Questions about the birth and the time after: What you should know

Induction of labor: what happens if I am past the calculated due date?

If the due date has passed, it does not mean that the birth must be induced. First, the due date is recalculated and the pregnant woman and the baby are examined every two to three days. For example, the baby’s heartbeat is checked and the amount of amniotic fluid is determined. Until the end of the 39th week of gestation, the doctor will not usually induce labor, provided there are no risks to the mother and baby. From 40 to 41 weeks, birth may be induced if it is necessary and there are risks. In the 42 SSW, the pregnancy can be induced even if there are no signs of risks. If the birth is finally induced, the expectant mom must be admitted to the hospital as an inpatient, as induction of labor can take several days. Induction of labor can be done in several ways.

1. Natural induction of labor

There are many methods to induce labor naturally. For example, labor can be induced by taking a walk and moving around. It is important here that pregnant women do not move too far from home on their own. But spicy food, an enema or even a labor cocktail with castor oil can also induce labor. Before you try to induce labor with any of these methods, you should get enough information. It is best to talk to your midwife to clarify any questions you may have and to discuss how to proceed.

2. Induction of labor with medication

If the birth is induced with medication, prostaglandins are given first. These cause the cervix to soften and open. Prostaglandins can be given in the form of tablets or as a gel for the cervix. Another option is the hormone oxytocin, which promotes contractions and induces labor.

3. Mechanical induction of labor

In mechanical induction of labor, a balloon catheter is inserted into the pregnant woman and filled with saline. This balloon exerts pressure with the filling causes a slight dilation of the cervix. The body reacts to this dilation by releasing prostaglandins. In addition, cervical massages are used to promote opening. Another method is egg release, in which the midwife carefully attempts to detach the outer covering of the amniotic sac from the cervix. The body reacts to this mechanical intervention by releasing prostaglandins.

Important: Don’t worry if your baby is waiting. You will be regularly examined by doctors and cared for by your midwife. Soon you will be holding your little miracle in your arms!

The birth

The birth begins: When do I have to go to the clinic?

The birth is probably a very exciting time for every pregnant woman, because it is clear: Soon you will hold your baby, which you have carried for so long, in your arms. However, it is not possible to make a general statement about when is the right time to go to the clinic, because every pregnant woman and every birth is different. As soon as the contractions occur every five minutes over a period of one hour and last for at least one minute, you can make your way to the clinic. If you feel comfortable at home, you can stay longer. The important thing is that you feel safe. As soon as you become unsure, you should go to the clinic, where you will be cared for by midwives and doctors.

The position of the baby at birth: what do I do if the baby is wrong side up?

Babies are naturally born with their heads down. This position of the baby is called the cranial position. However, not all babies lie head down just before birth. If the baby lies with the head in the womb and the feet and buttocks down, this is called the breech presentation. Here we distinguish different types such as the perfect foot position, in which the baby’s feet would be born first. Another position of the breech presentation is the perfect breech-foot position. In this position, the baby’s legs are crouched. The most common variant is the so-called pure breech position, in which the baby has the little feet in front of the face. In the pure breech position, a cesarean section is not necessary, but like the other positions of the breech presentation, it also offers certain risks for the baby. It is best to get information from a clinic near you that has a lot of experience with this and talk to your midwife. Every situation is different and your midwives and doctors can help you individually and answer your questions.

Painkillers: what are the drug and non-drug options?

In the early stages of birth, when the contractions are not yet very strong, a warm cherry pit pillow, for example, can help. The pillow can be placed in the area of the lower back or simply in the place where it feels good for the expectant mom. A relaxing massage or a relaxing bath in the tub can also help make the pain more bearable. It’s best to ask the midwife if this option is available and if a tub is free. Many clinics also offer acupuncture and homeopathy. Here, too, it is worth asking in advance what is possible in the respective clinic. If the pain becomes more intense as the birth progresses, you can slowly switch to painkillers. At first, mild painkillers can be administered in the form of suppositories, which initially work well for several hours. If the pain is more severe, pregnant women are given an IV line through which painkillers can be administered as an infusion. You can learn which painkillers you can take and when in a childbirth preparation course or you can discuss this individually with your midwife and your doctors.

Spontaneous cesarean section: What happens if a spontaneous cesarean section does occur during delivery?

