Labor: What are the Stages of Labor?

You may think that knowing when you are in labor is obvious, but for many women, it may not be so simple.

At times, women may experience symptoms of false labor, includingBraxton Hicks contractions (also known as practice contractions) which, although similar to real contractions, are not labor.

Determining what is real labor and false can be accomplished by clocking contractions, timing how long each contraction lasts for and how long it takes from the start of one contraction to the next.

If you are having Braxton Hicks contractions, they will be irregular and go away in time. They may resolve with walking, lying down or through other changes in activity, but true contractions and labor will not resolve and will not resolve and will increase in intensity.

Signs of labor

The onset of labor can be signified by cervical changes that are present on physical examination.

There are several signs that labor may start in the near future. At times, a woman may notice that the baby is sitting lower in the pelvis; this is referred to as “dropping” or “lightening.”

Cervical changes may become present on physical exam, and“nesting” – a strong desire to tidy and organize the house – may become more evident. The nesting instinct is not experienced by everyone, however.

Additionally, some women may experience a bloody mucus discharge indicating the loss of their mucus plug as labor nears. If your water breaks, labor will likely ensue and your health care team should be notified.

If you have questions about any symptoms you may be having during this time, it is important to speak with your health care provider to determine if there is a need to be seen in the office or hospital.

Stages of labor

There are three stages of labor: the first, second and third stages.

First stage of labor

The first stage of labor describes the time at which labor begins until a woman’s cervix is fully dilated to around 10cm. This period can last anywhere from 12-19 hours in duration. The first stage of labor is divided into three phases: early, active and transition.

A woman is in hospital during a later stage of labor.
The second stage of labor, when the cervix is fully dilated and the mother gives birth, typically lasts from 20 minutes to 2 hours.

The early phase is the time at which labor begins until the cervix is dilated to around 3 cm. This phase lasts for 8-12 hours. Contractions are mild, irregular and last for about 30-45 seconds in duration. There is a 5-30 minute rest period between contractions which cause symptoms such as lower backache, cramping, and pelvic pressure or tightness.

These contractions will soon become regular and more intense. During this time, the amniotic sac may rupture (also known as when the water breaks). Most likely, you will be at home during this phase.

The active labor phase is the time from 3-7 cm cervical dilation. When the active labor phase starts, you should head to the hospital. This phase lasts for 3-5 hours. Contractions become stronger, lasting for about 45-60 seconds in duration, and there is 3-5 minute rest period between contractions.

The transition phase is the time from 7 cm to full dilation to 10 cm. This phase is often accompanied by nausea, hot flashes, chills, and shaking. The transition phase generally lasts for 30 minutes to 2 hours. Contractions are intense and last 60-90 seconds in duration. There are only 30 seconds to 2 minutes of rest in between contractions.

Second stage of labor

The second stage of labor is the time of full dilation (10 cm) to birth. This is the time when you will push and lasts for 20 minutes to 2 hours.

Third stage of labor

The third stage of labor is the time when the placenta (afterbirth) is delivered and takes around 5-30 minutes. Women will often experience shaking and shivering during this stage of labor.

Rapid or prolonged labor

Labor duration can vary from woman to woman. It may follow the typical stages and times of labor as described above but, in some cases, women may experience rapid or prolonged labor.

During rapid or precipitous labor, a woman experiences only active labor, birth and delivery of the placenta; this type of labor typically lasts anywhere from 3-5 hours in duration.

Alternately, there are some women who experience a prolonged labor or failure to progress. During prolonged labor, the duration lasts from 14-20 hours and is at times a cause for concern, especially in the active phase of birth.

When to go to a hospital

Your health care provider will give you specific instruction on when to present to the hospital. However, you should always speak with your health care team about any concerning symptoms that may be cause for emergent evaluation.

It is important to head to the hospital when:

  • You show signs of being in active labor (strong, regular contractions 3-5 minutes apart)
  • Lower back pain or cramping develops that does not resolve
  • Your water breaks
  • Bloody-brown vaginal mucus or discharge is found
  • Other concerns arise that may signify an emergency.

