Pregnancy, Childbirth, and the Newborn: The Complete Guide, 4th Ed.


The following are terms that are used to describe pregnancy, childbirth, and newborn care. For further discussion of these terms and their definitions, see the pages noted within the parentheses.

4-1-1 or 5-1-1 rule.

This rule means that your labor contractions are intense enough to require you to focus and breathe rhythmically through them, and are four or five minutes apart with each lasting at least one minute for a period of one hour. This pattern signals to you that your labor may be progressing and it’s time to call your caregiver or birthplace. (244)

active labor.

The second phase of the first stage of labor. When your cervix is dilated to 4 to 5 centimeters, your contractions usually reach the 4-1-1 or 5-1-1 pattern. During this phase, dilation usually speeds up, contractions typically become painful (but manageable), and labor progresses with each contraction. (248)


An ancient Chinese medicine technique that uses needles placed at strategic points along meridians, or energy flow lines, in your body to guide it toward wellness and balance. (279)

advanced practice nurse practitioner.

A maternity caregiver who provides prenatal and postpartum care, but doesn’t attend women during labor. (17)


As your uterus contracts after birth to its nonpregnant size (a process called involution), you may experience periods of discomfort or pain. Although this pain is common and isn’t nearly as intense as labor contractions, you may need to use slow breathing to help manage it in the first few days. (269334)


Glands in the breast that produce and store milk. (401)


A medical procedure in which a needle is used to withdraw a small amount of amniotic fluid from your uterus. A laboratory analyzes the surfactant levels in the fluid to determine whether your baby’s lungs are mature enough to function outside your womb. (292)


A procedure in which fluids are infused into your uterus to dilute any meconium that was expelled in the amniotic fluid , or to remove pressure on the cord caused by your baby’s head or trunk. (288)

amniotic fluid.

The fluid that surrounds your baby in the amniotic sac. It protects your baby by absorbing bumps from the outside, maintaining an even temperature, providing a medium for easy movement, and allowing your baby to develop her lungs by “breathing” the fluid. (39)

amniotic sac.

Made up of the membranes (amnion and chorion) that create the sac that surrounds your baby. Also called “bag of waters.” (39)


See artificial rupture of membranes (AROM). (280)


Any effect that reduces your perception of pain. In this book, this term is used to refer specifically to medications that act on the brain so you don’t recognize pain stimuli or don’t interpret them as pain. (193)


Male hormones that signal the development of a baby boy’s scrotum and penis. (39)


A condition in which the number of red blood cells is lower than normal, reducing the blood’s capacity to carry oxygen. (353)


Indicates a loss of sensation, including pain sensation. Anesthetic medications block nerve endings from sending pain impulses to your brain. (193)


Proteins that protect your body from bacteria and toxins. During pregnancy and breastfeeding, your baby receives antibodies from you, which will protect him against diseases to which you’re resistant or immune. (164)

Apgar score.

Within one minute after your baby’s birth and again at five minutes, your caregiver will evaluate your baby’s well-being by conducting this routine newborn assessment, which assesses how well she’s adapting to life outside your womb. (266)


The darker skin surrounding each nipple. (36401)

arrest of labor.

A condition in which labor stops progressing, as measured by cervical dilation. (276)

artificial rupture of membranes (AROM).

A procedure in which your caregiver breaks your bag of waters with an amnihook (a long plastic device that resembles a crochet needle) in the attempt to speed up the labor process. Also called amniotomy. (280)


One side of your body is doing something different from the other side. For example, the lunge, side-lying, and semi-prone positions are asymmetrical positions. (230)


A position in which your baby’s head is tilted and the top of it isn’t centered on the cervix. Can lead to a prolonged labor. (286)


Speeding up a slow labor by using self-help methods or interventions such as artificial rupture of membranes (AROM) or Pitocin. (281)


Listening to sounds inside your womb, such as your baby’s heartbeat. In labor, intermittent auscultation describes how your nurse or caregiver listens to your baby’s heartbeat during and between contractions with a Doppler ultrasound stethoscope. At the same time, he or she may place a hand on your abdomen to feel your contractions, then count your baby’s heartbeats, noting whether they speed up or slow down and recording the findings. (252)

baby blues.

