So what goes on after the water breaks?

Factual Questions
1

I’ve read numerous threads about babies lately, but I’m still in the dark about the whole procedure.

So the water breaks, and the woman goes to the hospital. She lays down until the contractions get closer and then she gets the epidural? But doesn’t that numb everything so she can’t push? How long does it take to push out a baby? After the baby is born, women pass the “afterbirth”, correct? Is there a normal time when that is passed? Does it hurt?

Then after the baby is born, how long does it take for the vagina to heal? My friend who had a baby told me that women basically wear adult diapers to catch the rest of the blood. How long does that last?

Then what happens after the baby is born? S/he is weighed, has its mouth and nose aspirated, then given to the mom for like 10 minutes and then taken away?

My mom forgot what happened and I’ve never felt comfortable enough to ask my friends who are mothers about the whole process. Is there a standard procedure or does it depend?

Thanks in advance for your input!

And mods, I wasn’t sure if this fit in GQ or IMHO, so please move the thread if it’s in the wrong place. :slight_smile:

2

As a guy I don’t know about this stuff either. Good question.
Ladies?

3

I have no children - however, every other woman I know my age does, so I have quite a few stories.

It really depends on the woman/baby in question.

I think usually your description is accurate. However, the water doesn’t necessarily break - sometimes if a woman has gone over term Drs will induce labor, and possibly break the sac themselves.

In other cases, the water breaks and it’s weeks before baby arrives (this is what happened with my grandmother’s 7th child - water broke at about 6 months - she managed to hang on till about 7 months so my uncle wouldn’t be too tiny). There’s a big risk of infection.

Some women pass the after birth with little muss or fuss (I think they’re so wacked out from the actual birth that the placenta sort of sneaks out and they don’t notice too much). Some women, like my mom, have to have part of the placenta scraped out with a scalpel which is very uncomfortable.

Regarding crotch healing - some women (few I think) have little or no tearing - the vagina opening stretches, baby comes out, opening unstretches. I think many more woman have tearing that requires some stitches. Some women elect to have the opening cut prior to the birth in order to prevent ripping. If the tearing is minor, things can heal up fairly quickly. However in bad cases, the tear can go right through to the anus in which case healing time takes much longer. All the women I know that delivered vaginally had frozen maxi pads on hand that they sat on - apparently this is helpful. The bleeding is similar to a light to heavy period, depending on the woman. Most Drs. suggest that any sort of sex is a no go for at least 4 weeks, however, I do know women who got back on the horse (so to speak) sooner than that. I don’t know how that was at all.

So…I suppose that’s some info. But it’s really hard to predict. Also, I haven’t talked about my many friends that had C-sections, which is a totally different ball of wax.

4

Labor doesn’t always start with the water breaking, and if an epidural is involved, the timing of its placement is pretty variable.

What is consistent is the onset of contractions - these start out of variable length and timing, and may or may not hurt particularly. (Mine just felt like pressure until my water broke, well into the process.) They get closer and closer together and more regular - that’s a good sign that things are getting serious (the sort-of-random ones can go on for days without doing much).

The “point” of the contractions is to open up the cervix. Ideally, it will have gotten shorter and softer on its own (“effaced”) before the contractions really get going. It starts out closed, and dilates to about 10 cm to get the baby’s head through. The amount of dilation when the contractions really get going is also quite variable - I had a coworker who walked around for a month at 7 cm, while others start labor while things were still pretty much closed up. The “bag of waters” is basically a membrane sac enclosing the baby. It can break while things have barely started, or not until the baby is crowning, or anywhere in between.

I think most hospitals nowadays want you to be at least 4-5 cm before they will agree that labor is really starting and admit you. (If your water breaks, they also let you in, because there is an increased risk of infection if you don’t have a baby within 24 hours of your water breaking.) Similarly, most places like you to be at least that dilated before they place an epidural, because it can slow down labor. The exact rules vary at different hospitals, though.

Once the cervix is dilated to 10 cm, they let/encourage you to push. The epidural may be turned down for this, or not. A good epidural is supposed to block pain without removing your voluntary control over the muscles, so you can still push when you have one - you just can’t really feel what you’re doing. (In practice, it’s not usually that good. I had a C-section after 4 hours of pushing. They just cranked up the epidural and cut me open. Once I was stitched up and they were ready to lift me off the table, they asked if I could wiggle my toes. “Sure!” I said, and did so. So then they asked if I could move my legs, so I picked both legs off the table and held them in the air. The nurses almost fainted, and started screaming at me to put them down before I hurt myself. I guess most people can’t do that.)

