When you first find out you are pregnant, you may immediately start envisioning the perfect labor and child birth. You will be at home, your water will break, contractions will start, you will show up at the hospital, have a quick labor and delivery, and then your baby will be born! However, most of the time, this image of “perfect” labor is not the reality.

Quite often, a woman will have to face the possibility, or reality, of an induction to get her labor started and to deliver her baby. Inductions can be a welcome relief to some women, while others dread them. Inductions are performed for various reasons. Sometimes they are performed because of a problem in the pregnancy. Other times, factors may include the size of the baby, or because the woman is past the 40 week mark of pregnancy and labor has not started on its own. Inductions can also be done if a woman’s water has broken, but she has not started having contractions, or she was having contractions and they stopped.

There are many ways your doctor or midwife may attempt an induction if it is needed at the end of your pregnancy. If your cervix is not dilating and effacing on its’ own your provider may choose to insert a pill called cervidil that has a drug in it called prostaglandin. Prostaglandin is one of the natural chemicals that your body produces that plays a part in the ripening of your cervix.

If your cervix is already ripe, or after you have had the cervidil and it has done its’ job, your doctor or midwife might choose to go ahead and break your water. Many times just the breaking of your water will make contractions start and labor progress on its’ own, without any further medical intervention.

If breaking your water does not work, then the doctor may begin administering the synthetic form of the hormone that your body naturally makes, oxytocin, which is called pitocin. Pitocin generally will start labor contractions, however it can cause labor to be very painful. Most people who are administered pitocin end up needing pain medication during labor, in order to get through labor. For the women who want to go natural, with no pain meds, pitocin is normally not something that they want to have to help induce labor.

Induction is not a necessity in all labors, and many women who are lucky will get their picture perfect labor and delivery. It is always best however to know and research all the possibilities ahead of time so that when the time does come, if you have problems getting labor started, you will know all your options.

What is amniotic fluid and what is it’s purpose? Also referred to as the “bag of waters”, the most pregnant women generally know about it is that about the time labor begins their amniotic sac will break, or be broken by their midwife or doctor, causing the start of the delivery process. They don’t however know what its purpose is during a pregnancy.

The amniotic fluid is the clear, slightly yellowish fluid within the amniotic sac that surrounds the baby in the uterus. The baby grows in this amniotic sac, surrounded by the amniotic fluid, as he learns to move his limbs, open his eyes and breathe. Amniotic fluid levels generally sit at approximately 800ml through most of the pregnancy, dropping slightly in most cases to about 600ml by the time a woman reaches the 40 week mark.

The amniotic fluid has many purposes. It helps to cushion hard blows and jolts to your belly to protect the baby and it allows your baby the freedom to move while permitting symmetrical musculoskeletal development. It also maintains an even temperature so that your baby does not get too hot or too cold, even if you are extremely hot or cold.

Amniotic fluid also helps your baby develop his lungs. While in the womb your baby practices breathing by breathing in and out the water in the amniotic sac. The baby swallows and inhales the amniotic fluid and replaces the volume in the amniotic sac by urinating and exhaling the liquid.

In some cases, a woman may have too much or too little amniotic fluid. Having too much is called polyhydramnios and having too little is called oligohydramnios. In either case, a woman might be watched more closely by her physician throughout her pregnancy.

The general population knows very little about Group B Strep (GBS), and many pregnant women have never heard of it, or have only heard of it in passing. Most are shocked when, late in the third trimester their doctor or midwife ask them to be tested, and the test then comes back positive. There are many questions surrounding GBS. What is it? Is it an STD? How does it affect newborns? How is it transmitted to a newborn? How can you prevent infection, and are there alternatives to antibiotics?

What Is It?
GBS is a bacteria found in the lower intestines of 10-35% of all adults. In women it can also be found in the vagina. To test for it, your provider will swab the area between your vagina and anus and send it for a test sometime between the 35th and 37th weeks of your pregnancy. GBS should not be confused with the strep that causes sore throat, Group A Strep. GBS is not contagious, and in most cases it causes no harm to the adult that has it. However, in some cases, it can cause serious infection, known as Group B Strep disease.

Is It An STD?
Since it can be found in the vagina, many people assume that GBS is a STD, which is not true.It is simply a bacterium that is found in many people. It causes no discomfort and can not be transmitted sexually; therefore a carrier of GBS does not need to change their sexual practices.

How Does It Affect Newborns?
Approximately 8,000 babies born each year will contract a serious form of GBS disease. Of these 8,000, as many as 600 will die and another 20% will be left permanently handicapped. If a baby is infected with GBS, will appear either as an infection in the blood (sepsis), or as meningitis. It is also a frequent cause of pneumonia in newborns. It can also leave them with hearing or vision loss, as well as physical or learning disabilities.

How Is It Transmitted To A Newborn?
GBS is transmitted to a newborn during their descent through the birth canal. However, having a c-section is not recommended pas a way to prevent the infection in your baby, as the bacteria can also be found in your uterus and amniotic sac.

Prevention of Infection
If a pregnant woman tests positive for GBS, she can often be given a series of penicillin shots through an IV while in labor, prior to delivery. It is best to get these shots at least 4 hours prior to delivery. In most cases, if the woman has these shots, the baby will not be infected. If time does not permit for the woman to receive these shots, then immediately after birth the nurses will give your baby a shot of penicillin in the leg, to help prevent infection. In this case a mother will normally be asked to stay in the hospital for 48 hours in order for the neonatal team to watch the newborn for signs of infection.

Alternatives to Antibiotics
There have been no studies showing the success of alternative and/or home remedies in the prevention of the passage of GBS to your newborn. However, there are some that doctors and midwives may suggest you try.

Vaginal washing and immunotherapy have been suggested as a way to help clean out your vagina. Some practitioners have suggested supplements for the mother. These supplements include garlic, vitamin C, echinacea, and/or bee propolis. After a series of these supplements a woman can be retested to see if the bacterium has disappeared. This has worked in many, but not all cases of GBS in pregnant women.