Labour & Childbirth

Stages of labor

There are three stages of Childbirth:

  • Labor
  • Delivery of the baby and
  • Delivery of the placenta

Though each woman goes through a unique and special labour experience, the phases typically remain the same.

Labor, the first stage of childbirth, in turn has three phases:

  • Early
  • Active and
  • Transitional

Early (Latent) Labour

This is usually the longest stage of labor and could extend from a few hours to several days. It starts with short, infrequent contractions that result in the cervix thinning (efface) and dilating.  During this process, you body releases the hormone oxytocin to induce contractions.

Symptoms of Early Labour

Mild to moderate contractions that could be regular or irregular – Contractions may last 30 to 40 seconds. They may be 20 minutes apart and become progressively closer together, but not necessarily follow a consistent pattern. Some women may also experience

  • Backache (constant or with each contraction)
  • Menstrual-like cramps
  • Indigestion/ Diarrhea
  • Blood-tinged mucous discharge (also known as a bloody show)
  • Rupture of the amniotic membranes (your water will break), though it’s more likely to happen sometime during active labor Things to do in Early Labor It is normal to feel excited and anxious. But at the same time, it is important to keep your emotions in control and relax as much as you can to save up your energy and strength for later on, when you need it the most.
  • Try and catch a few winks. If you’re unable to, keep yourself busy by doing some chores or chat up a friend, or watch TV.
  • Much on a light snack, but keep in mind to go slow on fatty foods and not to stuff yourself.
  • Pack your hospital bag, as you may need to go to the hospital soon
  • Drink water – it’s important to stay hydrated! But stay away from acidic juices.
  • Check your contracAt this point in time, you don’t have to obsessively time them. But do monitor them to see whether they’re getting closer than 10 minutes apart.
  • Empty your bladder as often as you can;a full bladder can get in the way of labor.

Active Labour

This phase usually lasts from two to three and a half hours. By this time, your cervix dilates to 7 centimeters and you’ll usually be in the hospital.

Signs and Symptoms of Active Labor

Contractions get increasingly intense and last longer – (40 to 60 seconds) while also getting more frequent. This may be accompanied by:

  • Increasing backache
  • Increasing bloody show
  • Leg discomfort or heaviness
  • Extreme tiredness
  • Rupture of the membranes if they haven’t already

What you can do during Active Labour

This is the period where emotions may run high. You may also be restless and find it hard to relax as the labour pains get more and more intense.

  • Ask your partner to give you a gentle massage to help ease pain.
  • This is the time to start your breathing exercises. Do whatever relaxes you and makes you feel comfortable. It’s perfectly ok to abandon them if they are not working for you.
  • Stay hydrated.Your throat may feel parched and mouth may go dry. Keep sipping water to replace fluid loss and keep your mouth moist.
  • Pee regularly. You may not realize that you need to go because of the pelvic pressure build up but a full bladder can hamper your progress. If you’ve been given an epidural, you’ll be hooked up to a catheter.

Transitional (Advanced) Labour

This is the last and most intensive phases of labour. This is considered to be a very exhausting and stressful period, as it demands tremendous energy and involves a lot of hard work. Your cervix will dilate from 7 to its final 10 centimeters. It’s also the shortest, generally lasting from 15 minutes to an hour (sometimes up to three hours).

Signs and Symptoms of Transitional Labour

Contractions become very strong and last for about 60 to 90 seconds. Since the contractions are spaced at very short intervals, it may seem as though you barely have any time to relax before the next contraction begins. During this period, unless you’re numbed by an epidural or other pain relief, you may feel:

  • Strong pressure in the lower back
  • Irritable and disoriented
  • Difficulty in breathing
  • Rectal pressure
  • An increase in bloody
  • Weakness in the legs that may tremble uncontrollably
  • Nausea and/or vomiting
  • Drowsy between contractions
  • Fatigue or exhaustion 

What you can do during Transitional Labour

This stage of labour is physically demanding and can drain you out completely. During this crucial moment, you will require a great deal of mental and emotional support. You’re bound to be exhausted, impatient and disoriented. By the end of this phase, your cervix will be fully dilated and your contractions may stop for a short while. Before you know it, its time to begin pushing baby out.

  • Continue breathing techniques.
  • Remember to Breathe. Take one contraction at a time and try to relax between contractions with slow, rhythmic breathing.
  • Change positions till you find a comfortable one
  • Focus on the baby.Your bundle of joy will soon an appearance!When you’re a full 10 cm dilated, you’ll be moved to the delivery room, if you aren’t already there.

    Second Stage: Pushing and  Delivery of the Baby

    This is the pushing stage where the baby makes its way through the birth canal. This stage could last from just 15 minutes or to several hours! Many women find the contractions in the second stage easier to handle than the contractions in active labour as it offers some relief.

    During this stage:

    • Your urge to push gets stronger as the baby descends.
    • Each contraction will move the baby further down the birth canal and closer to being born.
    • Eventually, the baby’s head will ‘crown’, passing through the perineum as you feel an intense burning sensation.
    • When the baby’s head emerges, it turns to one side, allowing the shoulders to be delivered one by one, before the rest of the baby’s body slips out.
    • The feeling of relief is tremendous – with the pain stopping almost instantaneously.
    • Once the baby is born, the umbilical cord will be clamped at two places and then cut between the clamps

    Third Stage: Delivery Of The Placenta

    This stage of labour lasts for about five to ten minutes
    Soon after giving birth, your uterus begins to contract again. After the first few contractions the placenta will be dislodged from the uterine wall. In most cases, this is quite uncomplicated. Sometimes, an injection of syntometrine is given to hasten delivery of the placenta (usually within five minutes of the birth). It just takes a few pushes before it’s out, or your Doctor may gently pull the cord to help remove it while you relax your tummy.

    Very rarely, the placenta (whole or part) is retained (known as retained placenta) causing heavy bleeding. It has to be removed through surgery.

    What Happens After Birth?

    After you deliver the placenta, your uterus will contract and get very firm.  Contraction of the uterus helps cut off the open blood vessels where the placenta was attached. If your uterus doesn’t contract properly, you will continue to bleed excessively from those vessels. To help the uterus contract, you will be given Oxytocin.

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