What happens on the day of the birth? What are the different stages? At what point does the epidural intervene? How is the birth of the baby? We tell you everything about the course of childbirth.
Arrival at the maternity hospital and the progress of labor
Some signs are unmistakable. The birth has started well. It is time to leave for the maternity ward. Here is an update on your arrival and the progress of your labor.
This is it, the big day! Repeated contractions, loss of water, an intuition that “it’s time,” you leave in a hurry – or not – for the maternity hospital. And you are right because the birth is near. When you arrive, you are received by a midwife who notes the obstetrical file you have with you. She then asks you various questions about your feelings. Then the clinical examination takes place. You are installed in the pre-labor room or directly in the birth room, depending on the maternity hospital. The father-to-be is at your side. The midwife then performs a vaginal touch. This procedure usually is familiar to you as it has been performed several times during your pregnancy to check the state of the cervix. This examination confirms the diagnosis of early labor or the absence of labor. If the cervix has started to open, it means that the delivery has begun. As soon as you are admitted, your blood pressure will also be taken, and a monitoring device will be used to ensure that the baby is doing well. This device has a pressure sensor placed on your belly with the help of an elastic belt. It records the rhythm of the fetal heartbeat, but also the frequency and intensity of contractions. The monitoring allows you to see how the baby is coping with the uterine contractions. If you want an epidural, this is also the time to say so. The anesthetist will probably come and explain the procedure to you.
The cervix is dilating
You and your partner are in the delivery room, wearing a hospital gown and sterile slippers. The temperature is relatively high, the atmosphere calm. All you have to do is wait for the cervix to dilate. This natural process often takes a long time, especially for a first baby. It is customary to say that the cervix dilates by about 1 cm per hour. But in reality, it is better not to calculate. During labor, the health of the baby and the mother is regularly monitored. In principle, the midwife examines you every hour to check the progress of the cervix. Be patient; we speak of complete dilation when the cervix is open to 10 cm. In some maternity hospitals, it is acceptable not to leave the monitor on all the time.
If the pregnancy has gone well, there is no pathology, and the fetal heart rate is satisfactory, there is no reason not to let the mother-to-be sit or walk around for a while. To relax, accessories such as the ball, the suspension, or the bathtub can be used. Immobility does not favor the progress of labor. The most analgesic positions are those that allow birth to progress. The installation of an infusion is not systematic during dilation but is necessary in the case of epidural. It allows sugar to be injected because labor is often tiring. In the same way, it sometimes happens that the cervix does not dilate anymore or only very slowly despite close contractions. The midwife will then be able to put in the infusion a product to accelerate the labor, is oxytocin.
Epidural or not?
Those who wish it can benefit, during the dilation, of epidural anesthesia. It is usually applied at the request of the mother when the contractions become too painful. It is a very personal choice. Some women prefer to wait as long as possible because it is a way for them to take ownership of their delivery, while others, very anxious, want it early enough. In theory, the epidural is applied when the cervix is dilated between 3 and 8 cm.
It should be noted that when a certain threshold of pain is exceeded, the anesthetic acts less well. The installation of the epidural takes a few minutes. You are sitting on the edge of your bed, with your back rounded; the anesthetist pricks a first time to anaesthetize the injection area locally. Then they use a fine needle to insert a catheter between your two lumbar vertebrae. The catheter contains the anesthetic and remains in place throughout the delivery. In the case of a cesarean section, the product is reinjected. Today, maternity hospitals are increasingly offering self-dosing epidurals. It is you who administers the quantity of anesthetic products according to the pain. In specific structures, one also proposes the déambulatory epidural anesthesia to allow the mom to walk during labor. Most of the time, the midwife breaks the water bag after the epidural is applied. This gesture is also a means of restarting labor. If you have opted for a physiological birth, the medical team will wait for the water to break spontaneously.
When it comes to the big day, you can’t know what will happen. Preparedness may help you control your expectations and prepare for the arrival of your kid.