Pregnant woman deliver baby

Emergency delivery: What to do when the baby’s coming – right now | Your Pregnancy Matters

Every year, nearly 9,000 women in the U.S. go into labor and, unable to make it to the hospital, have an unplanned or unattended birth at home or in the car on the way to the hospital. Some of those women later make it to UT Southwestern.

My colleagues and I typically recommend that women head to the hospital to deliver when their water breaks or when contractions become regular, meaning four or five minutes apart for more than an hour. But sometimes, neither of these signs of labor occur.

That’s exactly what happened to Jenea Jones, a labor and delivery nurse who used to work at Parkland Hospital here in Dallas and had to deliver her own baby in her vehicle. Jenea shares her story below, along with some tips for what to do if you find yourself in a similar situation, either as a delivering mom or as a bystander.

I used to work as an overnight labor and delivery nurse at Parkland Hospital. I’ve seen my share of amazing birth stories, but I never expected to star in my own!

I was about a week past my due date with my fourth baby, and I was patiently waiting to go into labor. I went about my shift, working with laboring moms and training emergency responders in labor and delivery techniques. Toward the end of my shift, I noticed that my contractions were getting a little closer together – some more frequently than those of my patients!

With my previous baby, I didn’t make it home after my shift. I went into labor at work and was admitted to the hospital right away. This time, I really wanted to go home first, then head back to the hospital when labor began. My contractions weren’t regular or intense yet, so I clocked out at the end of my shift and headed home.

Related reading: Hungry during labor? Women may now get more than ice chips

Once I got home, I ate some cereal, watched a little TV, dozed off for a bit, then took a shower. The contractions got stronger and more intense, but they were irregular and my water hadn’t broken. I decided it was time to go to the hospital when the contractions started to get a little more painful. In the car, everything was very annoying to me: the radio, the sound of my husband at the time talking on the phone, just everything. I remember thinking that was weird because I’d been coping with my contractions pretty well to that point. Then the situation got hairy.

Most women will notice a definitive change in how pre-labor or false labor contractions feel compared to real labor contractions. The real thing typically feels more intense, more painful, and might move into the cervix, back, or another part of the body, and the change might occur too quickly to get to the hospital in time. As we drove down I-30, I began to feel rectal pressure, which usually is an indication that the baby’s head is entering the birth canal and it’s time to push. That’s when I knew we weren’t going to make it to the hospital.

We were about 20 minutes away from Parkland when I said, “We need to pull over right now – the baby’s coming. ” I refused to panic, but I couldn’t help thinking how this is the kind of thing that happens on sitcoms, or to a friend of a friend, not to a labor and delivery nurse!

We pulled over along I-30 in the grass in front of a hotel and called 911. The next thing I knew, several men’s faces were peering through the windows of our vehicle. The emergency responders were there, ready to help me deliver. I started to push, and the baby – Carys – arrived soon thereafter, but she was in trouble. The umbilical cord was wrapped twice around her neck, membranes covered her face, and she was pale and limp.

I switched from “laboring woman” mode to “nurse” in an instant. Labor and delivery nurses are taught with neonatal resuscitation to warm up the baby with a warm towel. All I had was my undergarments, so i used them to rub her back and stimulate her skin. But Carys still wasn’t responding.

I asked one of the emergency responders for an Ambu bag, which is a device that produces positive-pressure ventilation by forcing air into the chest to get the lungs working. Thankfully they had the bag and a pediatric mask. As I worked to resuscitate Carys, one of the paramedics started to cut the umbilical cord, and I stopped him – that was her only steady source of oxygen.

After several minutes, Carys began to perk up. The emergency responders cut the cord and escorted us to a waiting ambulance for the 20-minute ride to Parkland. In the rush after delivery, all of my senses were totally heightened. I remember looking up at the EMT and saying, “It’s such a gorgeous day today, isn’t it?” He looked at me like I must have been in shock, but I think I was just flying high on endorphins.

Looking back on the delivery, I have to laugh at myself. I had planned to deliver Carys naturally, with no pain medication. I kept that to myself, though, because I didn’t want to let myself down if my birth plan changed at the hospital. As luck would have it, I got my wish – but in a very unexpected way!

Childbirth Options, Differences & Benefits

Overview

What are the types of delivery methods?

