Vaginal Delivery

WHAT YOU SHOULD KNOW:

A vaginal delivery is the birth of your baby through your vagina (birth canal).


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may get a blood clot. The clot may break loose, travel to your lungs, and cause trouble breathing. This problem can be life-threatening. You may develop an infection in your uterus, urinary tract, or perineum tears. You may need a blood transfusion or surgery to stop your bleeding during delivery. The nerves in your perineum and legs may be damaged. If you have had a C-section before, your uterus may tear during a vaginal delivery. Tears that occur in your vagina, perineum, or anus will need to be closed with stitches. After a vaginal delivery, sex may be painful. You may also have a uterine prolapse (the uterus falls into the vagina).

  • Forceps or suction used to help deliver your baby may injure your baby's face or head. The tools may also damage the nerves in your baby's neck and arm. He may also be at risk for bleeding in his brain. He may get a hematoma (blood pooling under the skin) from birth with or without tools. A hematoma may cause your baby to have jaundice (yellow skin).

WHILE YOU ARE HERE:

Before your vaginal delivery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.

  • Activity: Caregivers may have you move in bed, stand, or walk while you are in labor. This can help relieve some discomfort and may help your baby move into position for birth. Caregivers may also suggest that you urinate as often as possible during your labor. A full bladder may slow your baby's delivery.

Medicines:

  • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.

    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.

    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

  • Regional anesthesia: Medicine is injected to numb the body area where the surgery or procedure will be done. You will remain awake during the surgery or procedure.

  • Medicine for contractions: Medicines may be given to help keep your contractions strong and regular. These medicines may also be given after you have your baby to help stop bleeding from your uterus.

Tests:

  • Cervical fluid swab: Caregivers use a swab to take a fluid sample from your cervix. Fetal protein fluid begins to leak from your vagina as your body gets ready for delivery. Caregivers check the sample to learn if you are getting closer to having your baby.

  • External fetal heart monitoring: Caregivers may use this to monitor your baby's heartbeat, and the contractions of your uterus. A small metal disc (monitor) with gel on it is placed on your abdomen. A belt will be fastened around your waist to hold the monitor in place. The monitor may need to be moved as your baby moves inside you. It may also be put on and taken off, or left in place. The monitor is attached to a machine with a TV-type screen, or a printer. The screen or the paper print out shows a tracing of your uterus contracting, and the baby's heartbeat.

Stages of labor:

  • First stage: Your uterus will contract to help your cervix dilate (open). Your contractions will soon occur more often and get stronger. Caregivers may place a belt on your abdomen to measure the strength of your contractions. The fluid sac that surrounds your baby in the womb will break open. Your caregiver will break the sac if it does not break by itself. You may need medicine to induce (start) your labor. You may also be given pain medicine. The first stage ends when your cervix is dilated to 10 centimeters.

  • Second stage: When your cervix is dilated, you are ready to push during contractions to move your baby through your birth canal. Caregivers may tell you when to push, or you may be told to push when you feel the urge. Caregivers may use forceps or suction to help deliver your baby. You may also need an episiotomy (incision) to make the vaginal opening larger. The second stage ends with the birth of your baby.

  • Third stage: Once your baby is born, your caregiver will put clamps on the cord that connects your baby to the placenta. The placenta provides oxygen and nutrients to your baby during pregnancy. The cord is then cut. Your uterus continues to contract to push out the placenta. The third stage ends when your placenta is pushed out.

After your vaginal delivery:

If you have an episiotomy or a tear that occurred during the birth, your caregiver will close it with stitches. Caregivers will check your baby's skin color and how active he is. You may be able to hold your baby soon after he is born. Once caregivers have checked that you and your baby are okay, you will be taken to another room.

Activity after delivery:

Your caregiver may suggest you get out of bed to sit in a chair or walk. Activity can help prevent blood clots.

Breast care:

If you will breastfeed, ask caregivers to show you how to hold and breastfeed your baby. Ask how to care for your breasts, even if you will not be breastfeeding.

Uterus care:

A caregiver may massage your abdomen several times to make your uterus firm. This may be uncomfortable. You may have abdominal pains for up to 3 days after you give birth because your uterus is still contracting. The contractions help release blood from inside your uterus so it shrinks back to its normal size. These contractions may be stronger and hurt more while you breastfeed your baby.

Perineum care:

Your perineum is the area between your vagina and anus. Keep the area clean to help prevent an infection. Wash the area gently with soap and water when you bathe or shower. Rinse your perineum with warm water when you use the toilet. Ask your caregiver about any special wound care needed if you had an episiotomy. You may need to use a warm sitz bath to decrease pain. A sitz bath is a bathtub or basin filled to hip level. Stay in the sitz bath for 20 to 30 minutes, or as directed.

Vaginal discharge:

You will have vaginal discharge, called lochia, after your delivery. The lochia is bright red the first day or two after the birth. By the fourth day, the amount decreases, and it turns red-brown. Use a sanitary pad rather than a tampon to prevent a vaginal infection. It is normal to have lochia up to 8 weeks after your baby is born.

Going home:

Your caregivers will decide with you when it is best for you and your baby to go home. If you need support at home, ask your caregiver about home visits by another caregiver. This caregiver can help you learn about breastfeeding, bottle feeding, baby care, and perineum care.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Vaginal Delivery (Inpatient Care)

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