What to expect when you're expecting (158 page)

Then you’ll get your baby back (assuming all is well) and you may, if you wish to, begin breastfeeding (but don’t worry if you and/or your baby don’t catch on immediately; see Getting Started Breastfeeding,
page 435
).

Sometime after that, it’s off to the nursery for baby (if you’ve delivered in a hospital) for a more complete pediatric exam and some routine protective procedures (including a heel stick and a hepatitis B shot). Once your baby’s temperature is stable, he or she will get a first bath, which you (and/or dad) may be able to help give. If you have rooming-in, your baby will be returned as soon as possible and tucked into a bassinet next to your bed.

For the Coach: What You Can Do.
Once again, these responsibilities can be shared with a doula.

Continue giving comfort and support (a whispered “I love you” can be more valuable to her during the pushing stage than anything else), but don’t feel hurt if the object of your efforts doesn’t seem to notice you’re there. Her energies are necessarily focused elsewhere.

Help her relax between the contractions—with soothing words, a cool cloth applied to forehead, neck, and shoulders, and, if feasible, back massage or counterpressure to help ease backache.

Continue to supply ice chips or fluids to moisten her mouth as needed. She’s likely to be parched from all that pushing.

Support her back while she’s pushing, if necessary; hold her hand, wipe her brow—or do whatever else seems to help her. If she slips out of position, help her back into it.

Periodically point out her progress. As the baby begins to crown, remind her to keep an eye on the mirror so she can have visual confirmation of what she is accomplishing. When she’s not looking, or if there’s no mirror, give her inch-by-inch descriptions. Take her hand and touch baby’s head together for renewed inspiration.

If you’re offered the opportunity to catch your baby as he or she emerges or, later, to cut the cord, don’t be afraid. Both are relatively easy jobs, and you’ll get step-by-step directions and backup from the attendants. You should know, however, that the cord can’t be snipped like a piece of string. It’s tougher than you may think.

The worst is over, and the best has already come. All that remains is tying up the loose ends, so to speak. During this final stage of childbirth (which generally lasts anywhere from five minutes to half an hour or more), the placenta, which has been your baby’s life support inside the womb, will be delivered. You will continue to have mild contractions approximately a minute in duration, though you may not feel them (after all, you’re preoccupied with your newborn!). The squeezing of the uterus separates the placenta from the uterine wall and moves it down into the lower segment of the uterus or into the vagina so it can be expelled.

Your practitioner will help deliver the placenta by either pulling the cord gently with one hand while pressing and kneading your uterus with the other or exerting downward pressure on the top of the uterus, asking you to push at the appropriate time. You might get some Pitocin (oxytocin) via injection or in your IV to encourage uterine contractions, which will speed expulsion of the placenta, help shrink the uterus back to size, and minimize bleeding. Once the placenta is out, your practitioner will examine it to make sure it’s intact. If it isn’t, he or she will inspect your uterus manually for placental fragments and remove any that remain.

Now that the work of labor and delivery is done, you may feel overwhelmingly exhausted or, conversely, experience a burst of renewed energy. If you’ve been deprived of food and drink, you are likely to be very thirsty and, especially if labor has been long, hungry. Some women experience chills in this stage; all experience a bloody vaginal discharge (called lochia) comparable to a heavy menstrual period.

How will you feel emotionally after you’ve delivered your baby? Every woman reacts a little differently, and your reaction is normal for you. Your first emotional response may be joy, but it’s just as likely to be a sense of relief. You may be exhilarated and talkative, elated and excited, a little impatient at having to push out the placenta or submit to the repair of an episiotomy or a tear, or so in awe of what you’re cuddling in your arms (or so beat, or a little bit of both) that you don’t notice. You may feel a closeness to your spouse and an immediate bond with your new baby, or (and this is just as normal) you may feel somewhat detached (who is this stranger sniffing at my breast?), even a little resentful—particularly if the delivery was a difficult one (so this is the little person who made me suffer so much!). No matter what your response now, you will come to love your baby intensely. These things just sometimes take time. (For more on bonding, see
page 430
.)

What You Can Do.

Have a good cuddle with your new arrival! Once the cord is cut, you’ll have a chance to breastfeed or just do some snuggling. Speak up, too. Since your baby will recognize your voice, cooing, singing, or whispered words will be especially comforting (it’s a strange new world, and you’ll be able to help baby make some sense out of it). Under some circumstances, your baby may be kept in a heated bassinet for a while or be held by your coach while the placenta is being delivered—but not to worry, there’s plenty of time for baby bonding.

Spend some time bonding with your coach, too—and enjoying your cozy new threesome.

Help deliver the placenta, if necessary, by pushing when directed. Some women don’t even have to push at all for the placenta to arrive. Your practitioner will let you know what to do, if anything.