Learn what to expect on your baby's birth day.
-So you're having a baby. It's such an exciting time, but it can be a little overwhelming too, especially when it comes to labor and delivery, but we are gonna take some of the mystery of the whole process for first-time parents and put your minds at ease just a bit. Joining us now is assistant Clinical Professor of Obstetrics and Gynecology at New York Presbyterian Hospital, Dr. Nancy Jasper. It's great to see you. -Thank you. -Thanks so much for coming in. -Absolutely. -It's good to have you. Now, let's start with, "Should you take a childbirth class?" Because I think a lot of parents say, "You know what? We don't really need it. We're having an epidural, anyway, so I don't need the information," or "We'll figure it out when we get there." -Right. -How important is it? -I think it's very important for the first-time parents, especially, to take a childbirth class. They allow the couple to really spend some focused time bonding around this pregnancy. -Okay. Let's move ahead now to labor. How do you know when you're in labor because when we watch it on television, it's all very dramatic and suddenly the water breaks and the woman is having contractions, and then the baby comes, but it's really not like that. And there's also false labor, which could start weeks before the baby comes. How do you know this is it? -Well, I always tell patients a good sign are the following: One is if you're having contractions every 5 minutes or less for an hour. They should be lasting about 30 to 45 seconds, and at that point, certainly, they should start thinking that they are truly in labor and not false labor. The other is, of course, if the water breaks even without contractions. And the third is, if they get what is known as bloody show, which is where they might get some staining, looks like it may be the start of a menstrual cycle, usually associated with some cramping, and those three things, many times, will tell us that someone is starting into labor. -Okay. For moms who-- or for first-time moms, how do you describe contractions? I know it's hard. It's different for every woman, but what is it like? What does it feel like? -Well, contrary to the false labor pains or Braxton Hicks that many women will get, where the uterus will just tighten. They'll feel their uterus tighten and then it relaxes over a few minutes. Those usually are not painful, but the contractions that you get with labor start to hurt. -Yes, they do, as matter of fact. They do. I can attest to that. -Yes. -Yeah. -Then, we usually start saying that labor probably is beginning and it's a good time to start timing your contractions. -Okay. Along those lines, how do you know when it's time to go to the hospital because some women get there and the doctor says, "No, no, no you're too early, go home and labor there for awhile, and then come back." How do you avoid that? -Well, what I usually tell my patients is they don't need to rush to the hospital. They need to be waiting at home for me to call back. And the things I'm gonna ask are, "How far are you from the hospital?" and "How uncomfortable are you at home?" And then based on those answers, I will usually say, "Okay, I think you can stay home a little while longer," or "You should come in." -Okay. Does the water always break? And what do you do if it does? -No, it doesn't always break. -Okay. -It doesn't always break, and there are many women who will say my water never broke for all the labors that I have. If it does break, you need to call your physician because at that point, we do start you on a clock as far as how fast your labor is going because rupture to membranes does increase your chances of infection. -Okay. How long does labor typically last on average? -Usually when someone goes into active labor-- that means their contractions are regular, they're starting to dilate- they usually deliver within 24 hours. Most of the time, it's much less than that. -Okay. Now once they get to the hospital, what will happen? Will you go right into a room, be hooked up with an IV? -I think it depends upon the institution that you're going to and what type of labor environment you're going into. Certainly, if you are trying to have a "natural labor" and don't wanna have an epidural or anything, along that time, medication for pain, you many times can get away without necessarily having an IV from the start, but certainly, if you're looking to have some pain relief during labor, you have to have an IV for safety reasons. -Okay. Let's go back to the epidural. -Uh-huh. -I know some women get to the hospital and say, "I want my epidural now. I don't wanna feel any pain. When can I have it?" Sometimes it's too early; sometimes it could be too late? -Uh-huh. Well, as long as we know that someone is in labor, they can have their epidural, and so long as their baby is not actively being delivered, they can also get something for management. -Okay. That's good to know. Now, a lot of women think that once they get to the hospital, they're gonna deliver, but it could-- you know, it could take some time. How do you know when it's time to start pushing? When does the active labor begin? -Well, you have to be fully dilated in order to push, and that's something that only an exam will tell you. So, your physician or the nurse or the midwife, whoever is there doing your vaginal exams, will come in and check you, and then at that point when they say, "Okay, you're fully dilated or you're 10 centimeters," that's the time that you can begin pushing, but sometimes we do what's called letting women labor down, which means that even though they're fully-- they're having enough contractions, they may be tired, we let them labor a little while longer, bringing the baby further down into their pelvis before they start pushing. -All right. We just have a little bit of time left. Let's talk about episiotomies now-- -Uh-huh. -'cause I know it's a scary topic for some women. Do you have the choice of whether to have it or not and should you? -I think the big thing is, is that certainly the majority of women are able to deliver without an episiotomy these days. There's a lot of controversy around whether you should have one or not, but most people feel that if you have a small tear like an episiotomy, there is no harm in that. But certainly, if someone has been pushing for a long time or they're very swollen in their vaginal area, you probably would benefit from having an episiotomy instead of having a very bad tear. -Dr. Jasper, great information. Hopefully, we've taken the mystery out of labor and delivery just a little bit. Thank you so much for coming in. -Oh, you're quite welcome. -All right. -Thank you. -And we wanna hear your ideas and questions. You can email us at firstname.lastname@example.org. Thanks for watching Parents TV, your source for the best information for your growing family. -Thank you for watching Parents TV, our families, our lives.