LISA: I’m Lisa Birnbach for howdini.com Any woman whose been pregnant will tell you that those nine months of pregnancy, actually ten months can really start to drag in the final days. But suddenly the excitement begins and you’re going into labor. Or are you? How do you know when labor is really starting, and its not a false alarm? We’re here with Dr Keith Eddleman, Director of Obstetrics for Mount Sinai hospital in New York. Where I had at least three kids that I can remember and author of two books about pregnancy including Pregnancy for Dummies. Dr. Eddleman thanks for being here.
KEITH: Thanks for having me.
LISA: How do you know when you’re in labor? I’m sorry to ask but some people may not know.
KEITH: That’s an extremely common question, especially for first time moms. One of the things is you start to have contractions, and they get closer and closer together. They last about thirty to forty seconds a piece, and they become increasingly stronger the further along they get. And sometimes its not easy to tell in the very beginning, but if you have progressively stronger contractions, getting closer and closer together, then its time to call your doctor.
LISA: Now there are other indicators that you’re going into labor that might perceive of follow contractions, right?
KEITH: Yeah, there are a couple of hints; the thing is they don’t tell you when you’re going to go into labor. It tells you things might be gearing up-
KEITH: Things like the bloody show, a little bit of blood mixed with mucus that comes from the cervix. Also a lot of women have an increase in the amount of mucus coming out of the cervix, its sometimes called a mucus clog. And some women feel a sudden increase in the pressure in their lower pelvis which means the baby’s head is descending down the pelvis. Those are three signs that are sort of warning signs if you will.
LISA: If you’re being seen by a doctor regularly, none of this would be a mystery.
KEITH: Well in your last few prenatal visits starting at about thirty-six weeks, your doctor is going to start doing internal exams to check the cervix every week. And you’ll get an idea based on those exams whether or not your cervix is starting to dilate. Cause a lot of women it slowly dilates a little bit toward the last few weeks of pregnancy. Then when you start to have regular contractions, that dilation increases more rapidly.
LISA: When should a pregnant woman in her last days of pregnancy go to the hospital? If she’s not, if she doesn’t feel the baby kicking for example, is that a tell tale sign to hurry up?
KEITH: Absolutely, there are really three major things. One is if you have bleeding, bleeding is more then what we call the bloody show, which is usually very minimal like a period. If you have heavy bleeding go to the hospital immediately. If you don’t feel the baby moving, then you should go to the hospital immediately. Or if you feel like the baby wasn’t moving like it was, I haven’t felt the baby move as much today, and then go. The third is if you are having contractions, usually the pain goes away between the contractions. If it doesn’t, if you are having pain between the contractions, you should go to the hospital.
LISA: How do feel about induction?
KEITH: It’s a common fallacy that induced labor is a harder labor then regular labor or actual labor. That’s not true at all. The only thing we do with the medications that we use to induce labor is to induce a normal labor pattern. The strength of the contractions are the same, the frequency is the same. Its using a synthetic form of the hormone that we, that you make.
KEITH: To just achieve the same thing.
LISA: And it would grow the way a natural process would grow?
KEITH: Absolutely, you start with mild contractions, they are spaced apart, you make them more frequently, you make them more strong, and-
LISA: You scream at your husband.
LISA: It’s just like anything else.
KEITH: And you get your epidural and it’s just like a normal labor.
LISA: Okay, lets talk about epidurals. I love an epidural; in fact I had one thins morning before I get here. Now why would a doctor advise against an epidural?
KEITH: There are only a few situations for that, that would be advised against. In other words if the woman had a coagulation disorder, or a severely low platelet count, then there is a risk of putting the epidural in. But those are the only times that I would recommend not having an epidural. The overwhelming majority of the time women can have them, and we encourage them. I agree with you, I think that pain during pregnancy is not a necessary thing. It should be a happy process.
LISA: Right. Right, exactly. Well thank you so much Dr. Eddleman we’ll see you again soon.
KEITH: Okay, thank you.
LISA: For howdini.com I’m Lisa Birnbach.