Cesarean section is a surgical procedure in which the baby is delivered by doctors. An incision is made in the lower abdomen, which is later sutured shut. There are several forms of cesarean section, each differing in urgency and planning. On the one hand, there is primary and secondary cesarean section, on the other hand, elective cesarean section and emergency cesarean section. In the case of primary cesarean section, it is already clear before the birth that the child will be delivered by cesarean section. The intervention is always planned and medically justified, for example by possible risks for mother and child. The elective C-section is performed – as the name suggests – at the request of the expectant mother. The planning of the elective cesarean section is not medically justified, but usually due to personal reasons.

Secondary cesarean section refers to a cesarean section that occurs spontaneously during childbirth. This means it was not planned beforehand and the natural birth has already started. Why it has a Secondary Sectio can have different reasons. In contrast, emergency cesarean section, emergency cesarean section differs mainly by its urgency. Like secondary cesarean section, it is not planned and it is necessary to switch to cesarean section due to complications during natural birth. The difference here is the extent of complications, which requires quick action to protect both mother and child. In this case, the operation takes place under general anesthesia, because it works faster and the child must be born within six minutes. However, emergency cesarean sections are extremely rare, and usually the procedure can be performed as a secondary cesarean section.

If the cesarean section is planned, it can usually be performed while the mother is conscious (i.e., without general anesthesia), allowing her to witness the first minutes of her newly born child. For this purpose, pregnant women are usually anesthetized with spinal anesthesia or epidural anesthesia (PDA). During the procedure, your partner sits by your head the entire time to support you. Your midwife also accompanies you and can explain what is being done and answer any questions you may have. Once your baby is born, he or she will be placed on your chest for bonding in the first few minutes, just like a natural baby. If you have any concerns or fears about a C-section, it is best to ask your midwife or a doctor if they can answer your questions.

Tip: In the case of an elective cesarean section or Primary and Secondary Sectio, there is the possibility of an emperor birth. Here, the cloth stretched between the mother’s head and abdomen is lowered when the baby is brought into the world. The light is dimmed and the baby is brought out of the womb first with the head and then with the body, as in natural birth. This gives parents the opportunity to see their child immediately and watch the birth. However, not every hospital offers an emperor birth. Therefore, it is best to ask beforehand whether this is possible.

The stages of birth: what happens during birth?

The birth begins with the opening phase. The opening phase is the period from the first contractions to the complete opening of the cervix. It is usually the longest part of the birth and lasts between six to twelve hours. Initially, contractions in this phase occur at longer intervals of about 15 minutes. As time progresses and birth occurs, the intervals then shorten to every one to two minutes.

Once the cervix is fully open (about ten centimeters), the second phase of birth begins: the exit phase. This phase is characterized by strong contractions and usually lasts between one hour and 20 minutes, but can go up to three hours. During the exit phase, there is an urge to push, which is triggered by the pressure on the cervix. If this pressing urge occurs in combination with contractions, these are called pushing contractions. Active pushing causes the baby to slide deeper into the birth canal. The contractions here occur approximately every two to four minutes and can last between 60 and 90 seconds. The exit phase of labor ends when the baby is born.
The final phase of birth is the postpartum phase. It begins when the baby is born and ends when the placenta is expelled. After the baby is born, the uterus initially relaxes before contractions begin again about 15 minutes afterward. This last phase of birth is the shortest phase, lasting 10 to 20 minutes. The duration of each phase may depend, among other things, on whether or not it is the first birth.

But always remember, that each birth can proceed at a different pace. Don’t drive yourself crazy in advance! You will do great!

The time after birth

Puerperium with baby blues: what to watch out for after birth?

The period from six to eight weeks after birth is called the puerperium period. This period is particularly important because mother and child need to recover from the birth. In addition, this time is characterized by intensive getting to know each other and finding each other between parents and child. Before you go home with your baby, you spend a few more days in the hospital, depending on the type of birth. With a natural birth, the hospital stay is usually between 2 to 3 days, while with a cesarean section you have about four days of hospital stay. In an outpatient birth, you leave the clinic or birth center just a few hours after the baby is born.

At home, in familiar surroundings, many new experiences await and the new parents have time to get used to the new everyday life with baby. Especially for the moms, the time after the birth can be very intense. 80% of women, for example, experience the so-called baby blues. Despite the joy of having a baby, many moms feel like crying and have to deal with severe mood swings. This is due to hormonal changes after the birth. After all, not only does the body start to change again after the birth, but the hormones also get mixed up again. While estrogen and progesterone decrease, prolactin levels increase to stimulate milk production. But don’t worry, the hormone level settles down again and the emotional fluctuations disappear after a few days.

Important: Don’t take on too much during this time and concentrate on your child and your body. The birth demands a lot of strength, which is why you should use the time afterwards to recover. So take it slowly, give yourself breaks and don’t be afraid to ask for help.