In terms of the actual vaginal birth, I can’t give you a personal account because I had a C-section. But tearing is certainly not universal, and many believe that it can be reduced or eliminated by stretching beforehand and by not trying to hurry the birth. Episiotomies (where the doctor cuts into the perineum to increase the size of the opening) used to be practically universal, but are less common today. More recent studies show that they often made things worse (just tear on the dotted line!), and that a tear heals faster and better than a cut.

If there are no special concerns, there’s no reason for the baby to be taken away, and hospitals usually don’t nowadays. The first hour is the best time to establish breastfeeding. My own baby was five weeks early, so she was taken to NICU for about four hours after I had had a brief look at her.

I healed quite quickly from the C-section - I was walking around with pain in a few hours, and with minimal pain in a week or so. You’re not allowed to lift anything heavier than the baby for 6 weeks after a C-section, although I understand that most mothers of more than one child end up breaking that rule and picking up the older child at some point. I did end up carrying both my daughter and her car seat after a couple of weeks - it was too difficult logistically not to.

I had less lochia (bleeding) than I think is typical for a vaginal birth - I think they cleaned things up a bit while they were getting the baby out. I think it lasted about ten days for me. But it can go on for 8 weeks or more in some cases. I think that 4-6 weeks is pretty typical. You basically get all the periods you got to skip during the pregnancy, one after the other. :stuck_out_tongue:

5

In my case, nothing happened after the water broke, so I had to be induced. The first time, it happened at home and I went to the hospital and twiddled my thumbs for about six hours until my doctor decided we should move on. The second time was a scheduled induction and the doctor broke the water with a long thing like a crochet hook. (No this doesn’t hurt.)

Expelling the placenta can be somewhat uncomfortable. The pains are not as intense as labor, but similar. You also tend to get cramps while nursing for a couple of days. This is natural and is related to the uterus returning to its non-pregnant size.

6

All I can say is :eek: !!!

Good lord that sounds so painful! All this about tearing and breast tenderness and shots in the spine…shudder. The SO and I want to start having children in about 5 years and this all seems so scary! First being “as big as a house” then the pain of pushing and healing after having a baby. Man women are wonderful! I just wish that the SO could experience the “joy of childbirth”. :stuck_out_tongue:

Oh, how long does it take until the breast tenderness goes away? My friend said that it hurt her a lot the first time to breastfeed because she just wasn’t producing the milk until about a day later. And then she said after she started breastfeeding regularly, it started to hurt when she didn’t breastfeed. Something about too much milk in the breast? It seems like a ‘damned of you do, damned of you don’t’ kind of thing. :rolleyes:

And I thought that not having periods would be one of the best reasons to get pregnant!

…I keed. I keed.

But man. Oi. crosses her legs until she’s ready to have the itty bitties.

7

Yeah, breastfeeding can hurt at first. I recommend taking a breastfeeding class before the baby is born - there was a one-hour class at my doctor’s office that was really helpful. They had a life-sized baby doll that they used to let you try out different nursing positions and understand better what a good latch is like.

Once breastfeeding is established, you can get engorged if you miss a feeding, which is uncomfortable, although not obscenely painful. It feels kind of like when you have an infected hangnail and your finger gets swollen, if you’ve ever experienced that - tight and achy, like your skin isn’t quite big enough to hold what’s inside.

Now mastitis - that’s painful! (It’s an infection of the milk duct.) But it goes away readily with antibiotics.

Honestly, it’s not that bad. Pregnancy itself was kind of fun, although I was also ready for it to be over by the time she was born.

8

That typical Hollywood gush of water? Happens in 10% of births according to my Lamaze teacher. The first time my wife’s water broke she had a trickle-- about a cup of fluid. About a week later she had a gusher requiring a mop.

9

You might want to take a look at this thread where a similar discussion of the birth process is going on.

As far as after the birth – this varies all over the place depending on the mother’s condition and the location of the birth (hospital vs. birthing center as well as the geographic location).

In the “good old days” 40 or 50 years ago, the baby was whisked away while Mom recovered from the anaesthesia and she next saw it (the baby, not the anaesthesia) when it was brought to her hours later, with a bottle of scientific formula.

