Labor and Delivery, Vaginal Birth
(Vaginal Birth; Labor and Delivery)
Reasons for Procedure
- Uterine infection
- Tear of tissue around the vagina
- Complications requiring forceps, vacuum extraction, or cesarean delivery (C-section)
- Blood clots
- Injury to the baby
- Bleeding disorder
- Lung or heart disease
- Infectious disease (eg, active genital herpes infection, HIV )
- Water breaking before your contractions start
- Placenta previa (placenta positioned over the canal opening)
- Abruptio placenta (early separation of the placenta from the wall of the womb)
- Umbilical cord prolapse (umbilical cord slips out of the birth canal before the baby's head)
- Large baby or a baby in the wrong position inside the womb
What to Expect
Prior to Procedure
- Be sure to go to all prenatal care visits with your doctor
- Eat nutritiously and drink plenty of fluids.
- Get as much sleep as possible.
- Read about giving birth and take a childbirth class.
- Choose a support person to be with you during labor and delivery.
- Write a birth plan that explains what you want and helps you to think about possible complications.
Talk to your doctor about:
- Ways to contact her after hours and when you should call
- Steps you should take when in labor
- Whether you want pain relief during labor
- Perineal massage—The perineum is the area between the anus and the vagina. Massaging it may help to reduce your chance of trauma to that area.
- How you will travel to the hospital
- Arrangements for home and work
Be aware of the signs of labor, which include:
- "Water breaks" (amniotic fluid that surrounds the baby leaks out through the vagina)
- Back pain
- Slight vaginal bleeding
Pain medicines by IV or muscle injection
- Given when contractions become stronger and more painful
- Can cross into the baby's bloodstream
- Liquid pain medicine injected near spinal cord
- Given in small amounts by an anesthesiologist (a doctor who specializes in anesthesia)
- Does not cross into baby's bloodstream
- Decreases pain and feeling in your lower body
- Provides good pain relief and allows you to continue with delivery
- Can cause headaches and drop in blood pressure, as well as changes in baby's heartbeat
- Liquid pain medicine injected into spinal fluid
- Used for pain relief during delivery, especially if forceps or vacuum extraction is needed
- Often used for C-section
- Numbs lower half of the body and reduces your ability to push
- Provides good pain relief and works quickly
- Can cause headaches after delivery and drop in blood pressure during labor and delivery, as well as changes in baby's heartbeat
- Injected into vagina or surrounding area
- Used if an episiotomy (cutting near the vagina) is needed
- Also used when vaginal tears are stitched
- Does not relieve pain of contractions during labor
Description of the Procedure
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Immediately After Procedure
- Right after birth, your baby may be placed on your abdomen or chest. This skin-to-skin contact may lead to improved breastfeeding success.
- You may need stitches if your perineum is cut or torn.
- You may receive abdominal massage to help the uterus clamp down and decrease bleeding.
- The vaginal area, perineum, and rectum will be cleansed.
- An ice pack will be placed on the perineum to soothe and decrease swelling.
- You may be given a shot of oxytocin to help decrease bleeding.
- The doctor will give you pain medicine.
How Long Will It Take?
Will It Hurt?
Average Hospital Stay
- Sore breasts—Your breasts may be painfully engorged when your milk comes in. Also, your nipples may be sore.
- Constipation —You may not be able to move your bowels until the third or fourth day after delivery.
- Stitches may make it painful to sit or walk.
- Hemorrhoids —Hemorrhoids are common. They may make it painful for you to move your bowels.
- Hot and cold flashes—This is due to your body trying to adjust to the change in hormones and blood flow levels.
- Urinary or fecal incontinence—During delivery, your muscles were stretched. This may make it hard for you to control your urine and bowel movements for a short period of time after delivery.
- "After pains"—The shrinking of your uterus can cause contractions. These can worsen when your baby nurses or when you take medicine to reduce bleeding. It is normal to have this after delivery.
