The 40 week (give or take) long journey is done. The birth is behind you, the announcement boy/girl has been made, and the Apgar test has been done. If there were no complications, your baby is in your arms, skin to skin, maybe already learning how to latch on or nursing.

Now that the birthing process is over, you are likely exhausted from the delivery and feeling overwhelmed with emotions of excitement, relief, and love.  However, before you are left to bond with your baby, there are a few things your obstetrician may need to do.

• Your baby may have been delivered, but your placenta needs to come out as well. Your doctor / midwife may ask you if you want to see it.

• If you had an episiotomy or have a tear requiring stitches, your midwife or doctor will stitch up your perineum.

• Your bladder will be checked and you will be asked if you can go to the bathroom.

• If you had an epidural, it will be removed.

• Your midwife or the labor nurse will massage your uterus to help it contract and stop bleeding. This may feel uncomfortable, and you may feel liquid gushing out.

• If you are having difficulties nursing your baby, or haven’t done so yet and wish to, you can ask your midwife or a lactation consultant at the hospital for assistance.

Your baby will also be checked by your doctor / midwife.

• Right after birth, your newborn’s airway will be cleared and gently suctioned with a rubber bulb to remove blood and fluid from the nose and mouth.

• The umbilical cord will be cut.

• The APGAR test will be done one minute after birth and then again at five minutes.

• If you chose to bank your baby’s cord blood, your obstetrician / midwife will clamp or cut the cord and then collect the cord blood.

• He will be dried and covered to keep him warm.

• Your baby will then be laid on your stomach or chest so can bond and/or start nursing.

• The doctor or nurse will examine him to make sure there are no obvious problems that need emergency treatment.

CONGRATULATIONS!

“Birth preparation course” sounds like the most impossible combination of words, doesn’t it?! In other words, how can you prepare for something when you have no idea what to expect? How can you prepare for an event you can’t control, or foresee how it will start and develop? And if it is such a natural process then all you need to do is listen to your body, right?  What else is there to prepare for?

Well, even though you really cannot foresee how and what your birth experience will be like, learning about your options and possibilities is the greatest variable in the mystery of what is to come. Simply stated, knowledge is power.

When you conceive, there is an excitement of anticipation and not much thought is given to the child birth experience that is unavoidably to come. However with time, thoughts, wonders and fears may start to creep in.

If you have already researched your options, you are ahead of the game. Otherwise you may find it helpful to know what types of childbirth methods are available to you today.

No matter what type of birth experience you are planning, you should know the basic facts about other options in case you will be forced to abandon your original plan for medical reasons such as risk to the health of yourself or your baby. Try to stay open minded about the possibility that your birth plan will not be executed as you dreamed. If you remain flexible, the disappointment you may experience could be lessened.

Birth preparation courses usually take place at the hospital where you plan to give birth. In most courses, you will take a tour of the hospital and get familiarized with procedures and facilities available to you.

You will learn about types of childbirth and techniques to help yourself handle labor and the process of childbirth. Most courses should cover: signs of labor, the normal progress of labor and birth, techniques for coping with pain, ways your partner can help you during labor and recognizing when to call your doctor or midwife.

For more information about birth preparation courses, contact your hospital for scheduling.

A cesarean section delivery may be unavoidable in certain situations, especially when there is a real threat to the wellbeing of the baby or mother or both. In such cases, it is a blessing to have the option of such a procedure. But in other cases, when it may not be necessary or can be avoided, you may want to consider the possibility to pass up this invasive surgery.

Like any other medical procedure where you are being cut open, a cesarean section is a major surgery. This means there is a recovery time, about 2 to 4 times longer than the recovery time needed after a vaginal birth. There is also the risk of infection around the incision area, as well as the possibility that future births will result in another cesarean section.

Elective cesarean section is becoming more accepted these days. Some expecting mothers get impatient and want to meet their baby rather than wait. Others want to choose their child birth date, or want to avoid the pains of labor and maybe have a tummy tuck along the way.

