The process of labor and delivery is one of the most important and sacred moments in a woman’s life. It is also one of the most natural processes that a human being can experience. Childbirth generally occurs between 37 and 41 weeks after conception, with the average being 40 weeks.

The labor and delivery experience is unique for each individual. Typically, it involves dilation of the cervix, control of pain, rupturing of membranes or the amniotic sac that contains fluid, and contractions that become regular and stronger. Sometimes, however, unexpected events can happen during labor and delivery, and the original plan needs to be modified in order to ensure a healthy mother and baby. This can involve additional medical management, or procedures like cesarean delivery. It is important to discuss with your provider your questions about the labor course and type of delivery as well as your preferences. We look forward to helping you welcome a healthy baby into the world.

About labor

Labor is the process through which a baby and the placenta are delivered from the uterus through the vagina. Fetal heart rate monitoring is employed continuously during labor to ensure fetal wellbeing.

Contractions play an important role in labor and delivery. They help the baby descend into the birth canal and push the placenta out after delivery. Oxytocin is a hormone that your body naturally releases during labor to cause contractions, but sometimes the levels of oxytocin are not enough to produce strong contractions. In these cases, pitocin (synthetic oxytocin) can be given through an IV to help increase the strength of your contractions.

• Generally, the first stage of labor begins with contractions that are spaced approximately 3-5 min apart and ends with full cervical dilation to 10 centimeters. During this time the cervix opens, and the amniotic sac may break (the water breaks). This may occur spontaneously or be induced. Artificial rupture of the membranes is a procedure that is sometimes done to help speed up labor. It is commonly done when there are concerns about the baby’s wellbeing, such as diminished fetal movement or concerns about infection. It can also be done for other reasons, such as if the mother is very tired and wants to hasten the delivery.
• The second stage of labor is when the cervix is fully dilated, and contractions are at their strongest. This is when pushing begins and the baby starts to move down the birth canal.
• The third stage is when the baby is delivered and concludes with the delivery of the placenta, the organ that nourished the baby during pregnancy.

Reasons for a Cesarean section

• Failure to progress is a lack of progress in labor. Contractions may not open the cervix enough for the baby to move into the vagina.
• Concern for the baby as when the umbilical cord is compressed, or fetal monitoring detects an abnormal heart rate.
• Problems with the placenta.
• A very large baby.
• Breech presentation.
• When the mother has a medical condition that makes vaginal birth unsafe.

C-sections are generally safe, but like all surgeries there are some risks involved. Dr. Patel will discuss your alternatives based on your and the baby’s needs. Importantly, it is possible to deliver vaginally after a previous C-section depending on the type of incision you received during your C-section, and other factors. Discuss your concerns with Dr. Patel.

Medication Management

Medication management during labor and delivery is an important part of the care that we provide to our patients. Our team of obstetricians, nurses, and pharmacists work together to ensure that our patients receive the best possible care. We use a variety of medication regimens to manage labor pain, including epidural anesthesia and intramuscular analgesics.

We also offer a variety of options for postpartum (after delivery) pain management, including oral pain medications and epidural analgesia. Epidural anesthesia is the most common form of pain control used during labor. It involves placing a small tube in your back to deliver pain medication. Epidural anesthesia is very effective and safe for both you and your baby. Spinal anesthesia is like epidural anesthesia, but the medication is injected directly into the spinal fluid. Spinal anesthesia is generally only used if you need a C-section.

The goal is to provide our patients with the best possible pain relief while minimizing the risk of side effects. We individualize your care based on the needs of each patient, and we are always available to answer any questions that you may have about your care.

What is labor induction?

Labor induction is the process or treatment that stimulates labor to begin sooner than it would naturally. It might be recommended when there are medical concerns for either you or your baby. Dr. Patel may suggest labor induction under certain circumstances such as: carrying the baby past your due date (41 weeks); if you have a medical condition like preeclampsia or other issues. Preeclampsia is where you have high blood pressure and protein in your urine after the 20th week of pregnancy. Labor induction isn’t without risks. It might increase the chance you’ll need a cesarean delivery (C-section). But in some cases, it’s the safest option for you and your baby.

The process of labor and delivery is an amazing and miraculous event. It is a time of great joy and happiness, as well as a time of intense physical work. It is important to be prepared for this event, both mentally and physically.

Dr. Dwaita Patel is a board-certified obstetrician and gynecologist at City OB+GYN in New York City, and a fellow of the American College of Obstetrics and Gynecology (FACOG). She specializes in women’s health and provides all deliveries and major surgeries at Tisch Hospital/NYU Langone Medical Center in Manhattan.

Dr. Patel is smart and kind and finds great joy and fulfillment in her work. She offers the full scope of obstetrics including pre-pregnancy, prenatal, labor and delivery and postpartum care for low and high-risk patients. She also offers medical treatments and minimally invasive surgery for gynecologic conditions. Contact her to schedule a consultation today.