1. Stage
In the first stage of labor, contractions cause your cervix to gradually open (dilate). This is usually the longest stage of labor. At the beginning of labor, your cervix begins to soften to open. This is called the “latent” phase and you may feel irregular contractions. It may take hours or even days before you go into labor.
The actual onset of labor is when your cervix dilates about 4 cm and regular contractions open your cervix.
During the latent stage, having something to eat and drink. It's a good idea because you'll need energy due to contractions.
If your labor starts at night, try to relax and sleep if possible. If your labor starts during the day, stand upright and be gently active. This helps your baby move towards your pelvis and your cervix to dilate.
Breathing exercises, massage, and a warm bath or shower can help relieve pain during this early stage of labor.
Contact a midwife. when to contact
Contact your midwifery team if:
- If your contractions are regular and occur 3 every 10 minutes
- If your water breaks
- If your contractions are very strong and you feel like you need painkillers
- If you are worried about anything
- If you go to the hospital or your midwifery unit before your labor has fully started, they may recommend that you go home again for a while. Once labor begins, your midwife will check in with you from time to time to see how you are progressing and will offer you support, including painkillers if you need it. You can either move around or get into a position that feels comfortable to move.
The midwife will give you regular vaginal exams to see how your labor is progressing. If you don't want to, you don't have to - your midwife can discuss with you why she is doing these things. Your cervix needs to be about 10 cm open for your baby to pass through. This is what is called full dilation.
In labor, the time from the beginning of labor to full dilation is usually 8 to 12 hours. In the 2nd or 3rd pregnancy it is usually faster (about 5 hours). Birth When you reach the end of the first stage of labor, you may feel the urge to push.
Monitoring your baby during birth
The midwife will watch you and your baby during labor to make sure you are both okay. This will involve using a small handheld device to listen to your baby's heart every 15-20 minutes. You will be free to move as much as you want.
If you have concerns about yourself or your baby or choose to have an epidural, your midwife may recommend electronic monitoring. Electronic monitoring involves attaching 2 pads to your abdomen. One pad is used to monitor your contractions, while the other is used to monitor your baby's heartbeat. These pads are connected to a monitor that shows your baby's heartbeat and contractions.
Sometimes a clip called a fetal heart monitor may be attached to the baby's head instead. This can provide a more accurate measurement of your baby's heartbeat. Even if you don't have any concerns, you may want to be monitored electronically. Electronic monitoring may restrict your freedom of movement.
Because you are concerned about your baby's heartbeat, you can turn off the monitor if you have a pad on your belly and your baby's heartbeat is shown to be normal.
Accelerating labor
Birth can sometimes be slower than expected. This can happen if your contractions aren't coming often enough, aren't strong enough, or your baby is in an awkward position. If this is the case, your doctor or midwife can talk to you about 2 ways to speed up your labor:
1. Opening the water sac: Piercing the membrane that contains the fluid around your baby is often enough to make contractions stronger and more regular. This is also known as artificial rupture of membranes (ARM). Your midwife or doctor may do this by making a small puncture in the membrane during a vaginal exam. This can make your contractions stronger and more painful, so the midwife will talk to you about pain relief.
2. Artificial labor with oxytocin
If puncturing the bladder doesn't work, your doctor or midwife may recommend using a medicine called oxytocin (also known as pitocin) to strengthen your contractions. This is usually the wrist It is given through a vein in your scar or arm. Oxytocin can make your contractions stronger and more regular, and your uterus may start working quite quickly, in which case your midwife will talk to you about your pain relief options. You will also need electronic monitoring to check that your baby is coping with contractions and regular vaginal exams to check if the drip is working.
2. Stage
The 2nd stage of labor is the stage from the moment your cervix is fully dilated until the birth of your baby.
Finding a comfortable position to give birth
Your midwife gives birth. It will help you find a comfortable position. You may want to sit, lie on your side, stand, kneel, or squat, but squatting can be difficult if you're not used to it. If you have a lot of back pain during labor, kneeling on all fours may help. It's a good idea to try some of these positions before you go into labor. Talk to your birthing partner so they know how they can help you.
Pushing your baby out
Once your cervix is fully dilated, your baby will move through the birth canal towards the entrance of your vagina. You may feel an urge to push that makes you feel like you have some stool. You can push when you feel the urge during contractions. You may not feel the urge to push right away. If you have had an epidural, you may not feel the urge to push at all. If you are giving birth to your first baby, this stage should not last more than 3 hours. If you have had a baby before, it should not take more than 2 hours.
This stage of labor is a difficult task, but your midwife will help and encourage you. Your birth partner can also support you.
How will your baby be born?
When your baby's head is almost ready to come out, your midwife will ask you to stop pushing and take short breaths and blow out through your mouth. This allows your baby's head to be born slowly and gently. Breathing this way also gives time for the skin and muscles in the perineal area between your vagina and anus to stretch.
Sometimes your midwife or doctor will recommend an episiotomy to prevent tearing or speed up labor. This is p It is a small incision made in the genital area. You will be given an injection of local anesthetic to numb the area before the cut is made. When your baby is born, an episiotomy or any large tears will be stitched closed.
Once your baby's head is born, most of the hard work is done. The rest of her body is usually born during the next 1 or 2 contractions. Generally, you will be able to hold your baby right away and enjoy skin-to-skin contact together. You can breastfeed your baby whenever you want. Ideally, your baby will have his or her first breastfeed within an hour of birth.
3. Stage
The third stage of labor occurs after your baby is born, when your uterus contracts and the placenta comes out of your vagina. There are 2 ways to manage this stage:
1. Active - by giving medication to make it happen faster
2. Physiological – this stage occurs naturally, without medication
Your midwife will explain both ways to you while you are pregnant or in early labor, so you can decide which you prefer. There are some situations where physiological management is not recommended. Your midwife or doctor can explain whether this applies to you.
What is active management?
Your midwife will inject oxytocin into your thigh immediately after birth. This causes your uterus to contract. Evidence shows that it is better not to cut the umbilical cord immediately, so your midwife will wait between 1 and 5 minutes after birth to do this. This may be done sooner if you or your baby have concerns.
Once the placenta has left your womb, your midwife will pull the cord attached to the placenta and pull the placenta out of your vagina. This usually happens within 30 minutes after your baby is born. Active management speeds delivery of the placenta and reduces your risk of heavy bleeding after birth (postpartum hemorrhage), but increases your chance of nausea and vomiting. It may also worsen postpartum pain (contraction-like pain after birth).
What is the physiological management?
Oxytocin injection is not given and the 3rd stage of labor occurs naturally. The cord is not cut until blood flow stops. This means that blood is still passing through the placenta to your baby. This is usually 2 to It takes 4 minutes. Once the placenta leaves your uterus, there will be some pressure underneath you and you will need to push the placenta out. It may take up to an hour for the placenta to come out, but it usually only takes a few minutes for the placenta to be expelled.
If the placenta does not separate naturally or you start bleeding heavily, you will be advised to switch to active management by your midwife or doctor. You can do this anytime during the 3rd stage of labor.
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