Nevertheless, there are many women who prefer to give birth vaginally. If you are one of them, start with speaking to your healthcare provider and write a birth plan to better your chances of having things go your way. Make sure your OBGYN is on board with your plans. Also check the cesarean section rate at the hospital you intend to deliver at. If your OBGYN or the hospital do not have the right answers for you, considering switching to another provider.

You can help avoid undergoing a cesarean by taking care of yourself and listening to your provider. Towards the end of the pregnancy, your doctor will monitor the size of the baby and may alert you to change your diet if there is a concern that your baby will be too large to be delivered vaginally. Do not take this advice lightly.

Listen to your body and take care of yourself throughout your pregnancy. Eat healthy, exercise, sleep well and stay safe. If you are at a higher risk for a cesarean or your baby’s position does not allow for a vaginal birth, talk to your OBGYN about what you can do to help change the situation.

Medical science has yet to discover what exactly causes contractions to start and labor to begin.  If your due date has come and passed with no delivery in sight, you may be at a point where you are ready to do anything to get the process started. It is normal to want to meet your little one already, or want the pregnancy to be over because you are uncomfortable.

There are different home remedies to jump starting labor, but you should know that none of them is a sure thing, so don’t get your hopes too high, and cross your fingers when you try them.

You can try Maternity Acupuncture. Certain spots between the thumb and the pointer finger, near the ankle, and on the shoulder are considered by shiatsu practitioners to be linked to the uterus. According to shiatsu practitioners, pressing these points can speed labor up.

Having Sex can help induce labor. Semen contains prostaglandin, a natural fatty acid that helps soften and dilate your cervix. That, as well as an orgasm, can cause your uterus to contract.

Take a Long Walk. Gravity helps lower the baby and the pressure on your cervix can dilate it.

Raspberry tea helps to tone the muscles of the uterus.  To make it – boil water, let it sit for 5 minutes and then, add two to three teaspoons of red raspberry tea leaves. Drink two to three cups a day. Start only after week 35.

Your OBGYN may offer to strip the amniotic membranes to induce labor, if your cervix has started to dilate. This method can cause labor to start within 48 hours. However effective, it may be painful procedure.

Try nipple stimulation. Rubbing your nipples with your fingertips helps release the hormone oxytocin, the natural version of the labor-inducing drug Pitocin, which causes contractions to begin. It’s a slow process that requires breast stimulation for an hour at a time, three times a day. Some practitioners only recommend doing this at a hospital, where you can be monitored, since very strong contractions could affect the baby’s heart rate.

Castor Oil taken with orange juice for example, can stimulate prostaglandin production and in turn cause contractions. However, it is also a known laxative, so you may get terrible diarrhea before or during labor, suffer from vomiting, sever cramping and other unpleasant side effects. So think twice and speak to your doctor before choosing this method.

Consult your health provider before trying any method.

Vaginal birth is the normal biological consequence of pregnancy, regardless of previous births experiences. It is important to know you are not limited to a cesarean section procedure in future pregnancies even if your previous delivery was a cesarean section.

Vaginal Birth after Cesarean is actually quit common. Some 90% of woman who have had a cesarean delivery can deliver vaginally the next time around.

The biggest concern for women who have had a previous cesarean is the risk of a uterine rupture during a vaginal birth. Studies show increased rates of uterine rupture in women who go through labor induction or augmentation. Discuss the possible complications of induction with your OBGYN before you make your decision.

You can avoid a cesarean this time around if the reason for your first cesarean delivery is not repeated with this pregnancy, you have no major medical problems, you baby is a normal size, the baby is head-down

To be considered for VBAC you must have had no more than 2 low transverse cesarean deliveries and no additional uterine scars, anomalies or previous ruptures. You will be monitored through labor and may end up undergoing a cesarean if the situation shall call for one.

You may require a cesarean delivery if you are pregnant with twins, have diabetes or high-blood pressure.

If your due date has come and gone and you are still pregnant, with no signs of contractions in sight, your OBGYN will check you and have an ultrasound to estimate the size of the baby and how much amniotic fluid is around him. If the baby is estimated to be in any danger you will be induced soon there after.