Pain relief during labor

All pain is not equal and women may experience pain differently during the labor and delivery process. While some women do not require pain medication, many do. There are various ways to manage pain during labor which includes both natural and medicinal methods.

Natural methods

Natural methods of pain management during labor include:

Pregnant woman receiving pain relief.
Pain-relieving medication can be administered with an injection during labor.
  • Breathing and relaxation techniques
  • Water
  • Massage
  • Applying heat or cold – with a cold washcloth, for example
  • Support from a loved one or doula
  • Positional changes
  • Visualization
  • Guided imagery
  • Aromatherapy
  • Listening to music.

Medicinal methods

Medicinal methods of pain management include:

  • Opioids: these are injectable medications that can be delivered into a vein or muscle. Medications typically used include morphine, butorphanol, fentanyl, Nubaine and Demerol.
  • Epidural and spinal blocks: during an epidural, a catheter is placed in the lower back through which a combination of medications including narcotic and local anesthetics is typically delivered. A spinal block is typically a single injection of pain-relieving medication into the spinal fluid.
  • Pudendal block: this form of pain relief requires an injection of medication into the vagina and pudendal nerve. Medications used during this procedure include lidocaine or chloroprocaine.
  • General anesthesia: this form of anesthesia is rarely used. However, it is necessary for certain situations. During the administration of general anesthesia, a total loss of consciousness is obtained with a muscle relaxant and nitrous oxide.

Speak with your health care provider about the risks and benefits of each form of pain relief to see which option is best for you and your baby.

CHILDREN’S CEREALS

EWG’s analysis of more than 1,500 cereals, including more than 180 children’s cereals, shows that a child who eats a bowl a day for a year ends up consuming 10 pounds of sugar.

Moreover, the cereals loaded with the most added sugar frequently come in packaging that features cartoon characters to appeal to kids. A single serving can contain nearly as much sugar as three Chips Ahoy! cookies, and more than two Keebler Fudge Stripe cookies. And because the serving sizes listed on many cereal boxes are unrealistically small, even sugar-conscious consumers are eating even more than they realize. To top it all off, 11 of the 13 most heavily sugared children’s cereals feature marketing claims like “Good Source of Fiber” that suggest misleadingly that the products are healthful.

So how do you navigate the cereal aisle to find the least sugary products? Check these lists to see which have the most and the least sugar before you head to the store.

In all, EWG researchers ranked more than 1,500 cereals by their total sugar content by weight and compared the findings with guidelines issued by federal health agencies and other organizations. Twelve that are more than 50 percent sugar got nominated to EWG’s cereals “Hall of Shame.” The list includes Kellogg’s Honey Smacks, Malt-O-Meal Golden Puffs and Post Golden Crisp.

EWG also took a second look at 84 popular children’s cereals it had previously analyzed in its 2011 Sugar in Children’s Cereals report. It found that not one on the 2011 “worst” list had lowered its sugar content over the last three years.

The new report includes tips for any cereal eater who wants to cut back on sugar, including paying attention to the nutrition labels to find out which products are the least sugary. EWG recommends no more than a teaspoon (4 grams) per serving. Preparing breakfast from scratch and eating fruit, unsweetened hot cereals or other whole foods with no added sugar are smarter choices.

Maternal Smoking During Pregnancy Leaves Its Lasting Mark On The Child’s Genetic Make-Up

If mothers smoke during pregnancy, they influence the epigenetic programming of their unborn child’s genetic make-up in the long term. This may give rise to an increased risk of the development of disease risks later in the child’s life. Researchers at the Helmholtz Centre for Environmental Research (UFZ) in Leipzig, the German Cancer Research Center (DKFZ) in Heidelberg and the Heidelberg University discovered that these changes are not limited to individual regions of DNA. In fact, the researchers stated in the Molecular Systems Biology journal that they particularly accumulate in enhancers of gene expression.

