The Third Stage of Labor: Delivering the Placenta
Delivering the placenta is the third and final stage of having a baby. You’ve made it through your pregnancy and the big delivery, and now you’re holding your precious newborn baby. You might be thinking, “Glad that’s over!” But actually you’ve entered the final stage of delivery. The third stage of childbirth is the delivery of your placenta. And while it may seem anticlimactic compared to meeting your little bundle of joy, this stage of labor and delivery is very important and symbolic for many mothers. During pregnancy, the placenta provides everything the baby needs, including nutrition, water and oxygen. It also removes what isn’t needed, like waste products and carbon dioxide. The delivery of the placenta represents the end of an important era living in the safety of your womb. It’s the beginning of a new stage of life “on the outside.” The placenta is a disk shaped organ attached to the mother’s uterus on one side and the baby’s umbilical cord on the other. It has two sides. The maternal side is usually dark red in color, while the fetal side is almost translucent in color and shiny. The doctor will examine the delivered placenta to ensure each side appears the way it is expected to. How is the Placenta Delivered During Vaginal Birth? With a vaginal delivery, the uterus will continue to contract after the baby is out. These contractions move the placenta forward for delivery. Mercifully, these contractions aren’t typically as strong as labor contractions, and some women don’t even feel them (if you can believe that!). Your doctor might press on your stomach or ask you to push to help move the placenta forward. Typically, the placenta delivery is quick, happening within five minutes after the baby is delivered. But it can take longer for some women. Some women report being so focused on their baby for the first time that they don’t notice the placenta delivery. Others, however, observe an additional gush of blood after delivery that’s followed by the placenta. How is the Placenta Delivered During Cesarean Birth? If your delivery is via c-section, your doctor will physically remove the placenta from the uterus before closing the incision in the uterus and your stomach. Active Management Vs. Physiological Management During the Third Stage of Labor Generally, there are two options for how you complete the third stage of labor: active management and physiological management. But a combination of both may also be used. Active management uses an injection of a drug called syntocinon or ergometrine in your thigh soon after the baby’s birth. This speeds up the delivery of the placenta, usually happening within 30 minutes of birth. This is the recommended method, as it lowers the risk of heavy blood loss. Physiological management is generally used in midwife-led units and home births. This gets the placenta to come out mainly by pushing, gravity, contractions and sometimes nipple stimulation. It does not include the use of oxytocin injections and can take up to one hour. What is a Retained Placenta? The placenta should be delivered within 30 to 60 minutes after having the baby. If it isn’t delivered or doesn’t come out in its entirety, this is called a “retained placenta.” There are many reasons the placenta may not fully deliver. The cervix may have closed and is too small for the placenta to move through. The placenta may be too tightly attached to the uterine wall. A portion of the placenta may break off and remain during delivery. Retained placenta is a major issue because the uterus needs to clamp back down after giving birth. Tightening of the uterus helps blood vessels inside to stop bleeding. Therefore, if the placenta is retained, you may experience bleeding or infection. Your doctor will work with you on your best options to remove the placenta entirely. If you’re pregnant or planning to get pregnant, contact us today to discuss your birth plan! We are here to help and answer any questions you may have.
Your Breech Baby
Our Southlake, Fort Worth ObGyns explain what happens when you carry a breech baby You’re ready to give birth, and you feel like you’re prepared — until your ObGyn tells you that you have a breech baby. For a vaginal birth, the baby is ideally positioned head down, but 3 to 4 percent of pregnancies involve a breech baby. During the last weeks of pregnancy, if the baby is positioned buttocks, feet or both first instead of head down, we call it a breech presentation. Breech Positions Defined Every breech baby doesn’t present in the same position. Your breech baby may be in one of three breech positions. Our Southlake and Fort Worth ObGyns may refer to your breech baby in these ways. When the baby presents bottom down first and has bent knees, this is a complete breech. If the baby stretches his or her legs out toward the head, we call it a frank breech. When the baby is positioned with one leg hanging down, we call it a footling or incomplete breech. Our Southlake and Fort Worth ObGyns may discover your breech presentation during a pelvic examination or when they are feeling your belly. If so, they will order an ultrasound to confirm their suspicions. Can My Breech Baby Be Repositioned? We might be able to turn a breech baby using external cephalic version, or turning the baby. According to the American Congress of Obstetricians and Gynecologists, more than 50 percent of the time, turning a breech baby baby works; however, some babies may turn back into the breech position after the procedure. If you still have a breech position after week 36, we may try to turn the baby. This procedure should be done where a delivery room is easily accessible in the rare case that any problems occur. During the procedure, your ObGyn will use her hands to apply firm pressure to the abdomen to get the baby to rotate to a head-down position. During this process, we use an ultrasound to guide us, and we monitor the baby’s heart. Not every mother with a breech baby will qualify to have an external cephalic version. We do not attempt this with a mother carrying multiples. What Are My Delivery Options for a Breech Baby? If your baby has not turned head down, you will probably need a C-section. This is usually the safest way to deliver a breech baby for the sake of both mother and baby. Talk to our Southlake and Fort Worth ObGyns if you have concerns about a C-section. We are highly experienced in performing the procedure. For more information about pregnancy and birth, contact us for an appointment.