Emotional changes or mood swings that are common in new parents during the first few weeks after the birth of a baby. For example, going from elation to sadness in a matter of minutes isn’t uncommon for new parents. (348)

benefit-risk analysis.

A process by which your caregiver considers whether treatment will achieve the desired results or create problems, then weighs the treatment’s benefits against its risks before forming his or her recommendation for treatment. (8)


Your body’s natural painkillers, these hormones are secreted when you experience pain, stress, and physical exertion. Also called “endorphins.” (242)

birth ball.

A large inflatable plastic physical therapy or fitness ball that provides a soft yet firm place to sit comfortably. Used as a comfort tool in labor to enhance mobility and labor progress. (212)

birth doula.

Someone (typically a woman) who’s trained and experienced in supporting women and their partners during labor and birth. (23)

birth plan.

A one- to two-page letter to your caregiver and staff that describes your fears and concerns as well as your wishes and priorities for the treatment of you and your baby. Also called a “birth preference list,” “wish list,” or “goal sheet.” (148)


After conception, the fertilized egg quickly divides from one cell into two, then four, eight, sixteen, and so on until it becomes a multicellular structure called a blastocyst, which begins to implant in your uterus about five to nine days later. Once it’s fully implanted, a blastocyst is called an embryo. (38)

Body Mass Index (BMI).

A measurement of the relative amounts of fat and muscle in your body. It’s calculated by using a ratio of your height to your prepregnancy weight. (117)

Braxton-Hicks contractions.

Contractions of the uterine muscle that become more frequent and intense in the third trimester, and that make your uterus hard for about a minute but aren’t painful. Unlike labor contractions, Braxton-Hicks contractions don’t cause changes in your cervix. (42)

breech presentation.

When your baby is positioned with his buttocks, legs, or feet over your cervix, instead of head down (vertex). (295)

castor oil.

A strong laxative that causes powerful bowel cramps and contractions, which may initiate uterine contractions to induce labor. (278)


Stress hormones, including epinephrine (adrenaline), norepi-nephrine, and dopamine. High levels of stress hormones can slow labor progress. (215242)

cephalo-pelvic disproportion (CPD).

A condition in which your baby’s head is believed to be too large to fit through your pelvis. This diagnosis may be made by your caregiver based on observations during pregnancy, or may be used as a retrospective diagnosis after a prolonged labor that resulted in the birth of a large baby. (313)

certified nurse-midwife (CNM).

A maternity caregiver who has graduated from nursing school, passed an exam to become a registered nurse, and completed one or more years of additional training in midwifery. (16)

certified professional midwife (CPM).

A maternity caregiver who has received training from a variety of sources, including apprenticeship, school, and self-study, and has been the primary attendant at twenty or more births. A CPM practices outside hospitals and provides care similar to that of a licensed midwife. (17)

cervical ripening balloon.

A silicone catheter that’s placed within the cervix, then inflated with saline solution. Used to induce labor by accelerating cervical dilation. (279)


The lower part of the uterus, which protrudes into the vagina. (34)

cesarean birth.

The experience of giving birth by a surgical procedure in which your baby is delivered through incisions in your abdomen and uterus. The procedure is also called a “cesarean section,” “C-section,” “cesarean delivery,” or simply “cesarean.” (306)


The surgical removal of the foreskin covering the glans (tip) of the penis. (372)

code word.

A word that you choose in advance and share with your caregivers. By saying the word during labor, you communicate that, despite your original plan to birth without pain medications, you now want help getting medicated pain relief. (189)


Prolonged crying in a young baby. Typically defined as three or more crying episodes each week for three or more weeks, with each episode lasting three hours or longer. (379)


The first breast milk: a highly nutritious yellowish fluid that’s low in volume, but high in antibodies and the nutrients your baby will need for the first few days of life before your milk supply increases in volume. (43164401)

combined spinal-epidural (CSE).

A method for delivering pain medication. CSE uses a spinal narcotic in early labor (which may allow for more mobility), then an epidural anesthetic later in labor, when you need more pain relief. (197)

complicated labor.

