Getting ready for birth class? I’m so glad to hear it! Everybody should spend time being educated and prepared for the birth process!
Hopefully, your class will include introductory terminology before jumping into the processes of labor and birth and understanding the postpartum phase, but in case they don’t, I thought I’d give you a run down on terms you have probably been hearing in prenatal appointments, and will definitely hear during your childbirth education course.
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Anatomy – Your Pregnant Body
- Uterus – The muscular organ located above and behind the bladder that expands during pregnancy to hold and protect your growing baby. When not pregnant it is the size of a small piece of fruit and works with your ovaries on a monthly cycle to maintain a healthy hormone cycle and production.
- Fundus – the top of the uterus. “fundal height” is a measurement from your pubic bone to the top of your uterus and is used to measure uterine growth.
- Cervix – the bottom of the uterus, which is thickened and closed into a tight “neck” during pregnancy, but stretches out and becomes like the rest of the uterine wall during labor.
- Vagina – the canal that is an opening in your body that allows sperm to enter the uterus before pregnancy, and allows baby to exit the body during birth.
- Perinium – the span of skin between the anus and the vaginal opening.
- Placenta – a temporary organ that attaches to the wall of the uterus to filter and supply the baby’s blood by pulling vital nutrients and oxygen from the mother’s blood and passing them to the baby. Usually around 1.5 pounds and 6-8″ across by full term. The placenta is also responsible for a great deal of hormone production and acts as a part of the endocrine system.
- Amniotic Membranes – the “amniotic sac” that is made up of a double layer of semi transparent tissue. The outer layer of tissue connects to the placenta, but the membranes work together to surround baby.
- “Water” – Amniotic Fluid – This is the fluid buffer that surrounds baby — typically around a quart of fluid is contained in the sac. It acts as an incredible cushioning system for the baby. It is clear, and protects baby.
- Mucus Plug – When pregnancy is established a thick layer of mucus seals the neck of the uterus (the cervix) from microorganisms and infections.
- Round Ligaments – These ligaments that attach to the wall of your abdomen and stretch down to your labia and keep the uterus pulled downward and forward can be annoying boogers during pregnancy. When not pregnant, they are around 2″ long, but during pregnancy, they are eventually stretch up to as much as 12″. “Round Ligament Pain” is a common irritation during pregnancy and something to discuss with your caregiver.
- Uterosacral Ligaments – These attach from the sides of the uterus and go back to the sacrum (a small bone at the base of your spine). These can also be a cause of pain, typically low back pain, at the later stages of pregnancy as the weight of the uterus pulls them forward.
- Pelvis – The bone structure that attaches your legs and hips to your spine — the pelvis was designed with a structure that can shift and change to allow baby’s head to work its way through.
Stages of Pregnancy
- Gestation – the full period of time from the first day of the fertile cycle in which you conceived until the time of birth. The average gestation period of humans is 40 weeks.
- Due Date – the approximate point when your body will have reached the average gestation period of 40 weeks. Based on first day of last period OR conception date.
- Trimesters – The three stages of pregnancy divided by weeks/development of baby. (see “How Far Along Am I In My Pregnancy”)
- Pre Term – all of the pregnancy prior to 37 weeks gestation
- Full Term – the phase of pregnancy from 37 to 42 weeks
- Post Term – any days of pregnancy past the 42 week mark
Types Of Births
- Unmedicated Vaginal Birth – giving birth with no synthesized pain relief methods such as narcotics or epidurals.
- Vaginal Birth – birth through the birth canal involving the labor and pushing process.
- Cesarean Section – a major abdominal surgery that opens the stomach muscles and uterus to extract the baby through the incision.
- Midwife Attended Birth – a birth overseen and attended by a midwife and her team without the presence of a surgeon.
- Obstetrician Attended Birth – a birth overseen and attended by an obstetric surgeon
- Home Birth – to give birth in your home. Allows for free movement during labor and the comfort and peace of familiar surroundings. Generally, does not allow for medications for pain relief, but allows for more coping mechanisms
- Free Standing Birth Center – a facility equipped for labor and delivery and staffed by midwives. Usually overseen by an off-site doctor. Allows for the comforts and freedoms of home, but in a different facility. May have access to more pain relief medications and methods than a home birth. Generally a larger staff and a rotation of midwives.
- In Hospital Birth Center – a midwife run ward of the hospital that has access to operating rooms and obstetricians. Access to anesthesiologists and
- Labor And Delivery Hospital – a hospital ward run carefully to optimize the ability to care for a high volume of births with constant obstetrician oversight and emergency procedure capabilities. The most common birth choice in the United States.
