Q: How long does labor last, and will I feel pain the whole time? A: Much of labor is spent in "early labor". During this phase, it is best to be at home where you can walk, sleep, or snack. During active labor, contractions become regular and painful, and the cervix dilates. Normal dilation during active labor for a first-time mom should progress a minimum of 1 centimeter per hour; with pushing time, that's 6 - 12 hours.
Q: How will I know when to go to the hospital? A:Ideally, you'll get to the hospital when you're in active labor, not early labor. Look for contractions every 4 - 5 minutes for at least an hour, and they should be getting stronger, longer, and closer together. If you can't talk through them, start looking for the car keys.
Q: Once I'm admitted can I walk around? A: Most hospitals will let you pace around, but you'll need to check fetal heart rate monitoring every 15 minutes. You may also take a shower to relax or bounce on a birthing ball to ease pain. But, if you have an epidural, you'll be hooked up to an IV and you might be too numb to walk.
Q: Will an epidural slowdown labor? A: If you're too numb when it's time to push, it can be hard to feel what to do. According to Jonathan Waters, MD, chief of anesthesiology at Magee-Womens Hospital, in Pittsburgh, epidurals slow labor by about 40 minutes, on average. In some cases, the anesthesia can actually speed labor once a mother relaxes through the pain.
Q: Why would I need Pitocin to speed up labor? A: "Perhaps in the past, Pitocin was used too liberally or too aggressively, but most hospitals have a Pitocin protocol," says Amanda Flicker, MD, an OB-GYN at Lehigh Valley Hospital, in Allentown, Pennsylvania. "They start at a low dose and increase it slowly to get the strength of the contractions to where they need to be. You shouldn't fear it."
Q: What are my pain-relief options besides epidurals? A: Many women find they can manage their pain by using nonmedical strategies such as Lamaze breathing or the Bradley Method, which emphasizes visualization and a solid understanding of the birth process. Other options include hypnosis and water birth.
Originally published in the August 2009 issue of American Baby magazine.
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