When I was pregnant, it seemed as though time had slowed down to a crawl. But now, when I look back at those months, it seems they rushed right by.

Finally, you've ready for the main event, and you will soon meet the little one who will change your life forever.

Of course, a lot will happen before your baby is actually born.

When you arrive at the hospital, you'll be admitted by a nurse who will ask you about your medical history and your pregnancy. She'll review your prenatal record, and talk to you about your birthing plan.

You'll probably be given a physical exam. You may be asked for a urine sample, your vital signs will be taken and a staff member may feel your stomach to see where your baby is and estimate how big he is. During your labor, you'll have periodic vaginal exams to check your progress and confirm the position of your baby.

Next, a provider will look at your baby's heart rate and check the pattern of your contractions. You may be hooked up to an electronic fetal monitor that gives your health care team a detailed picture of how your baby is doing during your labor. The provider will attach the monitor with two cloth or Velcro belts placed around your stomach. One belt secures a monitor that tracks your baby's heart rate, and the other belt holds a monitor that records your contractions.

Your provider may want you to have an IV, or intravenous line, attached to your hand or arm during your labor. This way, she can make sure you're getting enough fluids, and have a quick way to give you any medicine if it's necessary.

At the same time your IV is being inserted, your provider may draw some of your blood for testing. The tests usually include a complete blood count or "CBC" to look for anemia or infection. If you are having complications, your provider may order other studies including tests to look at your liver and kidney function.

Each of us on your health care team will be working hard to make sure that all is going well for you and your baby. You may not be aware of most of this activity since it's "behind the scenes", but just know that you are in very good hands!

Well, it looks like things are well underway in the labor and delivery room. We'll return to Nurse Ashley in just a few minutes, but first let's explore the stages of labor.

You may have learned about the three stages of labor in your childbirth classes, but here's a quick review.

Let's start with Stage 1, which is made up of 3 different phases - Early Labor, Active Labor, and Transition. Early labor can last for 6 to 8 hours, although with your first baby, it may last as long as 14 – 20 hours. Early labor begins with cramps that gradually become stronger and more regular. Your cervix is thinning and dilating. Early labor ends when your cervix is dilated to 3 or 4 centimeters. At this point you are in Active Labor, and should be at the hospital.

When you're in active labor, your contractions will be about 3-5 minutes apart and feel more intense. This stage usually lasts 3-6 hours for a first time mom. You may have some nausea and vomiting, along with pressure in your hips. At this point in your active labor, if you’re not already at the immediately. After you are dilated to about 7 centimeters, you’ll go into the next phase of Stage 1, which is transition.

Transition is the phase where your contractions are the strongest, and you may have the most nausea and vomiting. Fortunately, this phase doesn't last as long as the others -- from half an hour up to 2 hours for first babies. This is the third and final phase of Stage 1 labor. When your cervix is dilated to 10 centimeters, it's time to move into the second stage of labor, which is pushing.

Keep in mind that the length of time for each of the phases of labor varies a great deal from one woman to another.

Let’s talk about some of the questions you might have about regional anesthesia. As you may have learned, regional anesthesia includes epidural and spinal anesthesia. Some women are concerned about whether or not the anesthetic will be safe for their baby. The good news is that the small amounts of pain relievers injected into the epidural or spinal space do not get into your bloodstream very quickly. This means that only very tiny amounts of the anesthetic actually get into your baby's bloodstream.

One question that I hear frequently is "when will it be too late for me to decide that I want some pain medication?" The decision of when to place an epidural is one that you'll make together with your providers and your anesthesiologist. In general, women receive an epidural or spinal anesthetic when they’re in active labor, dilated from 4 to 7 centimeters, and having regular, forceful contractions. Technically, it’s never "too late" to have an epidural. However it takes about 10-15 minutes to place the catheter and another 10-20 minutes for the medicine to take effect. If you are dilated too far and your baby is close to being born, there may not be enough time to get this kind of pain relief in place.

