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Labour

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Every birth is different but being familiar with what is likely to happen during your baby’s birth can help make the ‘big day’ a little less daunting.

Labour is a term that’s given to the whole birthing process and is divided into three stages – essentially ‘before’, ‘during’ and ‘after’ the baby’s birth. Each labour is different, but first-time mothers usually have longer labour times than women who have previously had a child. 

Stage 1 – Your body is preparing itself

During the first or initial stages of labour your body is ‘getting ready’ for your baby’s birth. Labour can start in different ways and you may notice some of the following signs that things are beginning to ‘kick-off’:

  • Period-like cramps, backache or an upset stomach.
  • A ‘show’ or plug of pink, sticky, jelly-like mucus that gets dislodged from your cervix (the bottom part of your uterus).
  • Your ‘waters break’ – the amniotic sac surrounding your baby breaks and the fluid begins to drain through your vagina – if you are at home when this happens call your midwife or doctor so they can advise you about what to do next.
  • Regular contractions – you start to have regular, strong contractions that last for about 30 seconds or so.

Contractions

The contractions that you are now feeling are the muscles at the top of your uterus pushing your baby down onto your cervix – this pressure helps ‘soften’ the cervix which is starting to open or ‘dilate’ ready for the baby to pass through.

During these early stages you may want to move around or do some relaxation exercises to help cope with the more painful contractions – you may also want to eat or drink something as it can take a while to reach the next stage!

Labour is said to be ‘established’ once the cervix has dilated to more than 3 cm – but it will eventually need to be about 10 cm for the baby’s birth. By the end of stage 1 your contractions will be stronger, more painful and more frequent – and can feel like they are beginning to run into each other.

Stage 2 – The birth

Stage two is where all the pushing and hard work happens and officially begins once your cervix is fully dilated (about 10 cm) and ends when your baby is born.

Your midwife or doctor will guide you through the birthing stage indicating when to push and when to try and relax. They will also encourage you to try and find a comfortable position – standing, sitting, lying down or squatting – it’s up to you.

Once your baby’s head is seen your midwife or doctor will ask you to stop pushing so the head is born slowly – giving your skin and muscles time to stretch rather than tear (although this cannot always be avoided). The rest of the baby’s body usually follows more easily and you’ll soon be holding your new baby ready for the cord to be cut.

Stage two can take up to two hours, particularly if it is your first baby, and both you and your baby’s condition will be closely monitored to check everything is progressing correctly.

Stage 3 – After the birth

The third or last stage of labour is focused mainly on you – the mother – your uterus will continue to contract to loosen and remove the placenta, and you will lose some blood at this point.

You may be offered an oxytocin injection to speed up the delivery of the placenta and prevent too much blood being lost.

You may have some small tears or grazes in the perineum skin and muscles (the area between your vagina and anus) which are generally left to heal naturally.  However, sometimes the tears can be large, or you have had an episiotomy (where a small cut is made to widen your vagina opening during stage 2 of labour), in which case you will need stitches. A local anaesthetic injection is given before this happens (unless you had an epidural). 

Meanwhile, your baby will be going through their own checks and you will be offered a vitamin K injection for your baby to help prevent a rare bleeding disorder (haemorrhagic disease) that occurs in newborns – there are also oral doses available if you prefer your baby to not have an injection, this should be discussed with your midwife or doctor before the birth of your baby.

Once the third stage is all complete its time to get to know your new baby!

For more information managing pain during the different stages of childbirth, see Pain Relief in Labour. 

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