the delivery, muscles around the opening of the urinary track and the anus will be over-stretched, especially when the labor last a bit longer. These muscles are called sphincter, and they are controlling your urine and stool releasing. After they are stretched and pressed, you may feel there is a bit leak, particularly when you laugh, cough or sneeze. But the muscles will recover eventually, and special sphincter muscle trainings can shorten the recovery time.

It is not too difficult to experience these discomforts and symptoms during such a happy moment in your life. With better understanding and confidence that you will recover completely upon time, and with helps from your family, your parents and friends, you will fully recover within a few months.

10.4 - How would you want to deliver your baby?

Nowadays, many options are available for you to choose the one option that you think is the best for you and your beloved baby to perform the delivery. There are two things that you need to know before choosing, the first thing is that the option should fit to your knowledge and within your capability of handling including physically and financially, and should do you good; and the second thing is that the option should do your baby good. This is really that simple.

Places to delivery

Give birth in a hospital. Hospital birth has been a traditional way of giving birth for many years, and is still currently the place that the majority of women give birth in the United States. This is the only place for you if you have any higher risk factor, like having high-risk pregnancy, giving a vaginal birth after the previous cesarean delivery, or taking the advantages of accessing latest medical technology, and so on. Different hospitals offer you slightly different birth environments, and you may want to check it up before choosing. There are at least three types of delivery environments in hospitals: Traditional birth, family-centered birth, and in-hospital birthing center.

Give birth in a standalone birth center. Non-hospital birth centers offer more private and comfortable birth services with little medical intervention, and take your needs and desires as the most important. You may wear your own clothes, and eat and drink while giving birth, and your family and friends can attend your delivery if you are willing to. Birth center will also offer some other services that you will not get from all hospitals, like tubs or Jacuzzis for water delivery. But they will only offer minimal medical supports and services, and are only good for those women who are healthy without any pregnancy complications.

Give birth at home. Home birth has been a tradition long before hospital birth, and is still popular in undeveloped areas. It is also available in developed countries in the United States and in European countries, and women who chose home birth have increased since 2004. You should only consider home birth if you are totally healthy, your pregnancy is totally normal, and you have delivery experience before. Studies show that there are two to three times higher risk of infant death of home birth, even though the overall risk is low.

10.5 Methods of Delivery

Vaginal delivery. This method is the most common and safest way of delivery that has been well described in Section 10.3.

Caesarean delivery or C-section. When vaginal delivery is not possible in some situations, such as the baby’s head is not in the head-first or head-down position, the baby is too large to be delivered by the vaginal delivery, or the baby is in distress conditions. In some cases, when the mother does not want to use the vaginal delivery way, she may choose the C-section as her delivery method. But once the current delivery way has been chosen as caesarean, future delivery will be also considered to be caesarean way to ensure the safety, since the section wound will make it higher risk for vaginal delivery next time.



Water delivery. A water birth is to give birth in water, and it can be in a hot tub, a bathtub, or a water pool. Water birth is available in most of the birth centers and in some hospitals, and if you choose water birth in hospital, you will receive the same medical condition as non-water birth. This option is available only for those women with healthy and full-term pregnancy without any pregnancy related complications like infection, bleeding. The reasons that mothers choose water birth are indicated in the table as follows.

10.6 - Importance of Oxygen in the First Second of Life

Newborn babies usually take their first breath, normally showed as the first cry, within ten seconds after birth, and if they don’t, the attended obstetrician will have to stimulate the baby to cry, or have to give oxygen to the baby. In the past, it was unknown if lack of oxygen or called hypoxia has anything to do with intelligence. But a group of scientists in Southmead Hospital of Bristol in United Kingdom confirmed that those children with hypoxia at birth are with bigger risks of lower intelligence, even though everything was fine with the pregnancies. The data was published on a well-known British journal called Lancet.



A common rates of 2 ~ 3% of mature babies, and 30% of immature babies born at week 28, suffer from hypoxia at birth. It has been found in these children that hypoxia results in degeneration of brain tissue (encephalopathy) and decrease of blood flow to the brain, when the studies were conducted in 11,981 children. Compared to those children without hypoxia at birth, children with oxygen deficiency at birth have increased risks of lower IQ intelligence that are related to brain tissue degeneration.

When considering normally IQ as 90 ~ 110, these 8 years old children with hypoxia at birth have 65% higher chance to get IQ values below 80, compared to children who did not have hypoxia. The data indicate that lack of oxygen in the first minutes of their lives were enough to cause neuronal damages that will affect them in their whole lives.