The second stage of labor is the pushing stage. For a first-time mom, this will usually last one to three hours. If this is not your first baby, you may only have to push for 30 minutes to an hour. In fact, some moms push for less than 30 minutes! At this point, you are 100% effaced and you're dilated to 10 centimeters. Your contractions are strong, and coming every 2 to 5 minutes. At last it's time to push!

Though pushing your baby out is hard work, you may feel better in the second stage because now you can work with the contractions, instead of against them.

There are two basic pushing techniques, called valsalva pushing and self-directed pushing. You'll find a full description of each of these techniques, along with some very effective positions for pushing, in the Baby Book.

Whatever way you push, trust your own instincts. Your body knows what to do, and will help you push more effectively.

Your labor team will help you decide about the way that you push and the position that you're in while pushing. But don't think that you're the only one who's working hard. Your baby plays an active role in this delivery! Let's take a look at what your baby is doing while you're hard at work pushing! Please click on the highlighted item.

The first step of your baby's journey probably took place before your labor even began. Engagement is when your baby's head settles into your pelvis or what we described earlier as "dropping" or "lightening".

The next step is called "descent", and it happens during the second stage of labor, while you're pushing. Your contractions have been pushing your baby's head downward. Her head may move a little to the left or right, and her chin up or down, as she shifts until her head is in the right position to continue her downward descent.

Once she's in the correct position, "flexion" begins. Your contractions and the bones of your pelvis put a small amount of pressure on your baby's head. This pressure pushes her chin into her chest. Her head gradually rotates toward your pelvic bone as her head descends deeper into your pelvis. This allows the back of your baby's head, the widest part, to pass through the widest part of your pelvis.

The next step in your baby's monumental journey is called "extension". As your contractions exert downward pressure and your pelvic muscles exert upward pressure, your baby's head changes position. Her head, which was curled forward against her chest, is now extended backward as if she’s trying to look up at the sky. At this point, your baby's head emerges from your body.

The next step, called "external rotation", is when your baby turns her head to line it up with her shoulders. This is when your baby's nose and mouth are suctioned and you may possibly hear that first cry.

The last amazing step in your delivery is called "expulsion". The pressures caused by your contractions rotate your baby's shoulder under your pubic bone and upward, resulting in the birth of your beautiful baby.

It’s time to focus on the end of Stage 2, or pushing. You will have begun pushing back when your cervix was dilated to 10 centimeters. With the help of your contractions, your baby has worked her way down your birth canal. You and your coach may both be feeling tired, but also very excited. This is a time when you need to listen to your body, continue to work with the rhythm of your contractions, and try to relax and enjoy the birth of your baby.

When your baby begins to emerge, you may feel a strong pressure and a burning or stinging sensation. This is caused by pressure from your baby's head, which blocks the nerve endings in your vaginal area. This causes a natural anesthesia to this area. Your labor team will coach you through this time. It's important that you don't push your baby's head out too quickly.

When your baby's head comes to a full "crown", your provider may suggest that you stop pushing. This is because your body already knows just what it’s supposed to do. Your uterine contractions will slowly glide your baby's head out for you.

Just before your baby's born, your provider may suggest that you have something called an episiotomy. After administering a local anesthetic, your provider makes an incision in your perineum, which is the area between your vagina and rectum. This makes room for your baby to emerge from your vagina, hopefully without tearing your skin.

When your baby's head emerges, any mucus will be suctioned from her mouth and nose so that she can take her first breath. If her umbilical cord is wrapped around her neck, which is fairly common, your provider will gently unwrap the cord and then deliver the baby's shoulders and body.

This is it! Your baby is born! Your provider will dry her off, stimulate her to cry, make sure that her umbilical cord is clamped and cut, and then place her in your waiting arms. Or, who knows, maybe Dad will get the first chance to hold her!