It’s hard to know exactly what will happen when you give birth. Most people have a plan in mind for how they hope their labor and delivery goes. When it comes to delivering your baby, it’s good to know there are many methods pregnancy care providers use. Types of delivery include:

Vaginal delivery.
Assisted vaginal delivery (vacuum or forceps).
C-section (Cesarean birth).
VBAC (vaginal birth after cesarean).

What type of delivery is best?

A vaginal delivery is the safest and most common type of childbirth. Vaginal deliveries account for about 68% of all births in the United States. Most medical organizations and obstetricians recommend a vaginal delivery unless there is a medical reason for a C-section.

Vaginal delivery

What is a vaginal delivery?

In a vaginal birth, your baby is born through your vagina or birth canal. It’s the most preferred and most common way to deliver a baby because it carries the lowest risk (in most cases). A vaginal delivery occurs most often between weeks 37 and 42 of pregnancy. A vaginal delivery has three stages: labor, birth and delivering the placenta.

Some benefits of a vaginal delivery include:

Faster recovery.
Safest for the pregnant person and the baby.
Lower rates of infection.
Babies are at lower risk for respiratory problems and have a stronger immune system.
Lactation and breastfeeding are usually easier.

A vaginal delivery can be spontaneous or induced:

Spontaneous vaginal delivery: A vaginal delivery that happens on its own and without labor-inducing drugs. Going into labor naturally at 40 weeks of pregnancy is ideal.
Induced vaginal delivery: Drugs or other techniques start labor and soften or open your cervix for delivery. Pregnancy care providers often recommend inducing labor when a pregnant person has a medical condition or is past due. Labor is usually induced with Pitocin®, a synthetic form of the drug oxytocin.

What happens if you don’t push during a vaginal delivery?

In most cases, once your cervix is fully dilated and your healthcare team is in place, your provider will ask you to push during a contraction. Pregnancy care providers have differing opinions on when to push, how long to push, delayed pushing or waiting until you feel the urge to push.

It’s hard to say what will happen if you don’t or can’t push during a vaginal delivery, because your birthing experience is so unique. However, studies show that resisting the urge to push or delaying pushing (laboring down) can cause complications like infection, bleeding or damage to your pelvis.

It’s best to discuss pushing with your pregnancy care provider ahead of time so you know what to expect during labor.

Assisted vaginal delivery

What is an assisted vaginal delivery?

An assisted vaginal delivery is when your obstetrician uses forceps or a vacuum device to get your baby out of your vagina. Assisted deliveries often happen when:

You’ve been in labor a long time.
Your labor isn’t progressing.
You become too fatigued to continue pushing.
You or your baby are showing signs of distress.

Assisted deliveries only occur when certain conditions are met.

What are examples of assisted deliveries?

The procedure your obstetrician recommends will depend on the conditions that arise while you’re in labor. Assisted delivery procedures can include the following:

Forceps delivery: Forceps are a tong-like surgical tool obstetricians use to grasp your baby’s head in order to guide them out of the birth canal.
Vacuum extraction delivery: In a vacuum extraction, your obstetrician places a small suction cup on your baby’s head. The cup is attached to a pump that pulls on your baby while you push.

Vacuum extraction and forceps delivery are similar in their advantages and disadvantages, and often the choice between them comes down to the experience of your obstetrician.

C-section

What is a C-section?

During a C-section birth, your obstetrician delivers your baby through surgical incisions made in your abdomen and uterus. A C-section delivery might be planned in advance if a medical reason calls for it, or it might be unplanned and take place during your labor if certain problems arise. There are about 1.2 million C-section deliveries in the United States each year.

Your provider may recommend a planned cesarean delivery if you:

Had a previous C-section delivery.
Are expecting multiples.
Have placenta previa.
Have a breech baby.
Have a baby with fetal macrosomia or a large baby.
Have a uterine fibroid or other obstruction.

Sometimes, your labor and delivery changes, and a cesarean birth becomes necessary for the health and safety of you or your baby. An unplanned C-section might be needed if any of the following conditions arise during your labor:

Fetal distress (your baby isn’t tolerating labor).
Labor isn’t progressing.
Umbilical cord prolapse.
Placental abruption.
Hemorrhage or excessive bleeding.

