Frequently Asked Questions About Labor and Delivery

In the following sections, we try to answer some of the most frequently asked questions about labor and delivery.

What is an induction?

Your doctor may mention an induction of labor to you at some point during your prenatal visits or during labor. Inducing labor involves using artificial oxytocin (the hormone the brain releases that causes contractions) to bring on labor and to promote delivery of the infant. Most of the time, inductions are done for medical reasons, which may include:

Suspected large baby.
High blood pressure in pregnancy.
Any other reason your physician feels is important enough to deliver your infant.

When you arrive for a scheduled induction, you will be placed on monitors -- one to monitor your baby’s heart rate and one that monitors contractions of your uterus. An IV line will be started and lab work obtained. After monitoring your baby’s heart rate, your physician may order a pitocin drip. This is done through your IV line.

Pitocin, the synthetic form of oxytocin, is delivered through your IV at a slow rate and gradually increased until you begin an adequate contraction pattern. The goal of the pitocin drip is to put you in active labor so that you may deliver your baby. Your vital signs (temperature, pulse and blood pressure) will be monitored closely, as well as your baby’s response to the contractions.

A few other options for inductions are available. These include using cytotec (a prostaglandin that ripens the cervix) and artificial rupture of membranes (breaking the bag of water that surrounds the baby). It is important that you discuss with your physician any risks or side effects of an induction and discuss the type of induction that he/she has planned for you.

Should I have an epidural or natural childbirth?

This is a personal issue that should be discussed with your doctor. Every woman’s labor and delivery experience is different. During your pregnancy, think about the type of birth experience you want. Think also about your attitudes towards pain and pain management. This will help you to better discuss what type of pain management you want with your healthcare provider.

An epidural allows for safe, effective pain relief that lets labor progress almost naturally. Mothers remain conscious through the duration of labor and delivery and little of the drug goes to the baby. The epidural procedure is performed by an anesthesiologist. The anesthetic medication is injected through a catheter into the epidural space located between the vertebrae of your spine. The epidural usually numbs you from the waist down. Prior to giving the epidural, the medical team uses a local anesthetic in the area where the catheter will be placed to numb the area. This decreases the discomfort you will experience as the catheter is inserted.

Spinal blocks are the traditional type of epidural in which the lower half of the body is anesthetized. This type of epidural typically takes about 20 minutes to work.

As with any drug, there are potential side effects that can occur. These side effects are rare but may include headaches, drop in blood pressure, allergic reactions, fever in the mother, longer labor, and increased use of forceps or Cesarean section. Your healthcare provider will explain the risks associated with epidurals and will help you make an informed choice regarding pain management.

Other pain relief options include opiate analgesics that are given through an IV. These typically dull the pain of the contractions, but they do not eliminate it completely.

Pros of epidural:

I have a low threshold for pain.
From what I hear, labor pain is the worst pain of all.
It is safe for me and my baby.
It has worked for many people I know.
Why go through all the pain?
I’m not in this for the experience of labor. I’m here to have a baby.

Pros of natural childbirth (no epidural):

I handle pain well and I think I can do it naturally.
I believe breathing, relaxation and other mind/body exercises can help me handle the pain.
I don’t like the risks associated with pain medications and/or epidurals.
I’m not afraid of labor pain.
I’m into the idea of experiencing the whole labor and birth experience intensely, without any drugs at all.

What should I expect from a Cesarean section?

A Cesarean section (C-section) is the delivery of the baby through an incision made through the abdomen and into the uterus. Approximately 25 percent of births in the United States are via C-section. There are many reasons that your physician may deliver your baby via C-section, such as fetal distress, breech position, placenta problems, umbilical cord prolapse, multiple pregnancy, previous uterine surgery, very large baby, and non-progressing labor.

Often, the decision to deliver a baby via C-section occurs during the course of a woman’s labor, when some kind of problem is encountered. If the Cesarean delivery is planned in advance, you may be instructed to do the following:

Eat a light meal the night before your procedure, and do not eat or drink anything after midnight.
Shower the morning of your procedure and use special antibacterial soap, if supplied by your doctor.
Arrange for a ride to and from the procedure.
Arrange for help at home after returning from the hospital.

Once you are at the hospital, you rmedical team may make the following preparations:

An IV may be placed to provide medications and fluids.
A catheter may be placed to drain urine and keep your bladder empty.
An epidural may be placed to deliver anesthetics and pain medications.
You may need to have your abdomen and pubic area shaved.

The type of anesthesia used depends on the urgency of your C-section. During an emergency in which the baby must be delivered immediately, you medical team may use general anesthesia to save time. In most cases, they use an epidural or spinal block so you can remain awake to see your new baby. Anesthesia prevents pain during the surgery, but you may feel some pressure and tugging. The surgery typically takes 45 to 60 minutes from the timenthe obstetrician makes the incision to final stitching. After the procedure, your doctor may give you pain medication, either in your epidural or in your IV, to keep you comfortable. The average hospital stay for a C-section is about 3 to 4 days.

Information

For more information about Maternal/Child Services Education Programs at Shands AGH, please call 352.733.0165.

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