A labor that is longer, more painful, or more difficult than a normal labor, and may require medical help to ensure the well-being of you and your baby. (274)


Occurs when a sperm fertilizes an egg. The beginning of pregnancy. (35)


Tightening of the uterine muscle. During labor, these muscle contractions help open your ripe, effaced cervix and help your baby descend. Contractions become more frequent and more intense as labor progresses. (241)


Medications that may be given to speed up the maturation of your baby’s lungs if a preterm birth can’t be prevented. (292)

corticotropin-releasing hormone (CRH).

Comes from your baby, the placenta, and tissues within your uterus. Increased levels of CRH in late pregnancy may help initiate labor. (37)


The third phase of the second stage of labor. It begins when the widest part of your baby’s head is visible at the vaginal opening and no longer retreats between pushes, and it ends with her birth. (263)

delayed pushing.

An option for the second stage of labor, in which a woman who doesn’t have an urge to push (such as after receiving an epidural) may wait an hour or two, or until her baby’s head crowns, before pushing actively. Also called passive descent. (259)


The downward movement of your baby into your pelvis. (168)

diagnostic test.

Term used to describe a test that is more specific and more reliable than a screening test in identifying a woman with a pregnancy complication or a baby with a problem. (65)


The opening of the cervix, which allows your baby to pass through for birth. (169)

directed pushing.

An option for the second stage of labor, in which your caregiver tells you how long and how hard to push. This method is used if you can’t feel your contractions and delayed pushing isn’t an option or if spontaneous pushing isn’t effective. (259)

Doppler ultrasound.

A device that uses sound waves to monitor your baby’s heart rate. Typically used at prenatal visits as well as during labor and birth. (68)

due date.

An estimate of when your baby will be born. The majority of babies are born in the period from two weeks before their due dates to two weeks after their due dates. (36)

early labor.

Usually the longest phase of the first stage of labor, often because contractions are further apart, shorter, and less intense than they’ll be later in labor. Contractions are generally more than five minutes apart, and you can walk and talk during them. Also called the latent phase. (242)


An ectopic pregnancy occurs when the fertilized egg implants itself outside the uterus, usually in the wall of a fallopian tube (called a tubal pregnancy) but sometimes in the cervix, ovary, or abdomen. Most ectopic pregnancies can’t develop into a live birth and typically require medical intervention to manage. (127)


The thinning and shortening of the cervix in preparation for birth. (169)

elective induction.

An induction done without a medical reason, either because a woman requested induction or because her caregiver recommended it. Also called a “social induction.” (276)

electronic fetal monitoring (EFM).

Used to monitor your baby’s heart rate and your contractions, to assess how your baby is responding to labor. There are two types of EFM. External EFM uses belts to hold two sensors on your abdomen, and the less commonly used internal EFM uses two sensors placed inside your uterus. (252)


By two weeks after conception, your baby is called an embryo. (38)


About two weeks before the birth, your baby descends deeper into your pelvis. You may feel less pressure on your diaphragm and find breathing and eating easier. Also called lightening or “dropping.” (46168)


Painful swelling of the breasts. (405419)

epidural catheter.

A tube inserted into the epidural space near the spinal nerves and used to deliver pain medication. (196)


A surgical incision of the perineum that enlarges the vaginal outlet. Once common practice, now the majority of caregivers use it only when medically necessary to deliver the baby quickly. (289)


A hormone that promotes the growth of the uterine muscles and their blood supply, encourages production of vaginal mucus, and stimulates the development of the ductal system and blood supply in the breasts. In late pregnancy, rising estrogen levels increase the uterus’s sensitivity to oxytocin and help start labor. (37170)


To draw out your nipple to allow your baby to latch on well for nursing. Typically occurs when your baby suckles. (405)


Removing milk from the breast by hand or by using a pump. May be used to relieve fullness, maintain milk supply, or store milk for your baby’s consumption. (424)

expulsion breathing.

A way to breathe during spontaneous bearing down. During the pushing stage, use relaxed breathing when you don’t have the urge to push. When you have an urge to push, you may briefly hold your breath and bear down, or you may exhale with an open throat while pushing. (232)

external version.

A procedure used to attempt to manually turn a baby from a breech or transverse position to a head-down position (vertex). (297)

failure to progress.