Risks of C-section deliveries

Like any surgery, a cesarean birth involves some risks. In general, there is more risk associated with a C-section than with a vaginal delivery.

These might include:

Infection.
Loss of blood or need for a blood transfusion.
A blood clot that may break off and enter the bloodstream (embolism).
Injury to the bowel or bladder.
Longer recovery and longer hospital stay.
Abdominal adhesions.

Benefits of C-section deliveries

Some people prefer a C-section birth because it gives them more control on choosing a due date. This is called an elective C-section. Some providers may allow elective C-sections for nonmedical reasons, however, this is usually discouraged. In most cases, a C-section birth occurs because it’s medically necessary. The American Congress of Obstetrics and Gynecologists (ACOG) recommends that scheduled cesareans not be performed before 39 weeks gestation, unless medically indicated.

Some benefits of a C-section as compared to a vaginal delivery are:

Lower risk of your baby having trauma from passing through your vagina.
Less risk of your baby being oxygen-deprived during delivery.
Possible lower risk of incontinence or sexual dysfunction.

VBAC (vaginal birth after cesarean)

What is a VBAC?

If you’ve already had a cesarean birth, you may be able to have your next baby vaginally. This is a VBAC, or vaginal birth after cesarean. Because a surgical cut results in a scar on your uterus, the concern is that the pressure of labor in a vaginal delivery could cause your uterus to open (rupture) along the previous C-section scar. For this reason, certain criteria must be met in order for your obstetrician to attempt a vaginal birth after C-section.

Can I have a baby vaginally after a C-section?

People who have had a cesarean delivery might be able to deliver vaginally in a future pregnancy. If you meet the following criteria, your chances of a successful vaginal birth after cesarean (VBAC) are high:

Your obstetrician made a low transverse incision during your cesarean. This is the typical way to perform a C-section, unless they need to deliver your baby in a hurry.
You don’t have other uterine scars or abnormalities.
You had a prior vaginal delivery.
You haven’t had a previous uterine rupture.

What else should I know about delivery?

There are several other terms you should be familiar with in case your pregnancy care provider discusses them during labor and delivery.

Episiotomy

An episiotomy is a surgical incision that widens the opening of your vagina. This allows your baby’s head to pass through more easily. Most people will not need an episiotomy.

There are two types of episiotomy incisions: the midline, made directly back toward your anus, and the mediolateral, which slants away from your anus.

Amniotomy (breaking your bag of waters)

An amniotomy is the artificial rupture of the amniotic membranes, or sac, which contains the fluid surrounding your baby. Your pregnancy care provider may artificially rupture your membranes (AROM) to:

Induce or progress labor.
Place an internal monitor to assess your contractions.
Place an internal monitor on your baby’s scalp to assess their well-being.
Check for meconium (a greenish-brown substance, which is your baby’s first poop).

Your provider will use an amniohook, which looks like a crochet hook, to rupture the sac. Once the procedure is complete, delivery should take place within 24 hours to prevent infection.

Fetal monitoring

Fetal monitoring is the process of watching your baby’s heart rate during labor. This can be external or internal. Knowing how your baby is handling labor helps your pregnancy care provider decide if labor can continue or if delivery is necessary.

In external fetal monitoring, an ultrasound device is placed on your abdomen to record information about your baby’s heart rate, and the frequency and duration of your contractions.
Internal monitoring involves the use of a small electrode to record your baby’s heart rate. Your membranes must be ruptured before the electrodes can be attached to your baby’s scalp. A pressure sensor can also be placed near your baby to measure the strength of contractions.

Frequently Asked Questions

Which type of delivery is most painful?

This may come down to personal opinion. There are many factors involved — for example, using pain medication, the type of pain medication or your pain tolerance. You should discuss pain relief with your pregnancy care provider before labor so you know the risks and benefits of each type.

There are two general options: no medication (drug-free or natural delivery) or using pain medications.

A drug-free delivery means you intend to give birth vaginally without any pain medication. You can’t have a C-section without medication.

