Top 5 Pregnancy Delivery Tips From The Experts.

If you're psyching yourself up in the hopes the baby's labor and delivery is a breeze, it’s helpful for you to know what to expect during delivery.  Here’s advice from the experts to help you be well-informed during the birth of your baby so you can get to the fun part -- snuggling with your newborn.
Amy Levine

1. It may feel like a spectator sport.
If you're delivering in a teaching hospital or one with a training program, you can bet that medical students and residents will be observing.  “Some women (and their partners) don't mind being observed and are willing to give up some privacy for the education of future doctors. We are very grateful to these patients for their generosity, and make every effort to be respectful of their privacy,” says Dr. Michael Lu, Associate Professor of OB/GYN and Public Health at UCLA.  Dr. Lu continues, “I think there is a trade-off you make when you go to a teaching hospital. You may lose some privacy, and you may be delivered by or operated on by a resident under the supervision of the attending physician. But in many ways you get better quality care.  We have to be on top of our game.  On many levels you’re assured the highest quality care around.”

What you may not know:  You have the right to request that no observers be present. 

2. Passing gas, pooping, and peeing! Oh My!
 It’s completely natural to feel self-conscious about the possibility of this happening as you push.  Remember, these are natural bodily functions we all experience.  So let it go, literally. “To those of us who help mothers have their babies, it’s really not significant, other than telling us about their pushing effort. And frankly, because it is such a good sign, we welcome it as it can signify progress,” says Evelyn Resh a Certified Nurse-Midwife. When a woman has an epidural the signals to push in the right places that their body instinctively sends are often blocked. As a result, “I often say, push as though you’re moving your bowels. Or, I actually put my fingers in a woman’s vagina and ask her to concentrate on pushing my fingers out of her body,” Evelyn adds.

3. Once your baby is born vaginally, there’s another order of business
The placenta needs to come out too. “A few minutes after delivery, the uterus contracts from the size of a watermelon to a cantaloupe. These contractions shrink its size until the placenta can no longer stay attached to the lining inside the uterus. If there are no complications, this process usually expels the placenta with a push,” says Ina May Gaskin, a Certified Professional Midwife and author of Ina May's Guide to Childbirth and Spiritual Midwifery. A warning to the faint of heart: The placenta is two-faced, so to speak, as you don’t know which side it going to show first when it comes out of your body. It has a shiny side that’s attached to the cord, and a meaty side. Ina May wants to assure you both ways are normal.

4. How do you expel the placenta?
“When it's [the placenta] about to be expelled, it’s similar to giving birth. However, because there are no bones in the placenta, its expulsion—while it may remind the mother of what it felt like to push the baby out—usually feels quite good,” she adds.

Other tidbits to keep in mind: It helps to sit in a squatting position when you push it out.  And, the entire placenta needs to be removed otherwise you’re at risk of infection.  For this reason, it should never be pulled by the cord.  If you have a C-section the placenta is removed through the incision.

5. What if the placenta doesn't deliver naturally?
 “If the mother is bleeding too much, it may be necessary for the doctor or midwife to introduce one hand into the uterus via the vagina and loosen it from the uterus with the [health practitioner’s] fingertips. This is a painful procedure,” Ina May answers honestly.  Hopefully, this won’t happen to you, but if it does you now know what to expect. 

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