Saturday, July 21, 2012

Prenatal Visits and the labor

A generation or two ago, it was unusual for an expectant father to be present during labor, let alone hang out with his pregnant wife in the exam room when she saw her doctor. Now dads are encouraged to go to prenatal care appointments.
 
 
Assuming that all goes well, there will be about 15 routine prenatal visits scheduled with varying frequency: once a month until 28 weeks, three or four times up to week 36, and once a week for the last month.
 
If you can make time to join your partner at all or most appointments, she will likely appreciate it, and you'll benefit from knowing what's going on. Two visits in particular are especially worthwhile: the first appointment, and the prenatal ultrasound exam. "As a physician, I want the dad there for the first appointment to talk about what will happen, and to determine parents' preferences," Woods says.
 
During the exam, the doctor should give both of you some general advice on having a healthy pregnancy and address any specific medical issues. You can help by paying close attention and asking thoughtful questions. The exam typically involves simple things like collecting urine and blood samples from the mother, taking her blood pressure, measuring around her middle, and weighing her.
 
Afterward, don't be surprised if she needs you to "spend half an hour drying tears over the weight gain and explaining that, 'no, you don't look like a cow,'" Woods says. Another thing that could catch you off guard is the internal pelvic exam, which may be done in front of you. It's a standard obstetric procedure, but to the guy standing there while his wife has one -- even a guy who happens to be a medical doctor -- "no matter what, it just seems weird," Woods says.
During the 20th week of pregnancy, an ultrasound exam is normally done. This is when many parents get a first glimpse of the baby and take home a sonogram snapshot for the baby's album. Sometimes ultrasound is used earlier in pregnancy to screen for birth defects or if a doctor suspects a problem. Ultrasound at 20 weeks can also reveal the baby's sex. You may choose to find out what it is or wait to be surprised.
 
At some point, the mom-to-be will draw up her birth plan. That's a detailed description of how she wants to do labor and delivery -- where to go, who'll attend the delivery, how she intends to labor, whom she wants in the room, and what your role will be. Taking a birthing class together can help you figure out the best practical ways to support her throughout labor.
When the moment arrives, all might go according to the plan. Circumstances could also trash the plan utterly. Woods says that in his experience, having attended the birth of several hundred babies, it's usually the latter.
 
Because there are so many different ways for labor and delivery to play out, it's difficult to describe a typical experience for a father-to-be in much detail. Saying that any part of it will go one way or another involves a bunch of assumptions that may not be true for everyone.
Nevertheless, it's fair to assume that you'll deliver in a hospital, which is where 99% of all births in the United States occur. That means there will be doctors and nurses around, with medical support available as needed. If you plan on going to a certain hospital, you may benefit from visiting the maternity unit (what this is called differs from hospital to hospital) well in advance of the due date to get a real sense of what the place is like. Anticipate spending at least 48 hours there for the delivery.
 
There's no way you can predict it, but on average, for a woman having her first baby, labor lasts 12-24 hours from her first contractions to delivery. Your partner may be in the early phase of labor for many hours before the hospital will admit her. If at all possible, spend this time together and help to keep her feeling at ease. When it's time, proceed calmly to the hospital.
As labor progresses, it gets increasingly painful. Even with pain control measures, it hurts a lot. To you, it might seem like not much is happening as the hours pass. Stay focused on her. "Getting ice chips, cold cloths, foot rubs, back rubs -- suck it up, guys, it's only for a while," Woods says. "She is experiencing pain like we can't imagine."
 
In the worst throes of labor, she might tell you to get the bleep out of there. "Don't walk out," says Boulanger. "Be there from beginning to end."
 
The birth of your child is a big event that will change your life. But no matter how deeply you care, and regardless of how supportive you are, labor and delivery is not your show. Your name is in small type at the bottom of the show bill. Even mom is in a supporting role because, really, the baby is the star.

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