If the baby still has room to grow, your doctor may let you wait for another week or two before inducing labor. The longest most practitioners will let you go before inducing is the 42^nd week of pregnancy. After that time the placenta may become less effective and many risks may present themselves to both baby and mom.

Some other reasons you may be induced are if your baby is too big, your water breaks and labor does not start on its own, your placenta no longer functions properly, you have a chronic or acute illness or if you previously had a full-term stillbirth.

Inducing labor means to use medication and other techniques to start or induce contractions. The method in which you will be induced depends on the condition of your cervix at the time. If your cervix hasn’t started to soften, efface (thin out), or dilate (open up), it’s considered “unripe” – or not yet ready for labor.

Methods used to ripen the cervix and induce labor include prostaglandins, Foley catheter, Stripping or sweeping the membranes, Rupturing the membranes and Pitocin.

Prostaglandins are used in situations when you need to be induced but your cervix is not yet dilated or thinned out. Once admitted to the hospital, your healthcare provider will start the induction by inserting medication that contains prostaglandins into your vagina. This medication helps to ripen the cervix and sometimes stimulates enough contractions eliminating the need to use oxytocin.

Foley catheter may be use instead of using medication to ripen your cervix. Your healthcare provider may insert a catheter with a very small uninflated balloon at the end into your cervix. When the balloon is inflated with water, it puts pressure on your cervix, stimulating the release of prostaglandins, which cause the cervix to open and soften. When your cervix begins to dilate, the balloon falls out and the catheter is removed.

Stripping or sweeping the membranes is used if your cervix is already somewhat dilated and there’s no urgent reason to induce. Your health provider will insert her finger through the cervix and manually separate your amniotic sac from the lower part of your uterus. This causes the release of prostaglandins, which may help further ripen your cervix and possibly get contractions going.

This procedure is most commonly done during an office visit. You’ll be sent home to wait for labor to start, usually within the next 48 hours. Many moms-to-be find this procedure uncomfortable or even painful.

Rupturing the membranes is a procedure performed only if you are at least a few centimeters dilated. Your healthcare provider will insert a small, plastic hook tool through the cervix to break your amniotic sac. Once your water has broken, most OBGYNs will want you to deliver within 24 hours because of risk of infection for you and your baby.

oxytocin (Pitocin) is given through an IV pump to start or augment your contractions. Your healthcare provider will adjust the amount you need according to how your labor progresses.

Weather you treat it this way or not, a cesarean section delivery is surgery. Because it is a surgical procedure, it does require a period for both physical and emotional recovery.

With any other surgery, allowing yourself recovery time is logical and usually a relatively easy task. However, other surgeries do not send you home with a child to take care of when you return home.  Having to care for a child while recovering is difficult and it becomes harder to rest and let your body to recuperate. After all, your schedule is now in the hands of a tiny baby with needs he cannot fulfill independently.

What do you do? Ask for help and/or accept any help offered. If you have relatives in town who came especially for the birth or live nearby, take advantage of their presence and let them take some of the weight off your shoulders. You need the help and they will most likely be happy to give a hand.

First, take care of yourself. Drink plenty of water to avoid constipation, which is usually an issue for the first week after delivery. Make sure you get the rest you need, but at the same time make a point to walk around regularly, increasing activity gradually. It will help your healing process and prevent complications such as blood clots.

Secondly, don’t overdo it. Wait until your postpartum checkup (six weeks after delivery) before starting up exercising and/or resume sexual activity. Speak to your OBGYN when you meet about your readiness for these types of activities. Speak to your healthcare provider sooner if you have any questions or concerns.

Finally, cut yourself some slack. Recovery may take longer than you expected, or you may find yourself emotionally recuperated while still physically strained. Try not to let it get to you and certainly don’t be too hard on yourself. You have a newborn to care for, your body is healing, and you may be experiencing the blues – after all your life has changed completely! Keep your chin up and listen to your body. You will be 100% soon!

