Planning for a healthy pregnancy with regular exercise, a healthy
diet, plenty of water, avoiding alcohol and reducing caffeine is
an important first step. Good care during pregnancy includes regularly
scheduled prenatal exams. At different times in your pregnancy,
you will have additional exams and tests performed. Your first prenatal
checkup will include your health history, a physical exam and tests
that will provide information to check for problems during your
pregnancy and the opportunity to discuss any concerns.
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At each prenatal visit:
• You will be weighed
• Your abdomen measured
• Your blood and urine checked
First-trimester exams and tests may include:
• fetal ultrasound
• genetic testing
Second-trimester exams and tests may include:
• fetal ultrasound
• electronic fetal heart monitoring
• glucose tolerance test
Third-trimester exams and tests may include:
• fetal ultrasound
• hepatitis B
• group B strep screening
the ninth month
• baby feels lower in your pelvis
• abdomen will appear lower
• easier to breathe and eat more
• Heartburn may improve
• backache or hip discomfort
• more frequent need to urinate
…In the Hospital
When you arrive at the hospital, the nurse will check your blood
pressure and temperature and place a monitor on your abdomen to
check the baby's heart rate and your contractions. The nurse will
also perform a pelvic exam, which will determine the dilation and
effacement of your cervix. These assessments will help determine
whether you are in active labor. It is not unusual to be evaluated
and sent home if you are not in labor or in early labor.
What to Pack…
• Lip balm
• Warm socks
• Hand lotion
• Lollipops or hard candy
• Cell phone and numbers
• Toothbrush and other toiletries
• Camera or camcorder
• CD player
• Nursing bra
• Bathrobe and slippers
• Address book and stationary
• Loose-fitting outfit
• One undershirt
• One outer garment
• One receiving blanket
• One outer blanket
• A hat and pair of booties
• diapers and diaper covers
• Car seat for baby's ride home
The Labor Room…
Testing During Labor and Delivery
There are three stages of labor. The first stage occurs from the
time true labor begins until the cervix is completely dilated and
effaced. During the second stage the baby is delivered. The third
stage follows the birth of the baby through the birth of the placenta.
- Pelvic Exam - The most important test performed during labor
is the pelvic exam used to determine the progression of labor.
- Fetal monitoring - Fetal monitoring is used to detect the baby's
heart rate and response to uterine contractions.
The First Stage
The first stage of labor is the longest. There are three phases within
the first stage. At the end of the first stage, the cervix is dilated
to 10 centimeters. In mothers having their first child, this stage
usually lasts 12 to 16 hours. For women having second or subsequent
children, the first stage lasts around 6-7 hours.
- Part 1: Early Labor
During the early or latent phase, the cervix dilates to 4 centimeters.
The duration of the first phase is the longest, averaging around
8 hours. Your contractions may be irregular, progressing to rhythmic
and methodical. The pain felt at this early stage may be similar
to menstrual pain: aching, fullness, cramping and backache. You
will still be able to walk. Walking is usually more comfortable
than sitting. Most women spend these hours at home, or they may
be checked at the hospital and sent home until labor becomes more
active. You may feel eager, excited and social. It is important
that you conserve your energy for the work of labor.
Part 2: Active Labor
Active labor is marked by regular contractions that become longer,
stronger and closer together over time. Most providers recommend
that you go to the hospital when your contractions are five minutes
apart, lasting more then 60 seconds for at least an hour. Measure
your contractions from the start of one contraction to the beginning
of the next.
Your physician will want to know:
• How far apart are the contractions?
• How long are they and how intense?
• Are you using breathing techniques to manage the pain?
• Has your water broken?
• Have you had previous deliveries?
When you are in active labor contractions will
be about 3-4 minutes apart, lasting 40 to 60
seconds. Pain medication is often given at this stage. If you
have chosen to have an epidural anesthetic, it is usually given
at this stage.
- Part 3: Transition
Transition is the most difficult phase of labor. It is the shortest,
lasting from 30 minutes to two hours. The pain may be intense,
as the cervix stretches and the baby descends into the birth canal.
All of your energy is concentrated on doing the work of labor.
Try to remain calm and focused as your uterus works. At the end
of transition, you may feel a strong urge to push the baby out.
The baby is ready to be born.
The second stage labor lasts
anywhere from one contraction to up to two hours. The labor nurse
or physician will tell you when it is time to push. It is important
that you not push until instructed. When "crowning" occurs,
within the next few pushes, the baby is born. Fluid will be removed
from the baby's mouth and nose with a bulb syringe. The baby will
take its first breath, and may begin to cry. Immediately after birth,
the baby is still connected to the placenta by the umbilical cord.
The cord is clamped and cut.
The third stage is the shortest stage, lasting from 5 to 15 minutes.
You will be observed closely for the next few hours to make certain
that your uterus is contracting and bleeding is not excessive. Take
this time to rest and get acquainted with your new baby.
Labor and Delivery Checklist
Questions For Your Doctor:
• What do I do if I think I am in labor?
• What pain management options do I have?
• When is it necessary to perform a cesarean delivery?
To Do Checklist:
• Take a hospital tour and labor room
• Arrange for help at home if possible
• Prepare for the first weeks before delivery
• Make sure you have gas in the car.
• Pack your bags for the labor room.
Embryo: conceptus between time of fertilization
to 10 weeks of gestation
Fetus: from 10 weeks of gestation to time of birth
First trimester: up to 14 weeks of gestation
Gestational age: time from last menstrual period
(LMP) up to present
Gravidity: number of times a woman has been pregnant
Infant: time of birth to 1 year of age
Preterm infant: delivered between 24-37 weeks
Second trimester: 14 to 28 weeks of gestation
Term infant: delivered between 37-42 weeks
Third trimester: 28 weeks to delivery