The different pelvic stations:
- 4 = "floating" (till +36 weeks)
0 = "engaged" (narrowest station)
4 = on the "perineum" (vagina area)

The cervix will thin out (0-100%) which is called effacing in the final month. (The cervix has to thin out 100% before it can dilate more that 5 cm) and dilation. If the cervix is thinned out before labour it will quicken the delivery. Nurses call out “100%” , -2, 3 which are the effacement, station and dilation.

Six signs of labour:
1 - Braxton hicks contraction: practice contraction, last less than 30 seconds and can feel like aches. Changing activity will stop them. Only real contractions keep on going.
2 - Weight stabilization in the last 2 weeks before labour.
3 - Energy burst in the last 2 weeks before labour which lasts for 2 days, this is called nesting.
4 - Baby drops lower down into engagement. This is referred to as lightning.
5 - Vaginal discharge will be more apparent.
6 - Diarrhea, 24 hours before labour.

3 Main signs:
1 - Loss of mucus plug (a show). This can occur during urinating and is white/pinkish colour. It indicates cervix change, thinning out or dilating. Labour can be 2 weeks or 2 days away, so it's not worthy of a phone call to the hospital. It can be missed or not noticed.
2 - Water breaks, 3 actions to take: 1. Sit down 2. Note time 3. Call doctor. Don't take a bathe and prepare bags for hospital etc. Everyone will ask you the time you broke your water due to fear of infection after 24, 36, or 48 hours, if nothing has happened you will be induced. If the water is clear then this means everything is normal and if it appears to be green, this could mean that the baby has had a bowel movement or that the baby is in distress. Green means go to the hospital for a check. Usually contractions will start in 6-12 hours. If in doubt smell it, as it has no odour or colour. Even if it's only a trickle the clock has started. Correlates to changes in atmospheric pressure or being in a airplane.
3 - Contractions. Don't call the hospital until they are coming every 5 minutes from start to start. Only come to the hospital if you cannot talk during a contraction.

Breathing techniques are used when you can't walk, talk or joke during contractions. They all require:
A. You need a focal point, use object or picture.
B. A cleansing breath at start and end of contraction. The breathing techniques are used during the contraction to take the focus away from the pain.
C. Practice for a least a minute which is how long contractions last.

1 - Slow chest breath: 4 - 6 times/min while your having a contraction. In through the nose and out through the mouth.
2 - Hee - hees, short, equal pants in and out. Watch out that you don't hyperventilate.

Note: Switch from 1 to 2 when 1 no longer works.

3 Stages in labour:
1 - 1 - 10 cm dilation (this takes the longest time).
2 - Birth of the baby.
3 - Birth of the placenta.

There are 3 stages of dilation:
Early: 1 - 3 cm dilation, contractions 5 - 20 minutes apart lasting 30 - 45 seconds. Don't time them if they don't hurt or are irregular. Only consume clear liquids. Entertainment for example, watch a movie or read a book because. This part may last up to 10 to 12 hours until contractions become 5 minutes apart.

Active: 4 - 8 cm, contractions 2 -3 minutes apart, lasting 1 minute. This is when you're admitted to the hospital. The midwife will break your water if it's still intact to check for meconium. This will increase pressure by the baby and make the contractions come quicker.

Transitional: 8 - 10 cm, contraction lasting 60 -90 seconds without out any breaks, taking up to 2 hours. Urge to push, blow it away, like candles on a cake to prevent damage to the cervix.

Birth of the baby last 1 to 2 hours and the contractions come every 3 - 5 minutes and lasts for 1 minute. When the baby reaches the narrowest part of the cervix and the top of the babies head is visible , a cut might be made to avoid tearing. When the head comes out the baby turns to let its shoulders through the bones. After the baby is born he or she will have a apgar test in the 1st and the 5th minute after birth after which it is given eye cream and a vitamin k injection. After 5 -10 minutes the mother will have to push the placenta out, then she will be given some pitocin which will be put in the IV (intravenous). This will make the womb shrink and the bleeding will lessen. Within 2 hours the baby should be given breast milk, if you are planning to breast feed.

Try pushing 3 - 4 times during a 1 minute contraction. Place chin on your chest. It is the same type of push as a bowel movement. You can take enema to avoid bowel movement during child birth before going to the hospital. The push should be long and steady so you don't bob the baby back and forth. The best position to give birth is squatting, else sit up as high as you can. Practice at least for 1 minute a day. The last breathing technique is the called the hee - hee - hee - hoos, which is 3 hees followed by a puff during the contraction. The puff is there as you'll have to blow away any urge to push during this phase. Be careful not to blow too much air out during the puff, else you hyperventilate.

