1. How will I know if my water breaks? To some, this seems like a silly question. Any woman who has ever experienced the “gush” of fluids that sometimes occurs knew without a doubt her water had broken. More difficult to identify is the little trickle of fluid, or the constant “wetness” that some women feel. There are cases where the bag of waters has been slowly leaking, and the woman was unaware of it. Some general guidelines to help you determine if your water has broken are:
- Amniotic fluid has no strong odor, like urine, but may smell slightly sweet or musky
- If the fluid is dark or medium green in color, it is almost certainly amniotic fluid
- Once the water has broken, the fluid tends to keep trickling out, especially if you cough, have a contraction, or get up and move around.
- You cannot stop the fluid from leaking out by contracting your urinary muscles, like you do to stop yourself from urinating
- Amniotic fluid will turn pH paper dark bluish black
2. I have such heavy vaginal discharge. Do I have an infection? Toward the end of pregnancy, most women will develop discharge that is heavy enough they need to wear a panty liner. The discharge may be white, clear, or light yellow in color, and vary in consistency from watery, to thin and stretchy, to thick globs of mucus. If you are having vaginal burning or severe itching (heavy normal discharge can cause mild itching just from the constant wetness) or other painful symptoms, you should be checked for an infection. Otherwise, be happy knowing everything is getting ready to help the baby slide out!
3. I lost my mucous plug. That means labor is about to begin, right? Maybe. Some women never notice their mucous plug coming out, as it can be lost gradually over a long period of time. Others will actually see a glob of mucous that looks somewhat like snot. For others, there may be small clumps of whitish to yellowish discharge. It is also normal to have brownish, light pink, or a small amount of bright red discharge streaking through the mucous plug.
Labor will sometime begin within a day or two of losing the mucous plug, but other women may go weeks after losing their mucous plug before they start labor. All it means for certain is that the cervix is beginning the long process of preparation, thinning out gradually.
4. If the cord is around the baby’s neck, I will have to have an emergency c-section, won’t I? Not usually. About one in five babies is born with the cord around the neck, and it rarely becomes an emergency. Sometimes the fetal heart rate pattern will cause the midwife or physician to suspect that there is a cord around the neck, as the heart rate may dip down, tracing a “W” shape during contractions. However, as long as the heart rate recovers within a short period of time, is not dipping extremely low, or staying at low levels for a prolonged period of time, this is something that will simply be watched. When the baby is born, the cord is slipped over the head and unwound. Sometimes the cord is too tight to slip over the baby’s head. In that case, the practitioner will either clamp and cut the cord before delivering the rest of the body, or will “somersault” the baby by flexing his or her head against the mother’s thigh while the rest of the body is delivered, in order not to place stress on the cord during the completion of the birth. This is somewhat hard to visualize if you’ve not seen it done, but works very well, and is my personal preference. I don’t like to clamp and cut the cord before the baby is born, because if the shoulders should get stuck, and the rest of delivery take a longer than usual amount of time, there is absolutely no oxygen going to the baby once the cord is cut.
5. Do I need to write a birth plan for you? My personal opinion is that you should not need to write a birth plan for your provider. If your provider’s style of practice is so out of sync with your wants and needs that you need to write a birth plan, it would be better to find a different provider. I meet with a woman numerous times over the nine months of pregnancy, and during those visits, I am getting to know her and finding out what her desires are for the birth. I make notes of her wishes on her chart, so that I can remind myself if there were any special requests. But mostly I try to make it clear that this is her birth, and I am working for her. I will accomodate her requests if at all possible, and if she has requests I can’t accomodate, I will be very clear about that long before the birth day, and try to help her find someone who can meet her needs. I believe that the provider-client relationship is very important and should be based not only on trust, but a fair amount of agreement on practice style, birth requests, etc. The last thing you need during labor is to have to fight over every thing you do or don’t want done.