Labor and Delivery
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Labor and delivery facts
- Every woman's experience is unique and below are typical guidelines that will help you understand what to expect.
- Normal labor can begin a few weeks prior to the due date or up to 2 weeks afterwards.
- There is no way to precisely predict when labor will begin.
- In the first stage of labor, the cervix dilates and effaces (thins). Contractions become longer and more frequent.
- The second stage is the time of pushing, or delivery of the baby. It begins when the cervix is fully dilated to 10 cm.
- In the third stage, the placenta and membranes are delivered.
- There are a number of methods for fetal monitoring that can be used during labor.
- Pain control options include breathing exercises, imagery, relaxation techniques, medications, and regional anesthesia.
What are the signs of labor?
Normal labor begins anywhere from 2 to 3 weeks prior to the baby's due date and up to 2 weeks after it. The due date itself is not exact and is only used as a guide. There is no way to precisely predict when labor will begin.
Symptoms and signs that labor is approaching are varied. Lightening is the process of the baby dropping lower into the pelvis in preparation for delivery. The baby's head lowers into the pelvis, and this can occur as late as a few hours before delivery. In some women, however, it can occur a few weeks before labor begins. Lightening can cause increased pressure on the bladder and the urge to urinate frequently. Many women may find it easier to breathe after lightening occurs because there is less pressure on the diaphragm.
Release or passage of the mucus plug is another sign that labor is near. The mucus plug normally blocks the entrance to the cervix and helps fight off infection. When the mucus plug is passed, the result is a blood-tinged or brown discharge from the vagina. This can occur days before labor or immediately prior to labor.
Rupture of the membranes is referred to as one's "water breaking." This means that the amniotic membrane that surrounds the baby has ruptured, and clear amniotic fluid is expelled from the vaginal opening. Rupture of the membranes is typically a sign that labor will begin during 24 hours. If labor contractions do not begin, a woman whose membranes have ruptured may have labor induced by a physician to avoid complications such as infection that result from prolonged rupture of the membranes. Sometimes, rupture of the membranes does not occur until labor has already started.
Diarrhea develops in some women prior to the onset of labor, so loose stools may be a sign of approaching labor in a woman near term.
Finally, labor itself begins when contractions begin to occur regularly. When contractions occur less than 10 minutes apart, this typically signals the onset of labor. Irregular contractions, known as Braxton-Hicks contractions, occur toward the end of pregnancy in the third trimester and do not necessarily mean that labor is near. Some women even experience these contractions as early as the second trimester of pregnancy. Braxton-Hicks contractions are milder than those of true labor and do not occur at regular intervals.
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