Normal vaginal delivery in Iran

vaginal delivery

In a vaginal birth, the baby will come out through the birth canal. Most women give birth at around 38 to 41 weeks of pregnancy. However, there is no way to know exactly when labor will happen.

Reasons for Procedure

Labor is the process that:
Positions the baby for birth
Delivers the baby out of the birth canal
Passes the placenta after birth

Possible Complications

Most births happen safely. Some problems that may happen include:

Tear of tissue around the vagina
Bleeding
Complications requiring the need to use forceps, vacuum extraction, or cesarean delivery (C-section)
Infection of the uterus
Injury to the baby
Blood clots

Things that may increase the risk of problems include:

Large baby or a baby in the wrong position inside the womb
Anemia
Infectious disease, such as active genital herpes or HIV
Water breaking before your contractions start
Diabetes
Bleeding disorder
Lung or heart disease
High blood pressure
Placenta positioned over the cervix—placenta previa
Early separation of the placenta from the uterine wall—placental abruption
Umbilical cord slips out of the birth canal before the baby's head—umbilical cord prolapse

What to Expect Prior to Procedure

Prenatal care will track the health of mother and baby throughout the pregnancy. It can help to identify possible problems. Choose a support person to be with you during labor and delivery. A birth plan can be made that explains what the mother wants. A childbirth class may also be helpful.

Talk to your doctor about:

Ways to contact her after hours and when you should call
Steps you should take when in labor
Whether you want pain relief during labor
Perineal massage—The perineum is the area between the anus and the vagina. Massaging it may help to reduce your chance of trauma to that area.

Be aware of the signs of labor, which include:

Contractions
Water breaks
Back pain
Slight vaginal bleeding

True Versus False Labor

False labor is irregular contractions of the uterus. It is often called Braxton Hicks contractions. They are normal but can be painful. They are usually also felt in the stomach and not the back. Timing the contractions is a good way to tell the difference between true and false labor. Note how long it is from the start of one contraction to the start of the next. Keep a record for an hour. True labor contractions will get closer together and become longer and stronger. They may also be felt in your back. If you think you are in labor, call your doctor.

Birth Labor

At first the uterus will begin to contract and move the baby down the birth canal. The cervix will slowly enlarge to a diameter of about 10 centimeters.
This will allow the baby to pass through and be delivered. This process usually takes a while. Labor can be quicker if there was an earlier vaginal birth.

Anesthesia

Rhythmic breathing, meditation, and acupressure may be help in early stages. Some women do not require any other pain control.
There are many medical options for pain control. All treatments to relieve pain during labor have risks and benefits.

Make sure you discuss these with your doctor:

Pain medicine by IV or muscle injection
Given when contractions become stronger and more painful
Can cross into the baby's bloodstream

Epidural block:

Liquid pain medicine injected near spinal cord
Given in small amounts by an anesthesiologist—a doctor who specializes in anesthesia
Does not cross into baby's bloodstream
Decreases pain and feeling in your lower body
Provides good pain relief and allows you to continue with delivery
Can cause headaches and drop in blood pressure, as well as changes in baby's heartbeat

Spinal block:

Liquid pain medicine injected into spinal fluid
Used for pain relief during delivery, especially if forceps or vacuum extraction is needed
Often used for C-section
Numbs lower half of the body and reduces your ability to push
Provides good pain relief and works quickly
Can cause headaches after delivery and drop in blood pressure during labor and delivery, as well as changes in baby's heartbeat

Local anesthesia:

Injected into vagina or surrounding area
Used if an episiotomy (cutting near the vagina) is needed
Also used when vaginal tears are stitched
Does not relieve pain of contractions during labor

Description of the Procedure

The nurse will prepare you when the cervix is fully opened and the baby seems to be heading down the birth canal. Your legs may be draped with cloths. Some doctors will clean the area around the vagina with an antiseptic solution. The doctor will tell you to push every time there is a contraction.
Legs may be placed into holders, especially if you have an epidural. The nurses and your support people may hold your legs in a comfortable position. This will help you to push. Your doctor may encourage you to find a position that is right for you.
You may be asked to slow pushing when the baby's head is seen at the opening to the vagina. The doctor may massage the perineum to gently stretch it to assist birth.
Once your baby's head is out, you will be asked to stop pushing. The doctor will check to make sure that the umbilical cord is not around the baby's neck. Then, you will be able to push the rest of the baby out. If the baby appears healthy and is breathing well, the baby may be placed on your stomach. The umbilical cord will be clamped and cut. Within the next 20 minutes, the placenta will be delivered.
Sometimes the baby's head does not move as expected through the birth canal. If this happens, your doctor may use forceps or vacuum extraction to move the baby.

Immediately After Procedure

Right after birth, your baby may be placed on your belly or chest. This skin-to-skin contact may lead to improved breastfeeding success.
You may need stitches if your perineum is cut or torn. The vaginal area, perineum, and rectum will be cleansed. The belly may be massaged to help the uterus clamp down and stop bleeding. Other steps may include:
An ice pack will be placed on the perineum. It will help to soothe the area and decrease swelling.
You may be given a shot of oxytocin to help decrease bleeding.
You will be given pain medicine.

How Long Will It Take?

The average time for a first baby is 12 hours. This can vary greatly, though.

Will It Hurt?

Labor causes severe pain during contractions. There may be brief periods of relief after each contraction. Talk to your doctor about your options for managing pain.

Average Hospital Stay

The usual length of stay for a vaginal delivery is 1 to 3 days. Your doctor may choose to keep you longer if problems arise.

Post-procedure Care

Having a baby will change you physically and emotionally.

Physical Effects

Physically, you might have the following:
Sore breasts—Your breasts may be painfully engorged when your milk comes in. Also, your nipples may be sore.
Constipation—You may not be able to move your bowels right away after delivery.
Stitches may make it painful to sit or walk.
Hemorrhoids—Hemorrhoids are common. They may make it painful for you to move your bowels.
Hot and cold flashes—This is due to your body trying to adjust to the change in hormones and blood flow levels.
Urinary or fecal incontinence—During delivery, your muscles were stretched. This may make it hard for you to control your urine and bowel movements for a short period of time after delivery.
After pains—The shrinking of your uterus can cause contractions. These can worsen when your baby nurses or when you take medication to reduce bleeding. It is normal to have this after delivery.
Vaginal discharge—This is heavier than your period and often contains clots. The discharge gradually fades to white or yellow and stops within 2 months.
Weight—Your postpartum weight will probably be about 10 pounds below your full-term weight. Water weight drops off within the first week as your body regains its salt balance.

Emotional Effects

Emotionally, you may be feeling:
"Baby blues"—About 80% of new moms have irritability, sadness, crying, or anxiety. This begins within days or weeks of giving birth. These feelings can result from hormonal changes, exhaustion, unexpected birth experiences, adjustments to changing roles, and a sense of lack of control over your new life.
Postpartum depression (PPD)—This condition is more serious and happens in 10% to 20% of new moms. It may cause mood swings, anxiety, guilt, and persistent sadness. Your baby may be several months old before PPD develops. It is more common in women with a family history of depression.
Postpartum psychosis—Postpartum psychosis is a rare but severe condition. Symptoms include difficulty thinking and thoughts of harming the baby. If you feel this way, call your doctor right away.
Sexual relations—You may not feel physically or emotionally ready to begin sexual relations right away. In most cases, you will feel more interested in sex in a few weeks

Abortion & Pregnancy Risks

Abortion

First trimester abortion is considered minor surgery. The risk of complications for the woman increases with advancing gestational age.