Even 30 years ago this process had humanized a great deal. My babies were theoretically supposed to be “rooming in,” which meant they were to spend a good portion of the day in the room with me, being breast fed on demand, under the supervision of a professional who knew about lactation. In practice, the first kid was born on December 30th, and the next day a large number of the hospital staff mysteriously got the flu, and all the babies were mostly kept in the group nursery and just brought around for feeding. For some reason this somehow required fewer staff members, although I could never understand why. By the time all the nurses and aides were healthy again (January 2nd), we were ready to go home. My second child had a slight jaundice and had to be kept in some special place where magic rays were supposed to draw off the excess bilirubin. (She was fine. )

There is usually bleeding for several weeks as the uterus gets back to its normal size and condition. Breast feeding helps this process, incidentally. Back in the day, doctors told us that any marital activities (sex) should wait for 6 weeks. But for the first couple of weeks any thought of anyone touching “down there” was completely out of the question. After that I was too tired. For a while, anyway. Which is always a good incentive for a dad to help out as much as he can so mom can save her energy for other important stuff.

10

Just a few clarifications. If the water breaks, and labor doesn’t start, and nothing is done there are several complications that can happen. One is that the cord can prolapse, or come out before the baby. This puts the baby at very serious risk for low oxygen injury ore even death. Infection is another problem. So, once the water breaks, mom should contact her doctor.

Actually, this is the beginning of transitional labor, and the mother can’t really control the need to push. The mother can assist by making an effort to push, but she could not stop pushing no matter who told her to.
Epidural anesthesia only effects feeling, not muscle contractions, so it doesn’t interfere with the process.
Vaginal tearing isn’t common. The doctor can make an incision called an episiotomy. Episiotomy is used less than it once was, but remains available to keep tearing to a minimum.
After the baby is delivered, its laid on the momma’s abdomen, while the remaining products of conception are delivered. Then the cord is clamped and cut, often by the father, or labor coach.
Then the baby is handed off to a nurse or pediatrician, who suctions the mouth and nose and checks his/her APGAR scores. He/she is wiped off, examined, weighed and wrapped in a blanket and given back to mom.
Healing of the vagina doesn’t take long, but the recomendation to wait to have sex is more to ensure the uterus returns to its pre-birth size and condition.
Breast feeding takes a bit of practice, but shouldn’t be really painful. Nipples have to be well cared for to prevent cracking, which can hurt. Many women don’t have a period while breast feeding, but, this does not mean she does not ovulate. You can become pregnant while breast feeding.
As long as mom is breast feeding on a regular basis, breast engorgement shouldn’t be a big problem. The doctor can prescribe a medicine to stop milk production when baby is weaned.

11

picunurse, do you know any reasons why labor sometimes doesn’t happen when the water breaks? I’ve had two otherwise normal pregnancies where I just didn’t go into labor when everything else seemed ready to go. I’m especially curious about the first time, because it broke on its own (right on my daughter’s official due date, too.)

12

If you me, you spend an hour and a half the next morning at a car wash trying to clean the residue from the passenger seat and carpet in my car.

13

For some women it works that way, for some others, you stay at home or go to a birthing center. Many women choose to stay up and moving as long as possible. Then, you lay on your side, get on all fours, kneel, sit on a big inflatable rubber ball, or whatever other position is comfy. Some women get into a tub of water. Some women get up and down througout the whole process, walking, changing position, doing whatever is comfy for them at the moment.

Sometimes. In a home birth, often the partner or birth attendant or midwife helps “catch” the baby, then the baby is immediately rested on mama’s chest. Eventually the baby is washed and weighed. Some moms choose to spend every moment with the new baby for several days, others need some time to recuperate.

Just wanted to give you a bit of a different picture–home birthing as opposed to the hollywood style hospital birthing. I’ve never seen a hospital birth personally, only what’s depicted and what others have told me about the whole process.

14

MixieArmadillo, most hospitals now have more home-like birthing centers. Of course, there are still the “normal” delivery rooms, hopefully used mostly for high risk moms and babes.

The water method of laboring is great, as long as its not a part of the actual birthing. I’ve cared for several tragic cases where the baby was born into warm water that resulted in profound hypoxia (lack of oxygen) due to near-drowning.
As long as the birthing attendant/midwife checks frequently for prolapse, walking is good.

cher3, I can’t tell you why some mother’s don’t progress to active labor when their water breaks. The answer is locked in the individual’s own physiology.
Personally, I went the opposite route. I had a loooooong labor, with membranes intact. The membrane is normally quite thin by due date, so ruptures easily. Mine was more like an inner tube.
I labored in a military hospital with the old brown metal beds with spindle head and footboards. I have a vivid memory of the doctor with his amni-hook at first flicking then putting his foot on the end of the bed and pulling with both hands.
:eek: My labor progressed nicely after he fell on his butt! :smiley:

15

Good Lord. You get to deal with a screaming baby while suffering through a 6-week period? :eek:

16

3 stages of Labour

  1. Dilation of the cervix.
    From 0cm-10cm.
    usually 0-3cm is achieved without the woman realising she’s in labour, but sometmes not. This stage takes about 1cm/hour in a first-timer and about 2cm/hr in someone who has done it before.
    Anything longer than 12hours or shorter than 30mins not ideal.