Maternal smoking during pregnancy is harmful to the unborn child as well as the mother. This is a known fact. “For the first time, we can now demonstrate that exposure to tobacco smoke also causes epigenetic changes in enhancers of gene expression,” said Irina Lehmann, Environmental Immunologist at the UFZ. These deregulated enhancers are distributed throughout the child’s entire genome.

Epigenetic changes form part of countless processes that occur during human development. The genetic material functions as a blueprint for all cells. In order for different cell types, e.g. liver or muscle cells, to develop, certain genes must be activated or deactivated at certain times. One of the ways this happens is through epigenetic changes which can be disrupted by various environmental factors. In their latest study, the group of researchers from Leipzig and Heidelberg revealed that epigenetic changes related to tobacco smoke increase the risk of children developing lung diseases.

The underlying data comes from the epidemiological study entitled LiNA (Lifestyle and environmental factors and their Influence on Newborns Allergy risk). In this study, researchers asked which environmental factors could have a negative influence on children’s health during pregnancy. In collaboration with the Municipal Hospital “St. Georg” in Leipzig, UFZ researchers have been monitoring 622 mothers and their children since 2006. The mothers underwent in-depth examinations for possible exposure to environmental factors during their pregnancy.

For their current work, two groups of mother-child pairs were examined: mothers who smoked during pregnancy and mothers who were not exposed to tobacco smoke. Together with the genome researchers working with Roland Eils at the DKFZ and the Heidelberg University, the researchers examined the epigenome of the mothers and the children. They wanted to find out whether there was evidence of epigenetic changes in the smoker families that did not occur in the non-smoker families – and which consequences this may have for the children’s health. “We were able to find evidence of epigenetic changes in smoking mothers as well as in the umbilical cord blood of the newborn babies,” said Lehmann. The changes thus occur in the womb and affect the unborn child’s gene regulation.

The researchers determined that smoking particularly affects enhancer regions in the genome. Enhancers are DNA regions that regulate the expression of one or more genes. Lehmann explained that: “If an enhancer region is affected by the effects of smoking, this may lead to deregulation of several genes at the same time.” The researchers give an example of the consequences of a deregulated enhancer in their work: the enzyme JNK2 (c-Jun N-terminal protein kinase 2) plays a role in inflammatory responses. If the enhancer that activates JNK2 is now affected, this may increase the risk of lung diseases in the children’s later life.

The researchers also determined that the epigenetic effects observed in the umbilical cord blood at birth can still be seen several years after the child is born. However, it could not be ascertained beyond doubt whether these effects are long-term impacts of exposure to smoke prior to birth. “Children who are exposed to tobacco smoke even before being born usually continue to be exposed to this after their birth,” said Lehmann. She added that the prolonged exposure to cigarette smoke after birth may contribute to the observed stability of epigenetic changes.

In their analysis, the researchers identified more than 400 enhancers affected by tobacco smoke. They regulate genes that play a role in a variety of diseases such as diabetes, adiposity or even cancer. “This discovery will allow us to start understanding the mechanisms that make smoking the cause of such a wide range of diseases,” said Roland Eils.

The insights from this research are intended to provide starting points for new options for treating environmental diseases. “The better our understanding of deregulation caused by environmental factors, the better we will be able to respond to this. Nevertheless in the case of tobacco smoke, avoiding exposure is still the best alternative,” said Lehmann in summary.

Source:

Environment‐induced epigenetic reprogramming in genomic regulatory elements in smoking mothers and their children, Bauer T, Trump S, Ishaque N, Thürmann L, Gu L, Bauer M, Bieg M, Gu Z, Weichenhan D, Mallm J, Röder S, Herberth G, Takada E, Mücke O, Winter M, Junge KM, Grützmann K, Rolle-Kampczyk U, Wang Q, Lawerenz C, Borte M, Polte T, Schlesner M, Schanne M, Wiemann S, Geörg C, Stunnenberg HG, Plass C, Rippe K, Mizuguchi J, Herrmann C, Eils R, Lehmann I, Molecular Systems Biology, doi: 10.15252/msb.20156520, published online 24 March 2016.

