Labor and delivery can be an extremely stressful and sometimes frightening time, especially for the first-time parent. By knowing what to expect during the postpartum period, many of the anxieties and fears that normally occur may be able to be avoided.

One of the biggest factors that plays a part in what to expect after delivery is the type of delivery that you have. If you have a vaginal delivery, your experience will probably be very different from someone who has had a cesarean section, and vice-versa.

With a vaginal delivery, you can expect to be extremely tired right after delivery. Labor and delivery can be physically a lot of hard work. In addition, the rapidly changing levels of hormones in your body may make you tired as well. You should be prepared to get as much rest as you can.

If you are prone to hemorrhoids, they may be inflamed or swollen after a vaginal delivery.

Also after a vaginal delivery, you can expect to have afterpains. Afterpains are contractions of the uterus that occur after delivery. These normally will not last longer than ten days after your delivery, and are a normal part of the uterus trying to get back to its regular size.

Your perineum will probably be sore after a vaginal delivery. You can use an ice pack to help with the swelling and soreness that often follows delivery. In addition, if you had an episiotomy, you will need to care for it carefully.

You should expect some discharge and bleeding (known as Lochia) after delivery. This will go from red to brown to yellow, and should not last for more than a couple of weeks.

With a C-section delivery, you can expect all of the above and more. You will have had major abdominal surgery. You will not only be tired, you will probably be generally out of it for a while due to the anesthetic. You will probably also have a catheter and an IV for a day or two. You should expect to stay in the hospital longer after a c-section delivery. You will probably require pain medications, and will also have to be diligent about keeping your incision clean, infection-free, and dry.

In addition, regardless of what type of delivery you have, you should expect some emotional changes. In addition to the obvious circumstancial causes, your body will take some time to get itself back to regular hormonal levels.

In the late 1940s, the American obstetrician Robert Bradley developed a method of childbirth that was unique for the time. This method is based on the idea that childbirth is and should be a natural process. Further, it assumes that, with the right preparations and precautions, most women can avoid pain medications and medical interventions during the labor and birth process. Proponents of the Bradley method suggest that around 90 percent of women who use the Bradley method to deliver vaginally can do so without pain medication.

The Bradley program typically lasts for 12 weeks. It is more intensive than other childbirth classes. The Bradley method assumes that it takes months to physically, mentally, and emotionally prepare for parenting and childbirth. Thus, the program attempts to address all aspects of childbirth, as well as other issues related to pregnancy and the postpartum experience. The Bradley method relies on an educated partner to act as the childbirth coach.

Here are some of the topics covered by the Bradley method:
- Relaxation techniques to be used during labor and birth, used to manage pain
- Distractions techniques that remove the focus away from the pain during labor and birth
- Breathing methods to aid in relaxation during labor and birth
- How to avoid unnecessary interventions
- How to reduce the risk of needing a C-section
- How to help your partner be a coach on labor day
- The stages of labor and techniques to deal with each one
- Breastfeeding
- Common pregnancy complaints and symptoms
- The importance of diet and exercise during pregnancy
- “Tuning-in” to your own body and trusting the natural process
- Immediate and continuous contact with your new baby
- Being prepared for emergency situations.

While most metropolitan areas have access to a Bradley instructor, this is not necessarily the case everywhere. The cost of Bradley Classes varies depending on individual teachers and the area in which the classes are offered. Bradley Method instructors are certified through the “American Academy of Husband-Coached Childbirth” - the training program designed by Dr. Bradley and those that followed him.

Every woman’s pregnancy experience is different. This is no less true for the labor and delivery experience. Some women experience only mild pain and discomfort; many experience a great deal of pain. Some women choose to go through labor and delivery with no pain medication; some women choose to use medications to relieve pain during labor and delivery. One of the types of pain relief available is Stadol.

During the early stages of labor your obstetrician may offer you intravenous or intramuscular injection of medication to ease the pain of labor. Narcotics, such as meperidine (Demerol) or butorphanol (Stadol), are often used. Narcotics will help with mild contractions in early labor but generally are insufficient to relieve the stronger contractions associated with active labor. In the past, other narcotics such as morphine have been used. Some of the general side effects of narcotics during labor can be:
- Nausea
- Vomiting
- Itching
- Sedation
- Decreased gastric motility
- Loss of protective airway reflexes
- Hypoxia due to respiratory depression

Stadol is often the choice of many women and their physicians when selecting a narcotic pain reliever. Stadol is considered more potent than morphine and Demerol. Stadol generally starts working in less then five minutes. Stadol is considered to have minimal fetal effects, and creates minimal nausea.

