What to expect during LABOUR

 

What to expect during labour

It's natural to be concerned about how you will

cope with labour, but one of the best ways to

overcome any anxieties you may have is to find out

as much as you can beforehand. Here we explain

what happens during labour and tell you about

your pain relief options. A first labour usually lasts

for anything between 6 and 20 hours, while any

subsequent labours are often much shorter.

During labour you will go through several stages

and it helps to know what happens in each so you

can recognise the signs that you are progressing,

Early labour (latent phase)

This can take hours, or even days as contractions

start to build up. Unless there's a medical reason

for you to go early to hospital, you'll be much more

comfortable at home during this stage.

Initial contractions are short and irregular. During

this time you may experience a ' show'.

Try to rest and stay relaxed when you are in early

labour, even if you can't sleep. Having a warm

bath should help to relax you and using a TENS

machine should ease any discomfort. You need to

continue to eat and drink normally.

Be aware of your baby's movements-they should

be the same as usual. Contact your midwife if you

need any advice.

First stage labour

Strong, regular contractions, lasting about 45-60

seconds and coming every three to five minutes,

indicate that you are likely to be in ' established'

labour.

This is when the cervix thins (effaces) and opens

. will need to ring the maternity unit

up (dilates) You

to talk to the midwife so that between you, you

can decide whether you should stay at home a bit

longer or go to the maternity ward.

If you are having a home birth now is the time to

call your midwife

Once in the maternity unit the midwife will go

through your birth plan and feel your abdomen to

establish which way your baby is lying. She will

listen to your baby's heartbeat, and will continue to

do this every 15 minutes, and will check that your

blood pressure, pulse and temperature are normal.

She may ask to do a vaginal examination to assess

how far your labour has progressed-the cervix

has to dilate to 10cm during the first stage-and

your options such as remaining upright, being

active, using a ball or water and the use of pain

relieving drugs will be discussed.

You will be encouraged to eat light snacks and

to drink isotonic drinks to maintain your body's

energy to cope with the physical demands of

labour.

As labour progresses your contractions will

become really intense with virtually no gaps in

between them. During this stage any pain relief

you are having will be monitored.

Your partner can help by offering you lots of

encouragement and support. Sips of water, a cool

flannel on your face or a massage may all help, but

equally you may ' go into yourself to gather your

strength and will hate any fussing. You may start

to feel the urge to push.

Second stage

The cervix is 10 cm or fully dilated now. It will

help to think of this second stage, which can take

up to two hours of active pushing, as the final

countdown to meeting your baby.

Yes, it's painful and pushing the baby out is very

hard work-but the end is in sight and your

midwife will help you through it.

Your contractions will become even stronger and

closer together and you will feel the urge to bear

down and push with each one.

With every push your baby will move further down

the birth canal and is closer to being born. You will

need to remain focused and work hard, but the

time will go very quickly.

Eventually the baby's head will crown', passing

through the perineum and you may feel an intense

burning sensation. The midwife will encourage you

to ' pant', a succession of quick, short breaths to

allow the perineum to stretch and not tear.

In some cases you may tear or your midwife may

need to perform a small cut-an episiotomy (this

can be repaired with stitches after the birth). Once

your baby's head is born, when you push with the

next contraction your baby will turn to allow one

shoulder to come out, followed by the other. The

feeling of relief is immense and the pain stops

immediately; many women also feel an intense

 ' high' at their achievement.

Once the baby is born the cord will be clamped and

cut-in some cases the new dad wants to do this

-and the baby will be given to you so, if you wish

to, you can have skin-to-skin contact.

Third stage: delivery of the placenta

It's not quite over yet! The placenta (or after-birth)

now has to come out and in most cases this is

quite straightforward. If you consent, your midwife

will give you an injection of oxytocin just as your

baby is being born, or immediately afterwards, to

speed up the delivery of the placenta (to between

five and 20 minutes after the birth).

Your midwife may gently pull the cord to help to

remove it while you relax your tummy.

A natural third stage, where no injection of

Oxytocin is given, is an option for some women,

but isn't suitable for everyone.

Pushing the placenta out yourself without the aid

of drugs takes up to an hour and you may bleed

more. Breastfeeding or skin-to-skin contact will

help to speed up the delivery process.

In rare cases the whole or part of the placenta is

retained and this may cause heavy bleeding and

requires removal under anaesthetic.

After the birth

You and your partner will be given time alone with

your baby before you are cleaned up and given

stitches if they are needed.

The area to be stitched will be numbed first and

you will be offered analgesia afterwards to reduce

any inflammation.

Your baby will be checked over to make sure

he's healthy and you will be offered help with

breastfeeding.