Labour : What to expect, How long and how to cope?

Parul was really worried. Her due date was in a weeks time and her gynaecologist had told her she would be doing a pelvic examination or pv check to find out position of the head and condition of the mouth of the uterus or cervix she said . Will she put that steel instrument or make her feel uncomfortable . What if she is not able to tolerate the pain . What if her baby gets stuck halfway . What if they do a caesarean at the end of all the pain. Parul had never been so scared in her entire life . All the movie scenes with women giving birth and screaming and shouting in agony kept running in her head . She was confused and needed some reliable information .

The birth of a baby is a very unique experience. No two deliveries are identical, and there is no way to predict how any specific delivery is going to go. However,an expecting mother can know the stages of the birth process and what to generally expect. Labour and childbirth can be a comfortable process contrary to popular belief that it is always very painful.

Childbirth usually occurs in three stages:

First stage: The time of the onset of true labor until the cervix is completely dilated to 10 cm.

Second stage: The period after the cervix is dilated to 10 cm until the baby is delivered.

Third stage: Delivery of the placenta or the after birth.

First Stage of Labor

The first stage of labor is the longest and involves:

• Early Labor Phase –The time of the onset of labor until the cervix is dilated to 4 cm.

• Active phase of labour : From the time of dilatation of cervix of 4 cm to 10 cm dilated also called a fully dilated cervix.

Each phase is characterized by different emotions and physical challenges. Think of it as a big adventure with some important guidelines.

Early Labor Phase

What to do:

During this phase, the mother should just try to relax. She should keep herself busy while conserving her energy. Drinking plenty of water and eating small snacks is a good idea . Keeping track of

the time of the contractions can help a mother understand good labour pains. In early labour in 10 minutes there are 3 to 4 contractions each lasting for 40 to 45 seconds.

What to expect:

Early labor will last approximately 8-12 hours. Cervix dilates to 4 cm .Contractions are typically mild and somewhat irregular but become progressively stronger and more frequent. Contractions can feel like aching in the lower back, menstrual cramps, and pressure/tightening in the pelvic area. The water might break – this is known as amniotic sac rupture and can happen anytime within the first stage of labor. If the water breaks (amniotic fluid rupture ) note the colour of the liquor and time of rupture.

Active Labor Phase

What to do

The contractions will be stronger, longer and closer. Walking or taking a warm bath helps in making the mother feel comfortable. Continue to drink plenty of water

What to expect

Active labor will last about 3-5 hours. Your cervix will dilate from 4cm to 9 or 10 cm. Contractions during this phase will last about 45-60 seconds with 3-5 minutes rest in between. Contractions will feel stronger and longer

Pushing Phase

What to do

During this phase, the mother will rely heavily on her support person. This is the most challenging phase, but it is also the shortest. Try to think “one contraction at a time” (this may be hard to do if the contractions are very close together).

What to expect

Transition will last about 30 min-2 hrs. Cervix will dilate from 8cm to 10cm. Contractions during this phase will last about 60-90 seconds with a 30 second-2 minute rest in between. Contractions are long, strong, intense, and can overlap. This is the hardest phase but also the shortest. There might be nausea, vomiting.

Tips for the support person

• Offer her verbal reassurance and encouragement

• Massage her abdomen and lower back

• Keep track of the contractions (if she is being monitored, find out how the machine works)

• Go through the breathing techniques with her

• Help make her comfortable (prop pillows, get her water, apply touch)

• Remind her to change positions frequently (go with her on a walk or offer her a bath)

• Provide distractions from labor such as music, reading a book or playing a simple card game

• Encourage her to relax between contractions thinking of each contraction as a wave.

• Don’t think that there is something wrong if she seems to be angry or crying – it is a normal part of transition

• Keep up your own strength. You will need it!

Third Stage of Labor

The third stage is the delivery of the placenta and is the shortest stage. The time can range from 5 to 30 minutes.

What to expect & what to do

After the delivery of the baby, the placenta is separates from the uterine wall and is ready to be delivered. Pressure may be applied by massage to the uterus and the umbilical cord is gently pulled. The result will be the delivery of the placenta, also referred to as the afterbirth. There may be shivering after the placenta is delivered. After completing all the stages of childbirth,mother is observed for the next few hours to make sure that the uterus continues to contract and that bleeding is not excessive.