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Arrival at the maternity ward and the course of labor
Some signs are clear. The childbirth got off to a good start. It’s time to go to motherhood. Update on your arrival and the progress of the work.
That’s it, it’s the big day ! Repeated contractions, loss of water, intuition that “now is the time”, you are going in disaster – or not – for motherhood. And you are right because childbirth is near. When you arrive there, you are greeted by a midwife who takes note of your obstetrical file, which you obviously have with you. She then asks you different questions about how you are feeling. Then it is the clinical examination. Depending on the maternity wards, you are installed in the pre-labor room or directly in the birth room. The future dad is by your side. The midwife then performs a vaginal examination. This gesture is normally familiar to you since it has been performed several times during pregnancy to check the condition of the cervix. This examination confirms the diagnosis of beginning labor or absence of labor. If the cervix has started to open, it means the birth has started well. As soon as you are admitted, we will also take your blood pressure and make sure the baby is well by monitoring it. This device has a pressure sensor that is placed on your stomach using an elastic belt. It records the rhythm of the fetal heartbeat, but also the frequency and intensity of contractions. Monitoring allows you to see how the baby is coping with uterine contractions. If you want an epidural, now is the time to say so. The anesthesiologist will probably come to explain the process to you.
The cervix dilates …
Installed with your companion in the delivery room, you both put on a hospital gown and sterile protective slippers. The temperature is rather high, the atmosphere calm. It only remains to wait for the cervix to dilate. This natural mechanism is often long, especially for a first baby. It is customary to say that the cervix expands by about 1 cm per hour. But in reality, better not to calculate. During labor, the health of the baby and mother is regularly monitored. In principle every hour, the midwife examines you to check the progress of the cervix. Be patient, we speak of complete dilation when the cervix is open to 10 cm. In some maternities, we agree not to leave the monitoring permanently. If the pregnancy went well, there is no pathology, and the fetal heart rate is satisfactory, there is no reason not to let the expectant mother sit or walk a few times. moments. To relax, we can offer you the use of accessories such as the ball, the suspension or the bathtub. Stillness does not favor the evolution of work. The most analgesic positions are those which precisely allow childbirth to progress. The installation of an infusion is not systematic during dilation but necessary in the event of an epidural. It allows you to inject sugar because the work is often tiring. In the same way, it sometimes happens that the cervix does not dilate any more or then very slowly despite close contractions. The midwife can then put in the infusion a product to accelerate labor, it is oxytocin.
Epidural or not?
Those who wish can benefit, during dilation, from epidural anesthesia. She is usually asked on demand when the contractions become too painful. It’s a very personal choice. Some women prefer to wait as long as possible because it is a way for them to take ownership of their childbirth, while others, very anxious, want it soon enough. In theory, the epidural is applied when the cervix is dilated between 3 and 8 cm. Note that when a certain pain threshold is exceeded, the anesthesia acts less well. Placing the epidural takes a few minutes. You are sitting on the edge of your bed, your back round, the anesthetist pricks the first time to locally anesthetize the injection area. Then he introduces, using a fine needle, a catheter between your two lumbar vertebrae. This contains the anesthetic, it remains in place throughout the delivery. In the event of a cesarean section, the product is reinjected. Today, maternity hospitals are increasingly offering self-dosed epidurals. You yourself administer the amount of numbing product depending on the pain. In some facilities, ambulatory epidural anesthesia is also offered to allow the mother to walk during labor. Most of the time, the midwife breaks the water bag after placing the epidural. This gesture is also a way to restart work. If you have opted for a physiological delivery, the medical team will wait for the water bag to spontaneously crack.