Labour and Delivery

During the three phases of labour, your body will prepare for your baby's delivery (stage one), then deliver the baby (stage two), and finally deliver the placenta. Throughout labour, your body will utilise contractions to dilate and efface the cervix. Learn the difference between actual labour contractions and Braxton Hicks Contractions, as well as the indications of labour and what to do while in labour.

How does labour work?

As your pregnancy nears its end, your body will prepare for labour and delivery. This is the method by which your baby will be born. Labour varies differently from person to person. Some labours are brief, while others are lengthy and tough. Other individuals may suffer labour that pauses or stops, necessitating medical intervention.

• Early labour: The average labour lasts 12 to 24 hours for a first birth and 8 to 10 hours for subsequent deliveries. Throughout this period, you will go through three phases of labour. The first stage of labour is often the longest, lasting from when you initially go into labour until your cervix opens. The beginning of this period is known as early labour. Early labour is characterised as dilating between 0 and 6 centimetres.
• Active labour: As your contractions strengthen, you will continue to the second stage of labour, known as active labour. Active labour is defined as dilating from 6 to 8 centimetres before switching to the second stage, which is dilating from 8 to 10 centimetres. During active labour, your contractions will intensify and your cervix will swiftly open. The second stage of labour occurs when you push. This is the stage of labour in which you will give birth to your child.
• Afterbirth: The third stage of afterbirth involves delivering the placenta. This is also known as afterbirth.

During these phases, your body prepares for labour by dilatation and effacement.

• Dilation: This is the process of opening up and extending your cervix in order to be ready to give birth. Dilation ranges from 1 to 10 centimetres. Your physician will conduct a vaginal exam to determine how dilated you are throughout your labour. In the second stage of labour, you will be 10 centimetres dilated and ready to deliver your baby.
• Effacement: During labour, the cervix expands and thins. Cervical shortening and thinning are quantified as percentages. Throughout your labour, you will proceed from 0% to 100% effacement.

Imagine your cervix as a circular entryway that has to extend outward and narrow before your baby may pass through. Contractions are what create the stretching and thinning. Contractions may be characterised in a number of ways, including unpleasant, period-like cramps and severe abdominal tightness. You may also notice a dull ache in your back and lower abdomen, as well as pressure in your pelvis.

When you experience a contraction, your uterine muscles tighten at regular intervals to dilate and efface your cervix. During contractions, your abdomen hardens. Between contractions, your uterus relaxes, and your abdomen softens. Even though contractions might be uncomfortable, they help you progress through your labour.

How will I know when I'm in labour?

It might be tough to tell whether you're really in labour. First-time parents, in particular, may mistake other signs or irregular practice contractions (known as Braxton Hicks Contractions) for actual labour. True labour follows a pattern and advances consistently over time.

When you're in actual labour, your contractions will follow a pattern. Instead of the erratic Braxton Hicks Contractions, you may have had throughout your pregnancy, which appeared and then disappeared at random, these contractions will continue for a longer amount of time. When you are really in labour, you should be looking for three things.

• Frequency: How frequent are your contractions? Keep track of them using a notebook or labour app on your phone to ensure they arrive at regular intervals.
• Duration: How long are your contractions? Your contractions will become more prolonged as your labour progresses. Time each contraction using a stopwatch, a clock, or the timer on your phone.
• Intensity: Are your contractions becoming stronger? As you go through the phases of labour, your contractions may get stronger and more severe. Note how your contractions feel from time to time.

Is there any indication that I may go into labour soon?

Many women exhibit many pre-labour indicators, which may indicate that labour may begin shortly. These indications of labour are:

• Backaches
• Diarrhoea
• Weight loss
• Nesting (cleaning and organising your house)

No one knows for certain what causes labour to begin, although various hormonal and physical changes may indicate the onset of labour.

What is a Braxton Hicks contraction?

Practice contractions, sometimes referred to as Braxton Hicks, are irregular contractions that do not cause cervical changes. Consider them a test run for the real deal. They may begin near the conclusion of your pregnancy and confuse individuals into believing they're in labour. This is known as false labour.

A Braxton Hicks Contraction feels like a quick, abrupt tightening of your abdominal muscles. Although this is remarkably similar to how a contraction feels, Braxton Hicks Contractions do not occur in a predictable pattern or develop over time. They may also cease if you lie down or relax. Keep note of your practice contractions as they occur. Writing them down is the most effective technique to distinguish between true and false labour.

What is lightening?

Lightening is the process by which your baby settles or descends into your pelvis. This may occur many weeks or even hours before labour. When this occurs, you may notice an increase in lower pelvic pressure. After lightening, your uterus may sit more on your bladder, causing you to urinate more often. After your baby is born, you may realise that you are no longer short of breath.

What is the mucus plug, and what happens when it slips out?

A thick lump of mucus known as a cervical opening is covered during pregnancy. This plug keeps your uterus locked off from the delivery canal and the rest of your body, preventing germs from entering. When your cervix softens, thins, and opens, mucus is ejected into the vagina. Not every mucus plug will seem the same. The mucus plug might be any of the following colours:

• Clear
• Pink
• Slightly bloodied

Labour might begin soon after you lose your mucus plug or many weeks later.

How can I time my contractions?

Once you're in labour, you should keep track of your contractions. Your healthcare physician will want to know how long your contractions last (duration), how frequently they occur (frequency), and how strong they are. When timing your contractions, you'll need a device to record them, such as a pen and paper or a phone app, as well as a timer or clock. Make sure to keep note of each contraction from beginning to conclusion, as well as the duration between them. This second measurement will help your doctor determine the frequency of your contractions.