Your Baby And Their Position During Pregnancy
- Umbilical Cord – This incredible spiral that is comprised of 2 arteries and 1 vein connects the placenta to the baby through what will be your baby’s belly button. The vein carries oxygenated, nutrient rich blood to the baby, then the arteries carry all the waste that baby’s body has filtered out and the oxygen depleted blood back to the placenta. Approximately 1/3 of the baby’s blood is in the cord and placenta at all times until after birth when the arteries stop returning blood to the placenta and the placenta has pumped all of baby’s blood out and back to baby. When the cord stops pulsing and goes limp after birth, it is because all of the baby’s blood is in the baby’s body. (This is why delayed cord clamping is vital for baby’s best health.)
- Anterior Position – The most optimal position for baby to have during labor, with baby facing the spine with their head down and their head tucked into their chest.
- Posterior Position – A more difficult position for baby to be in, as it often causes “back labor” (an intense, burning pain in the low back during contractions) and can prolong labor. However, this is not cause to be afraid of labor, it simply means there may be some additional effort needed. In this position, the baby is turned facing outward, so that they are facing the same direction you are, with their spine against your spine.
- Transverse Position – This is where the baby is lying crosswise in the uterus, instead of up and down. This is not a position that most babies will have once you are near the end of their pregnancy, as it is unnatural and their head is too heavy not to fall down into the pelvis.
- Breech Position – In the position, the baby is “Butt down”. With their bottom down in the pelvis and their head up. This is a very problematic position for birth, and while there are methods that can be used to turn baby, in most cases a breech baby will mean a cesarean section delivery. With the right bone structure, medical history, and a carefully trained and experienced care provider, breech births can be successfully done vaginally, but they are not to be attempted without careful study and preparation.
Labor And Delivery Terminology
- Dilation – This is the measurement used to see how much your cervix has stretched open. 1 is pretty much not at all. 4-5 is usually when active labor starts, though for some women labor doesn’t kick in until 6 or 7. 8cm is when you hit “transition phase”, and 10 cm is “complete dilation”, meaning you are ready to push baby out.
- Effacement – this is the measurement of how thin your cervix is. It starts out in a bottle neck shape, but eventually thins to the same thickness of your uterine wall. This is 100% effaced.
- Ripening – before your cervix can thin or open, it has to soften. How “ripe” your cervix is means how soft and stretchy it is. Once your cervix is ripe, the effacing and dilating can begin.
- Pelvic Station – This is a measurement of how far into the pelvis the baby has “dropped”. If baby is still above the pelvis then he is in a “minus” position. (-1, -2, -3, -4) -4 is the highest position measured. Once baby is settled into the pelvis she is in a “0” position. This is called “engaged.” As she descends down through the pelvis she moves into “plus” positions. (+1, +2, +3, +4) Once baby has reached a +4 they are “crowning“, which usually happens after some pushing. When baby is crowning that means that the top of their head is visible and ready to birth.
- Water Breaking, Water Rupturing, Ruptured Membranes, Breaking The Amniotic Sac – This means that the membranes holding the amniotic fluid have been opened, allowing the baby to drop down further into the pelvis. This is sometimes used as a means of labor induction, but if labor can start without this the amniotic fluid acts as a cushion during labor as well, making for less painful contractions.
- Induction – “Jump starting” labor. There are natural and chemical forms of induction. If labor is allowed to start on its own time, the hormone and chemical responses of your body are at their best, so it’s best to avoid induction if possible. However, it is necessary after 42 weeks, and with some health complications, so that pregnancy does not extend to a point of risks to baby and mamma.
- Contractions – These are the tightening and tensing of the uterine walls that stretch and pull the cervix so that it thins and spreads open to allow baby to exit.
- Braxton Hicks Contractions – These are toning contractions that “exercise” the uterine muscles. They can be felt very early during pregnancy as a “cramping” or tensing of the uterus. They may make your uterus feel hard as the muscles flex.
- Pre or “Early” Labor – Short contractions, 30-50 seconds long, on a consistent pattern. Often 10-20 minutes apart. This stage can last days, or even weeks, and come and go as the cervix softens and the uterus prepares for active labor. While these contractions are distracting, the mother can typically talk and walk through them, and it’s best to continue life as normal.
- Active Labor – Contractions lasting around a minute or longer, and as close as 4-7 minutes apart. This stage of labor usually lasts until your cervix has stretched back into the uterus enough to create an 8 cm opening. Contractions are intense, and coping techniques are usually needed for most of this phase.
