The Stages of Labour
The purpose of labour and contractions are to help push the baby from your body. During this process your cervix will dilate to 10cms or become ‘fully’ dilated, soon after your body will want to start pushing and your baby will be born, followed by the delivery of the placenta.
The first stage starts in many different ways and it will feel different for everyone. You may experience:
- period like pains
- a slightly upset stomach
- feeling sick or nauseous
- just feeling slightly under the weather
All of this can be explained by the huge hormonal and physical changes going on in your body.
Contractions will become increasingly painful and regular during this first stage and once this happens, your labour will have become established and you will have moved out of ‘early’ labour. In established labour, contractions occur about three or four times in ten minutes and it will be difficult to speak during them. At this point you will be offered pain relief if you require it.
Sometime during this stage you may have a ‘show’: a very mucousy plug that has until now sealed the cervix. There is no definite point when this is expected and you may have it earlier than this stage or sometimes it can be seen just before birth.
Breaking Waters (Amniotic Fluid)
If your waters break before your labour starts or even if you are not sure, make a note of the time and contact your local maternity unit immediately and wear a sanitary towel until you see a midwife.
When you are in labour your waters will at sometime break (or they may be broken for you). Waters are generally clear and straw coloured, some women experience a trickle and others a gush. If your waters break early in labour the risk of infection in increased so it is very important to keep the vaginal area clean. Do not use tampons, have sex or have a bath.
The 2nd Stage of Labour ...
...begins when your midwife or doctor tells you that you are fully dilated or ‘10cms’, or when you have an overwhelming urge to push. This stage ends with the birth of your baby.
If this is your first baby this stage may take over an hour or even longer to complete. However with subsequent babies may be very quick.
When your baby's head is visible, your midwife will help you control the delivery of the head. She may even ask you to stop pushing and pant instead. The aim is to push out the head with the help of a contraction in a controlled manner either with the midwife’s hand on the baby’s head or just guiding you with your breathing.
When your little one is born, the midwife will place your baby on your chest for some well earned skin to skin contact and then cut the cord connecting the baby to the placenta.
Delayed cord clamping
Historically, the cord has been clamped and cut (sometimes by the baby’s father) immediately after birth, but increasing amounts of research are suggesting there are many benefits to the baby of delaying the clamping of the cord by between three and five minutes. These include the baby receiving 30% more blood and 50% more red blood cells from the placenta before it is removed, which reduces the chances of anaemia (a lack of red blood cells) in the first few months of life and can improve your baby’s cognitive development.
There are benefits for you too, including lowering the chances of suffering from haemorrhage after birth or a retained placenta.
The Royal College of Midwives (RCM) are changing their guidelines from November 2012 so that delayed cord clamping will become the common and preferred practice, so do discuss it with your midwife and consider putting it on your birth plan.
The 3rd Stage of Labour
It may come as a surprise to you that there is a 3rd stage of labour especially once you’ve given birth to your baby. However the 3rd stage, when you give birth to the placenta, does not require much effort from you, but is vitally important in terms of your post natal health.
You may choose to have an injection to help expediate this (usually a drug called syntometrine) or you may choose the natural option which may take up to an hour. The injection, which is given just after birth, normally means the whole process is over within 15 minutes. You will usually get some more contractions to help deliver the placenta and then all you have to do is gently push it out from your vagina. The actual delivery of the placenta does not hurt.
Some women are surprised to get further pains (similiar to contractions) for a while after birth. These are called 'after pains' and are caused by your uterus contracting back to its pre pregnancy size. These pains may be felt more strongly during breastfeeding as breastfeeding releases the hormone oxytocin which is the same hormone that made your uterus contract during labour.
Finally, the midwife will check your uterus is well contracted by placing her hand on your abdomen near your belly button. This is very important because a poorly contracted uterus may cause excessive bleeding post natally. She will then check the placenta and membranes to make sure they are all complete as any retained parts could cause infection or bleeding.
If you have any questions about labour, you can contact Amber,
our midwife who will be happy to help you.