Labor and Deliver
What happens during delivery?
When your cervix has opened fully, your contractions will start to feel different, and you will have an urge to bear down. During this stage of delivery, your contractions may slow down to between two and five minutes apart and last 60 to 90 seconds. As the baby’s head moves down, you may feel pressure on your rectum and stinging in your vagina.
Be assured that Dr. Garofalo follows evidence-based guidelines and does not recommend routine episiotomy, a small cut in the perineum to widen the opening of the vagina. This procedure is only used by Dr. Garofalo in unusual circumstances. Once your baby’s head emerges, Dr. Garofalo will guide the shoulders and body out of the birth canal. If there are problems at this point, Dr. Garofalo may recommend vacuum extraction to gently guide your baby’s head out of the birth canal.
This second stage of labor usually lasts 20 minutes to three hours but may take longer. During this stage, you may want to ask for a mirror so you can see your baby’s birth. Try different positions to see which works best for you and which is most comfortable. Tell your childbirth partner where to stand so they can offer the most emotional and physical support. Push when Dr. Garofalo tells you to push, and try to rest between contractions.
After your baby is delivered, your placenta will soon follow. (The placenta is the organ that supplied your baby with maternal nutrients and helped your body process your baby’s waste.) To help you push out the placenta, your contractions will continue, but they will be closer together and less painful.
When is a Cesarean delivery needed?
If there are complications with your pregnancy or labor, your baby may need to be delivered by cesarean section. With this procedure, Dr. Garofalo will deliver your baby through an incision in your abdomen and uterus.
Certain medical conditions or previous surgeries, including a previous cesarean operation, may make vaginal birth risky. You may also need a cesarean delivery in the following situations:
- If you’re carrying more than two babies
- If you have a large baby or a small pelvis
- If labor is too stressful for your baby
- If your baby is positioned improperly (“breech”)
- If the umbilical cord is pinched
- If the placenta covers part or all of your cervix
If you undergo cesarean surgery, you will be given some form of medication to numb or block pain. Your vital signs will be monitored and you will be given oxygen via a mask or tube. Your childbirth partner will probably be able to be with you in the cesarean section room. A catheter will be inserted into your bladder to keep it empty and out of the way. A four- to six-inch incision will be made in your abdomen and uterus and your baby will be lifted out, followed by the placenta. The incisions will be repaired using stitches.
Risks from this procedure are unlikely, but they include infection, blood loss, blood clots, and injury to the bowel or bladder.
Cesarean delivery is a major surgery. Recovery will take several weeks, including three or four days in the hospital, and it will likely take more than a month until you feel back to normal.
What happens after delivery?
After delivery, you and your baby will be examined and monitored to make sure there are no problems. To keep fluids from your baby’s lungs, your baby may be held upside-down and a small bulb and syringe will be used to clear his or her mouth and nose. The umbilical cord will be clamped, then cut.
In most cases, you will be able to hold your baby shortly after birth, although a few short health evaluations, measurements and other procedures will need to be done. Within a few hours, a longer exam will be conducted to evaluate your baby’s health.
In most cases following a normal delivery without complications, you’ll spend at least two days in the hospital after giving birth. During this time you’ll rest and start to recover from your labor. You’ll also start to get to know your baby and how best to care for him or her. If you’re not ready to see visitors, let them know.
Your hospital will have many resources you can use, from lactation counseling to help caring for your baby’s umbilical stump. Take advantage of these resources, and be sure to get all your questions answered, whether they deal with your health or your baby’s. Before heading home, you should feel prepared to care for your baby and for yourself.