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Labour and Delivery

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Growing a baby inside you is a long process. It takes a whole nine months for the baby to develop and reach the size of a newborn. Labour and delivery however, occur within a short span of hours or days. 

Majority of expectant mothers will worry most about labour and delivery. 
Will I be able to bear the pain?
Will complications develop during delivery? 

Being well-informed will help to assuage worries, and give you a clearer picture of what to expect and the necessary steps to follow.  

What Is Labour And What Are the Signs?

Labour is the whole process of childbirth that starts with mild pain, signifying the contraction of the uterus. This ends with a baby’s delivery. 

It is imperative for every expectant mother to know how to identify accurately the signs of labour. This is because towards the end of the gestational period, you might experience various aches and discomfort which might be wrongly interpreted as labour pains. 

Labour is said to have occurred when you experience any of the symptoms below:

  • Thick mucus-like discharge from the uterus
    • Sometimes mixed with blood such that it appears pinkish 
  • Increased contractions that 
    • Do not go away with lying down
    • Worsen with activity 
  • Increased pressure on the uterus
  • Cramps and pains in lower back and groin area
  • Water breaks

What Are the Different Stages of Labour?

Labour occurs in three stages followed by the birth of the baby and the placenta. 

  • First stage: Early labour

This is the first stage of labour and probably the longest and least intense. During this stage, the cervix dilates and expands to 3-4 cm. This means that the cervix becomes shorter and thinner in preparation for delivery. This can occur in a few hours or a few days. The contractions can be mild initially, lasting for 30-45 seconds, spaced around ≥ 20 minutes apart. For those who have a very slow progression, you may not even notice it until you go into active labour. Stay in contact with your doctor and prep yourself for delivery!

During this stage, you can try the following to stay calm and comfortable: 

  • Listen to relaxing music
  • Practise breathing and relaxation techniques 
  • Take a shower or bath
  • Go for a short walk, or rest if you want.

For a minority of women, the amniotic membrane may also rupture. This results in the iconic “water breaking” scene that everyone is familiar with. Although, this should only occur at the “active labour stage”, should it happen, contact your doctor immediately for further instructions.

  • Second stage: Active labour

The active phase of labour usually lasts for 4-8 hours. At this stage, the cervix further dilates from 3-4 cm to 7 cm, at approximately 1cm per hour. You will experience contractions with more frequency, regularity and intensity. The contractions will last for 40-60 seconds with 3-4 minutes gap between each contraction. By this time, you should already be in hospital, or your chosen delivery facility. 

At this point you might experience: 

  • Increased back pain, leg discomfort, and feel nauseated
  • If your amniotic membrane did not rupture earlier, it should at this stage
  • Your blood pressure will be closely monitored
  • Two separate transducers (in the form of pads for electronic monitoring) may be fastened to your belly to simultaneously record your uterine contractions as well as the fetal heart rate. 
  • Your doctor will examine your pelvis once in a while to check how far the cervix has dilated. 
  • An intravenous line may be placed in your arm for various reasons:
    • Provide you with fluids to prevent your blood pressure from plunging, a common side effect of epidural should you opt for one
    • Easy administration of medication should the need arise
  • Third stage: Transitional labour

This is the final stage of active labour in which the contractions are the most painful and intense, occurring every 2-3 minutes and lasting 60-90 seconds each. At this stage, your cervix will further dilate from 7 cm to the final 10 cm. This phase usually lasts 15 to 60 minutes.

You will feel a strong pressure at the rectal area with or without the urge to push. 

The Delivery of your Baby

With the cervix fully dilated, the midwife/doctor will encourage you to start pushing your baby out. This can last for a few minutes up to a few hours. You can try different positions while pushing the baby. It is recommended to push during contractions, riding on the urge, or with the midwife’s instruction.

The baby will be guided out of the birth canal naturally once the head shows. Sometimes however, the doctor may make a small cut at the opening of the vagina facilitate access, or use special tools like forceps to help the baby out. When the baby is born, the umbilical cord will be cut. 

Delivery of the Placenta

Once the baby comes out, you will continue delivering the placenta. This stage is the shortest, and does not take more than 20 minutes. You might feel slight contractions and will be asked to push to deliver the placenta. Once the placenta is delivered, you will continue to experience contractions that help the uterus revert to its normal size. This is also the time when your healthcare provider will stitch you up if necessary. 

The entire process of labour and delivery is physically and mentally challenging. Being well informed, and having your loved ones nearby to support you, can make even the hardest process of labour and delivery, a manageable one.

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