that means the baby is coming very soon."

這意味著孩子很快就要出生了。"

If only!

要是這樣就好了!

"Eating the placenta is good for you."

"吃胎盤對你有好處"。

No!

不!

Don't go there.

不要去那裡。

"Labor usually lasts a couple of hours."

"分娩通常會持續幾個小時。"

Perhaps the biggest myth that we will talk about today.

也許這就是我們今天要談的最大的神話。

Hi, I'm Dr. Laura Riley,

嗨，我是勞拉-萊利博士。

and I'm a high-risk obstetrician

我是一名高風險的產科醫生

at NewYork-Presbyterian Hospital/Weill Cornell Medicine.

在紐約長老會醫院/威爾-康奈爾醫學中心。

My favorite thing to do is delivering babies.

我最喜歡做的事情是為嬰兒接生。

And I'm Dr. Dena Goffman.

我是迪娜-戈夫曼博士。

I'm also a high-risk-pregnancy physician.

我也是一名高危妊娠的醫生。

I'm the chief of OB at NewYork-Presbyterian/

我是紐約長老會醫院的產科主任。

Columbia University Irving Medical Center.

哥倫比亞大學歐文醫學中心。

And today, we will be debunking myths about childbirth.

而今天，我們將揭開關於分娩的神話。

Oh, this is good.

哦，這很好。

"Wide hips mean easier birth."

"寬大的臀部意味著更容易出生。"

This is a total myth.

這完全是一個神話。

And what we see as your hips

而我們所看到的是你的臀部

aren't even reflective of

甚至沒有反映出

what's going on with the bones in your pelvis,

你的骨盆裡的骨頭髮生了什麼。

which do matter.

這確實很重要。

Riley: The bony pelvis is connected by cartilage,

萊利。骨盆是由軟骨連接的。

which is softer, which loosens up within the course

比較軟，在過程中會鬆動。

of the latter part of pregnancy.

懷孕後期。

So that gives the baby a little bit more room.

是以，這給了嬰兒更多一點空間。

And then, labor, all those contractions

然後，分娩，所有這些收縮

and the coordination that forces the head into the pelvis,

以及迫使頭部進入骨盆的協調。

a lot of that depends on the baby, right?

這在很大程度上取決於嬰兒，對嗎？

I think one thing that is frustrating for people

我認為，有一件事讓人感到沮喪

is they will say, at 38 weeks,

是他們會說，在38周時。

"Am I going to have a vaginal delivery?"

"我將會有一個陰道分娩嗎？"

We can't tell. Because there's so many other factors

我們無法判斷。因為有這麼多其他因素

that go into whether or not your baby

你的寶寶是否會受到影響？

is coming out vaginally.

是通過陰道出來的。

It's not just the baby's size.

這不僅僅是嬰兒的尺寸。

It's the baby's position.

這是嬰兒的位置。

It's how well the baby tolerates

這是寶寶的耐受性如何的問題

holding its breath every three minutes.

每隔三分鐘屏住呼吸。

There's more to the story.

這個故事還有更多的內容。

"The best position to labor

"勞動的最佳姿勢

and give birth on is your back."

並在你的背上生下孩子。

That's a myth.

那是一個神話。

What you might see on television or in the movies,

你可能在電視或電影中看到的東西。

of a patient flat on their back,

病人平躺在床上。

is actually the worst position to labor and give birth in.

實際上是最糟糕的生產和分娩姿勢。

We love to have patients be in bed,

我們喜歡讓病人躺在床上。

certainly on their side,

當然是在他們這邊。

but there's also a lot of opportunity

但也有很多機會

to be sitting up and even to be walking around,

可以坐起來，甚至可以走動。

depending, again, on the situation with your pregnancy,

這同樣取決於你懷孕的情況。

your baby, and your labor.

你的寶寶，和你的分娩。

There's the opportunity, potentially, to take a shower.

有機會，有可能，可以洗個澡。

Some people use birthing balls as a place to sit.

有些人將分娩球作為一個坐的地方。

Many places now have wireless fetal monitoring,

現在很多地方都有無線胎兒監測。

where you actually can even monitor the baby

在這裡，你甚至可以監控嬰兒

while you're moving around.