Term used either to describe a labor that’s taking longer than expected for the cervix to dilate to 10 centimeters, or to describe a pushing stage that’s taking longer than expected. May be treated with augmentation or cesarean delivery; however, if your baby is handling labor well, you may also ask whether self-help measures can effectively help with labor progress. (312)

fallopian tubes.

Provide the path for an egg to travel from your ovaries to your uterus. (34)

false positives.

Describes situations in which test results for a condition are positive, but the condition isn’t present (for example, the fetal heart rate pattern indicates distress, but your baby turns out to be fine). (314)

family physician.

A physician who has graduated from medical school or a school of osteopathic medicine and has completed two or more years of additional training in family medicine, including maternity and pediatric care. (16)

feeding cues.

How your baby shows he’s hungry. Include rooting, mouthing, tongue thrusts, sucking, and increased activity levels. Crying is a late feeding cue, used when the other cues have gone unnoticed. (410)

fetal intolerance of labor.

See nonreassuring fetal heart rate. Also called “fetal distress.” (287313)

first stage of labor.

The period that begins when contractions are becoming longer, stronger, and closer together (progressing) and ends when your cervix is completely dilated. (240)


A tool (steel tongs) that’s used to assist with a vaginal birth. (290)


Breast milk produced early in the feeding. Foremilk is lower in fat and higher in sugar than hindmilk. (403)

fourth stage of labor.

Begins after the placenta is delivered and ends one to several hours later, when your and your baby’s conditions have stabilized. (240)

freestanding birth center.

A birth center unaffiliated with a hospital. (14)


The top of your uterus. (42)

general anesthesia.

A systemic medication that causes a total loss of sensation and consciousness. (194)


Another term for pregnancy, which lasts an average of 280 days or forty weeks after the first day of your last menstrual period. (36)

gestational age.

The age of your baby from the first day of your last menstrual period. Note that conception occurs within twelve to twenty-four hours after ovulation, which typically occurs fourteen days after the beginning of your last period. So, two weeks after conception your baby’s gestational age is four weeks. (38)

gestational hypertension.

High blood pressure that develops during pregnancy, defined as at least two consecutive readings that are over 140/90. This condition affects 10 percent of pregnant women in the United States. Also called pregnancy-induced hypertension (PIH). (140)

glycemic index.

An index that ranks foods according to how quickly and significantly they elevate your blood sugar. (115)

Group B streptococcus (GBS).

A type of bacteria. If you test positive for GBS in pregnancy, you may be given antibiotics during labor. (131)


Swollen varicose veins in the rectal area that may be as small as a pea or as large as a grape. (335)

Heparin Lock.

Involves inserting an intravenous (IV) catheter, but doesn’t require hooking it to an IV bag and pole until IV fluids are needed. Also called “Hep-Lock.” (250)


Breast milk produced later in a feeding session, released with the let-down reflex. This milk provides most of the calories and contains more fat and protein than foremilk. (403)


A complementary medicine technique that uses diluted derivatives of natural substances to stimulate your body to respond in a way that heals or corrects a specific problem, such as a labor that won’t start. (279)

human chorionic gonadotropin (hCG).

A hormone produced only during pregnancy. It ensures that your ovaries produce estrogen and progesterone for the first two to three months of your pregnancy, until your placenta matures and produces the appropriate amount. (37)


Overbreathing. If you find yourself feeling lightheaded or dizzy while using a breathing technique, try either slowing down your breathing, focusing on the exhalation rather than the inhalation, or breathing into your cupped hands. (224)


See vaccination. (386)

incompetent cervix.

A cervix that shortens and opens in midpregnancy without preterm labor contractions. (138)


A condition that causes you to leak urine when you have a full bladder, exercise, cough, or sneeze (urinary incontinence) or uncontrollably pass gas or leak stool (fecal incontinence). (352–353)


An intervention used to start labor. (275)

infant cues.

Your baby’s nonverbal communication. For example, when she’s overstimulated, she may close his eyes, yawn, get glassy—eyed, turn away, or stiffen. If you miss these cues and continue to stimulate her, she may begin a prolonged bout of crying. (377)

informed choice.

See informed decision. (8)

informed consent.