Other medications that can relieve pain during labor and delivery can include an epidural anesthesia or a spinal block. An epidural is administered through an extremely thin tube between the spinal cord and outer membranes. When used for labor it dulls feeling from your stomach to your feet. Having an epidural will still allow you to feel contractions enabling you push your baby out after your cervix is completely dilated. At times the epidural is turned down, or off, so that you can push well at the end of your labor.

A Spinal Block should not be confused with an epidural. With a spinal, the medication is given only once. With an epidural, a catheter is inserted into the location in the spine so that additional medicine may be dispensed at a later time. A spinal is most often used when you need pain relief for only a limited period of time, such as with a cesarean delivery or a vaginal delivery in which instruments are required to help the baby out.

Regardless of the method you choose to manage pain during labor and delivery, it is important that you discuss with your health care provider the risks and effectiveness of each method.

Blood that remains in the umbilical cord and the placenta after birth is often referred to as “cord blood.” Cord blood is a potentially valuable source of stem cells. Stem cells are the basic building blocks of your blood as well as your immune system. These cells are often used to help to rebuild the blood system and the immune system of a patient after the patient has been treated for cancer with radiation therapy or chemotherapy.

In addition, stem cells from cord blood seems to have some promise for medical research. Some researchers have suggested that this type of research could ultimately provide treatments for a variety of disorders, including Alzheimer’s disease and Parkinson’s disease. Other research suggests that one day stem cells could be used for the treatment of heart disease.

Many parents choose to donate or “bank” cord blood. This helps these cells to be readily used in treatment of a variety of illnesses. Often, cord blood is used by a family member, such as a sibling. Many metropolitan areas have Cord Blood banks or other places to which one can make a donation of cord blood.

Donating cord blood does not cost anything. If you wish to store and save your baby’s cord blood for your own family’s use, there is generally a fee. There are no medical risks to donating cord blood. The procedure for collecting cord blood takes place after the birth takes place. If there are complications during birth, cord blood will probably not be collected.

The actual procedure for collecting the cord blood is simple. Once your baby is born, the umbilical cord will be clamped. This will close the link between your baby and the placenta. There will be anywhere from 3 to 5 ounces of cord blood left in the cord. From there, it will be collected and then tested. It will be tested for infection, and the family’s health history will be examined to see if it meets certain standards. If these tests come through fine, the cord blood will be frozen and stored until someone needs it.

An Epidural refers to the process in which an anesthesia is injected into a part of the spine known as the epidural space. An epidural is often used during childbirth to block the transmission of pain signals to the brain.

There are a variety of side effects that can occur with an epidural. The three main side effects include:

- a loss of muscle power.

- a loss of sensation in other areas of the body.

- a loss of function in the sympathetic nervous system, which can affect blood pressure.

There are also a variety of safety risks that can occur with an epidural. These include:

- an accidental puncture of the dural space. If the dural space is punctured, this can lead to prolonged headache that lasts for days, weeks, or months. This puncture can generally be treated, although most will resolve by themselves. This occurs in around 1% of people who have an epidural.

- a bloody tap. This refers to an injury of a vein with the epidural needle. Generally speaking, the would will clot and there will be no other problems.

- failure of the block. In about 5% of cases, the pain relief will not be adequate. In these cases, another epidural is generally administered.

- placement of the catheter in a vein. If the catheter that delivers the anesthetic is placed into a vein, the anesthetic may be injected intravenously, which can be toxic.

- nervous system damage. In some cases, an epidural may damage the nervous system. This occurs in around 1 out of every 10,000 cases.

- formation of an abscess. This occurs in about 1 out of every 50,000 cases.

- paralysis or paraplegia. Occurs in about 1 out of 100,000 cases.

- death. This is extremely rare, occurring less than 1 in 100,000 cases.

Because of these risks, many women have chosen to use either different medications or even non-medical pain management techniques to manage their pain during labor.

Today, many women are choosing to give birth at home. A home birth allows a woman to go through labor and delivery in surroundings that are more comfortable and familiar than a hospital or birthing center. IN addition, a home birth avoids the routine medical interventions that often accompany a hospital birth. Also, a home birth may, in many instances, be a less expensive option than a hospital birth.

