Labor and Delivery: What You ... Video Transcript

Participants

, Steven Hockstein MD, Michelle La Mothe MD, MPH, M, Adrienne Moore MD, Kenneth Powers MD

Summary

After nine months of doctor's visits, large clothing, physical discomfort and joyous expectation, a mother finally reaches the last stages of pregnancy- labor and delivery. Join our panel of specialists as they take us step by step through the process of labor and delivery.

Webcast Transcript

MICHELLE LAMOTHE, MD:  Hello, and welcome to our web cast.  I’m Dr. Michelle La Mothe.  Childbirth – depending on who you ask, it’s either the most wonderful or the most excruciating experience one can have.  If you’re facing childbirth for the first time, you probably have lots of questions and concerns – what happens exactly, how long does it take, what are the possible complications?

Well, joining me today are two experts to answer our questions.  To my left, Dr. Adrianne Moore, Assistant Professor of Obstetrics and Gynecology at Weill Cornell Medical College, New York Hospital, New York, and her colleague, Dr. Steven Hockstein, Assistant Professor of Obstetrics and Gynecology, Weill Cornell Medical College, New York Hospital, New York.  Welcome.  Thank you both for joining and talking with me about labor and delivery -- childbirth.

MICHELLE LAMOTHE, MD:  ... generally.  At what time of a gestation, or the length of time of a pregnancy, does an average woman give birth to an average baby?  When can we anticipate that?  Dr. Hockstein?

STEVEN HOCKSTEIN, MD:  A woman’s due date is 40 weeks after her last menstrual period – 280 days.  And that is about the time most women deliver plus or minus a couple of weeks.

MICHELLE LAMOTHE, MD:  Okay.  So you have a window there of about a couple of weeks.  Dr. Moore, what are the signs and stages of labor?

ADRIANNE MOORE, MD:  Well, the signs of labor are rhythmic contractions, generally about five minutes apart, and lasting for a full minute.

MICHELLE LAMOTHE, MD:  And there are how many different stages to labor?

ADRIANNE MOORE, MD:  There are three stages of labor.  There’s – in the first stage is – are both early labor and the active phase of labor.  In the second stage of labor, which is probably the hardest, the most physically challenging, is the stage in which a woman is pushing after the cervix is completely open.  And the third stage of labor is simply the delivery of the placenta.

MICHELLE LAMOTHE, MD:  Can you talk a little bit about, Dr. Hockstein, about the beginning of contractions and how the cervix or the neck of the vagina begins to open to allow the baby to pass through?

STEVEN HOCKSTEIN, MD:  Well, it’s very common – throughout the latter part of pregnancy a woman has contractions.  They come, they go.  They are generally mild, and they’re not regular in their pattern.

During this time, the cervix will change.  It becomes softer, and it dilates some – a centimeter or two.  The woman will go into labor eventually around her due date, at which point the regular, painful, stronger contractions will dilate her cervix.  The cervix shortens at the same time as it dilates.  And the physician or nurse – when they check a woman – to check the progress during labor, they measure it in centimeters – if a woman is six centimeters dilated, eight centimeters dilated.  And they also check how thick it is.

MICHELLE LAMOTHE, MD:  And what about the breaking of the water that may or may not happen around this time?

STEVEN HOCKSTEIN, MD:  Well, the bag of water is a membrane that surrounds the fetus inside the uterus, and it contains the amniotic fluid.  During labor – sometimes prior to the onset of labor, this bag may break on its own, or a patient’s physician may break it.  When that happens, prostaglandins are released, and contractions become stronger, they become more regular, and the progress of labor generally picks up.