Midwife aftercare: Who is my postpartum contact?

After the birth, many new things come up for parents and child, so it is quite normal if many questions arise during this time and you want a contact person. In the course of aftercare, midwives offer professional care and support after the birth. The midwife monitors wound healing and involution in the mother and also checks the growth and weight of the child. She also answers parents’ questions about the newborn, the new situation and can also provide assistance with breastfeeding. Midwives are there to support parents and can also offer encouragement and encouragement, especially after the first birth, to give parents peace of mind. In the first 10 days after the birth, midwives can even come daily for aftercare, after which two visits per week are still possible until the twelfth week.

Regression: When should I start regression?

Your body begins to regress all by itself, even in the first few days after birth. This is because there are often afterpains. These are contractions of the uterus, which slowly contracts again to reach its normal size. Regression can be somewhat faster in breastfeeding mothers, as the contraction of the uterus is supported by the breastfeeding hormone oxytocin. Regression also includes the healing of all internal and external wounds, as well as the wound from a cesarean section. If you want to support the process of involution and your overstretched muscles in the abdomen and legs with special involution gymnastics, you should keep a few things in mind. First of all, it is important that you do not start too early and that you consciously take the time of the postpartum period to recover and heal. Especially in the case of a cesarean section or perineal tear, you should wait until the stitches have healed. If the wounds and health are okay according to the postpartum midwife, light exercises can be started. For example, the pelvic floor muscles can be exercised, or when standing up, one leg can be placed after the other to challenge the lateral abdominal muscles. Regression takes about nine months, which is the same length of time as pregnancy. So don’t put yourself under pressure and give your body enough time.

Important: The same applies to the registration for a postnatal course as for a childbirth preparation course: as soon as possible! So you better take care of it early and secure a free place if you know that you want to attend a course.

Placenta: What can I do with the placenta after birth?

The placenta supplies the baby with oxygen and nutrients for over nine months and is the most important interface between mother and child. It is therefore understandable that some new mothers find it difficult to have the placenta disposed of by the hospital. After birth, the placenta is only examined by a midwife to ensure that it has been completely detached during the postpartum period, after which the woman can decide what to do with it. One option, for example, is to bury the placenta in the garden and plant a tree on it for the newborn. Recently, some women also have globules made for their child from their placenta or make them themselves. For this purpose, the placenta is first boiled and dried, and then processed into powder. Sometimes one also hears that the placenta can be eaten. This is supposed to prevent postpartum depression, relieve pain and promote involution, for example. However, these effects have not been scientifically proven.

Special features of a birth during a pandemic

Giving birth during a pandemic can have some unique aspects. Mama Christina gave birth to her son during the Corona pandemic and tells us about her experience.
The first difference to a birth under normal circumstances is that a mask has to be worn. However, the welfare of the pregnant woman still comes first. Therefore, the mask may usually be removed when the birth is relatively advanced, as it allows for better breathing. In addition, pregnant women must be tested upon arrival at the hospital. In Mama Christina’s case, this was after the first cervical check. If corona is suspected or present, the birth must take place unaccompanied. There is a special area, or delivery room, for these cases. However, if the test is negative, the birth can continue relatively normally. When the birth starts and the cervix opens, the partner is then allowed into the delivery room to support the expectant mom. Even after the birth, the partner is allowed to stay in the delivery room with the mother and baby for a few hours until they have to go to the maternity ward. If the baby needs to go to the neonatal unit after birth, the fresh parents can visit at any time to be there for their child.

An alternative in the pandemic can be, for example, an outpatient birth. However, this must be clarified with midwives and doctors. The prerequisite here is that mother and child feel well and there are no risks during the birth or illnesses. Being back in a familiar and safe environment immediately after the birth can be a wonderful experience for new moms and, of course, also for the partner. It is important that aftercare for mother and child is still provided, for example by an aftercare midwife.

Mama Christina’s comparison to giving birth under normal conditions:

“The fear of having to go through the birth alone and being alone in labor for a long time is very worrying before that. But this time I actually ‘enjoyed’ the ban on visits, I have to say. Intensive time to get to know each other as a couple and the full time to rest, without visits, I found really nice this time.”

You can do it!

Whether under normal conditions or during a pandemic, a birth is always an extraordinary experience that is associated with excitement. But you don’t have to be afraid, because you don’t have to go through this experience alone and you will be cared for and accompanied by competent clinic staff and your midwife. The main thing is that you feel comfortable and trust in your strength. It will all be worth it in the end when you can finally hold your little miracle in your arms!