Source: Helmholtz Centre For Environmental Research – UFZ

EXPOSING THE COSMETICS COVER-UP: IS CANCER-CAUSING FORMALDEHYDE IN YOUR COSMETICS?

Does a chemical that may cause cancer lurk in your cosmetics?  Worse, in your kid’s personal care items?

Maybe.  According to data from the federal Food and Drug Administration, nearly 1 in 5 cosmetic products contains a substance that generates formaldehyde, a known human carcinogen.

The product label won’t tell you if formaldehyde is present, even though the manufacturer has made sure a small amount of it is inside in the jar or bottle, to prolong shelf life.  As everybody who has ever dissected a frog in biology class knows, formaldehyde is an effective preservative.

But the U.S. government and World Health Organization have classified formaldehyde as carcinogenic when its fumes are inhaled.  It is also a potent skin sensitizer and allergen.  Cosmetics companies generally don’t dump pure formaldehyde into their concoctions. Instead, they take a roundabout route by using what they call “preservative systems” that employ any one of several chemicals, called “formaldehyde releasers.”  These are chemicals that, when added to water, will decompose slowly over time to form molecules of formaldehyde.  Some manufacturers favor this method because it acts like a time-release capsule, maintaining a fairly constant level of preservative in the mix.  The reactions that generate formaldehyde occur silently as the products sit on shelves in stores or bathroom cabinets.

If you don’t want a product that contains a formaldehyde-releasing chemical, you have to play detective and scrutinize the product label. Chemicals in this category include:

  • DMDM hydantoin
  • Imidazolidinyl urea
  • Diazolidinyl urea
  • Quaternium-15
  • Bronopol (2bromo2nitropropane1,3-diol )
  • 5-Bromo-5-nitro-1,3-dioxane
  • Hydroxymethylglycinate

The FDA does not restrict the amount of formaldehyde that can be present in cosmetics sold in the U.S. But the American personal care industry’s ingredient safety panel, the Cosmetic Ingredient Review, has issued voluntary guidelines that echo the European Union’s legally enforceable directive, which bars more than 0.2 percent formaldehyde in personal care products.

The European Union’s policies are better than the FDA’s, but they do not completely protect people against cosmetic chemicals that may induce allergic reactions. The EU allows personal care products to contain  up to 2,000 parts per million of free formaldehyde. That’s more than enough free formaldehyde to cause dermatitis, an inflammation of he skin.  Concentrations of formaldehyde as low as 200 to 300 parts per million have been shown to trigger dermatitis.  Like formaldehyde itself, formaldehyde-releasing chemicals are allergens.

To be sure, the amount of formaldehyde in a cosmetic product at any given time is tiny.  The cancer risks presented by a cosmetic could be considered slight — but that product is not a person’s only source of exposure. People are also exposed to formaldehyde by pressed-wood products, cigarette smoke, vehicle exhaust and unvented fuel-burning appliances such as gas stoves, wood-burning stoves and kerosene heaters according to the National Cancer Institute and the Environmental Protection Agency. Personal care products that contain formaldehyde make an unnecessary contribution to an individual’s exposure to this chemical – particularly since research shows that cosmetic products can release small amounts of formaldehyde into the air shortly after they are applied. Formaldehyde is most dangerous when inhaled.

Cosmetics need preservatives to prevent the growth of bacteria. But formaldehyde releasers are not the only option. Last year Johnson & Johnson, one of the world’s largest manufacturers of baby care and adult skin and hair care products, announced it would cease adding formaldehyde releasers to its products. There are safer substitutes such as sodium benzoate.

How can you avoid formaldehyde in your products?  Check the label carefully, both for the ingredient formaldehyde itself and for the seven common formaldehyde releasers listed above. Or let EWG do the research for you. Check out the products in EWG’s Skin Deep Cosmetics Database.  It contains information on more than 77,000 products and their ingredients. The database, searched more than 200 million times by savvy consumers, highlights toxic substances like formaldehyde — and those insidious formaldehyde releasers.