- Transition – the last stage of the cervix shifting from being a “neck” to being part of the uterine wall. This is the most intense phase of labor as contractions have little or no pause between them, but come in continual waves. This stage rarely lasts long, but the mother will often feel panicked and out of control. As the cervix stretchs back and is pulled open, it will create a 10cm opening. At this stage your dilation is “complete.”
- Stalled Labor – sometimes active labor will stop for a couple of hours, then start again. It isn’t uncommon for there to be a labor stall between complete dilation and pushing phase as well. It’s okay to take these stalls as a welcome break! Your body will know when it’s time to push. Sometimes, however, the urge to push simply doesn’t come and you will have to trust your caregiver in directing your pushing.
- Pushing – Once your uterus has fully opened to allow baby out, you will have to put the effort into pushing the baby out of your body. This, to be perfectly honest, uses all the same muscles as a bowel movement, and requires you to “bear down” like if you were constipated. And then some more. If you have strong pushing urges then this will come naturally, but if you do not feel urges then you will have to conscientiously push like pooping. It’s the same area of your body and the same muscles that need to be activated, so don’t be afraid of it! And yes, most moms will have some small bowel movement at this phase because baby’s head is on the rectum and any fesces that are in that area have to come out before baby can. That’s just a normal part of it that all of your caregivers will have seen with almost every mom, so don’t even worry about it!
- Crowning – when baby’s head is visibly at the vaginal opening you are practically done. Take your time at this phase to let your skin stretch slowly around baby’s head and you will avoid tearing your skin as much as possible.
Post Birth Terminology
- Vernix – a thick, white substance on the baby’s skin that protects it from drying out in the womb. Acts as a lotion after birth, with amazing microbial benefits to the baby and should be rubbed into the baby’s skin instead of washed off. If there are excessive amounts then they will naturally be wiped off with towels and blankets. Some people describe it as “cheesy” because it has a soft, slightly oily texture.
- Cord Clamping/cutting the cord – the process of placing a plastic toothed clamp on the umbilical cord and then cutting it below the clamp to separate the baby from the placenta. In many hospital settings this is done immediately, but this can cause the baby to struggle with regulating their temperature and blood sugar, as it cuts them off from up to one third of their blood supply that is in the cord and placenta at the time of birth.
- Delayed Cord Clamping – The practice of waiting until the umbilical cord has gone limp (usually about 5-15 minutes) before clamping and cutting it. This is done in order to allow the placenta to pump the baby’s blood back to the baby so that the baby has its full blood supply.
- Skin to Skin – while this relates to any and all phases of infancy, in a birth setting immediate skin to skin helps baby regulate their body temperature and emotionally comforts them. Laying baby directly on mommy’s chest or tummy (depending on cord length) is the most beneficial and healthy form of skin to skin, but in a situation where that is not possible it is also extremely beneficial for baby to be placed on the bare chest of the mother’s partner or doula.
- Placental Expulsion – after the birth of the baby, when the blood flow from the placenta to the baby has finished, the placenta separates from the uterine wall and has to be delivered. This usually requires one or two pushes from the mamma. A gush of blood following the placenta is normal.
- Afterbirth – the placenta and the clots, amniotic fluid, and the postpartum flow that follows birth are all called “afterbirth”.
- Uterine Massage – often performed by nurses/care team as a kneading action on the uterus to help the uterus to contract so that it will tighten and slow the afterbirth bleeding.
- Lochia/Postpartum Flow – post birth bleeding. Lasts anything from 3-9 weeks after birth. Goes from bright red for several days to dark brown, then eventually to a yellowish/white discharge.
- Sitz Bath – a shallow bath, sometimes in a special bowl specifically for sitting in, that soaks the vaginal area. This can help relieve pain from areas with stitches or postpartum hemorrhoids. Sometimes these are herbal sitz baths when using sachets of pain relieving herbs to make a solution to soak in.
- Baby blues – mood swings and unexplainable sadness, but not prolonged or without phases of happiness as well. Sudden onset of crying over seamingly trivial things. Exhausted, but able to sleep easily. Most women experience some level of baby blues.
- Postpartum Depression – an unexpected phase of prolonged sadness, anxiety, or depression. Not to be confused with “baby blues”, PPD needs professional care giver help. PP depression can set in anytime during the first year, but is most common between 3 and 6 months postpartum. Symptoms include inability to sleep when sleep is available, overwhelming anxiety waves, constant mood swings but almost all moods are negative, minimal or no appetite. Happens to 15-20% of mothers.
- Postpartum Thyroiditis – often referred to as a “thyroid storm”, this is a short term thyroid imbalance that approximately 1 out 10 new moms experience during their child’s infancy. Symptoms include panic and anxiety attacks, excessive fatigue, and sleeplessness or insomnia.