After becoming informed about an option or treatment, you agree to it. (8)

informed decision.

The decision you make to refuse or consent to a health care option or medical treatment, after becoming informed about it through research and consultation with your caregiver and other knowledgeable medical professionals, as well as with supportive friends and family. Also called informed choice. (8)

informed refusal.

After becoming informed about an option or treatment, you refuse it. (8)

inhalation medication.

A gas you breathe to receive pain medication. (192)


A medical procedure used to intervene in the natural labor process, such as induction, augmentation, episiotomy, or cesarean surgery. (274)

intramuscular (IM) medication.

A shot given into a muscle to deliver medication. (192)

intrathecal space.

The space inside the dura (the membrane that surrounds your spinal cord) that’s filled with cerebrospinal fluid. It’s where spinal medications are injected. (198)

intravenous (IV) catheter.

A tube that’s inserted into a vein through a needle, allowing fluids and medications to be given directly into your circulatory system. (250)

intravenous (IV) medication.

An injection into a vein, often through an IV catheter, to deliver medication. (192)


After the birth, your uterus begins the six-week process of contracting to its nonpregnant size. (269333)


An excess of bilirubin that causes your baby’s skin or the whites of his eyes to become yellow by the third or fourth day after the birth. (389)


An exercise used to maintain the tone of your pelvic floor muscles, improve blood circulation in that area, decrease the incidence and severity of hemorrhoids and incontinence, and support your uterus and other pelvic organs. (95)

lactation consultant.

A breastfeeding expert. (400)


Fine, downy hair that develops on your baby’s arms, legs, and back while in the womb. (42)


Your baby’s connection with the breast to feed. A good latch permits your baby to nurse effectively. (409)

latent phase.

See early labor. (242)


Two or more babies gestating in the same womb. (53)

narcotics and narcotic-like drugs.

Medications that reduce the transmission of pain messages to the pain receptors in your brain. (194)

naturopathic doctor (ND).

A health care provider who has completed three to four years of postgraduate training in natural medicine. May also have taken an additional year of midwifery training to be able to provide prenatal care and attend births. (17)

neonatal intensive care unit (NICU).

A hospital unit where medically challenged newborns stay for monitoring and treatment until they can breathe on their own, stay warm at room temperature, and breastfeed or take a bottle. (293)

neuraxial medications.

Drugs that are injected into the space surrounding the spinal cord (neuraxis), such as epidurals and spinal blocks. (192196)

nipple confusion.

A condition experienced by some babies who have difficulty adapting to different sucking patterns and flows of liquid, when they’re fed alternately by a bottle and at the breast. (412)

nonreassuring fetal heart rate.

Term used when your baby’s heart rate isn’t responding to contractions in a reassuring way. Doesn’t necessarily indicate that something is wrong with your baby (there’s a high rate of “false positives”); however, it does indicate the need for closer monitoring and a possible need for intervention in labor. (287313)


A woman who has never given birth. (167)

obstetrician/gynecologist (OB-GYN).

A physician who has graduated from medical school or a school of osteopathic medicine and has had three or more years of additional training in obstetrics and gynecology. (16)

occiput anterior.

The back of baby’s head (occiput) is toward the front of your body. (167)

occiput posterior.

The back of baby’s head (occiput) is toward your back. (167)

oral medication.

A pill or liquid you swallow to receive a medication. (192)


Female sex glands where eggs are produced. (34)


When a ripened egg is released into your fallopian tubes. On average, this happens fourteen days after the first day of your last menstrual period. If you have intercourse between four days before and one day after ovulation, there’s a chance of conception. (34)


An egg produced by a woman. When an egg is fertilized by a sperm, conception occurs. (34)


A hormone produced in your pituitary gland, which stimulates uterine contractions to help trigger the onset of labor and promote labor progress. Also present during orgasm and during breastfeeding, it’s often called “the love hormone.” (37, 170, 242)

pain modifiers.

External stimuli that affect your awareness and perception of pain. (179)


Describes the condition of having given birth. (167)

passive descent.

See delayed pushing. (259)

patient-controlled epidural analgesia (PCEA).

A device that allows you to increase your epidural dosage when you need more pain relief. (198)

pediatric and family nurse practitioner.

