Choosing a vaginal delivery
Birth plans: Should you have one?
Early phases of labour
The amniotic sac is the fluid-filled membrane surrounding your baby. This sac will almost always rupture before the baby is born, though in some cases it remains intact until delivery. When it ruptures, it’s often described as your “water breaking.”
In most cases, your water will break before you go into labour or at the very beginning of labour. Most women experience their water breaking as a gush of fluid.
It should be clear and odourless — if it’s yellow, green, or brown, contact your doctor right away.
Contractions are the tightening and releasing of your uterus. These motions will eventually help your baby push through the cervix. Contractions can feel like heavy cramping or pressure that begins in your back and moves to the front.
Contractions aren’t a reliable indicator of labour. You might already have felt Braxton-Hicks contractions, which may have started as early as your second trimester.
A general rule is that when you are having contractions that last for a minute, are five minutes apart, and have been so for an hour, you’re in true labour.
The cervix is the lowest part of the uterus that opens into the vagina. The cervix is a tubular structure approximately 3 to 4 centimetres in length with a passage that connects the uterine cavity to the vagina.
During labour, the role of the cervix must change from maintaining the pregnancy (by keeping the uterus closed) to facilitating delivery of the baby (by dilating, or opening, enough to allow the baby through).
The fundamental changes that occur near the end of the pregnancy result in a softening of the cervical tissue and thinning of the cervix, both of which help prepare the cervix. True, active labour is considered to be underway when the cervix is dilated 3 centimetres or more.
Labour and delivery
Eventually, the cervical canal must open until the cervical opening itself has reached 10 centimetres in diameter and the baby is able to pass into the birth canal.
As the baby enters the vagina, your skin and muscles stretch. The labia and perineum (the area between the vagina and the rectum) eventually reach a point of maximum stretching. At this point, the skin may feel like it’s burning.
Some childbirth educators call this the ring of fire because of the burning sensation felt as the mother’s tissues stretch around the baby’s head. At this time, your healthcare provider may decide to perform an episiotomy.
You may or may not feel the episiotomy because the skin and muscles can lose sensation due to how tightly they’re stretched.
As the baby’s head emerges, there is a great relief from the pressure, although you’ll probably still feel some discomfort.Your nurse or doctor will ask you to stop pushing momentarily while the baby’s mouth and nose are suctioned to clear out amniotic fluid and mucus. It’s important to do this before the baby starts to breathe and cry.Usually the doctor will rotate the baby’s head a quarter of a turn to be in alignment with the baby’s body, which is still inside you. You’ll then be asked to begin pushing again to deliver the shoulders.
Delivering the placenta
Pain and other sensations during delivery
How to Treat Vaginal Prolapse
Vaginal Prolapse Self-Care at Home
Treatments at home for vaginal prolapse.
Activity modification: For a vaginal prolapse that causes minor or no symptoms, the doctor may recommend activity modification such as avoiding heavy lifting or straining.
Pessary: A pessary is a small device, usually made of soft plastic or rubber, that is placed within the vagina for support. Pessaries come in many different varieties. This nonsurgical treatment option may be the most appropriate for women who are not sexually active, cannot have surgery for medical reasons or because of advanced age, or plan to have surgery but need a temporary nonsurgical option until surgery can be performed (for example, women who are pregnant or in poor health). Pessaries must be removed and cleaned at regular intervals to prevent infection or erosion into the vaginal walls. Some pessaries are designed to allow the woman to do this herself. A doctor must remove and clean other types. Oestrogen cream is commonly used along with a pessary to help prevent infection and vaginal wall erosion. Some women find that pessaries are uncomfortable or that they easily fall out or that they cannot be retained (i.e., they fall out).
Kegel exercises: These are exercises used to tighten the muscles of the pelvic floor. Kegel exercises can be tried to treat mild-to-moderate cases of vaginal prolapse or to supplement other treatments for prolapses that are more serious.
Vaginal Prolapse Medical Treatment
Vaginal Prolapse Medications
Oestrogen replacement therapy may be used to help the body strengthen the muscles in and around the vagina. Oestrogen replacement therapy may be contraindicated (such as in a people with certain types of cancer) and has been associated with certain health risks including increased risk of blood clots and stroke, particularly in older postmenopausal women. Women’s bodies cease producing oestrogen naturally after menopause, and the muscles of the vagina may weaken as a result.
In mild cases of vaginal prolapse, oestrogen may be prescribed in an attempt to reverse vaginal prolapse symptoms, such as vaginal weakening and incontinence. For more severe prolapses, oestrogen replacement therapy may be used along with other types of treatmenT.
Vaginal Prolapse Surgery and Recovery
Alternative Therapy for Vaginal Prolapse
Physical therapy such as electrical stimulation and biofeedback may be used to help strengthen the muscles in the pelvis.
Electrical stimulation: A doctor can apply a probe to targeted muscles within the vagina or on the pelvic floor. The probe is hooked up to a device that measures and delivers small electrical currents that contract the muscles. These contractions help strengthen the muscles. A less intrusive type of electrical stimulation is available that magnetically stimulates the nerve that supplies the pelvic floor muscles from outside the body. This activates these and may help treat incontinence.
Biofeedback: A sensor is used to monitor muscle activity in the vagina and on the pelvic floor. The doctor can recommend exercises that the woman can use to strengthen these muscles. In some cases, these exercises may help strengthen the muscles enough to reverse or relieve some symptoms related to vaginal prolapse. The sensor can monitor the muscular contractions during the exercises, and the doctor may be able to determine if the targeted muscles would benefit from the exercises.
Vaginal Prolapse Follow-up
Vaginal Prolapse Prognosis and Cure
• Vaginal prolapse is rarely a life-threatening condition.
• Some mild cases can be treated without surgery.
• More severe cases of vaginal prolapse will likely require surgery for correction.
• Vaginal prolapse surgery is generally successful, but recurrence remains an issue.