Through advanced care and research, there are a variety of options on the location and method to giving birth. The most common child birthing experience today involves the hospital, but it is not your only option. If you want to have more freedom and control over the process and procedures during your delivery, take the time to learn about other options available to you. But before you start your research, know that you must be a healthy woman with a healthy, low or no risk pregnancy to consider child birth outside of the hospital.

Birthing Centers offer a home-like environment with the freedom to experience labor in your own way. Birthing centers are run by nurse-midwives, and are fully equipped with a variety of medications, IVs, oxygen, and resuscitation equipment should your baby need it. There are no electronic fetal monitoring equipment, epidurals, labor induction devices, drugs, or cesarean deliveries.

A birthing center offers a natural birthing experience, as close to a home birth as you can find. Something you should know and consider is the fact the women are discharged right after the birth, or no longer than 12 hours thereafter.

Hospital Birthing Centers combine the “homey” ambiance with the security of high-tech birthing options. They are also run by nurse-midwives and are very similar in décor to other birthing centers, but have the advantage of accessing high-tech medical care when needed.

These types of centers are most appropriate for pregnant women who are not sure they can make it through labor without pain medication and those who may need to spend up to 48 hours in the hospital post-birth.

Home Birth allows the mother-to be to experience birthing on her own terms within the comfort and familiarity of her own home. It is suggested that a midwife follow the pregnancy and assist with the birthing process. If you are interested in this experience, take the time to research and interview midwives to find the one who is right for you.

If a certified midwife tells you that a home birth is not in your best interest, listen to her. She has the experience and credibility to provide these suggestions. Best candidates for home births are healthy women with a normal pregnancy and a good after-care support system.

Most importantly, listen to yourself. Whatever decision you make, be sure you feel comfortable about it.

Giving birth at home was the norm around the world for centuries. A woman in labor would have a midwife at her side to help along the process, provide comfort and offer practical aid when and where needed.

In most countries, home birth is still the most common form of birthing. In the US, on the other hand, childbirth has been moved from the home and into the hospital since the 1900’s. Obstetrics has had a tremendous effect on the changes to the birthing experience in the past century. While many have become accustom to delivering in a hospital, there are a growing number of women who are going back to midwifery and choosing home birth over the hospital experience.

A home birth can be an option for you if you are a healthy expectant mother, have a high predictability of a normal pregnancy, and have no medical or obstetrical risk factors. Giving birth at home provides you with the comfort of familiar surroundings and gives you the liberty to choose as many participants to assist you. Mothers who have experienced home births claim that they encountered a more controlled birthing experience, a quality that is not necessarily guaranteed at a hospital.

Choosing to have a home birth is a decision you should feel strongly about. The successful homebirther is one who is dedicated to finding the right birth practitioner for care throughout the duration of pregnancy and the person who can provide assistance and comfort during the delivery.

Research is essential in learning about your childbirth options, and knowledge is key to making the most appropriate decision for yourself and your baby. Take the time to learn about the different birthing options, and try to stay open to unexpected changes (that can occur if baby needs immediate medical interference, etc.).

Postpartum depression is a serious illness, that can last for months after childbirth, miscarriage and stillbirth. Symptoms of postpartum depression include deep sadness, feelings of hopelessness, loss of appetite, sleep problems, extreme fatigue, difficulty to concentrate and even fatal thoughts. You may also find yourself unable to care for your newborn.

Unlike baby blues, which many women experience in the first couple of weeks after childbirth, postpartum depression can last for months. With baby blues, you may have trouble sleeping and feel moody, teary, and overwhelmed, but you will likely have these feelings along with being happy about your baby.

In rare cases, a severe form of depression called postpartum psychosis may develop after childbirth. Symptoms of postpartum psychosis may include strange behavior and hearing things that are not there. A women suffering postpartum psychosis may harm herself or her baby or others and needs immediate treatment.

It’s very important to get treatment for depression. The sooner you get treated, the sooner you’ll feel better and enjoy your baby.