A registered nurse who has additional training in pediatrics or family health. Provides well-child care and treats common illnesses. (25)


A physician who specializes in children’s health care. (24)

pelvic floor muscles.

Muscles attached to the pelvis that support your abdominal and pelvic organs. These muscles form a figure-eight around your urethra, vagina, and anus. (3495)


An obstetrician/gynecologist (OB-GYN) who has received further training and certification in managing very high-risk pregnancies and births. (16)

perineal massage.

A massage that stretches the inner tissue of your lower vagina. Can be used during pregnancy or the second stage of labor to relax the tissue so it will stretch around your baby’s head. (235)


The external genitals (labia, urethra, clitoris, vaginal opening) and anus. (34)


A medical procedure used to treat jaundice that shines a special type of cool light on your baby’s skin, causing the bilirubin level to drop. (389)


Commonly referred to as “Pit,” this is a synthetic version of oxytocin. (281)


An organ that develops in pregnancy, the placenta produces hormones and exchanges oxygen, nutrients, and waste products for your developing baby. It’s released and delivered shortly after your baby’s birth. (39)


Refers to where the back of your baby’s head (occiput) is in relation to your body. (167)

positive signs of labor.

Include contractions that become longer, stronger, and more frequent (progressing) and the rupture of membranes in a gush of amniotic fluid. These are the only reliable signs that labor has begun and your cervix is dilating. (171)

possible signs of labor.

Occur in late pregnancy and may indicate that the hormonal changes described on page 170 are underway but cervical changes aren’t yet occurring. These signs occur intermittently for days or weeks, but they don’t indicate labor. (171)

post-date pregnancy.

A pregnancy that has lasted to at least forty-two weeks. Although the average length of pregnancy is forty weeks, many pregnancies last longer. Caregivers may misuse the term “post-date” as early as forty weeks. (49275)


A condition in which the placenta stops functioning well, the baby’s growth slows or stops, and the risk of stillbirth increases. True postmaturity is rare even in babies born two weeks after their due dates. “Postmature babies” at birth have an absence of lanugo, scant vernix caseosa; long fingernails and toenails; and dry, peeling, or cracked skin. (49275)

postpartum depression.

A condition that generally presents itself between two weeks to one year after the birth. Symptoms vary in severity among women. (357)

postpartum doula.

Someone (typically a woman) who’s trained and experienced with helping a woman and her family adjust to postpartum life by teaching them about newborns’ needs and abilities, and about infant feeding, sleep, and cues, while providing assistance with household tasks. (26)

postpartum hemorrhage.

The excessive loss of blood (more than 500 milliliters or 2 cups) during the first twenty-four hours after the birth. (299)

postpartum mood disorders (PPMD).

Emotional conditions that can develop in the first year after birth, such as anxiety and panic disorder, obsessive-compulsive disorder, postpartum depression, bipolar disorder, and post-traumatic stress disorder. (357)

postpartum psychosis.

A rare condition that occurs in women after the birth and requires immediate care and psychiatric treatment. Symptoms include severe agitation, mood swings, depression, and delusions. (361)

precipitate birth.

A birth that results from a very fast labor. For a first-time mother, may be defined as an entire labor that lasts six hours or less, but it’s more often applied to a labor that is three hours or less. For a woman who has previously given birth, it’s one hour or less. (257)


High blood pressure and protein in the urine. A multi-organ condition with mild to severe symptoms that affects 5 to 8 percent of pregnancies. Previously called “toxemia.” (140)

pregnancy-induced hypertension (PIH).

See gestational hypertension. (140)

prelabor signs of labor.

Indicate that your cervix is probably moving forward, ripening, or effacing. These signs may progress into positive labor signs the same day they begin, or they may simply alert you that labor will begin in a few days or weeks. (171)


A period of hours or days in which you experience contractions, but your cervix isn’t actively dilating. It’s likely that these contractions are getting your cervix ready to dilate by moving it forward and helping it ripen and efface. Prelabor contractions may range from as little as thirty seconds long and twenty minutes apart, to as much as one or two minutes long and five to eight minutes apart. However, the contractions change very little in length, frequency, and intensity over time (nonprogressing). (171)


A baby that’s born before the thirty-seventh week of pregnancy. (392)


Describes the part of your baby that’s lying over your cervix and will emerge from your body first. Also called presenting part. (167)

presenting part.