Avoid taking any drugs before 4 cm else labour will slow down too much.
1 - Demerol (Pethidine) (IV) raises pain threshold and you may sleep during a pause through contractions. It is given to you every hour and will not be given after 8 cm because the baby will be effected by it during birth and it will be sleepy and groggy. The side effect is nausea. It's mostly for quick labours and not for long ones.
2 - Epidural - continuous regional anesthetic. Can also be used for a cesarean birth. It does not pass the placenta or harm the baby. However you cannot push, urinate or walk. This will stop the labour and allow you to lie down. You will need a catheter to empty the bladder the pushing will stop until the drug wears off. You will get 2 liters of IV fluid to increase blood volume. It may cause drop in blood pressure. Some parts may still be painful and it may cause shivering and shaking. It is administered by a large needle in the lower back, which is replaced by a catheter hanging over the shoulder. It is not possible to become paralyzed. It may cause a strong head ache lasting several days. The best time to take it is at 5 cm or afterwards.
3 - Walking epidural, an narcotic instead of anesthetic, allows you to walk, move and still feel. However the pain might still break through.
4 - General anesthetic works immediately, however it passes to the baby, you will need breathing assistance. The baby will breathe slow and you may feel nausea afterwards.
5 - Pitocin is a hormone that induces labour and is given if the baby is overdue, too big, during a stalled labour or when the water has broken and there are no contractions. This causes a lot more pain then normal contractions. It takes 12 hours for the whole procedure. It will become a fast and furious labour and the contractions are much stronger. If the procedure fails then a cesarean is necessary. The Pitocin can also cause titanic contractions and it has to be stopped them. With this you can take epidural anytime.

The second stage of labor can take a long time, and it may be tempting to ask for a little help with a vacuum or forceps. Moreover, babies delivered with vacuums or forceps may have bump or bruises from their hasty exit through the birth canal. That's why your health care provider will not use forceps or vacuum unless there's a compelling reason to help speed up delivery. Forceps is only allowed after station + 2 or + 3 when you can see the baby's head. It is also used if the mother is exhausted or when baby is in distress.

When applied properly, forceps or vacuum deliveries rarely cause any permanent injury to the baby. The forceps' marks on the baby's cheeks usually disappear in a few days. Very rarely, the baby's facial nerves may be temporarily injured. The resulting drooping of facial muscles almost always recovers completely in a matter of weeks. A vacuum delivery may leave a more noticeable caput and usually disappears in 2-3 days. A vacuum is only used twice and is the last choice.

For monitoring there will be 2 disks attached to your stomach to monitor contractions and the baby's heartbeat. If the baby keeps turning it will need a scalpel monitor. Internal pressure transducer is mostly used with pitocin to measure strength of the contractions.

Reasons for a Cesarean Section:
1 - Baby too big
2 - Fetal distress
3 - Wrong position (breech)
4 - Placenta previa (placenta blocking the cervix)
5 - Placenta abruptia (Placenta ruptures, due to age 40 + or high blood pressure. This is a rare condition.)
6 - Prolapsed cord (cord slips under baby's head)
7 - Failure to progress ( 1 cm after 4 -5 hours)
8 - Failed induction
9 - High blood pressure in pregnancy
10 - Herpes (sexual transmitted decease)

With fetal distress the baby's heart rate drops. They will first roll you to your other side to reposition the baby in case the cord is squeezed on a bone, then you'll get an oxygen mask to improve oxygen level of the baby and lastly the baby gets a small prick to measure the blood oxygen level. If everything is okay then you are left alone, else they will measure it again and if it is still low they will do an emergency Cesarean Section.

For a Cesarean Section you will be shaved and given IV and a catheter and a blood pressure cuff around the arm. The cut will take 5 minutes, the baby and placenta are taken out, then they stitch you back up and this takes 45 minutes. In recovery you will be shivering and shaking. You will have IV and blood pressure cuff. If you have been given duromorph you will be itching for 18 hours afterwards. With PCA you can control the amount of morphine yourself with a button connected to a pump. After C/S you will remain in the bed for 18 - 24 hours. It is best to get a private room if possible so partner can stay over and help out. Every move during recovery is much harder and you will need a lot of help. The nurses will keep checking if your bowels are working as they shut down temporarily after surgery. You are only allowed water and ice chips. However this will cramp up your stomach even more and your recovery will take even longer. Instead sip only warm fluids and you should recover quicker.
Chamomile tea is the best thing that will help. When your home you will need help with many things for at least 2 weeks, such as lifting the baby, opening the fridge door, picking things up and you are not allowed to drive. It will take at least 6 weeks to feel back to normal.

After delivery it will take at least 3 - 9 months for your waist line to get back to normal. Your breast will feel solid for 48 hours after delivery, you can put some ice packs on them. This is when they are producing milk. Sitting down could also be painful for a while and if you have hemorrhoids (piles) it can take up to 6 weeks to go away. There will be several discharges during the 4 weeks after delivery and the doctor will see you when it becomes white and creamy for a check up. They advice you not to apply anything in the vaginal area for 4 - 6 weeks and no swimming or bath etc. Weight loss is 9 - 13 pounds after delivery and 5 pounds of fluid in a week, which will be lost through sweat and urinating. Nursing your baby can help you shed pounds more quickly, especially during the first year. This is because your body burns calories while it makes breast milk. Through breastfeeding you lose 10 pounds.

Start and end each technique with a deep breath and use a focal point.

1 - Slow chest breath: Breath slowly for 4 -6 times/min. In through the nose and out through the month.
2 - Hee - hees: Short equal pants in and out. Watch out that you don't hyperventilate.
Switch from 1 to 2 when 1 is no longer work.
3 - Hee hee hee hoos: Same as 2 followed by a puff during a contractions. This is because you have to blow away the urge to push. Don't blow too much air during the puff to prevent hyperventilate.

- Start using breathing techniques when you can't walk, talk or joke during contractions.
- You have to blow away the urge to push until you are 10 cm dilated.