在你移動的時候。

And a lot also depends on

而且很多時候也取決於

whether or not you have anesthesia,

無論你是否有麻醉。

because once you have an epidural,

因為一旦你做了硬膜外手術。

it is fabulous for taking away the discomfort

它對消除不適感非常有效。

on your abdomen and those contractions.

在你的腹部和那些收縮。

But it does, in many ways, weaken your leg muscles.

但在許多方面，它確實會削弱你的腿部肌肉。

So most hospitals will not allow you

所以大多數醫院不允許你

to walk around with your epidural in

帶著你的硬脊膜走來走去

just because you may not be as strong.

只是因為你可能沒有那麼強壯。

This is definitely a myth.

這絕對是一個神話。

"You can induce labor by eating spicy food."

"你可以通過吃辛辣的食物來引產。"

So, this is a myth,

所以，這是一個神話。

and there are a number of them out there.

並且有很多這樣的人。

All of the things that people think

人們所認為的所有事情

you can do to induce labor.

你可以做些什麼來引產。

Pineapples.

菠蘿。

Riley: Cream cheese, bumpy roads.

萊利。奶油奶酪，顛簸的道路。

Sex.

性別。

Sex.

性別。

That one, there's some truth to it, right?

這句話，有一定的道理，對嗎？

Nipple stimulation.

刺激乳頭。

That's not a myth either.

這也不是一個神話。

I know it's not a myth.

我知道這不是一個神話。

Nipple stimulation actually does work.

乳頭刺激實際上是有效的。

The tough part about nipple stimulation

刺激乳頭的艱難之處

is that you get so many contractions at once,

是你一次得到這麼多的收縮。

your baby doesn't love it.

你的寶寶不喜歡它。

The sex and the nipple stimulation

性和乳頭的刺激

have sort of valid, plausible reasons why they may help,

有種有效的、合理的理由，他們可能會有幫助。

but I think there's not sort of a protocol

但我認為沒有一種協議

for how to do it and how to do it safely.

如何做到這一點，以及如何安全地做到這一點。

We know how to induce labor.

我們知道如何引產。

We have different medications that we can use vaginally,

我們有不同的藥物，可以在陰道內使用。

medications that we can use in the IV,

我們可以在靜脈注射中使用的藥物。

and we know how to do that safely.

而且我們知道如何安全地做到這一點。

I think there is no evidence for spicy foods.

我認為辛辣食物是沒有證據的。

Sex is fine if it's comfortable

性生活如果舒適就好

and something that you want to be doing.

和你想做的事情。

Walking, being active, kind of getting out and about,

走路，積極活動，有點出去走走。

but I think this baby's going to come

但我認為這個孩子會來的

when the baby's going to come.

孩子什麼時候會來。

"Your water breaks with no warning."

"你的羊水破了，沒有任何警告。"

I know people see it in the TV and movies,

我知道人們在電視和電影中看到它。

and it's a very dramatic event, and it's clear cut,

而這是一個非常戲劇性的事件，而且很清楚。

and you rush to the hospital, and the baby is born.

然後你趕到醫院，孩子就出生了。

That's not always how it happens.

事情並不總是這樣發生的。

Sometimes it does break with a huge gush,

有時，它確實會以巨大的湧出量來打破。

and it's very obvious.

而這是非常明顯的。

Sometimes there's a leak, and patients are unsure.

有時會有漏網之魚，而病人又不放心。

And sometimes people don't know

而有時人們不知道

whether it's urine or it's their water breaking.

不管是尿液還是他們的破水。

If it's urine, it comes out and then it stops.

如果是尿液，就會流出來，然後就會停止。

And if it's your water, it continues.

如果是你的水，就繼續。

It does not stop. So put a pad on,

它不會停止。所以要放一個墊子。

and if the pad is consistently wet and saturated,

以及如果墊子一直處於潮溼和飽和狀態。

you have to think, "Gee, maybe my water broke."

你不得不想，"哎呀，也許我的羊水破了。"

Sometimes we will break your water for you.

有時我們會幫你破水。

For some patients,

對於一些病人來說。

they will be in labor and progressing nicely in labor,

他們將進入分娩期，並在分娩中取得良好的進展。

and the water will not have broken on its own.