Your options for pain relief during childbirth could consist of:

Analgesics: Analgesics relieve pain without causing complete loss of feeling or muscle movement. The most common example of an analgesic used during childbirth is an epidural. You can receive an epidural for a vaginal or a cesarean delivery.
Anesthetics: Anesthetics (or anesthesia) keep you from feeling pain by blocking signals from your brain. These drugs are given as a shot or through an intravenous (IV) line. During a C-section, you may receive general anesthesia, which puts you to sleep. Another option during childbirth could be local anesthesia, which involves a shot of medication in a specific area of your body, like the nerves in your vagina and vulva.

Another factor in deciding what type of delivery is most painful is the recovery. Generally, a vaginal delivery is easier to recover from than a C-section delivery.

A note from Cleveland Clinic

Your labor and delivery experience will be unique to you. During pregnancy, it’s a good idea to familiarize yourself with the different types of delivery and other terms associated with childbirth. Your pregnancy care provider will recommend the safest delivery method based on your medical history and pregnancy.

A woman gave birth without coming out of a coma

October 16, 2009 09:48

A healthy child was born in the Moscow region, whose mother has been in a coma for more than six months. But doctors in Germany decided to tell about such a case only a year and a half after the birth of the child. They wanted to make sure that the baby that the woman gave birth to in a coma is developing normally.

A child was born in the Moscow region, whose mother has been in a coma for more than six months. The first examination showed that the baby is quite healthy. But, nevertheless, he will be under the close supervision of doctors for a long time. But doctors in Germany decided to tell about such a case only a year and a half after the birth of the child. They wanted to make sure that a baby that a woman gave birth to in a coma develops just like any other. And they confirmed that it is worth fighting for the lives of such children.

The medical center in the Bavarian city of Erlangen created a scientific sensation. The fact that a 41-year-old woman gave birth is simply wonderful. The fact that the last 22 weeks of pregnancy and childbirth took place for her in a coma is amazing. It happened in the spring of 2008. Doctors did not want to talk about it until they were convinced that the born boy was healthy and developing normally.

"She was overweight, smoked, had diabetes. All these factors can negatively affect the course of pregnancy. We are happy that she had a healthy boy," says Matthias Beckmann, head of the gynecology department at the Erlangen University Hospital.

With her diabetes and her weight - well over 100 kilograms - the doctors advised her not to get pregnant. Perhaps this is what led the woman to a heart attack. It took 30 minutes before the resuscitators started her heart and restored blood circulation, and 70% of her brain had already died by that time. But the fetus seemed to be fine, and the doctors decided not to terminate the pregnancy.

"The health of mother and child are interconnected. Even while in the womb, the child has the right to life. And we have done everything possible to keep them alive," states Andreas Freevär, representative of the ethics committee of the Erlangen University Hospital.

Science knows about 30 such cases, but this is the first absolutely successful pregnancy that took place in such extreme conditions for the embryo. Doctors had to determine almost by eye how much artificial nutrition the mother needed, and how much the fetus needed. They were not mistaken, and on the 156th day a caesarean section was performed.

"I think this case shows the state of modern medicine. A child has a chance, even if the mother is seriously ill. Moreover, thanks to this case, we will understand how we can help other children," says Michael Abu- Dakn, chief physician of the obstetrics and gynecology clinic at St. Joseph's Hospital.

After being discharged from the maternity hospital, the boy went to a family that had previously taken in his two older brothers, because, according to the official version, the children's father is constantly traveling and cannot take care of them.

The cinematography anticipated this sensation. In 2002, the Spanish director Pedro Almodovar made the film Talk to Her. The heroine, who is in a coma, gives birth to a child, and a hormonal surge returns her consciousness. With the heroine of a real story, alas, this could not happen. But the coma is little studied, and perhaps the unfortunate woman who lies in the Erlangen clinic somehow knows that she has become a mother for the third time.

in the world news

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Do pregnancy hormones help you quit smoking?
The safety of creating children from three parents was evaluated for the first time
Coffee during pregnancy: is it still possible or not?
Depression after childbirth is associated with changes in the immune system
Why frequent disinfection during pregnancy is dangerous
Asymptomatic neonatal illness increases future infections

Pregnant Dad Syndrome | How to help a pregnant wife

The signs of pregnancy in women are well known to everyone: the stomach grows, strange taste preferences appear, and mood swings occur. Usually during pregnancy, the mother leads a less active lifestyle, sleeps longer and eats more. What is dad doing at this time? As a partner, he often also adjusts to a changed lifestyle. And ... it changes not only inside, but also externally. His general motor activity decreases, nausea occurs in the morning, his tummy grows, drowsiness appears, etc.