In most of the cases, these children were underweight, born early, and score lower for their maturities, and they are often the babies from the mothers with lower education levels, suffering from hypertension or fever during their pregnancy. The effective intervention to prevent hypoxia and its effects on IQ intelligence is to educate and train obstetricians and neonatologist to improve breathing and oxygen parameters during childbirth.

10.7- Facts and General Recommendations

Giving birth is one of the most magnificent things in your life, and there are some facts and recommendations for you to help you experience the best and rare life time easier. Most of the experiences will be totally different from anything else you have seen or done, even you have received some training from prenatal classes, but when you experience by yourself, you will still be confused, embarrassed and surprised. This section will help you to get familiar with most of these real events that you are going to experience, and with tricks that you are going to need during the delivery. Most of your training classes will not tell you about them in details.

Firstly, you may wonder if there is anything unusual of your delivery date. The fact is that only about 5% of women deliver their babies exactly on their due dates, and most of them deliver between 37 ~ 42 weeks. Your delivery date is most probably within the normal range, and your baby is mature and totally normal.

There will be some moments considered normal in delivery that may be embarrassing in daily life. But since this is a special moment with life related important events that happen with medical reasons, what you need to know is that all of the doctors and nurses are familiar with these events, and they definitely understand the reasons and causes of what will happen during the delivery. But you are almost the only one that is new in the whole experience. And these are events that happen to most of women while delivering.

For instance, when you are preparing yourself for the delivery, both you and your doctors are working hard together closely. At this moment, something can be out of control, your stools and urine may come out without any of your control. This is completely normal and natural, and there is nothing to worry about. It happens only because you are using the same set of muscles of releasing for the delivery. And those substances produced by your body to facilitate the delivery are also working on other organs like bowel and urinary system. All you need to do is follow the flow of your body, listen to the instructions from your doctor, and enjoy the one time moment in your life as a proud mom.



There will be lots of bloody discharge out of your vaginal after giving birth, and it will last for at least a couple of days with bigger amount than regular period. This happens because your utero will be contracting to shrink, and needs to release the discharge to reduce its size. It is wise of you to have some adult diapers at home before heading to the hospital for your needs when you go home with your baby. The preparation will make you feel comfortable and make your after birth life easier. The hospital will provide you with some soft and elastic disposable undergarments while you stay there right after delivery.

You may also need to get used to the idea that you are a popular person in the delivery room, especially when you choose a hospital, there may be more people watching your private delivery to make sure of everything. After your delivery, when you use the lady’s room for the first couple of times, you may also need helps from the professionals. You also need to take care of the wound area while using the bath room, if you receive episiotomy for vaginal delivery, or a C-section for caesarean delivery, you need to avoid wiping yourself afterward, but using a bottle with warm water to clean yourself up instead. This is necessary to prevent possible infection and to help the wound to recover earlier.

After birth, your doctor may ask you everything in details about your aftermath feelings and events, and you may be amused by some of the questions. For example, if you receive a C-section for your delivery, one of the most important questions that you had better tell the truth is that you will be asked a couple of times per day if you start passing gas. You should not deny it, but tell the truth, because passing gas is a very important and sole sign that your bowel function is going back to normal, and it also means that the C-section surgery is successful. And thus you will not be allowed eating normally until you start passing gas.

One more important thing for you to take care of is foods and nutrition. During the delivery, you will lose lots of blood that is about half a liter. After the delivery, you will be still losing blood due to the discharge. And your breast feeding will need nutrition to produce milk efficiently. It is not difficult to understand that lots of nutrition is needed than usual for your body to meet all of those needs. Since you are just out of labor, and your bowel function is recovering, the foods recommended for the first couple of days will be those easier to be digested, nutritious, and full of vitamins and minerals. In the case of constipation, you may ask for foods that help to soften your stools. If you are breast feeding your baby, keep in mind that everything you eat will go to your baby through milk feeding.



games with your baby and doing exercises to help to improve his/her intelligence, they may tell you that you are wasting your time. They are wrong.

The exercises, recommendations and tips contained in this ebook have been created based on sound research done by scientists, psychologists, doctors, and college professors, in different countries worldwide during the last 40 years. Several different kinds of studies have been done, far too many to capture in this chapter, so we will focus on experimental studies.

Summary ● Nutrition is one of the most important factors in fetus brain development, especially in the times of before conception and the first trimester after pregnancy. ● You may not aware of your pregnancy status at this early stage and you should improve your nutrition condition when you plan to have a baby. ● The brain development related nutrition includes but not limited to vitamin B-complex, seafood, iodine, copper and iron. ● Malnutrition at the early stages of pregnancy can cause many different mental and health problems and should be avoided. ● It is recommended that you obtain adequate nutrition by eating diets with rich and various nutrients. ● If you think you need prenatal supplements, you need to consult your prenatal doctor.