Labour
Giving birth to a child is a unique experience. Something that can never be the same even if you have delivered before. And though you may have thought of labour simply as the time when the baby finally comes into the world, it is in fact divided into various stages, each with its own special contribution to childbirth.
Signs of Labour
Labour and birth can happen in a matter of seconds or take hours to occur. The signs of labour are unique to everyone and if you are a little doubtful, it is best to contact your gynaecologist.
During labour, what may be happening inside your body is this:
- There is a mucous plug that seals the opening of the cervix during pregnancy. When your body starts getting ready for delivery, this plug comes out. In some women, it comes out as a single pinkish blob while in others it may be in small pieces. The time gap between the plug coming out and proper labour beginning may vary from a few weeks to days and hours.
- The amniotic sac, the fluid surrounding the baby, breaks and the water gushes or trickles out. This is a sure sign that you are in labour and should call your doctor immediately
The physical signs that you may experience during labor are:
- Period like cramps
- Backaches
- Diarrhoea
- A blood like stain, which is due to the thinning of the cervix and the mucous plug, may drop out
- Water coming out as the membrane breaks
- Contractions (these can begin early but you'll know the time for delivery is near if the interval between each contraction is short and the contractions are strong)
Stages of Labour
The complete process of labour and delivery is divided into three stages.
First Stage
This stage is usually the longest and can last days or weeks without being noticed though it often takes place a bit quicker. The first stage refers to when your cervix begins to dilate and you begin to have contractions that gradually get closer and stronger.
This stage is again divided into three phases:
Latent phase - The very early period when your contractions just begin and you feel slight discomfort. You may also not feel anything at all when the phase lasts for a week or more. When these early contractions happen, it is best to distract yourself by taking a walk, reading, sitting, talking and relaxing at home, as there is not much that you or your doctor can do at this time. The cervix dilates to around 3cm to 4cm.
Active phase - This is the time when labour contractions are much more regular and come in intervals of 3 or 4 minutes. The cervix may dilate to about 6cm or 7cm and you may find it a little more difficult to talk or relax. You may call your doctor or midwife at this point.
If you are given a Pitocin, the artificial oxytocin, your phase may last for a shorter duration unlike if you are using an epidural. If you have already had a vaginal birth before, this phase may also be shorter for you.
Transition phase - The contractions become more intense and painful. You may feel that the interval between two contractions has shortened and you may not even feel the gap between them. The cervix dilates to around 10cm. You may get an urge to go to the toilet, as this is the time when the baby's head touches the rectum.
Many mothers get an urge to push at this time even though complete dilation may not have taken place. If you are taking an epidural and want to actively participate during the delivery and the pushing, it is best to lower your dosage of epidural at the end of this phase.
The exact time when you know that you are in actual labour can be a tricky one if your contractions start very soon and the gap between them are almost 4-5 minutes. Early labour contractions may also be confused with Braxton Hicks contractions, which sometimes start half way during pregnancy and may tend to lift and tighten your abdomen a bit.
Second Stage
This is the more active phase of labour when you will be actually delivering your baby. The cervix has dilated completely and it may be at this time when your water breaks. If it doesn't happen naturally, your gynaecologist may artificially rupture it. This stage can last for as little as 10 minutes for someone who has previously had a vaginal birth to two to three hours for a first time mom. There may be a burning or stretching sensation as the baby moves through the vagina.
The actual action of pushing should usually be started when you get a natural urge and the uterus has done its work of moving the baby. But some doctors may suggest pushing with each contraction so as to hasten the process. Listen to your doctor's instruction carefully and follow it to utilise your complete energy and deliver the baby without any problem. Most women find the semi-sitting or squatting position most comfortable as gravity helps to deliver the baby.
The stage is over when the baby has been born and the doctor has cut the umbilical chord. You can relish in the sight of your newborn for the very first time.
Third Stage
Once the baby is delivered, the uterus shrinks in size and the placenta, which provided your baby's nourishment for the last nine months, separates from the uterine wall. Though you may be too exhausted at this point, it is necessary to deliver the placenta, which is also known as the afterbirth. This stage can last anywhere from five minutes to a half hour.
To deliver the placenta, just one mild push may be all that's needed. Once this is done, your uterus will contract more and become very firm. It is important to cut off the open blood vessels at the places where the placenta was attached; if this is not done it can lead to profuse bleeding.
Pain Relief
Learn more about your options for pain relief during labor and find out how to best manage your pain during the worst part of labor. Also learn more about medicines available for relieving the pain of childbirth like a pudendal block and find out about alternative pain management options like using a TENs machine. In addition read about the benefits of birthing naturally and discover how using a doula can help.
What to Expect After
After birth, the doctor usually checks the pulse, blood pressure, and uterus contraction of the mother to ensure everything is fine. The baby may be given a dose of Vitamin K and will have an APGAR test done. Keep in contact with your doctor on a regular basis to understand what all you can or cannot do just after the delivery.
Following delivery, you may feel pain, like menstrual cramps, for a few hours or days. If you are breastfeeding, your uterus will tighten even more thanks to the oxytocin that is released during breastfeeding in the first few days. If you've had an episiotomy, where your doctor makes a small cut on the vagina to help widen the opening and make delivering your baby easier, it will be necessary to stitch the cut.
Every mother has an inborn strength to deliver and nurture a child. Use it and enjoy this novel experience.
Everything Else
Also learn more about how to prepare for labor by creating a birth plan. Discover your birthing options and create a birth checklist. Also hear from moms on how best to pack your hospital bag and find out about some of the surprises of delivery that no one tells you about.
In addition, find out more about what to do if you go into preterm labor, if you need to induce labor, if your baby presents breech and what does it mean for you and your baby if you need a c-section. Get all of your answers now.
For more information on your labor and delivery check out our pregnancy videos.
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