Studies show that the average hospital birth ranges in cost from five to seven thousand dollars, depending on the staff and the location. An average home birth tends to cost less than two thousand dollars.
A hospital birth requires a physician, whose fees range from $1500 to $3000. In addition, there is the cost of the anesthesiologist, hospital costs, cost of supplies and other fees. In contrast, the fees for a midwife, who typically assists in a home birth, range from about $1000 to $2000. The midwife’s cost generally includes prenatal care, childbirth classes, as well as birthing supplies.

How much home birth practitioners charge can vary considerably from place to place and from one caregiver to another. If you are considering a home birth, you should find out not only what the home birth will cost but also what additional costs you’d have to pay if you needed to be transferred to another provider or a hospital during pregnancy, labor, birth, or postpartum.

Some insurance carriers cover home birth, but others don’t. If you have insurance through an HMO that doesn’t have an in-network provider who does home births, you may be able to get the HMO to provide some coverage for an out-of-network provider, although you’ll probably have to be persistent.

Having a home birth is not for everyone. Moms-to-be who are more likely to have complications during childbirth, who have “high-risk” pregnancies, should give birth in a hospital. This includes:
- Women with a medical condition, such as high blood pressure or diabetes
- Women who have had a previous c-section or other uterine surgery
- Women who experience any number of pregnancy complications, such as premature labor, preeclampsia, or a baby in the breech position at 37 weeks
- Women who are carrying twins (or multiples).

One of the final signals that labor is near is the ripening of the cervix. Ripening of the cervix refers the process by which the cervix thins, softens, becomes relaxed, and opens in response to uterine contractions. Once the cervix ripens and then dilates, this allows the fetus to pass through the cervical opening.

Cervical ripening is the result of a series of complex biochemical processes. Collagens and enzymes re-align themselves, and other bodily changes contribute to the softening of the cervix as well.

When the cervix is not ripening on its own and a woman is at or past her due date, a woman and her health care provider may choose to induce labor. One of the parts of inducing labor can be the softening of the cervix. Some women choose to attempt this process naturally, using herbs. Black Cohosh and Blue Cohosh both tone the uterus and can stimulate contractions. They can be used to start or augment labor. They are taken orally either as a liquid or capsule. Borage and Flax Seed Oil, Black Current Oil or Evening Primrose Oil can soften the cervix, tone the uterus and stimulate contractions.

There are several things that your health care provider may try to help induce labor and soften the cervix, including:
- Stripping or sweeping the membranes. If your cervix is already somewhat dilated, your practitioner can insert her finger through it and manually separate your bag of waters from the lower part of your uterus. This causes the release of hormones called prostaglandins, which may help further ripen your cervix and possibly get contractions going.
- Rupturing the membranes. If your cervix is at least a few centimeters dilated, your practitioner can insert a small, plastic hooked instrument into it and break your bag of waters. This procedure causes no more discomfort than a vaginal exam. If your cervix is very ripe and ready for labor, there’s a small chance that this alone might be enough to get your contractions going.
- Using prostaglandin medications. Your practitioner may try to ripen your cervix by inserting medication that contains prostaglandins into your vagina. This medication may also stimulate contractions sometimes enough to jump-start your labor.
- Using a Foley catheter. Your practitioner may insert a catheter with a very small uninflated balloon at the end of it into your cervix. When the balloon is inflated with water, it puts pressure on your cervix, stimulating the release of prostaglandins, which cause the cervix to open and soften.

For many moms-to-be, especially first-time moms, labor can be a somewhat frightening prospect. Fortunately, you can ease your anxieties about labor by understanding exactly what occurs during labor and what to expect.

Labor is divided up into four stages. Because every woman is different, you may or may not be able to identify the stages as they are happening; or, a stage may last much longer than the average. Below are the four stages:

- First stage. This is typically the longest part of labor. For most first-time moms, the first stage of labor will last for around ten to fourteen hours. The First stage is broken up further into three phases. During the early phase, contractions are very light and are 20 minutes or more apart, becoming closer to 5 minutes apart. The active phase is next. During the active phase, contractions are about four to five minutes apart, and may last for a minute each time. During the transition phase, your contractions will narrow to 2 or 3 minutes between them, and will last for about a minute and a half.

- Second stage. This is the stage where you push. The pushing stage can last as long as three hours or more, but for most women it is shorter. A variety of factors, such as the position of tme mom, the position of the baby, and medications used can affect the duration of the second stage. Contractions space out somewhat, and will be about 4 minutes apart. The second stage ends when your baby is born.

