Birth of a Child

Childbirth is one of the most memorable and rewarding events of a couple's life. No matter how often a woman gives birth, each experience is an intimate and unique celebration of life. Though labor and delivery are not without pain and some degree of anxiety, if you remain confident, well-informed and fully supported by your partner and your doctor, you're likely to have no problem handling the awesome task of bringing a child into the world

Because the unexpected can happen at any time, you may not always be able to control every aspect of your labor and delivery, but don't let this bother you. You can maintain a sense of emotional control by asking questions, challenging assumptions about routine procedures, and openly sharing your hopes and fears with your partner and your physician. Whether you deliver vaginally or by cesarean section, receive anesthesia or experience “natural” childbirth, use a hospital delivery room or birthing center, the experience is yours alone, and every decision will be made in your best interest and that of your child.

Toward the end of your pregnancy, you eagerly await the arrival of your child as the culmination of nine months of careful planning and preparation. If this is your first child, you may feel a mixture of excitement and nervousness when you think about the delivery. And to be perfectly honest, you may also feel restless and irritable as the growing baby exerts greater demands on your body.

This jumble of emotions is completely normal and natural. As your due date draws near, you'll want to know exactly when labor will start and when your baby will be born. But although the process of labor is well understood, no one knows exactly why it starts, and your doctor won't be able to predict either the start of labor or how long it will last. Your due date is a best estimate, but only about 5 percent of women who carry their babies to term actually deliver on that day. The rest deliver from several days to several weeks before or after their due dates.

Nevertheless, you may begin to notice changes in your body that are commonly recognized as signs of impending labor. During a first pregnancy, the baby may “drop,” or engage in the birth canal 2 to 3 weeks before labor begins. You may suddenly feel as though you can breathe more easily, though the increased pressure on your bladder may also cause you to urinate more frequently. In subsequent pregnancies, this “lightening” may occur only a few hours before labor.

The irregular contractions you may have experienced throughout your pregnancy or the third trimester may increase in frequency and intensity. You may have a sudden burst of energy, often referred to as the “nesting instinct,” and feel compelled to take on a major domestic project, such as waxing a floor, baking bread, or reorganizing a closet. Hours to days before labor, the small mucus “plug” that has sealed your cervix throughout pregnancy may begin to stretch, then break apart as the cervix shortens and thins out in a process called “effacing.” Once this occurs, pink-tinged mucus, or “bloody show,” may be discharged from your vagina.

When you notice these signals, you should begin to finalize plans for the care of other children, arrange your transportation to the hospital, and call your doctor for last-minute instructions. Pack a small suitcase, placing any items you will need during labor in a separate bag. Continue to practice any breathing techniques you may have learned during childbirth preparation or Lamaze classes. They can help to distract you from pain and relax you during labor. (See the box “Breathing Techniques Help Bring Relief.”)

One additional sign often indicates that labor is imminent. The downward pressure of the baby's head against the amniotic sac may cause these membranes to rupture. The breaking of your “water” can occur as a trickle or a gush of odorless, colorless amniotic fluid. Alert your medical attendants as soon as this happens. Once the sac has broken, labor is imminent, often beginning spontaneously within 12 to 24 hours. In fact, in many women, the membranes don't rupture until labor is already underway.

Once your water breaks, keep your vagina clean to minimize the risk of infection. Don't take a bath, douche, or engage in sexual intercourse. Be prepared to describe when and how the membranes ruptured, and also be alert to any discoloration of the fluid—from yellow or tan to brown or green. This indicates the presence of meconium, a waste product discharged by your baby's bowels, which can be an indicator of fetal distress.