而水不會自行斷裂。

If you're unsure whether or not your water has broken,

如果你不確定你的水是否已經破了。

it's better to come in and let us tell you yes or no

最好是進來，讓我們告訴你是或不是

rather than stay at home,

而不是呆在家裡。

because if your water has broken

因為如果你的水已經破了

and there's a long time before your delivery,

而且離你的交貨還有很長一段時間。

you do increase the risk for getting an infection.

你確實會增加感染的風險。

"If your water breaks,

"如果你的羊水破了。

that means the baby is coming very soon."

這意味著孩子很快就要出生了。"

If only!

要是這樣就好了!

Yeah, we wish.

是的，我們希望如此。

This is not always the case.

情況並非總是如此。

It is all over the map.

它在地圖上到處都是。

Because a lot depends on how many children you've had.

因為這在很大程度上取決於你有多少個孩子。

If it's your fourth baby

如果這是你的第四個孩子

and you're contracting and your water breaks,

而你正在收縮，你的水破了。

it's coming fast. If it's your first baby,

它的到來很快。如果這是你的第一個孩子。

your water breaks, you're not contracting,

你的羊水破了，你就不會再收縮了。

it could be 12, 24 hours.

可能是12、24小時。

So it's hard to know.

所以很難知道。

Contractions that come consistently

持續出現的宮縮

with the baby's head against the cervix

胎兒的頭頂著子宮頸

are what makes the cervix open.

是使子宮頸開放的原因。

The cervix has to get to 10 centimeters before you can push.

子宮頸必須達到10釐米才可以用力。

So that process is the process of labor.

所以這個過程就是勞動的過程。

If your water breaks in the course of that process,

如果在這個過程中你的水破了。

great, but that doesn't tell us the timing.

很好，但這並沒有告訴我們時間。

For some subset of our patients,

對於我們的某些子集的病人。

the water will break and the patient may not be in labor.

水會破，而病人可能沒有分娩。

That happens in probably 8% to 10% of patients.

這種情況可能發生在8%到10%的病人身上。

So if you think your water is broken,

是以，如果你認為你的水已經破了。

you should call your provider and say,

你應該給你的供應商打電話，說。

"My water's broken. I am contracting or not contracting.

"我的羊水破了。我在收縮或不收縮。

And when should I come in?"

那我應該什麼時候進來？"

Because that answer is going to vary

因為這個答案會有所不同

depending on the circumstances around your pregnancy.

取決於你懷孕時的情況。

"Eating the placenta is good for you."

"吃胎盤對你有好處"。

No!

不!

Don't go there.

不要去那裡。

Absolutely not.

絕對不是。

Please, please don't eat your placenta.

拜託，請不要吃你的胎盤。

Many patients will ask about

許多病人會問到

the utility of eating the placenta.

吃胎盤的效用。

There was some suggestion that eating the placenta

有一些建議認為，吃胎盤

after birth might prevent depression, anxiety,

產後可能會預防抑鬱症、焦慮症。

and while we're completely supportive

雖然我們完全支持

of doing anything to prevent those issues,

的做任何事情來防止這些問題。

I think we have to recognize that there's no science

我認為我們必須承認，沒有科學

behind the placenta being helpful to that.

胎盤的背後是對這個問題的幫助。

There was actually a recent publication

實際上，最近有一份出版品

from the American Academy of Pediatrics

來自美國兒科學會

that outlined some of these less traditional practices

該書概述了其中一些不太傳統的做法

surrounding birth, and this one is specifically mentioned,

圍繞著出生，這個人被特別提到。

and that paper calls out the infectious risk

而那篇論文指出了傳染病的風險

without added benefit.

沒有額外的好處。

So we are happy to have these conversations,

是以，我們很高興能進行這些對話。

to talk with patients

與病人交談

through shared decision-making processes,

通過共同決策過程。

but our recommendation will almost always be

但我們的建議幾乎總是

you should not eat the placenta.

你不應該吃胎盤。

Instead of eating the placenta,

而不是吃胎盤。

it's really important to pay attention

注意力真的很重要

to your nutrition; your hydration;

對你的營養；你的水化。

your rest, when you can, with a newborn;

你的休息，當你可以的時候，與一個新生兒。

and lots of support from family and friends.

以及來自家人和朋友的大量支持。

"Labor usually lasts a couple of hours."

