Labour is the process by which the fetus, placenta and membranes are expelled through the birth canal. As the name implies it is HARD work and involves both MENTAL and PHYSICAL stamina.
Labour is the end of many weeks of excited anticipation tinged with anxiety and fear of the unknown. It is a journey which needs some preparation. You wouldn't run a marathon without preparing for it, and you shouldn't expect to go through your labour without some preparation.
You need to think positively and believe in your own capabilities, you need to eat well and have plenty of rest leading up to and especially during pre-labour. If you have been working to get your baby into the optimal position for labour (baby's back on your left side) and you are mentally and physically ready, your journey will not seem as daunting.
Labour is a normal life event and the birth of a baby is a unique moment in the life of any family.
There are three stages of labour;
FIRST STAGE OF LABOUR
The First Stage is thinning and opening the cervix (neck of the womb) which has to open to 10cm before the baby can be born.
This first stage has three parts to it;
The first part is the pre labour (latent phase). This part can take 12 or more hours and usually the contractions during pre-labour are mild and cramp like, with back pain and pressure 5 – 30 mins apart lasting 15 – 40 seconds.
It is during this stage that you must eat and drink and more importantly rest. This is only the beginning and these contractions are mild compared to the ones in active labour.
Carry on as usual and ignore it as much as you can. Take relaxing baths / showers for discomfort, panadol 4-6 hourly, wheat pack or hottie, walk around and take your mind off things and if it's night time TRY TO SLEEP.
The second part, of the first stage is active or established labour. The contractions are stronger and more intense, they will get as close as 2-3 mins apart (from the beginning of one contraction to the beginning of the next), lasting a minute or longer.
You will need to concentrate with these and breathe through them.
Try and stay relaxed and not fight the contraction.
Try changing positions, a massage from your support person may help, and remember to drink and rest as much as possible as this active phase can take a number of hours, especially if it is a first baby.
The third part of the first stage is known as Transition. Transition is the climax of the first stage of labour and the contractions will be as strong as they are going to get and this is the point that you usually feel that you can't go on.
When you get to transition remember you are very close to the birth of your baby.
At some point between active labour and reaching transition you will feel you need the support of your midwife and maybe even pain relief. If you need pain relief during your labour your midwife will discuss this with you and assess your needs at the time.
SECOND STAGE OF LABOUR
The Second Stage of labour is from when the cervix is fully dilated (10cm, or there is no cervix left) to when the baby is completely born.
This second stage can take two to three hours if it is your first baby and can be very hard work. The feeling to push is like needing to open your bowels and becomes overwhelming. This is something you should not worry about and should go with what your body is telling you to do and not hold back.
There may be a bigger gap between your contractions but they will become more expulsive. The baby comes through the birth canal by a series of passive movements, as the head distends the vaginal walls women experience and acute burning sensation (like a chinese burn) which is the stretching of the tissues and is a positive thing as the more stretch the less likelihood of needing stitches.
You can deliver in whatever position you are comfortable but your midwife may suggest altering your position if the descent of the baby is slow.
The baby is usually delivered onto your abdomen and skin to skin contact is encouraged for at least half an hour. A warm, dry towel is placed over the baby to dry it a little. This helps with bonding and with breastfeeding. The baby comes out of your tummy onto your tummy to be soothed and reassured.
Babies usually look blue when they are born and they go pink in the first few minutes. They may or may not cry and they may want to suckle very soon - or not - for 15-20 minutes.
THIRD STAGE OF LABOUR
The Third Stage of Labour is from the birth of the baby until the placenta is delivered.
There are two ways of "doing" the third stage.
Physiological means as nature intended. The cord is not clamped at least until it has stopped pulsating and often until the placenta is delivered. This allows the baby to make a gentle transition to life outside the womb and the baby receives extra blood which it uses to fill the extra space created when the baby lungs inflate with air. The mother then pushes the placenta out.
The second way is active management where we give the mother an injection of oxytocin which causes the uterus to contract down hard and the placenta separates. This hastens the third stage. The cord is clamped and cut quickly after the birth as we don't want the baby to get the drug. It also reduces blood loss at the time of birth.
See information on Third stage of labour options.
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