Proven is the fact that the hormonal background of the "pregnant dad" is different from the pre-pregnancy state. The amount of testosterone (male hormone) decreases, and the level of estrogen and prolactin (female hormones) increases. Most likely, these changes are secondary, that is, they come after a changed daily routine, the nature of nutrition, and are more common in men who are sensitive, attentive and caring.

Whatever changes happen to your husband, remember that he is also human. He may have his own fears, weaknesses and worries before the upcoming fatherhood. Try to let your husband understand how important he is to you, talk to him about your feelings, consult, confess your love. Spend time together more often, go for walks, go to concerts, exhibitions and visits. Pregnancy is not a disease, but a wonderful state of waiting for a baby. And if two people share it, it's wonderful!
Coping with the difficulties of pregnancy together

The body of each woman is individual, but some changes are observed in almost all expectant mothers. Many of them may have never been experienced by a woman before pregnancy, so they can be worrisome. Some of the changes are spiritual, some are physical. Some are due to the action of hormones, others are the consequences of an increase in the abdomen and body weight.

Here are the most common inconveniences encountered in mid-pregnancy:

• Edema.
• Problems of the gastrointestinal tract: constipation, accumulation of gases, belching, heartburn.
• Varicose disease of the lower extremities.
• Expansion of the veins of the vagina.
• Spasms of calf muscles.
• Back pain.
• Pain in the womb and duck walking.
All these conditions are temporary, but neither doctors nor modern medicines are able to save the expectant mother from them. And, perhaps, only dad can significantly brighten up the life of mom. How?

There are many ways to please a pregnant woman. Here are the 10 most faithful of them:

1. Accompany the woman to the appointment with the doctor and ultrasound
It is pleasant for the expectant mother to realize that her beloved man is nearby, or at least outside the office door, in which she experiences not the most pleasant sensations. She will be able to share her experiences and the news she heard from the doctor with her dad, when they are still fresh and not blocked by the comments of her friends on the phone.

2. Regularly give small gifts
It is not necessary to give a new iPhone, a car or a ring. Even the most modest gift will be a wonderful sign of attention.

3. Giving flowers
Flowers are especially pleasing when they are given just like that, for no reason. Dad can set a recurring reminder on the phone for a specific day of the week.

4. Talk about your love
There are magic words in the world, and of course they are about love.

5. Cook breakfast
Even if a man does not know how to cook at all, he is able to build breakfast - boil eggs, make toast, brew delicious tea. Does not work? Then you can bring your favorite dessert from the restaurant after a business dinner.

6. Invite to a restaurant
It is sometimes useful to take a break from pregnancy. Oddly enough, many women do not want to go to the cinema during pregnancy - it is dark and noisy there. As an option, you can consider going to the theater, to a concert. Or you can just buy a new movie and watch it at home.

7. Massage
Massage your wife - this is the sacred duty of every future dad. Massage technique is not important, gentle touches are important.

8. Help around the house
During pregnancy, mom does not need to breathe dust or carry bags of groceries. Any woman will appreciate the opportunity to take a break from worries if her husband takes on these responsibilities.

9. Forgive breakdowns and tantrums
Change plans every five minutes and demand the impossible? Oh, how familiar! But sometimes a man just needs to agree with a woman so that she immediately changes her mind and acts sensibly.

10. Compliments
Most women get prettier during pregnancy, but they don't even know it! It is in the power of a man to convince a woman how beautiful she is!
Did any of these points get you hooked? Or did you come up with something of your own? Regular evening walks in the park? Shopping trips together? Discussing plans? Don't wait for a man to guess or read this article. Just ask him to do something that will change your pregnant life for the better.
Preparing for childbirth

A woman prepares for childbirth in special courses. Dad can also attend such courses, especially if he is planning a partner birth. But at the same time, many organizational issues lie on it, which you need to think about in advance, even during pregnancy.

• Organization of transportation to the maternity hospital
This is the duty of the Pope. He may not have a car, but it is desirable for him to organize the transportation of his wife to the hospital. How and what car to go? Which route? How quickly can you get to the hospital? Let there be no surprises in this matter for both of you.

