1. Pregnancy,
Labor and
Birth
Bethany Dzivasen
Women’s Health Issues
Worcester State University
February 12, 2013

2. “We bring to childbirth our
histories, our relationships, our
rituals, our needs and values that
relate to intimacy, our sexuality,
the quality and style of family life
and community, and our deepest
beliefs about life, birth and death.”
INSPIRING QUOTE

3. Nine Months of Change and Growth
Physical Changes Emotional Changes
• Breasts enlarge • Hormone levels usually
• Congestion leave mothers to be
• Frequent Urination feeling depressed and
under the weather during
• Aches and pains their pregnancy.
• Shortness of breath
• Constipation
• Heartburn and gas
• Leg Cramps

4. Choosing A Practitioner and Birthplace
• Type of Providers to choose from:
 Midwives- Midwifery is a health care profession in
which providers offer care to childbearing women
during pregnancy, labor and birth, and during the
postpartum period. They also help care for the
newborn and assist the mother with breastfeeding.
 Physicians- A family physician is a medical doctor who
is trained to provide basic, comprehensive care to
people of all ages. Some family physicians provide
maternity care and have hospital delivery room
privileges
 Obstetrician- a physician who specializes in the branch
of medicine concerned with pregnancy and childbirth
 Maternal-Fetal Medicine Physician- specialists in the
obstetrics field who have additional training in
complicated obstetrics.

5. Birthplaces
• Home- Home birth is a good option for healthy
women who have healthy pregnancies, a safe and
supportive home environment, and easy access to
backup medical care
• Freestanding Birth Center- A healthcare facility
with midwives and obstetricians and a homelike feel.
• Birth Centers in Hospitals- This is a midwife type of
home atmosphere located inside a hospital.
• Hospital- The standard setting for many women who
prefer to be close to medical care while giving birth
or who intend to use an epidural for pain relief.

6. Maternity Care
• Too few women get adequate prenatal care.
• Too many women are exposed to the risks of high-tech
procedures, even when they are healthy and unlikely to
benefit from them.
• Too many women are subjected to these potentially
harmful procedures without giving informed consent.
• Too few women have the benefit of low-tech
supportive care practices that help them safely cope
with the demands of pregnancy, labor and birth.
• Too many women end up with physical and emotional
health problems after giving birth.

7. Prenatal Care
Your First Visit
– As soon as you suspect you're
pregnant, call to schedule an
appointment with your
obstetrician, family physician,
or midwife.
– Even if you've confirmed your
pregnancy with a home test,
it's wise to follow up with a
physical examination so you
can start getting prenatal care.
– They will ask about your
Fetus at 8 weeks old gynecological health, other
health history questions, family
medical history and your habits
that could impact the fetus.

8. Tests During Pregnancy
• Tests that give information about your health:
Anemia, HIV-positive or conditions that can
be treated.
• Tests for fetal impairments:
– Genetic Carrier Tests: test for diseases that can be
inherited by the fetus
– Screening Tests: measures the likelihood that your
fetus has a condition but cannot test that the fetus
actually has the condition
– Diagnostic Tests: identifies whether the fetus has a
particular condition

9. Special Consideration
• High-Risk Pregnancy
– Teens
– Late 30’s and 40’s
– Weight
– Abuse or Violence
– Sexual Abuse
– Disability
– Chronic Illness
– Addiction
– Previous Cesarean Section
– Depression or Other Mental Illness

10. Preparing for Labor and Birth
• Planning for Pain Management: The pain relief
methods you choose to use can affect your experience
and memories of labor.
• Planning with Confidence, Knowledge, and Flexibility:
Learning about our options for coping with labor and
working with a knowledgeable support team can help
us feel less anxious.
• Preparing for Breastfeeding: Talk with your doctors and
midwives about breastfeeding in advance.

11. Stages of Labor
Prelabor
How long will it last?
On and off for days or weeks
How dilated will my Cervix be?
0 to 3 cm
How strong will the Contractions be?
Vary greatly in length and intensity.
What else might be happening?
Mucus discharge, backache. It’s hard to tell when you
more from this into latent- phase labor.

12. Stages of Labor
Stage 1:Latent Phase
How long will it last?
A few hours to a day or more
How dilated will my Cervix be?
0 to 4-5 cm
How strong will the Contractions be?
Vary widely. Usually short and spaced apart.
What else might be happening?
Mucus discharge, backache and upset stomach

13. Stages of Labor
Active Phase
How long will it last?
Between 2 and 10 hours
How dilated will my Cervix be?
4-5 to 7-8 cm
How strong will the Contractions be?
Last about a minute or more, spaced regularly.
What else might be happening?
You may feel tired or discouraged, wondering if you can do it.
Pressure in your lower back, need to change position often

14. Stages of Labor
Transition Phase
How long will it last?
A few contractions to 1-2 hours
How dilated will my Cervix be?
7-8 cm to full dilation
How strong will the Contractions be?
Occur about every 2 minutes and last at least 60 seconds with short
rest time in between
What else might be happening?
Intense emotions and physical sensations. You may feel restless,
irritable, and exhausted. Trembling, nausea, and vomiting are
common just before the cervix becomes completely dilated.

15. Stages of Labor
Stage 2: Pushing, giving birth
How long will it last?
A few contractions to over 3 hours
How dilated will my Cervix be?
Fully dilated, 10 cm
How strong will the Contractions be?
Powerful contractions about every 3 minutes
What else might be happening?
Pain lessens and you may be able to rest for a brief time
before the urge to push becomes uncontrollable. A burning
sensation when the baby finally makes it through the birth
canal

16. Stages of Labor
Stage 3: Delivery of placenta
How long will it last?
May last up to 30 minutes or longer
How strong will the Contractions be?
No contractions, then one to several strong
cramps
What else might be happening?
Provider may massage uterus to cause it to contract
and reduce bleeding; this can be painful

17. Stages of Labor
Stage 4: Recovery
How long will it last?
May last 1-2 hours if birth was un-medicated and
not prolonged or difficult
How strong will the Contractions be?
Mild or moderate cramps as uterus contracts
What else might be happening?
Thick, bloody vaginal discharge that may last 2-4
weeks. Uterus will tighten to prevent bleeding.
Swelling and discomfort if your perineum.
Trembling legs.

19. Discussion Question
What would your birthing plan look like? Where
would you want to have your baby? Would
you want a doctor or midwife? Would you
look for a form of pain relief or would you
want to have your baby the natural way?