Ginger’s Essences

No modern medication can rival the range and variety of therapeutic effects that can be induced by ginger. However, the full awareness of the health benefits and value of the herbal ginger remedies is rather limited because of the monopolistic health-care systems and a historically biased regulatory environment in most countries. Out of the hundreds of species in the plant family Zingiberaceae, the ginger remains the most famous and popular herb. Ginger is a rhizome, according to the correct botanical classification, though the underground stem of the ginger is often mistaken to be a root. Many different varieties of the ginger herb exist in the wild and in cultivation, these varieties range from mild to spicy in taste, and all of them require tropical conditions and fertile soils to grow at an optimal rate. The ginger herb has traveled out from Southeast Asia to the new world, over a period spanning 5,000 years, and most regions of the world now cultivate it as a food crop.

ginger parts

The ancient trade in ginger helped shape nations and insured the universal cultivation and survival of the herb, it is considered a botanical treasure by some of the great figures of history. The interaction of over four hundred chemical constituents present in ginger produce the observed effects of herbal ginger remedies, these result producing compounds can be grouped into four major classes: those which affect taste, those responsible for fragrance, and chemicals which act as nutrients and synergists in the human body. The pungent compounds which affect taste are the focus for most of the therapeutic value associated with the ginger. These taste compounds, are known as gingerols and shogaols, the protein digesting enzymes and antioxidant compounds present in abundant quantities in the ginger are also key elements in its overall effects over the body. Most of the observable physical effects on the body, such as the anti-inflammatory action, the anti-parasitic effect, and the anti-microbial and the digestive remedial actions, may all be due to the presence of one principal action – which is enzyme action on the body. At the same time, the observed effect, namely an anti-inflammatory action, can also be due to the presence of a number of principal actions at core, it can be due to enzymes, because of eicosanoid balance and due to the presence of antioxidants in the herbal remedy. The main key to understanding the diversity of the ginger’s overall action may lie in the dynamics of the eicosanoid compounds; indeed, these may represent the point to develop a full understanding the various beneficial effects of the ginger remedy. The physiologically active compounds known as the eicosanoids are synthesized by the body from essential fatty acids already present from absorbed food. The development of an imbalance in these vital elements is the reason for a wide variety of diseases and conditions, which evolve in response to the imbalances. The modulation and control of the compounds known as eicosanoids have been attempted by pharmaceutical companies, in order to develop treatment methodologies for a host of disease conditions, this step is essentially a failed step, because of the many serious side effects such compounds can induce in the human body. The advantage of herbal ginger remedies is that the ginger helps in naturally bringing a balance to many of these vitally important eicosanoid compounds, without inducing any corresponding side effects in the body of the person using the herbal remedy.

ginger-health-benefits-uses-ginger-tea

The benefits of ginger herbs have been enjoyed by many millions of people, over the course of millennia, as part of herbal treatment strategies. Thus, ginger remedies have been utilized for spiritual upliftment, they have been used to provide digestive comfort and physical strength, they have also been taken to stimulate and bring relief from infirmity in the body, the herbal remedies made from the ginger have been touted as the herbal remedy of choice and most traditional Eastern herbal formulas consider ginger remedies as a part of their herbal treatment methodologies. The ancient Indian Sanskrit name for the ginger very appropriately vishwabhesaj, translated as the universal medicine. The early twentieth century saw more than 25,000 U.S. physicians called the eclectics, praising the pain relieving and cold fighting properties of the ginger. Traditional use of the ginger remedies was also made by many different cultures historically in many different regions of the world – these societies used the herb for some of the same basic therapeutic applications to which we put the herb to use. Some of these herbal remedies and applications of the ginger included its use as an analgesic, its anti-arthritic ability was utilized universally, the wound healing properties were utilized widely, the antihelmintic and anti-ulcer abilities were widely known and put to use, its actions as a stimulant and its aphrodisiac properties also found great use in traditional medicine.

ginger ale

At the same time, traditional treatment of a variety of respiratory diseases, and problems in the reproductive and digestive system were treated using herbal remedies derived from the ginger. For many types of cardiovascular diseases, the ginger remains a primary preventive treatment especially in the treatment of critical cases of such conditions. Similar in action and usage to the common drug aspirin, the herbal remedies made from the ginger possesses a therapeutic potential and an ability to prevent thousands of deaths arising from sudden heart attacks and strokes as well as in the treatment of diseases such as cancer of the colon. The ginger has an advantage over aspirin, in that it will produce no side effects in the body whatsoever even after prolonged and continuous use. Ginger’s anti-ulcer effects are complemented on the whole by a host of other important beneficial properties pertaining to the digestive system, which includes immense relief from both diarrhea and constipation; it helps protect the liver and is an effective probiotic support agent. Ginger has also been documented as clearly having an effective anti-nausea effect. The ginger-based herbal remedies can thus be used to rid the body of nausea arising from the continuous use of chemotherapy and those which affect people during oceanic travels, it is also helpful during nausea from a term of pregnancy and in treating nausea following gynecological surgery, in all such cases, herbal remedies based on the ginger is the natural treatment of choice for the nausea. The assistance that ginger gives to the digestive system marks it as a prominent bioavailability herb, and the ginger assists the digestion of other consumed nutrients and is a greatly recommended addition to the natural supplemental regimes during treatment processes for many digestive complaints. While not generally recognized, intestinal parasites pose a much greater threat to the industrialized world than they are credited for. Here too, the potent range of anti-parasitic activities displayed by the ginger can play a great role in the treatment of parasite infections. Historical observations of the ginger, place it in a role of an effective remedy for cold, this ability of the ginger arises from a combination of principal actions and benefits which can include eicosanoid balancing within the body, its pro-biotic supporting role, its anti-toxic and cytoprotective influences on the body among other beneficial effects.

The remedies based on ginger also have a very significant antimutagenic potential, and these can be used to beat powerful carcinogens such as the compound benzopyrene and the more toxic burned byproducts of the amino acid tryptophan in the body. Ginger’s reputed anticancer abilities also deserve further research and study, this property of the herb must be further investigation and its role in cancer-treatment programs must be studied in the future so as to take advantage of any beneficial effects. In addition, to all of these abilities herbal remedies made from the ginger positively affect all other parameters of health such as levels of the compound cholesterol and the levels of blood sugar, at the same time, the herb helps in balancing a variety of vital body systems such as the performance of the circulatory system, the functioning of the respiratory and reproductive systems besides others. Topical remedies made from the ginger also have very positive and beneficial effects; the potency of the ginger in this topical role has been demonstrated during external treatments which showed dramatic results and improvement from a variety of skin disorders in many patients.

The safety of herbal remedies made from the ginger is remarkable. It can be said that almost no modern pharmaceutical products can compete with the range of therapeutic properties displayed by this herb and this does not even include the complete absence of all adverse physical side effects from prolonged use of the herbal remedy. However, when using ginger products during a term of pregnancy and before surgery, patients must be careful about doses and use the herb in moderation at such times. A general safe and preventive dosage of the herbal remedy for the use of the general population can be up to 1 gram a day of the powdered herbal remedy. Dietary use of therapeutic ginger remedies must be gradual and over a long period of time in all cases, as this will ensure the optimal benefits. The quality of the rhizome will also greatly influence the effectiveness of the remedy made from ginger. Organically certified ginger products are the best, as many of the commercial ginger products are normally subjected to many potential levels of chemical contamination, at different stages of the manufacturing process. For regular supplementation, both the fresh and the dry ginger herbal remedies are recommended and these two can even be used in tandem. Though the properties and benefits given by each will be slightly different and both will have specific strengths and weaknesses. Commercially the herbal remedies made from the ginger are available in many forms, which include the fresh and dried forms, ginger syrups, and as herbal capsules and extracts.