- Third Stage. The third stage of labor is when it is time to deliver the placenta. You will be asked to push again, and the placenta will come out much easier than the baby. This usually comes a few minutes after birth, and usually within no more than an hour.

The postpartum stage is considered a fourth stage of labor. This is the time that yoru body sort of snaps back into place, and you recover so that you are able to take up your new duty of parenting.

Labor can be an excruciatingly painful process. It is no wonder that so much time, energy, and money have gone into the research of ways to deal with labor pain. Fortunately, there are many pain relief options during labor.

Some of the non-medicinal ways to cope with pain during labor can include:

- Relaxation techniques. Learn to relax the specific parts of your body that might be hurting, whether it is your back, your uterus, or wherever. Learning breathing patters may also help you with the process of relaxation.

- Massage. Having your partner or birth coach give you a massage during labor may help to alleviate some of the general pain and tension.

- Changing positions. Many women find that shifting around during labor help to ease the pain. In particular, positions that utilize gravity in helping the baby to descend tend to be successful.

- Water therapy. A bath, a shower, or even a foot bath may help to reduce pain during labor.

- Movement. Rocking or swaying may help to keep the pelvis moving and reduce pain.

During the early stages of labor your obstetrician may offer you intravenous or intramuscular injection of medication to ease the pain of labor. Narcotics, such as meperidine (Demerol) or butorphanol (Stadol), are often used. Narcotics will help with mild contractions in early labor but generally are insufficient to relieve the stronger contractions associated with active labor. In the past, other narcotics such as morphine have been used. Some of the general side effects of narcotics during labor can be:

- Nausea

- Vomiting

- Itching

- Sedation

- Decreased gastric motility

- Loss of protective airway reflexes

- Hypoxia due to respiratory depression

Stadol is often the choice of many women and their physicians when selecting a narcotic pain reliever. Stadol is considered more potent than morphine and Demerol. Stadol generally starts working in less then five minutes. Stadol is considered to have minimal fetal effects, and creates minimal nausea.

Other medications that can relieve pain during labor and delivery can include an epidural anesthesia or a spinal block. An epidural is administered through an extremely thin tube between the spinal cord and outer membranes. When used for labor it dulls feeling from your stomach to your feet. Having an epidural will still allow you to feel contractions enabling you push your baby out after your cervix is completely dilated. At times the epidural is turned down, or off, so that you can push well at the end of your labor.

A Spinal Block should not be confused with an epidural. With a spinal, the medication is given only once. With an epidural, a catheter is inserted into the location in the spine so that additional medicine may be dispensed at a later time. A spinal is most often used when you need pain relief for only a limited period of time, such as with a cesarean delivery or a vaginal delivery in which instruments are required to help the baby out.

Regardless of the method you choose to manage pain during labor and delivery, it is important that you discuss with your health care provider the risks and effectiveness of each method.

Sometime between weeks 35 and 36 of your pregnancy, you will likely want to prepare a bag of things to bring to the hospital for labor and delivery. Things that you will likely need include:

PAPERWORK
_____ Insurance cards
_____ Health Care Provider phone numbers
_____ Hospital pre-admittance forms
_____ Your Birth Plan

ITEMS FOR LABOR
_____ Object to use as a focal point
_____ Slippers
_____ Bathrobe
_____ Extra Socks
_____ Hair bands
_____ Lip Balm
_____ Lotion or massage oil
_____ Favorite pillow
_____ MP3 or CD player with relaxing music
_____ Books, magazines or other reading material
_____ Glasses
_____ Toothbrush and toothpaste
_____ Hairbrush or comb
_____ Watch with a second hand
_____ Camera or video camera
_____ Extra Batteries
_____ Rolodex, Address book, or phone book

ITEMS FOR YOUR HUSBAND OR PARTNER
_____ Change of clothes
_____ Toiletries
_____ Snacks
_____ Reading material

ITEMS FOR AFTER DELIVERY
_____ A nightgown
_____ Clothes to wear home
_____ Baby Book
_____ Thank You cards or notes
_____ Nursing bras
_____ Nursing pads
_____ Sanitary napkins
_____ Deodorant
_____ Facial Soap
_____ Makeup
_____ Prescription medications
_____ Sibling gift(s)

ITEMS FOR BABY
_____ An outfit to wear home
_____ A hat or cap
_____ Diapers
_____ A car seat
_____ Receiving blanket