Baby Position
Lightening or dropping
If this is your first pregnancy you can expect lightening to occurr
during the last few weeks of pregnancy. If this is not your first
baby, lightening probably won't ocurr until labor begins.
lightening or dropping is the process in which
your baby naturally positions itself for delivery. The baby's body
becomes inverted and the head descends into the pelvis usully just
behind the pubic bone. The baby's body along with the curve of your
abdomen shifts down and forward. As a result, pressure is taken
off the mother's diaphragm making it easier for her to breath and
to digest. This gives the mother a lightened feeling. Thus the name
"lightening."Although pressure is relieved from the upper
regions of the mothers abdomen, increased pressure is applied within
the pelvis. This can cause a more frequent need to urinate, and
aches and twinges of pain within the pelvic region.
The Epidural
A tube inserted into the spine to administer
pain relieving drugs.
The procedure
- The mother lies on her side and curls into
a ball to increase space between the vetebrae.
- A local anesthetic is used to numb the area.
- An epidural needle is inserted between two
vetebrae.
- A catheter (a thin flexile plastic tube)
is inserted through the needle.
- Once the catheter is in place, the needle
is removed
- The doctor then uses a computerized pump to control
the flow of pain control drugs through the catheter.
It takes about 30 to 40 minutes from the time
the doctor begins the process of placing the epidural to the time
the drugs start working effectively.
Benefits of the epidural
- It provides the most pain relief to the mother
while greatly limiting drug exposure to the baby.
- It relieves pain while retaining the mother's muscular
control.
- It usually allows the mother to rest during
the first stage of labor, so she can save her energy for when
it's more prominently needed (during the second stage of labor
and the birth).
- If the mother needs a Caesarean section
or a forceps delivery anesthesia can be administered through the
epidural.
- If the mother experiences a vaginal tear
or if the doctor needs to perform an episiotomy (an incision to
widen the birth opening) Pain control drugs can be administered
for an additional 24 to 48 hours through the epidural.
Side effects
- Non continuous pain relief.
Over 95% of women who receive epidurals are
satisfierd with their epidural experience. However, some experience
a less than consistent control of pain. Their pain comes and goes
during the delivery. This ocurrs less frequently now with the
use of computerized pumps. However, scar tissue, an abnormal spinal
curvature, or a misplacement of the needle can result in the reduced
effectiveness of the epidural.
- Spinal headaches
- Nausea
- Fever
- Muscle weakness
- Decreased respiration
- Low blood pressure
- Increasing the length of labor (usually no more than an hour). Since the epidural relieves the
pain, this is not a major concern.
Birth
Umbilical cord
Once the baby has been delivered, Two clamps are placed on the umbillical
cord, and it is painlessly cut with a scissors about 1 to 1.5 inches
from the base. If you or your partner would like to cut the cord,
usually you may. A metal pin or pastic clamp is applied and left
on the remaining cord. The remaining cord will fall off your baby
within 12 to 15 days after birth.
Episiotomy
An incision made to enlarge the vaginal opening.
- A local anesthetic is injected
- The doctor enlarges the vaginal opening by
making an incision through the muscle and skin lying between the
vagina and the anus.
Reasons for having an episiotomy
- To reduce the pressure on a baby that is premature
or abnormally fragile.
A jagged tear in the tissue surrounding the vagina
is more difficult to repair than a straight incision. The following
situations increase the risk of tearing, so an episiomy is often
used to prevent tearing in these situations...
- To deliver a baby that is too large for the opening,
such as one with broad shoulders.
- To deliver a breech baby, a baby that comes out
feet first.
- A foceps delivery
- A vacuum extraction
- If the mother cannot wait long enough for
the opening to dilate before giving birth. If a woman decides not to take an epidural, the doctor may need
to speed up the delivery, requiring an episiotomy to avoid tearing.
Without an epidural, the mother may not be able to endure the
pain long enough for complete dilation to ocur, and may become
desperate to end the delivery quickly. Without pain relief the
mother may also be unable to relax and to conserve her energy
for the final stages of delivery. If she becomes exhausted the
doctor may need to finish the delivery early requiring an episiotomy.
So as you can see, you may be able to avoid an episiotomy by taking
an epidural. This will allow you to relax and to endure a longer
period of labor, during which your opening would have ample time
to dilate.
Side effects
- An episiotomy is an incision through skin
and muscle. It will be uncomfortable following the procedure.
- If the incision is not repaired properly,
it can lead to rectal problems.
- Surgical procedures do damage tissue, cause
scarring, can lead to complications, and thus, according to many,
should be used as a last resort.
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