- Diastasis Recti – a separation of the abdominal muscles along the front of the abdomen caused by over straining or by too quick growth of the uterus in combination with the hormonal changes causing the softening of connective tissues.
- Preeclampsia – a hypertensive condition with symptoms like high blood pressure and protein present in urine that can escalate into the life threatening conditions of eclampsia and HELLP syndrome. Less severe results can be fetal growth retardation, preterm labor, and potentially placental abruption and blood clots.
- High Blood Pressure – can indicate issues like preeclampsia and needs to be monitored on a regular basis.
- Deep Vein Thrombosis (DVT) – clots in the legs and pelvic area of pregnant women. Pregnancy causes an increased risk for blood clots because your body produces more clotting agents in preparation for labor and afterbirth.
- Cholestasis – a liver condition that causes itching, most often in the hands and feet, but often other places as well. No threat to mother, but can be a threat to the unborn child.
- Intrauterine Growth Restriction (IGUR, SGA) – indicates a baby significantly smaller than what is healthy for the gestational age.
- Placental Abruption – a separation of the placenta from the uterine wall. A partial abruption is possible -both are immediate emergency.
- Placenta Previa – a condition where the placenta has attached to the uterine wall in a position that covers the cervix. This is a very dangerous condition and requires great care and monitoring and requires a c-section. A partial previa that is detected in early pregnancy, where the placenta is attached to the edge of the cervix, can resolve by the end of pregnancy as the placenta can shift away a marginal amount.
- Urinary Tract Infections/UTI – an infection in the urinary tract or bladder. Indicated by a burning sensation when urinating, or fever, or blood in the urine. Can cause preterm labor if not controlled.
- Fetal Malposition – when the baby’s head has descended into the pelvis in a position that is problematic for labor and distressing for baby.
- Premature Membrane Rupture – leaking or gushing amniotic fluid before full term. This makes infection a strong possibility and usually indicates that preterm labor will soon follow. On very rare occasions, with careful care, the leak caused by a premature rupture can seal and the amniotic fluid return to normal.
- Incompetent Cervix – when the cervix wants to dilate open early in the pregnancy. Often special procedures and bed rest are done to continue the pregnancy.
- Preterm Labor – when labor begins at any point before 37 weeks.
- SPD/ Symphysis Pubis Dysfunction –
- Round Ligament Pain -a condition where the ligaments keeping your pelvis alligned become overly relaxd, causing pelvic girdle pain.
- Decreased Fetal Movement – when lack of movement is felt in later stages of pregnancy, kick counts and fetal monitoring in stress tests or by ultrasound may be used.
- GBS – Group B Strep — if this bacteria is present in the birth canal then the newborn will be susceptiable to it due to the birth process. The mother will need antibiotics during labor to ensure that it is not transmitted to the baby.
- Fetal Distress – when oxygen deprivation causes changes in heart rate or movement. If heart rates are not responding to the course of labor then interventions and possibly a c-section will be needed to birth baby more quickly.
- Placenta Abruption – When the placenta separates from the uterine wall before the baby is born. A partial abruption is when only part of the placenta separates.
- Cord Prolapse – When the umbilical cord descends into the birth canal before the baby, putting it in a position where it will be clamped off by the baby’s head.
- Breech Presentation – A bottom-down position of the baby where their head is near the mother’s ribs. Many variations based on leg and foot position and direction that baby is facing.
- Shoulder Dystocia – A situation where the shoulder of the baby get caught on a bone in the pelvis.
- Shoulder Presentation – A malposition of the infant where the arm or shoulder of the baby are wedged into the birth canal before the head.
- CPD – Cephalopelvic Disproportion means that the baby’s head is too large to move through the birth canal. True CPD is extremely rare, but many “failure to progress” situations are given this label.
- Failure To Progress – When labor extends past a healthy time frame without progress being made.
- Fever/Infection – A fever in the mother during labor indicates the likelihood of uterine infection.
- Meconium In Fluid – Indicator that baby is distressed. Generally, means a need to deliver the baby more quickly.
Natural Labor Support Methods
- Counter Pressure – Pressure applied to the lower back to relieve labor pain. Especially used for “back labor”, where baby’s head is against the tailbone.
- Change of Position – There are dozens of positions that are condusive to moving baby down during labor. Often, switching from one position to another will relieve some of the pain of contractions.
- Water Labor – laboring in warm water can give massive amounts of emotional and physical relief to a mother during contractions. Inflatable “birth pools” are often used for this because they are deeper and easier to access then a standard bath tub.