Frequently Asked Questions About Breastfeeding
We answer some of your most-common questions about breastfeeding. No doubt, you’ve heard many opinions about breastfeeding through the years, but how is breastfeeding actually beneficial for mom and baby? Here are a few of the questions we hear most frequently from new moms when it comes to breastfeeding. Why is Breastfeeding Important? Your breast milk is truly special because it contains the perfect amount of minerals, sugar, protein and water that a baby needs for growth and development. It also contains DHA (docosahexaenoic acid) and other fatty acids that researchers believe are important for your baby’s brain and eyes as they develop. How Long Should I Breastfeed? Our Southlake and Fort Worth ObGyns recommend that mothers breastfeed their babies during the first six months of life. Breastfeeding has many benefits for both mother and baby. However, even if you are only able to breastfeed for a short period of time, you will provide healthy benefits to your baby. What Are The Benefits of Breastfeeding? The CDC states that infants who are breastfed have a lower risk of several health issues including: Asthma Obesity Type 1 diabetes Ear infections Sudden Infant Death Syndrome (SIDS) Gastrointestinal infections (diarrhea/vomiting) While mothers who breastfeed have a lower risk of developing: Breast cancer Ovarian cancer Type 2 diabetes High blood pressure When Will My Milk Come In? Milk production begins in the second trimester of pregnancy. Your body begins making colostrum, a special milk that’s full of essential nutrients and is easy for newborns to digest. Your milk supply will increase about 30 to 40 hours after you’ve delivered your placenta. By then, the change in your hormones has signaled to your body that it’s time to feed your baby. Breastfeeding Benefits Recap Breastfeeding is beneficial for both mother and baby. Our Southlake and Fort Worth ObGyns know that you may have questions and concerns, and we’re here to help. We deliver babies at Baylor Regional Medical Center at Grapevine, which offers breastfeeding classes to help moms-to-be prepare. La Leche League is also a good resource.
Pregnancy Hospital Bag Checklist
Pack the essentials for your hospital stay as you welcome baby. The big day is almost here. You’ve been waiting many months to meet your baby. The rollercoaster of emotions, the discomfort, the anticipation and all the preparations have led you here. Your baby is days away from coming. But, do you have everything you need during your hospital stay? Pack a Hospital Go Bag The thought of a comprehensive, everything-you-could-possibly-need hospital bag can sound overwhelming. But take comfort in the knowledge of many women who’ve gone before you and conquered the hospital go bag. We’ve compiled a list of necessities and nice-to-haves for your pregnancy hospital bag. Before the big day comes, be prepared by spending time packing your bag. Clothing Slippers and socks Robe, nightgowns or pajamas that can unbutton easily for breastfeeding Nursing bras Inexpensive or old underwear that you don’t mind getting ruined Loose, comfy clothes to wear home Flip-flops for the shower Toiletries Lip balm and body moisturizer Travel shampoo/conditioner Travel hair dryer Hair elastics Nursing pads, nipple cream, maxi pads Eye mask and earplugs for much-deserved relaxation Make-up and skincare products Glasses and/or contacts Medications from home if directed by physician Paperwork Contact list for sharing your big news Phone numbers for anyone helping with the house/pets while you’re gone Your birth plan and any paperwork you’ve been asked to complete by the hospital and/or for insurance Gear Camera/video camera, phone and chargers Pillows Music, books, magazines, games and playing cards Notebook and pen Watch or smartphone with an app to time contractions Movies Water bottle Baby Items A going-home outfit for baby Approved infant car seat with the base properly installed in your vehicle A few onesies, socks and a hat Cozy blanket Package of newborn/size small diapers Package of unscented baby wipes Partner Items Warm clothing in case hospital room is cold Pillows/blankets Money for meals at the cafeteria Laptop Snacks and drinks Change for vending machines We know this is a long list, and you’re going to need a big bag. But it’s better to be prepared and have the most peaceful experience possible while delivering your baby. Back at Home: Preparations For Being Gone Before the big day nears, create a plan that ensures things around the house are taken care of when you’re welcoming a new member to the family. If you have other children or pets, make sure to set up plans for where they can stay in any scenario. Have contacts on hand for this that can respond at a moment’s notice (grandparents, aunts, uncles, etc.). Ask someone you trust to collect your mail and water your plants. If possible, pay bills in advance for peace of mind. With the chaos of delivery day, consider creating a phone tree that engages family members to help spread the good news. Checklist for the House: Do You Have These Items Covered While You’re Gone? Pets Plants Mail Lawn care/Sprinklers Security system Thermostat Conclusion Delivery day can be a swarm of emotions and craziness, but being prepared ahead of time is a big help for mom, her partner and loved ones. Enjoy the big day, and relax in the peace of knowing what you need is in your bag.
