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Cervical Dilation During Labor

Clip Number: 7 of 37
Presentation: Vaginal Birth After C-Section (VBAC)
The following reviewers and/or references were utilized in the creation of this video:
Reviewed By: Authors for this presentation included: John Gorsline, MD; Tom Arnett, MD; Seth Katz, MD; Michal Whiton, MD; and Art Schoenstadt, MD.
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Once you are in the labor and delivery area, your labor partner can wait there with you.
Two monitors may be placed around your abdomen. One will measure your contractions, and the other will monitor your baby's heartbeat. A nurse may draw some blood, and give you an intravenous line, or IV. Your cervix should be checked regularly, to measure how close you are to beginning the actual delivery. If you are having trouble urinating, you may be given a catheter, which is a small plastic tube inserted into your bladder.
For some women, it is normal to feel sick and even to vomit during this part of labor, because of the changes your body is undergoing. For this reason, many women eat nothing and drink only clear liquids at this time. Walking around or changing positions in your bed may make you feel better. Your health care professionals can give you suggestions to help you feel more comfortable.
Once your cervix has dilated, or opened, to four centimeters, you are officially in "active labor." This means you can now receive an epidural, if you want one. After this point, your healthcare provider should monitor your progress, such as your contractions and how quickly your cervix dilates. If you do not progress as expected, your doctor may help you do so with medications or other methods.
When the cervix has dilated to ten centimeters, labor usually becomes more intense and contractions become more frequent. At this point in labor, the baby is usually positioned head down, facing the mother's back, with its chin tucked in, and coming out of the uterus with the back of the head first. After the baby has moved into the birth canal, most women need to help the delivery process by pushing during their contractions.
In 19 out of 20 new mothers, the baby is delivered within 2 hours. Although it can be normal to take longer, many women deliver in one hour or less.
For many women, this stage of labor is the most exhausting, because it takes a lot of energy to push. Eventually your baby's head will begin to come out of the vagina. When the biggest part of the head is coming out of the vagina, it is called "crowning."
At some time during this stage of your labor, your doctor may decide that you need an episiotomy. An episiotomy is a small incision, or cut, in the opening of the vagina. It widens the birth canal, and helps to control tearing as the baby moves through the vagina. It can also be helpful when forceps or vacuum assisted deliveries are necessary, which we will talk about a little later. You might want to talk with your doctor ahead of time, about what might cause the need for an episiotomy, and discuss your individual situation.
After the crowning, your doctor will deliver your baby's head, and clear its mouth and nose of fluid. Your baby's shoulders will be delivered next. After the shoulders, the rest of the baby's body usually slips more easily through the birth canal. When your baby has been delivered your doctor will cut the umbilical cord. Birth assistants will begin to clean, dry, and warm up your baby. Sometimes, a pediatrician will also be there to make sure that the baby is doing well.
After you deliver your baby, the placenta will need to be delivered, which can take up to half an hour. Your doctor will assist you with this, if needed. After delivery of the placenta, the uterus normally begins to contract and shrink, which helps to stop any heavy bleeding. If needed, you may be given additional medication to help stimulate these contractions. It will take several weeks for the uterus to shrink back to its normal size.
Your physician will then inspect the outside of your vulva and the vagina for tears or lacerations. If you have an extensive tear or if you have had an episiotomy, these will be sewn up at this time.
Some women want to hold or breast-feed their baby immediately. This will be possible as long as you and your baby are not having any problems that need to be taken care of first.
Once you and your baby are examined, and everything is fine, you can hold your child. Your friends and family can join you, and you will probably want to have a good, long rest.
 

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