Good job Mom, and welcome to the world, little one! Although congratulations are definitely in order, there is still a bit of work to be done. Let's visit with Dr. Oliver once again to find out about the third and final stage of labor. Please click on the highlighted item.

The third stage of delivery is sometimes called "afterbirth". After your baby is born, your placenta is no longer needed so it will begin to separate from your uterus. Usually within 30 minutes after delivery, your placenta is completely separated and your provider will remove it from your vagina. You may notice some mild contractions but they are much less intense than your labor contractions.

After the placenta is delivered, your provider will massage your uterus to make it contract, which helps to close the blood vessels where the placenta was attached, and to reduce your blood loss. Through your IV or by injection, you may be given a medicine called pitocin, or oxytocin, to help keep your uterus contracted to reduce blood loss. Your provider will check your placenta to make sure that it’s completely separated from your uterus. This is important because if any placenta remains in your uterus, it will cause further bleeding and possible infection.

The last part of your delivery is when your provider checks your cervix, vagina, and perineum. If you had an episiotomy or have torn during delivery, you'll receive stitches at this time. The nurse will then help clean you up and help you with breast-feeding or anything else that you need.

What you've just learned about is what your provider would call a "normal" delivery, where a woman is able to deliver her baby vaginally. The truth is, not all deliveries are quite as smooth. There are a variety of complications that can come up during the course of your labor.

There are times when a baby can develop problems during labor. The fetal monitor that is strapped to the mom's abdomen will let the providers know that there may be a problem. A general term for this is "non-reassuring fetal testing". Sometimes administering oxygen, changing the mother's position, or giving her large amounts of fluid through her IV can help this situation. Other times, a cesarean section will be done.

The position of a baby at the end of a pregnancy is an important part of how the delivery will go. Although most babies enter the pelvis head first, with their chin tucked against their chest, some do not. Malpresentation is the term that most health professionals use when a baby is in the wrong position for birth. Two of the most common types of "malpresentation" are "sunny side up" and "breech".

A baby who is "sunny side up" is facing the wrong direction, with her nose and chin facing up toward the mother’s abdomen instead of down. Often the force of contractions will turn the baby to the correct position during labor or pushing.

Another type of malpresentation that you may have heard of is called "breech". This is when a baby's bottom or feet, instead of her head, are in position to come out first. If a baby is breech, the provider may try to adjust her position before the mom goes into labor by pressing on her abdomen with ultrasound guidance. Regional anesthesia may be offered. If adjusting the baby’s position does not work, the mom may still be able to have a vaginal delivery, or, depending on the circumstances, she may need a cesarean section.

Up to 1 in 4 babies is delivered by a cesarean section. Sometimes moms know in advance if a C-section will be required, but other times, that decision isn't made until labor is underway. It's a good idea to be prepared emotionally and intellectually just in case it's necessary for you to have a C-section.

Having a C-section doesn't necessarily mean that a mom can't participate in the birth of her baby. Advances in regional anesthesia mean that in some cases, moms can be awake and aware during the cesarean delivery. Depending on the situation, some hospitals even allow dads to be in the operating room. Generally, a sterile drape is arranged around mom's abdomen, and a screen is set up so that mom does not have to watch the provider make the incision.

In other cases, a general anesthetic may be necessary. General anesthesia sometimes takes effect faster, and may be best for an emergency situation. This type of anesthesia does make mom unconscious during the operation.

After anesthesia has taken effect, the provider makes a cut in the mother's lower abdomen, and then a second incision in her uterus. The baby is eased out, either by hand or with forceps or a vacuum extractor. The cord is clamped and cut, the placenta is removed, and the provider then closes the incisions.

Depending on the circumstances, the provider will often make the incisions in such a way that the mom can have her future babies vaginally. You may remember that this is called "vaginal birth after Cesarean" or V-BAC.

You'll find more information about both cesarean section and V-BAC in the Baby Book.