Recovering From a C Section: What to Expect
Recovering From a C Section: What to Expect During pregnancy and labor, situations can arise that necessitate a cesarean or “C” section delivery. The physicians at Women’s Integrated Healthcare guide women to understanding when a C section is necessary as the safest measure of delivering their baby. About 30 percent of women have C sections. Here’s how to prepare. In the United States, about one in three births occur via C-section. So, it’s important for women and their loved ones to understand the procedure and its recovery. The C section procedure is a surgery to deliver a baby via an incision in the abdomen and uterus. In some pregnancies, a C section is called for by the doctor to protect the health of the mother and child. Reasons for C-sections include multiple babies, failure to dilate, abnormal birth position, the baby isn’t getting enough oxygen, or problems with the placenta or umbilical cord. A C-section is major abdominal surgery, and as such, it takes time to heal. While it is a rather common procedure, recovery is much different from that of vaginal birth. Here are some things you need to know about recovering from a C section. C Section Recovery: What You Need to Know Women who deliver via C section can expect, on average, a two-to-three day hospital stay. The incision will be watched closely while in the hospital. Women are encouraged to rest as much as possible while in the hospital, as it’s significantly harder to rest when mother and baby come home and “real life” sets in. Get rest and recover. We mentioned how hard it is to get rest when you’re home with dozens of things to do and a baby who doesn’t sleep through the night, but ask for help. Line up helpers for household chores, and sleep whenever the baby sleeps. Speaking of rest, it might be hard to find a comfortable snoozing position. Use body pillows to relieve pressure on your sore abdomen, and even try the living room recliner if the bed isn’t comfortable. Also, make sure you’re controlling your stress levels so you can get some much-needed shut-eye. Be careful picking up and holding your baby. Your doctor will probably instruct you not to pick up more than 10-15 pounds for at least a few weeks. It’s best for someone to hand you your baby while you’re already in a seated position. Breastfeeding positions can be uncomfortable, especially if the baby is pressing on the tender C section incision area. Women find relief by placing a pillow over the incision site and experimenting with the baby’s positions to relieve pressure on the incision. Try a football hold or lying on your side. If you use an unorthodox method, make sure the baby is latching properly to avoid sore nipples. Get a helper to assist in moving your baby around while breastfeeding. Move often. Yes, rest and try to recover, but also get up and walk when you’re awake, as it’ll help relieve the gas pains you’ll probably suffer. Plus, you’ll need to retrain those abdominal muscles to work properly. It will probably hurt to cough, sneeze and stand up. Again, pillows to the rescue. Press a pillow against your abdomen as you need to cough and sneeze. It’ll help with some of the pulling and pressure applied to your incision. Get help standing up and sitting down whenever you can. Grab solid objects for support. C Section Recovery Kit As you near the end of your pregnancy, ask your doctor if there’s a chance you might need a C section. He or she might be able to predict based on the baby’s position or other factors. Or, perhaps you’ve already got the procedure scheduled. Whatever the case, it’s important to be prepared. Here’s a list of what you need to have on hand for recovery. OTC pain meds: Your doctor might send you home with prescription pain medications, but at some point, you’ll be ready to switch to over-the-counter solutions. Have them handy before you need them. Ibuprofen and acetaminophen are great options for pain management. Pillows: You’ll want pillows for a couple of reasons. First, they’ll help you find a comfortable sleeping position. Some women find relief by placing a pillow under their abdomen while lying on their sides. Second, you might use several to help you find a comfortable breastfeeding position. Third, you can grab a pillow and push it against your belly as you cough, sneeze or get out of bed or a chair. Belly support: A good belly binder can aid in recovery from a C section by helping to support the abdominal muscles. By stabilizing your midsection, it can also provide back support and relief from back pain. Laxatives and gas-relief medication: Unfortunately, two common side effects of C-section surgery are gas pain and constipation. You’ll want good, over-the-counter medications on your side to help you cope with the discomfort. Comfortable, high-waisted clothes. You won’t want anything constrictive or that rubs against your incision. High-waisted underwear is a must. There are even lines of C-section underwear on the market. Sanitary pads: Surprisingly, you might bleed vaginally after having a C section. Have multiple types of pads, from heavy to light, on hand, and expect to need them for about three weeks postpartum. Helpers: Line up a list of friends and family who are willing to help you around the house, since you won’t be able to lift the laundry basket for a few weeks. Again, a C section is major surgery, and it requires rest, recovery, patience and preparation. With the right supplies and support, women who deliver this way can make a speedy recovery and enjoy their new baby to the fullest. If you are pregnant and think you may deliver by C-section our Southlake OBGYN’s right here in Grapevine, are happy to work with you. We provide expert, compassionate care. Contact us for an appointment.