  2. Full dilation and delivery of the baby.
    a. Passive stage- this is usually 1 hour (2 hours if you’ve had an epidural). It’s the time between full dilation and when you have an overwhelming, uncontrollable desire to push. If you sart actively pushing during this stage, you’ll exhaust yourself by the time the active stage happens-a common reason for forceps/ventouse or c-sections.

b. Active stage- from when you first NEED to push (or are told to push if you’ve had an epidural) until baby is delivered. This should not be longer than 1 hour, and ideally less than 30mins. This is the fun bit.

  1. Delivery of the placenta.
    This should have been achieved within 30mins of delivery of the baby- the outside limit is 1 hour. At which point you’re talking about a manual evacuation, probably in theatre, under anaesthetic.

picunurse-ever been at a 6 week postnatal check when a breastfeeding mother has a positive pregnancy test? Oh yes, THAT is a lesson in the crappy method of contraception that is lactation.

17

I had a neighbor, a nurse :eek: whose first pregnancy was full term twins 8 lbs 6 oz & 6 lbs 8 oz, who came to me 4 weeks after delivery saying her husband was just soooo in need… yes, three babies 10 months apart. I would have spanked her, if it would have done any good. The last time I heard from her, her 6th was on the way.

The time frames you mentioned are interesting to me.
My son, as I said was born in a military hospital in 1967. On a Wednesday I saw my doctor who said I was 7cms and contractions were 7 minutes apart. He said “see you tonight” By that evening the contractions were 5 minutes apart, and stayed that way until Sunday night, actually Monday morning at 1 am I went to the hospital with them 3 minutes apart. I was alone in the labor room from 1am until the membrane rupturing ceremony at 3pm. At 3:30 I was transitional. I fell asleep between contractions. The doctor sat next to me saying one more and we’ll go (to the delivery room) he said it probably 20 times. In the labor room I was given spinal anesthesia. My son was born at 6:04 PM His APGARs were 4-6-10 He had a cephalo hematoma the size of a ping-pong ball.
Do you think I should have has a C-section?

18

Heh…yes.

Bear in mind, Irish hospitals are basically the home of managed childbirth. We joke that the 12 hour limit was because back in the day they’d have another 3 women queueing up to deliver.

Our golden rule is that if you’re more than 4cm dilated and having less than 3 contractions in 10 minutes (and baby is cephalic, engaged etc etc), you get augmented by ARM. Still not moving things on, you get oxytocin.

If you continue to keep falling off the 1cm/hour line while at maximal doses of oxytocin, and are having satisfactory contractions, you get sectioned.

At any rate, if you’ve been in full labour for more than 12 with ruptured membranes and delivery doesn’t look imminent within 2 hours, you’ll have a section if the baby isn’t engaged, or a ventouse if over 9cm dilated and the head is mid or low cavity.

Basically, the OBs here feel that well, sure, we COULD let you labour for 3 days and you might deliver a healthy baby, or you might not. If it’s likely you’ll need an emergency section eventually, the earlier they do it, the safer it is, so they don’t waste time.

19

irishgirl Thanks. It was over 35 years ago, and he turned out to be a genius, so no harm, no foul.

Even though I know the basic physiology, I tried my best to stay away from labor and delivery, and postpartum (it smells funny in there.) In fact, the only peripartum patient I ever cared for, was a woman with malignant hypertention at 22 weeks. She ended up delivering. (negative outcome) Her blood pressure was back to normal within 6 hours. It was her fourth failed pregnancy for the same reason. It was sad, but my total terror of the peripartum scene overshadowed everything else.
Give me a 1500 gram premie, post op from a first stage Norwood procedure for HLHS any day!

20

See…that’s why you work in paeds, and I want to be in Ob/Gyn!

I’ve never really thought about it, but yes, the postnatal wards do smell a bit…blood, dirty nappies, breastmilk and fear…
I hate early PET patients…it’s so sad, because there’s only one way it can go if the BP doesn’t stay down. :frowning: