Medical terms in the delivery room

You just arrived at the hospital with regular contractions every 5 minutes, the nurse puts you in the triage room and a resident shows up to do a vaginal exam. As she does the exam, the mumbles to the nurse:

”Intact bag…70…2…-1…OA….”. You think you’re back in school! What do all these numbers and comments mean?

When your OB or midwife does an internal exam during labor, they check on several things:

  • How effaced your cervix is
  • How open the cervix is
  • Where the baby’s head is (low or high in the pelvis)
  • The position of the head
  • Whether your water has broken

When your OB says “bag intact” it means your water hasn’t broken. If the water had broken, (s)he’d say „clear amniotic fluid“ or even „meconium“ which means that your baby has let some bowel movement into the water.

“70” means how many % the cervix has effaced. During pregnancy the cervix should be 0% effaced, at birth the goal is 100%. The first hours of birth the cervix effaces to 70% or 80%, only then the cervix slowly starts to open. Sometimes you are 100% effaced and 1cm dilated. This means your cervix is “thinned out” and usually opens a bit faster.

The number 1-10 looks at the dilation of your cervix. In the above case the cervix is only 2cm dilated which means you are not in active labor yet and most likely can go back home for now- if you want of course. Active labor starts at 5-6cm. Once you reach 10cm you have the urge to push and enter a new phase of labor.

The number -1 looks at the height of your baby’s head in the pelvis. Your little one could be way above the pelvis at -3, then moves down to -2, -1 and 0. 0 means your baby is in the most narrow part of the pelvis. From there we go to +1, +2, +3 and +4 which is the actual birth. The more + we have during labor, the better.

OA means your baby’s head is in a “occiput anterior” position. Your little one’s back should be facing your belly, not your spine. OA therefore is a good position. OP means “occiput posterior” which means your baby still needs to make a turn to fit better through your pelvis.

Of course this is a lot of information so make sure to ask your OB or midwife if everything looks fine. Most of the time this is the case and if baby still needs to come down a bit your doula will move you into good positions to support the progress of labor.

What cryptic terms have you heard during birth?

Stephanie Heintzeler, Midwife and Doula,

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice. All contents copyright © Health & Parenting Ltd 2018. All rights reserved.

Midwife or Doctor: How to Choose

When it comes to prenatal care, it is important to choose a practitioner who not only meets your needs, but one who is professional and respects your beliefs. Many women do not think about the type of prenatal care they want before they get pregnant; however, when the time comes to make a decision, it should be well thought out. Choosing to be cared for by a midwife or an obstetrician-gynecologist may shape how your pregnancy – and your childbirth – progresses. The last thing you need during pregnancy is to be dealing with stress or tension. That is why it is important to choose someone you are completely comfortable with.

Choosing a Practitioner

There are a few things that you’ll want to take note of when trying to decide between a midwife and an Ob-Gyn. Besides personal beliefs, some women prefer one practitioner over the other for medical reasons, experience, safety, etc. If there are specific things that you are concerned about or need special treatment for, the right practitioner will be essential for a healthy pregnancy.

Routine Approach to Pregnancy

Ob-gyns are well-equipped and take a routine approach to your pregnancy. They will answer your questions and ensure your safe progress during pregnancy. However, since they see many patients, time can be an issue. You may not necessarily get all your questions answered or concerns heard.

If you have certain pre-existing medical conditions, you may be considered high-risk during pregnancy and may need to be cared for by an ob-gyn. Conditions such as high blood pressure, diabetes, heart disease, etc. are all considered serious medical conditions and may need more attention. An ob-gyn will have equipment and facilities available to monitor your pre-existing conditions throughout pregnancy.

Usually, midwives take on pregnancies that are not complicated, to ensure the safety of the mother and the baby. Most midwives have the back-up of a doctor for referral if a condition develops during pregnancy or birth.

Holistic Approach to Pregnancy

If you’re looking for someone who can give you time and gets as involved as you want, you may prefer to have a midwife take care of you during your pregnancy. Midwives generally have time to answer questions you may have and can ease you in your pregnancy by helping you along the way, both physically and emotionally. A midwife is able to talk to you about specific birth plans and talk you through your options.

Check List

Before you choose either an ob-gyn or a midwife, go through your checklist and decide how you want to proceed in your pregnancy. Decide on things such as where do want to give birth: in your home or in a hospital? Do you want to try a new birthing experience, such as water birth? Do you have medical problems or have a family history of diseases, such as heart disease or diabetes? Will your medical insurance cover all your needs with this practitioner? Interview doctors or midwives if you have to until you find someone you are comfortable with.

Were there any specific ways you chose a practitioner when pregnant? Let us know your experience with either practitioner.

Written by Manal, first time mom, rearing an infant.

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice.  All contents copyright © Health & Parenting Ltd 2018. All rights reserved.