• Collection of things for the maternity hospital
In fact, it is necessary to collect not one, but as many as three bags for the maternity hospital - in the maternity block, in the postpartum department and for discharge! And don't forget the documents! The help of the pope will be especially relevant if you have to go to the hospital when the woman has already begun contractions or the water has broken. She is noticeably nervous in this situation, and the composure of a man can do a good job.

• Arrangement of a children's room
Many parents start renovations while they are expecting a child. This is understandable, because the living space needs to be adapted for a new tenant. Repair dust and noise are not very compatible with an interesting situation, so it would be wiser if dad joins the home improvement.

A partner is also a partner in Africa

If the family decides on a partner birth, then this is one situation, but if the mother goes to the birth alone, this does not mean that the father can relax and do nothing. What business could he have? What should he do?
• Be as free from work as possible on the date of delivery and for a few weeks after it
Childbirth is something that concerns all family members and does not happen so often. Despite the fact that the man is not in the hospital, the very fact that he worries about his family, without being distracted by something else, will give the woman in labor strength.

• Stay in touch
Dad needs to take care of topping up his phone and his wife's phone. Before the expected date of birth, you need to regularly charge them, do not forget to turn on the sound. Alas, we often forget about such simple things. Often women are frustrated just because their phone runs out during childbirth, runs out of money on it, or they can't get through to their husband because he's unavailable!

• Being around
A well-known picture is a sleeping husband in a car near the walls of the maternity hospital. Yes, it's still relevant. Although in many maternity hospitals it is already possible to wait in a cafe, in a hall, in a corridor, etc. In any case, the closer the future dad is to the hospital, the better.

• Be ready to help
Sometimes relatives are required to buy something, go somewhere, help make a decision. After the birth, dad's help will also be needed: to bring things for the woman and the child to the postpartum department, buy something from the dowry, organize an extract.

Born - not free

When the time comes to pick up the child and wife from the hospital, dad should be fully armed.

It is not necessary to decorate the walls of the maternity hospital, it is better to prepare the apartment for the arrival of mother and baby. It should at least be clean. A young mother will also appreciate if a bouquet of flowers, balloons and, possibly, a poster (or at least a piece of paper) with a touching inscription will be waiting for her in the apartment. Dad needs to think about how to organize transportation from the hospital home. If you are accompanied by relatives on discharge, who will then go to visit you, you will need to buy a simple treat. Do not plan long feasts. Baby and mom need rest now.

Going to be discharged, dad should not forget women's, children's things, a camera or a video camera. Be sure to buy flowers for the wife and the medical staff!

At the maternity hospital, upon discharge, a woman should be given an exchange card, a certificate from the registry office for registering the child, a sheet with recommendations and conclusions about the baby’s health, indicating the procedures performed and the vaccinations made. The husband needs to check if the wife has forgotten these documents.

Now dads often organize a solemn discharge - balloons that fly into the sky, a limousine, musical accompaniment, professional photography and video filming. Think about whether you want it and whether it will please you. If you answered yes twice, go ahead.
As you can see, pregnancy and childbirth are a lot of things for mom and dad. How to do everything and not forget anything? Write lists! A wife should write to her husband what to do! It's easier for men to navigate. Not all of them know how to take the initiative and can immediately understand the situation. To shrug and say: “But mine didn’t think of it before” - this is not about moms, mom is, first of all, a manager. If this science of managing people is not familiar to you yet, then it's time to start mastering it.
Memo for future dads

How to organize help for a mother with a child after childbirth?

1. Define your male childcare responsibilities and stick to them. The more specific they are, the better. You can bathe the child. You can take the child and nurse him, say from 6 to 8 in the morning, giving the wife a chance to sleep. You can walk with the baby, go grocery shopping, buy diapers and baby water, etc.
2. Choose what appeals to you and suits your daily routine, and do it constantly. Such regularity will allow you to cope with the role of the father at first and give mom time to rest and recover faster after childbirth.
3. You can register a child and receive a birth certificate within 30 days after his birth. In order for your mother not to go to the registry office or the MFC, take these chores on yourself.
4. A newborn person also needs certificates! Don't forget about it! Registration, medical insurance, foreign passport - these are just some of them. But it is still necessary to draw up documents for receiving benefits and, if this is not the first child, maternity capital.