it’s finally time for the baby who has been growing inside you to emerge into the outside world. If everything is normal, you will probably have a natural delivery. However, you may have a condition that will make having a Caesarean necessary. Read on to find out more about what to expect.
Having a natural delivery
After experiencing the different stages of labor, your cervix (neck of the uterus) will be fully dilated and you will finally be ready to deliver your baby. For first-time mothers, this stage usually takes about an hour, and rarely more than two hours. For women who have already had a baby, it may last only 15 to 20 minutes.
The delivery stage is more exhausting than painful. It’s certainly hard work for the mother and any support she can get will help. You can ask your husband, mother or close friend to accompany you during your delivery. He/she can assist you by encouraging you to push at the right times or by giving you gentle reminders on breathing techniques.
Sometimes hospitals in Egypt prefer that anyone who has been with you during labor leaves at this point. However, if you’ve made it clear to your doctor from the beginning that you want someone with you all the way through, and there are no last-minute medical complications, then he/she should be allowed to stay for the delivery.
The delivery process
Even though your uterus can expel the baby without any effort from you at all, through involuntary contractions, your pushing helps the process along. You can help control your delivery by breathing deeply before each push, trying to push at the height of each contraction and making a conscious effort to relax the lower half of your body afterwards.
Don’t relax too quickly at the end of each contraction because relaxing slowly will allow the baby to continue to progress down the birth canal. As your baby's head pushes down on your pelvic floor and rectum, you will feel an extreme urge to push. You will probably be asked to control this urge initially to allow time for your vagina and perineum (the area between your vagina and your anus) to thin out. This will help avoid any tearing or the need for the doctor to perform an episiotomy, an incision made to widen the vagina. Your doctor will let you know when you should or shouldn’t push.
You may experience a stinging or burning sensation around the vaginal area which indicates that the baby’s head is pushing up against the opening. Once the vaginal tissue is fully stretched out, the area will go numb, nature’s form of pain relief.
You will probably be asked to stop pushing, breathe shallowly or 'pant,' and let the uterus push the baby out on its own. The doctor will also check the umbilical cord. If the cord is around the baby's neck, it may be gently lifted over so as to ease the delivery or the doctor may choose to cut it.
With one contraction the baby's head is delivered and the hardest part is over. Sometimes the baby’s whole body comes out in one contraction but often, immediately after the head is delivered, the contractions stop, allowing your body a brief moment of rest. The medical attendant will wipe the baby's face, to make sure that any fluid which might be blocking the air passages is removed.
The next contraction will push out one of the baby’s shoulders, followed by another contraction pushing out the other shoulder.
The rest of the body will then slide out easily.
As he comes out, the baby will twist and turn, making the necessary adjustments to ease his exit. The doctor will be there to firmly grasp your baby as he slides out.
Once the baby has been delivered, the medical attendants will make sure that there is no fluid in the lungs and you will hear your baby crying for the first time.
You should be able to hold him as soon as possible after this and, if you want to, give him your breast to nurse.
Usually, your baby will have streaks of blood on his head and the body will be covered in a white, fatty substance called vernix. He may also be a bluish color at first or have a slightly elongated head. Don’t worry, this is all quite normal.
After your baby has been delivered, the placenta, the organ that has been your baby's life support system for the entire nine months, is pushed out.
You will be probably be so involved with looking at your newborn baby that you may not even notice what is happening - in any case it should be relatively painless.
The placenta comes away from the wall of your uterus and is pushed out by slight contractions. These contractions may also make you feel the urge to push. The whole process lasts about 10 or 20 minutes.
The placenta is then examined to make sure that it has been completely expelled because if any part of it remains inside it could cause hemorrhaging later.
After the placenta has been delivered, you will be examined to make sure that no additional tearing has occurred. Unless the cord linking your baby to the placenta has already been cut during the delivery it will be clamped and cut after the placenta has been delivered.
Having a caesarean section
A Caesarean is performed if a natural vaginal delivery is considered dangerous. A horizontal incision is made into the abdomen and uterus and the baby is delivered through this opening.
The operation takes between 45 and 60 minutes, the baby is delivered in the first 5 or 10 minutes and the rest of the time is used to repair the incision. Stitches are usually of the absorbable type for the inner layers, and either absorbable or removable for the outer layer. Either way, the scar will be minimal.
Either a general anesthetic or an epidural is used to anesthetize the area. If you have an epidural, you can remain conscious throughout the whole process and see your baby as soon as he or she emerges.
Although Caesarean births are quite common, and are usually unavoidable, they are considered major operations which require a longer recovery period than natural deliveries. Usually pain-killing medication is needed after the birth and the scar may take a while to heal.
When is a Caesarean necessary?
The most important thing to know above all else is that a Caesarean section is a life-saving medical procedure which delivers babies that cannot be delivered through a natural vaginal birth. There are certain known medical conditions that make a Caesarean unavoidable. But remember that your doctor is the most qualified person to inform you on the necessity of a Caesarean section in your particular case.
Various medical cases call for a planned Caesarean. For example, a woman with placenta previa or low-lying placenta must be delivered by Caesarean since the placenta partially or completely covers the cervix, thereby blocking the baby’s entry into the world
. This condition is diagnosed early in pregnancy via ultrasound, which allows the doctor to determine the location of the placenta.
Another condition, which is usually diagnosed during the last trimester of pregnancy, is breech presentation, when the baby’s positioning is not natural. Depending on the type of breech presentation, the doctor will most likely decide to perform a Caesarean to avoid fetal distress caused by blood flow being cut off or the baby’s oxygen supply impeded which might occur during vaginal birth.
A Caesarean is also necessary when there is a disproportion between the baby’s head size and the mother’s pelvis. The size of the baby is easily determined by ultrasound, and if the mother has a very small pelvis, compared to the size of the baby, the doctor may assert that a vaginal delivery is difficult if not impossible.
Maternal medical conditions also play a critical role in the method of delivery. If the mother is suffering from any form of genital infection, it is too dangerous to deliver the baby vaginally. Also, if the mother has diabetes or severe hypertension, labor pains may be too strenuous for her system and a Caesarean could be necessary.
Finally, if the mother became pregnant immediately after having had a previous Caesarean, then the uterus may not have had a chance to heal properly and might rupture during the second labor, so a repeat Caesarean is usually necessary.
Although many Caesareans can be anticipated sometime during the nine months of pregnancy, some Caesareans cannot be foreseen and are therefore decided at the time of delivery.
Rules of Recovery
The hospital stay after a Caesarean lasts anywhere from three to five days, and most mothers will start to feel physically normal after one week. Expect lower abdominal and shoulder pain, as well as discomfort around the stitches.
The dressing of the wound, along with any stitches, is usually removed in about a week, but the internal healing should take around six weeks, and the scar will fade in three to six months. You will experience vaginal bleeding after the operation just as you would after a natural delivery. You should devote as much energy as possible to returning to your normal lifestyle, keeping the following rules of recovery in mind.
*When breast-feeding, holding your baby may pose a problem due to the tender abdominal wound. Use pillows to raise the baby up to the level of your breast.
*You can start gentle postpartum exercises the day after delivery, but heavy exercises should be postponed for six weeks. Check with your doctor regarding which exercises to begin with.
*Do not over-exert yourself by lifting anything heavier than your baby for the next four weeks, or climbing any stairs for the next two weeks.
*Sit and stand perfectly straight. Don’t crouch over your stomach.
*When you cough or laugh, support the wound with your hands.
*Ask family and friends to help you with cooking, cleaning, and looking after older children.