See presentation. (167)

preterm labor.

A labor that begins before the thirty-seventh week of pregnancy. (136)


A woman who is pregnant for the first time. (167)


A woman who has given birth once. (167)


A hormone that relaxes your uterus during pregnancy, keeping it from contracting too much. It also relaxes the walls of blood vessels (helping you maintain a healthy blood pressure) and the walls of your stomach and bowels (allowing for greater absorption of nutrients). (37, 170)

progressing contractions.

Contractions that become longer, stronger, and more frequent over time. (172)


A hormone that’s produced after the birth and stimulates the production of breast milk. (242401)

prolapsed cord.

A rare condition that occurs when the water breaks and the umbilical cord slips below the baby so it’s either in the vagina or lying between the baby and the cervix. Requires a call to 911 and transport to the hospital for an immediate cesarean. (302)

prolonged labor.

A labor that progresses more slowly than expected. Diagnosis is somewhat subjective. (245)

prolonged prelabor.

Prelabor that lasts longer than a day. (171)


A hormone produced in your amniotic membrane. Increased levels in late pregnancy ripen your cervix in preparation for labor and stimulate muscles in your uterus and bowels to begin labor. (37170)


Describes the moment when you feel your baby’s movements for the first time, during the second trimester. (42) regional anesthetic. Pain medication that affects a large area of your body. (193)


A hormone from your ovaries that relaxes and softens your ligaments, cartilage, and cervix, making these tissues more stretchable during pregnancy and letting your pelvic joints spread during birth. (37)

respiratory distress syndrome (RDS).

A condition in which a newborn infant has difficulty breathing and is unable to get sufficient oxygen due to immature lungs. The most common complication of premature birth, it requires immediate medical treatment. (292)


Women who cope well in labor rely on rhythm in various forms. Rhythmic activity calms the mind and lets a woman work well with her body. (206)


The softening of the cervix. (169)


The repetition of a meaningful rhythmic activity during contractions to increase your ability to cope. (206)


Procedures or treatment that’s offered to all pregnant women and their newborns, regardless of medical status. (8)

rupture of membranes.

Breaking of the bag of waters that may manifest itself either as the leaking of a small amount of amniotic fluid from the vagina, or as a gush of fluids. Rupture may happen before labor or may signal the onset of labor, or it can happen at any point during labor and birth. (172)

screening test.

A medical test that can rule out a particular condition or may indicate an increased chance that the condition is present. In the latter case, a diagnostic test confirms the condition. (65)

second stage of labor.

The birth of your baby. This stage begins when your cervix is fully dilated and ends when your baby is born. (240)

serial induction.

Medication to induce labor is given during the day, but is discontinued at night to allow you to eat and sleep. (281)

shared decision-making.

A collaborative approach to making an informed decision, in which you and your caregiver discuss the medical risks and benefits of treatment and any possible alternatives. (8)

special care nursery.

A hospital unit for newborns who need extra medical monitoring or support, but don’t need the intensive care of a NICU. (293)

spinal block.

An injection of anesthetic near the spinal nerves that takes effect quickly and lasts for an hour or two. (196)

spit up.

When a baby expels a dribble or more of milk (up to 2 to 3 tablespoons is common) after a feeding. (411)

spontaneous bearing down.

An option for the second stage of labor, in which you naturally bear down or strain for five to six seconds at a time and take several breaths between efforts. This type of pushing makes more oxygen available to your baby than if you hold your breath and bear down for as long as possible. (259)

spontaneous rituals.

Methods of coping invented by you over the course of your labor and reinforced by your support team. May include positions, movement, repeated words or sounds, specific kinds of touch, and so on. (207248)


Refers to the location of the top of your baby’s head (or other presenting part) within your pelvis. Descent is measured by station. (168)

sterile water block.

An alternative option for relief of back pain during labor. A caregiver or nurse injects tiny amounts of sterile water into four places on your lower back. The injections cause severe stinging for a minute or more, but then provide pain relief by rapidly increasing endorphin production. (286)

sudden infant death syndrome (SIDS).

