At Portsmouth Regional Hospital, we are prepared to give you the special care you need for a healthy and safe childbirth. Our entire staff shares a common focus on providing a warm, family-centered birth experience. We will partner with you to individualize your labor and birth process; keeping your needs and desires at the forefront.

Please do not hesitate to discuss any of your concerns with your doctor, labor nurse or childbirth educator.

The Childbirth Process
Natural Childbirth
Other Pain Management Options
Cesarean Birth
Labor Induction

The Childbirth Process

Even if you have attended prepared childbirth education classes, the process of labor and birth can cause feelings of nervousness and anxiety. Here are some basic explanations of what you might experience during the childbirth process.

Labor is divided into three stages:

The first stage of labor starts with the beginning of labor and is completed when the cervix is completely dilated to 10 centimeters. During this stage, contractions are working to open (dilate) the cervix. This stage happens, typically, in two phases, early labor and active labor. Early labor is different from one woman to the next. The cervix is usually dilated from 0-4 centimeters. Contractions are becoming regular and may or may not be uncomfortable or painful. In active labor your contractions will become regular (every 5 minutes or less) and more painful. Many women say this is an intense time during labor. During the labor process, your labor nurse will be there to support and coach you through contractions.

The second stage of labor starts with the complete dilation of the cervix and is completed when the baby delivers. This is the pushing phase of labor. Your labor nurse and doctor will help guide you through this stage of labor. On occasion, your doctor may have to perform an episiotomy. An episiotomy is a small incision used to widen the birth canal and maybe use for certain situations that occur at birth. Your doctor will tell you why she/he needs to perform this procedure. You will also receive some numbing medicine (local anesthesia) prior to the episiotomy.

The third stage of labor begins after the baby is delivered and is completed with the delivery of the placenta. During this stage of the childbirth process, your doctor will be there to help deliver the placenta. You may have to push a few times and it usually only takes a few minutes after your baby is born.

Natural Childbirth

Each woman's perceptions and expectations for labor and birth are different. Some women desire a childbirth where no medications are given to help manage discomfort and pain associated with the labor process. There are many techniques, besides medication, to help women get through labor. Some of these techniques include:

• Breathing techniques
• Using a birthing ball
• Massage
• Music therapy
• Frequent position changes
• Walking
• Rocking in a rocking chair
• Heat therapy
• Water therapy (warm bath or shower)

Other Pain Management Options

If you find that your labor is different than you expected, or you have already decided that more natural techniques are not for you, we have other alternatives for you.

We have a variety of pain medications that can help you manage pain during labor. Known as narcotics, these medications can be given as a shot into a muscle or intravenously (into the vein through and IV). These medications are safe for you and your baby. Your doctor or nurse can tell you about specific side effects associated with the particular medication you receive/request.

Epidural anesthesia is another option available to you during labor. A very small plastic tube (called a catheter) is inserted between the bones in your lower back. An anesthesiologist will put the catheter in place and the procedure takes about 15 minutes. Medicines are given to you through the catheter that will cause numbness in your lower abdomen, legs, and birth canal, although, you will still be able to move your legs. The catheter will remain in your back, providing continuous pain relief until your baby is born. After your delivery, the catheter will be removed. Epidurals are safe for you and your baby.

Cesarean Birth Anesthesia Options

Cesarean birth is an operation that involves delivering the baby through the abdomen. It is used when vaginal delivery is not possible. There are many reasons why a woman would need to have a Cesarean birth, some of these reasons are known before birth, such as a previous Cesarean birth, a baby in breech presentation, or placenta previa. Other reasons are not discovered until the labor and birth process begins, such as the baby's head is too large to pass through the birth canal or a prolapsed umbilical cord.

If you need to have a Cesarean birth, you will need to have anesthesia. The most common type of anesthesia used for a Cesarean birth is spinal anesthesia. It is similar to an epidural but has some distinct differences. The medicines given to you will be stronger and you will not be able to move your legs. Also, there is not a catheter that stays in your back; just a onetime shot of the medication is given between the bones of the lower back.

On a rare occasion and usually in an emergency, general anesthesia is needed. This is when you are asleep during the surgery. An anesthesiologist will be with you during the entire operation, no matter what type of anesthesia you have. A nurse will be there to care for you, and another nurse will be there to care just for your baby. Once your Cesarean is over, you will be moved to your postpartum room to recover. You will be monitored for a little while to be sure you have not effects from the surgery.

Induction of Labor

Sometimes there may be reasons for your doctor to discuss and suggest induction of labor, such as prolonged pregnancy (overdue), or high blood pressure-these are just a few examples. Generally, induction of labor should wait until at least 39 weeks of pregnancy, unless there is a medical indication that would require delivery to be sooner. The American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) recommend that elective induction of labor should not be offered until at least the 39th week of pregnancy. It is important to stay pregnant as long as possible so your baby can be fully mature when he/she is born.Click here for information on labor induction.