Pregnancy: When is it Time to Go to the Hospital?
How to listen to labor symptoms and know when baby is really on the way. Whether this is your first baby or fourth, more than likely, you’ve got a bag packed for the hospital and sitting by the front door. (If you don’t, you should!) You’ve probably also got checklists on the fridge for family to get the mail, feed the pets and water the plants while you’re away. (Same here!) You’re as ready as you can be for baby to come. Being prepared is a great way to bring peace of mind to an otherwise stressful situation. But, when do you really know when it’s time to head to the hospital? Every woman’s journey is different and unique, but there are some signs of labor to look for as you’re waiting for baby’s arrival. Some are conveniently obvious, such as contractions and water breaking. But, other signs are more subtle. Signs of Labor Your water breaks. In only about 15 percent or less of women, water will break. If you’re fortunate to experience this obvious sign of labor, you know beyond a doubt that it’s time to head for the hospital. But, if you’re reading this blog, it’s likely because you may be experiencing more subtle signs. Keep reading to learn more. You’re having consistent contractions. These will become stronger and more frequent during labor onset. This is where all that knowledge from childbirth classes will kick in. Using a timer (there’s lots of apps for this in the App Store and on Android), time your contractions. If they are consistently happening every few minutes, it’s time to go to the hospital. Subtle Signs of Labor These signs are less obvious and can be more gradual. You’ll want to keep in touch with your doctor if you’re experiencing them. He or she can help you determine when to get in the car. The baby “drops.” This means your baby is getting into position for delivery, low within your pelvis. Your cervix dilates. During each visit as the due date draws near, your doctor checks whether your cervix is starting to dilate, or open, and/or efface, or thin out. You experience vaginal discharge and/or a change in color and consistency. You have diarrhea, loose-feeling joints, cramps, worsening back pain and fatigue. When to Call the Doctor During Late-Term Pregnancy If you’re not sure whether you’re experiencing any of these signs, it’s always best to call your provider, even if it’s after business hours. He or she will help you know if it’s time to hit the road for the hospital. Definitely give your doctor a call and head to the hospital in these situations: Your water breaks You notice bright-red discharge (blood) You develop a severe headache, blurred vision or sudden swelling. These are signs of preeclampsia. Our compassionate and experienced Grapevine and Fort Worth obgyns are here to help you have an informed, healthy pregnancy, labor and delivery. Contact us today for an appointment.
Decisions to Make Before Giving Birth
Four important decisions to make before giving birth Our Grapevine and Fort Worth ObGyns encourage women to make a birth plan to ensure that they have the labor, delivery and birthing experience they want. With that in mind, we’re highlighting four important decisions to make before giving birth. What kind of atmosphere will you prefer during labor and delivery? This is one of the first decisions to make before giving birth. It’s important for you to be as comfortable and relaxed as possible during labor and delivery. Think about who you want present during labor and delivery, and what items – music, extra pillows, audiobooks – would make you feel comfortable. It’s important to make decisions about your labor and delivery experience. There are many decisions to make before giving birth. For example, would you like to watch your baby’s birth? Do you want to give birth in a certain position?Do you want your partner to be with you if you need a C section? Do you want to avoid fetal monitoring during labor? You need to discuss the type of pain relief, if any, you think you might want during labor and delivery. It’s time to talk about the kinds of labor and delivery pain relief methods you want before, during and after delivery. You may consider epidural and spinal blocks, local anesthesia during the delivery, or no pain relief methods at all to experience natural childbirth. Finally, when the baby is born, there are decisions about his or her care that you should make before giving birth. Some important decisions to make before giving birth are related to what happens to your baby right after he or she is born. There are several things to think about. Do you want your partner or someone else to cut the umbilical cord? Are you planning on cord blood banking? Would you like for the baby to be laid on your chest immediately after birth? Are you interested in circumcision for your male child? During pregnancy, we know there is a lot to consider. We hope that knowing in advance some important decisions to make before giving birth will help make your experience better for you, your partner and your baby. Contact us for more information about obstetrics care.