The sudden death of a baby younger than one year that remains unexplained after a thorough investigation. There are steps that can be taken to further reduce the rare chance of SIDS; however, for about 1 in 2,000 babies, it appears to be impossible to predict or prevent. (391)

supine hypotension.

When lying on your back makes your uterus press on the abdominal vein that carries blood from your legs to your heart (inferior vena cava), causing a drop in blood pressure. (89)


A substance that allows your baby’s lungs to expand during an inhalation and remain partially inflated during an exhalation. (293)

synthetic prostaglandins.

Medications that mimic the hormone prostaglandin. (281)


Describes a medication that affects your entire body. (193)

tandem nursing.

Breastfeeding two children at the same time (such as twins or your baby and toddler). (429)

telemetry monitoring.

Wireless electronic fetal monitoring, which allows you to walk and use the shower or bath. (283)

tension spots.

Body areas that you habitually tense when stressed. For example, your shoulders, forehead, mouth, jaw, or fists. (216243)

third stage of labor.

Begins with the birth of your baby and ends with the delivery of the placenta. (240)

Three Rs: relaxation, rhythm, and ritual.

A theory about how women cope with labor when given support and freedom to explore coping options. You stay as relaxed as possible throughout labor, until you discover your coping rhythm. Your partner’s role is to reinforce this ritual for as long as it continues to help you. (206245)

tocolytic medication.

A drug used to slow or stop contractions; for example, during preterm labor. (288)


Final phase of the first stage of labor, which serves as the transition to the second stage of labor. Your cervix is reaching complete dilation, and your baby is beginning to descend into your birth canal. Contractions are ninety seconds to two minutes long and two to three minutes apart. (254)

transverse incision.

The most common incision (cut) for a cesarean birth. Horizontal incision on the lower abdomen (at the “bikini line”) through the bottom of the uterus. (316)

transverse lie.

When your baby is positioned sideways in the uterus, with his back or shoulder closest to the cervix. Only occurs in 1 in 2,500 births. Your caregiver will attempt an external version to turn your baby, and if unsuccessful, your baby will be delivered by cesarean. (167295)


Observation area in the hospital, where an admitting nurse assesses your condition, your pattern of contractions, your dilation (with a vaginal exam), and your baby’s well-being, in order to determine whether you’re ready to be admitted to the hospital, or whether you should return home with instructions on when to return. (249)

trial of labor after cesarean (TOLAC).

When a woman with a prior cesarean chooses to let labor begin and progress, with the hope of having a vaginal birth after cesarean (VBAC). (323)


Pregnancy is divided into three trimesters, each one lasting about three months. (38)


See Doppler ultrasound and ultrasound scan. (68)

ultrasound scan.

Equipment that uses intermittent transmission of sound waves to help your caregiver “see” inside the uterus. Can be used as a screening test or a diagnostic test for evaluating your baby’s development. (68)

umbilical cord.

Links the placenta to your baby’s navel, and together the umbilical cord and placenta pass oxygen and nutrients from you to your baby. While the placenta provides a barrier against most (but not all) bacteria in your bloodstream, most viruses and drugs cross to your baby. The placenta also exchanges waste products from your baby, which your blood then carries to your kidneys and lungs for excretion. (39)

urge to push.

The most significant sign of the second stage of labor. You may find yourself holding your breath and straining or grunting during each contraction. (258)

uterine atony.

Poor uterine muscle tone. The most frequent cause of postpartum hemorrhage. (300)

uterine rupture.

The separation of a uterine incision from a previous cesarean or uterine surgery. (323)


A hollow, muscular organ the size and shape of a pear in which a baby develops. (34)


An administration of a vaccine to prevent illness. Also called immunization. (386)

vacuum extractor.

A tool (silicone suction cup) that’s used to assist with a vaginal delivery. (290)

vaginal birth after cesarean (VBAC).

A vaginal birth after a previous cesarean, as a result of a successful trial of labor after cesarean (TOLAC). (323)

vernix caseosa.

A white, creamy substance that protected your baby’s skin in your womb. (264366)


Presentation in which the top of your baby’s head is down over your cervix. (167)