- Vaginal discharge—This is heavier than your period and often contains clots. The discharge gradually fades to white or yellow and stops within two months.
- Weight—Your postpartum weight will probably be about 10 pounds below your full-term weight. Water weight drops off within the first week as your body regains its salt balance.
- "Baby blues"—About 80% of new moms have irritability, sadness, crying, or anxiety . This begins within days or weeks of giving birth. These feelings can result from hormonal changes, exhaustion, unexpected birth experiences, adjustments to changing roles, and a sense of lack of control over your new life.
- Postpartum depression (PPD)—This condition is more serious and happens in 10%-20% of new moms. It may cause mood swings, anxiety, guilt, and persistent sadness. Your baby may be several months old before PPD strikes. It is more common in women with a family history of depression.
- Postpartum psychosis—Postpartum psychosis is a rare, but severe condition. Symptoms include difficulty thinking and thoughts of harming the baby. If you feel this way, call your doctor right away.
- Sexual relations—You may not feel physically or emotionally ready to begin sexual relations right away. In most cases, you will feel more interested in sex in a few weeks.
- When your baby sleeps, take a nap.
- Set aside time each day to relax with a book, or listen to music.
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Get plenty of exercise and fresh air.
- Schedule regular time for you and your partner to be alone and talk.
- Make time each day to enjoy your baby. Encourage your partner to do so, too.
- Breastfeeding is encouraged unless your doctor tells you otherwise
- Clean less and have easier meals. Take a break from having visitors if you feel stressed.
- Ask for help when you need it.
- Talk with other new moms and create your own support group .
- Delay having sexual intercourse and putting any objects into the vagina until you have had your 4-6 week check-up
- Be sure to follow your doctor's instructions .
Call Your Doctor
- Signs of infection, including fever and chills
- Increased bleeding: soaking more than one sanitary pad an hour
- Wounds that become red, swollen, or drain pus
- Vaginal discharge that smells foul
- New pain, swelling, or tenderness in your legs
- Pain that you cannot control with the medicines you have been given
- Pain, burning, urgency or frequency of urination, or persistent blood in the urine
- Cough, shortness of breath, or chest pain
- Depression, suicidal thoughts, or feelings of harming your baby
- Breasts that are hot, red, and accompanied by fever
- Any cracking or bleeding from the nipple or areola (the dark-colored area of the breast)
The American Congress of Obstetricians and Gynecologists http://www.acog.org/
American Pregnancy Association http://www.americanpregnancy.org/
Baby Center http://www.babycenter.ca/pregnancy/
Women's Health Matters http://www.womenshealthmatters.ca/
Depression during and after pregnancy. Women's Health.gov website. Available at: http://www.womenshealth.gov/faq/postpartum.htm . Updated April 2005. Accessed June 11, 2008.
Epidural anesthesia. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/epidural.html . Updated August 2007. Accessed June 11, 2008.
Obstetrics: Normal & Problem Pregnancies . 3rd ed. New York, NY: Churchill Livingstone; 1996.
Spinal block. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/labornbirth/spinalblock.htm . Updated December 2006. Accessed June 11, 2008.
2/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Beckmann M, Garrett A. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2009;CD005123
12/4/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Marín Gabriel M, Llana Martín I, López Escobar A, et al. Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn. Acta Paediatr . 2009 Nov 12. [Epub ahead of print]
4/29/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Hjelmstedt A, Shenoy ST, Stener-Victorin E, Lekander M, Bhat M, Balakumaran L, Waldenström U. Acupressure to reduce labor pain: a randomized controlled trial. Acta Obstet Gynecol Scand . 2010;89(11):1453-1459.
12/9/2013 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Hodnett ED, Gates S, et al. Continuous support for women during childbirth. Cochrane Database Syst Rev. 2013 Jul 15;7.
- Reviewer: Andrea Chisholm, MD
- Review Date: 09/2013 -
- Update Date: 12/09/2013 -