It might be difficult to measure the severity of your contractions. This might vary differently from person to person. Keeping note of the strength of your contractions is sometimes as simple as recording when you are unable to move, speak, or laugh during them.

Is there anything I can do to deal with contractions?

As your pregnancy nears its close, it's a good idea to consult with your doctor about various methods for dealing with pain and suffering during labour. Your physician will discuss numerous choices for pain relief with you.

There are various methods to treat the discomforts of labour at home or without medication, including

• You may distract yourself by going for a stroll, shopping, or watching a movie
• Soak in a warm tub or shower. If your water has broken, consult with your doctor about taking a tub bath
• Sit on a birthing ball
• Listen to music
• Lower the lights
• Try aromatherapy
• Get a massage
• Maintain an upright posture. This may aid in the descent and rotation of your baby
• If it's the evening, try to get some sleep. You'll want to save your energy before active labour and delivery

How will I know when my water broke?

You may be acquainted with the term "my water broke." This is really the rupture of the amniotic membrane. During pregnancy, your baby is within a fluid-filled sac known as a bag of water. When this membrane ruptures, you may experience a quick rush or trickle of liquids. This experience, like many others during labour and delivery, may be unique to each individual. The fluid is normally odourless and might seem clear or straw-coloured.

Unlike urine leaks, this will not cease. The amniotic fluid will often continue to leak.

If your water breaks, contact your healthcare practitioner. Inform your provider about the moment your water broke, the volume (trickle or gush), the colour of the fluid, and the odour. Tampons should not be used if your water has ruptured. Your labour may begin shortly after your water bursts. Some women are already in labour when their water breaks, while others do not experience the first stage of labour for some time thereafter.

When should I contact my healthcare practitioner or visit the hospital?

Your provider can answer any questions you have regarding the difference between actual and false labour, as well as talk about how you feel. When you discover that you are experiencing regular contractions, contact your physician to discuss when you should go to the hospital. Some women can remain at home during early labour, while others may need to come in sooner.

Additionally, get in touch with your healthcare provider if:

• You believe your water has broken. This might be a rapid surge of fluid or a steady leak of liquids
• Are you bleeding (more than spotting)?
• Contractions that are very painful and last one minute have been occurring every five minutes for the last hour

What happens when I go to the hospital?

When you arrive at the hospital, you will check in at the labour and delivery counter. The majority of patients will be seen in a triage room initially. This is part of the admissions process. It is normally advised that you bring just one individual to the triage room.

You will be transferred from the triage area to the labour, delivery, and recovery (LDR) room. They will ask you to put on a hospital gown. Then they will take your temperature, blood pressure, and pulse. An external foetal monitor will be put on your abdomen for a brief period of time to monitor uterine contractions and your baby's heart rate. Your healthcare professional will also inspect your cervix to see how far along labour has proceeded. An intravenous (IV) line may be inserted into a vein in your arm to provide fluids and drugs.

What does it mean to have labour induced?

Labour does not always start spontaneously or develop as expected. In some circumstances, your provider may discuss the possibility of inducing labour. This is a medical technique in which your doctor induces labour. This may happen if you:

• You have passed your due date
• Have medical issues such as high blood pressure, hypertension, infection, or diabetes
• Your water broke, but labour did not start
• Have a low amount of amniotic fluid

There are various techniques to accelerate or induce your labour. Your physician will advise you on the best and safest choice based on your health. To induce labour, you may use:

• Medicines (oxytocin) are administered via an IV (straight into your vein)
• Breaking your amniotic sac (which contains water)
• Separating the amniotic membrane (the fluid sac within your uterus that contains the baby) from the uterine wall. This is also known as sweeping the membrane
• A drug that may be inserted straight into your vagina softens and encourages your cervix to open

The cervical ripening process takes time, hence labour induction may take longer than spontaneous labour.

What are the different techniques of delivery?

There are two kinds of deliveries: vaginal and caesarean section. During vaginal delivery, your baby will naturally travel through the birth canal. A C-section is a surgical operation in which your doctor creates an incision in your belly and delivers the baby in an operating room. Vaginal delivery is the most common method of birth. However, you may require a C-section for a number of reasons, such as:

• If your infant is not lying head down
• If your child is too big to pass normally through your pelvis
• If your infant is in distress
• If the placenta blocks the cervix (a condition known as placenta previa)
• If you are in need of a C-section due to health issues or difficulties
• If your baby has to be delivered right away due to an emergency

Many times, a caesarean birth is not decided until after labour starts.

How long will I stay at the hospital?

The duration of your hospital stay will vary depending on the facility where you give birth and the kind of delivery. As a surgical operation, a C-section often requires a longer hospital stay. If you have problems or health concerns during your birth, you may need to remain in the hospital for an extended amount of time.

As you prepare to give birth to your baby, you will experience a wide range of emotions. It is reasonable to feel both thrilled and frightened. Discussing the signs and symptoms with your healthcare professional can help you understand what to expect. Your partner and healthcare staff are here to make you feel as comfortable as possible throughout the birth process.

Frequently Asked Questions on Labour and Delivery

1. What is a placenta?
   The placenta is an organ that develops in the womb, also known as the uterus, during pregnancy. The umbilical cord is a tube-like structure that connects the placenta to the growing foetus. The placenta delivers oxygen and nutrition to a growing infant via its umbilical cord.
2. How to cut the umbilical cord?
   Soon after a baby is delivered, two clamps are put around the umbilical cord, and the cord is severed between them. When the cable has fully dried, the clamp on its stump may be removed. The stump should be clean and dry. The stump will fall off on its own in a week or two.