"分娩通常會持續幾個小時。"

There are occasionally patients

偶爾也有病人

who've had children in the past

過去曾有過孩子的人

who start to contract at home

開始在家裡收縮的人

and come in and quickly have a birth with us,

並進來和我們一起快速生孩子。

but it is definitely the exception, not the rule.

但這絕對是個例外，而不是常規。

Depends on how many kids you've had.

這要看你有多少個孩子了。

Labor usually lasts, I'd say 12 to 24 hours

分娩通常會持續，我想是12至24小時

is average for your first baby.

對你的第一個寶寶來說是平均水平。

Second, third, way faster, thank goodness.

第二，第三，速度更快，謝天謝地。

Goffman: The labor process

戈夫曼：勞動過程

has multiple stages and phases.

有多個階段和階段。

The early part of labor can take a fair amount of time.

勞動的早期部分可能需要相當長的時間。

Some people will start with cramping.

有些人一開始會出現抽筋。

Then the cramping is, like, unbearable,

然後，抽筋是，難以忍受的。

and then they'll realize it's contractions.

然後他們會意識到這是宮縮。

Those contractions, then, are maybe 20 minutes apart,

那麼，這些宮縮可能相隔20分鐘。

and then they're 10 minutes apart.

然後他們相隔10分鐘。

And you actually need a lot of contractions

而且你實際上需要大量的收縮

that are three minutes apart, consistently,

始終保持三分鐘的間隔。

to soften the cervix.

以軟化子宮頸。

And most people will do some of that at home

而大多數人都會在家裡做一些這樣的事情

for several hours,

幾個小時。

and then they'll call us and say, "I think I'm in labor."

然後他們會給我們打電話說，"我想我要生了"。

And then we'll say, "Come on in."

然後我們會說，"進來吧"。

Once you get to sort of that 6 or so centimeters,

一旦你到了那種6釐米左右的地方。

things start to speed up.

事情開始加速。

And then you eventually get to 10 centimeters,

然後你最終達到了10釐米。

and then the real work happens.

然後，真正的工作就會發生。

Goffman: Usually, you will begin to push

戈夫曼：通常情況下，你會開始推動

shortly after you are determined to be 10 centimeters.

在你被確定為10釐米後不久。

And then that pushing process

然後那個推動的過程

is called the second stage of labor,

被稱為第二階段的分娩。

and it's from the time that you're fully dilated

而且是在你完全擴張的時候

until the time that your baby is out.

直到你的寶寶出來的時候。

Once the cord is clamped and cut,

一旦臍帶被夾住並切斷。

then we go on to the next step,

然後我們繼續下一步。

which is, we need to deliver the placenta.

也就是，我們需要交付胎盤。

We then are going to do some things

然後我們要做一些事情

to help prevent you from bleeding,

以幫助防止你出血。

so that's sort of the last piece,

所以這算是最後一塊了。

making sure that we identify and repair

確保我們識別和修復

tears that were created during the birth process.

在生產過程中產生的淚水。

"Doctors slap the baby on the back after birth."

"醫生們在孩子出生後拍打他的背部。"

That's a myth.

那是一個神話。

That's old school.

那是老式的。

And the movies.

還有電影。

I was just going to say, I think, actually, it's the movies.

我只是想說，我認為，實際上，是電影的問題。

I think that it comes from the desire

我認為，這來自於對

to stimulate the baby to take a big deep breath

刺激寶寶大口深呼吸

after we clamp the cord.

在我們夾住繩子之後。

But you don't really have to do that.

但你並不是真的要這麼做。

The babies do it on their own.

嬰兒們自己做。

They start crying.

他們開始哭泣。

So sometimes you will see us rub the baby's back

所以有時你會看到我們給孩子擦背

or tap the bottom of the baby's feet

或拍打嬰兒的腳底

just to sort of make it go, "Ah!"

只是為了讓它變得 "啊！"。

And then it takes a deep breath,

然後它深吸一口氣。

coughs up fluid, and then starts screaming.

咳出液體，然後開始尖叫。

"An epidural increases the chance of needing a C-section."

"硬膜外麻醉會增加需要剖腹產的機會。"

Myth! Epidural does not increase

神話!硬膜外孕不會增加

the risk of needing a C-section.

需要剖腹產的風險。

I think that misinformation comes from the fact

我認為這種錯誤的資訊來自於以下事實

that some patients probably get the epidural so early

有些病人可能很早就接受了硬膜外手術