- Perineal Support – to use warm rags or oil and massage or pressure to help the perinum to stretch enough to allow for birth.
- Double Hip Press – pressure on the outside of each hip, pushing inward, to relieve pain and allow for wider opening of the pelvis.
- TENS Machine –
- Acupressure – use of pressure points to alliviate pain of contractions and encourage relaxation.
- Bradley Method – breathing rhythm and vocalization methods for coping and maintaining emotional control.
- Hypnobirthing – A meditation discipline for use during contractions.
Birth Interventions and Emergency Methods
- Natural Induction – non-medical induction methods including nipple stimulation, herbal use, laxatives, membrane sweeping, cervical stretching, acupuncture, orgasm, and several others.
- Nipple Stimulation – a method of timed stimulation used to generate consistent contractions that can begin labor.
- Herbal Induction – the use of uterus irritating herbs to cause contractions.
- Stripping or Sweeping The Membranes – separating the water sac from the cervix by “sweeping” a finger around the inner edge of the cervix without rupturing the waters.
- Artificial Rupture Of Membranes (AROM) Induction – Amniotomy – Using a hook to break the water sac/membranes so that the fluid cushion is released and baby more thoroughly engages with the cervix, intensifying contractions.
- Pitocin or Syntocinon Induction- use of a synthesized form of oxytocin used in an IV to force the uterus to contract.
- Cytotec/Misoprostol Induction -a tablet inserted vaginally to soften and thin the cervix, allowing contractions to work more effectively.
- Cervidil/Dinoprostone – A gel encased in a polyester sac that is inserted into the vagina with a string like a tampon for easy removal. Used to relax the smooth muscle of the uterus, but linked to allergic reactions and postpartum bleeding issues.
- Foley Catheter Induction – Use of a balloon type catheter that is inserted into the cervix and inflated to force dilation.
- IV/Intravenous Injection with Heparin Lock – when a needle is used to place a flexible port in a vein that can stay in place with or without anything flowing into or attached to it.
- Fetal Heart Rate Monitoring – the use of a doppler to measure the heart rate of the baby in utero.
- External Belt Monitor – an elastic belt that holds one or more dopplers is secured around the tummy to keep a constant feed of the baby’s heart rate.
- Doppler Monitoring – manual use of a monitor for accurate, short term monitoring.
- Internal Fetal Monitor – a wire attached to the top of baby’s head through the cervix for constant monitoring. Significantly invasive and should only be used in drastic situations, as a 2013 study showed that it nearly doubles c-section rates.
- Intermittent Monitoring – the use of manual dopplers to check baby’s heart rate at regular intervals instead of having a constant feed.
- Narcotic and Opiate Pain Relief – the use of narcotics and opiates either alone or in tandem with an epidural. Unpleasant post partum side effects and does cross the placenta to dose the baby as well.
- Pudendal Block – an injection of local anesthesia into the pudendal canal to numb the vaginal area. Does enter the blood stream and cross the placenta.
- Epidural – a regional anesthesia that blocks feeling and use of the lower half of the body. Often given in tandem with an opiate, the epidural is a significant cause in failure to progress, ineffective pushing, and has a great many negative side effects. However, it is the most effective and immidiate pain reliefe available for labor and can prevent a section if used to allow an exhausted mother to rest, or to allow inflammation to reduce.
- Episiotomy – a surgical cut made to expand the vaginal opening. Made routine in the 1930s, it was debunked in 2005 as “Evidence does not support maternal benefits traditionally ascribed to routine episiotomy. In fact, outcomes with episiotomy can be considered worse since some proportion of women who would have had lesser injury instead had a surgical incision.”
- Vacuum Extractor – a suction tool attached to baby’s head and used to force delivery if immediate birth is needed. Many risks to the mother and baby are involved, and it is generally only used as a last option before a c-section.
- Forceps – An alternative to the vacuum extractor, forceps look similar to large spoon salad tongs, and pose many risks, but can effectively guide a “stuck” baby through the birth canal.
- Scheduled Cesarean Section/C-Section – typically due to persistent malposition or maternal or fetal health complications, a scheduled section can be set up with an epidural and clear drapes for a family friendly experience.
- Emergency Cesarean Section – labor complications or medical emergencies may cause the need for an emergency section where the mother is fully sedated for as quick of a procedure as possible.
Watch For Our Ultimate Guide To Breastfeeding and Lactation Terminology, and A Dictionary Of Twin Pregnancy Terms.
*feature photo used with Creative Commons Liscence Permissions. Cropped portion of original Photo by Jason Lander on Flikr.