GIVING BIRTH




	The birth day is near and near every day! In the last month you'll be seeing your practitioner once a week. He will continue measuring the length of your uterus, watching the baby's movements and listening his heartbeat. Your weight and blood pressure will be checked too. In this stage, your doctor will watch more closely too the position of your baby. His position will define some aspects of this last weeks and the medical intervention needed to bring your baby to the outside world. Almost all the baby's (approximately 97 percent) settle in a vertex position by the ninth month. Through a vaginal exam (a swab of your vagina and anus) your practitioner will be able the baby's head (or other baby's body part, if he not be head-down). Other additional exam that can also do is the Leopold's Maneuvers, that consists in series of hand movements on your abdomen that will allow your doctor to feel your baby's body. By the 36th week you will be submitted for a group B streptococcus or GBS. Even if you have a positive result doesn't mean that you have an infection. This bacteria that lives in your vagina and rectum cause no harm to you. But it is important that you don't get an uterine infection with GBS (Group B Streptococcus), because your baby may become infected too. This kind of infection can represent a serious problem to your baby. To prevent this illness in the newborn it will be recommended to all pregnant women tested positive for GBS to have intravenous antibiotics during active labor. At week 39 you practitioner may preform a vaginal exam to verified your cervical dilatation, effacement (the thinning of the cervix) and the the station (location of the baby's presenting part). Station We can define station as the baby's presenting part in relation to the pelvis. These part usually is the head and when the baby's forehead is even in the inner, bony prominences of the pelvic bones, the baby is engaged in the pelvis at "0" station. The other stations, are above or below station "0" and they are numbered in centimeters. Great number of women go into labor when they are between station "0" and "2" (see image nº 1) Cervical effacement Your cervix is situated at the top of the vagina and in many women is easy feeled with the fingers. In other women is quite high in the vagina and behind te top of the baby's head (posterior cervix) and is harder to reach. The so called cervix, as the appearance of the soft side of a thumb and has approximately 2 to 5 centimeters (before the first labor, then it can goes shorter and softer). We call effacement to the thinning of the cervix. The practitioner will define the effacement of the cervix in terms of percentage and as it will effaces it go shorter and soften. (see image nº2) Cervical dilatation The cervical dilatation is measured in centimeters in a scale from 0 to 10. This means that at 10 centimeters, the cervix is completely dilated and has moved around the baby's head (that is approximately his head size). In general, cervix rarely dilates much before labor, especially with the first baby. Once it is completely dilated, a new stage of labor begins: the pushing phase.

When labor starts
There is any certain sign that will give you the exact time labor will began. Neither station, dilation or the measurement of effacement can give you the time your labor will began. A women with no noticeable dilatation and that doesn't expect to enter in labor in the next days, may go into labor in the next day, as a women that as 3 centimeters of dilatation for weeks may no deliver before the expected day. Although, you must have present in your mind that pregnancy is a continuous process and that labor is discussed in terms of stages. This stages are different for every mom and not easy to define to a first time mom. There are four stages in labor and the last one is after the baby is born, the postpartum period.


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