Stages of labour
Monitoring your baby’s heart rate during labour is done either intermittently or continually.
This is done by a Doppler or Pinard which is a small hand held devise that’s used to check your baby’s heart rate (similar to how they hear the baby during your antenatal visits). This is done regularly for short periods throughout your labour.
This is done by a Cardiotocograph (CTG) and is a machine that’s strapped to your belly to continuously listen and monitor the baby’s heart rate and your contractions. This is used when there are concerns about you or your babies’ health. Sometimes these concerns are already known prior to labour started and the doctor or midwife will have discussed this way of monitoring the babies’ heart rate.
The first stage of labour begins when contractions occur regular and the cervix dilates. First stage is complete when the cervix has opened to 10 centimetres dilated.
In the very early stages of labour, your cervix softens and becomes quite thin. This can go on for hours, days even. During this early stage you may feel nothing at all for some time. Eventually, you might feel some discomfort but there is no pattern and the contractions are irregular.
In early labour you may have:
- a blood-stained mucus discharge called a ‘show’
- lower back pain
- period-like pain that comes and goes
- loose bowel motions
- a sudden gush or a slow leak of ﬂuid from the vagina when your waters break or your membranes rupture. The ‘waters’ should be clear or slightly pink. (A greenish or bloody colour can indicate a problem with the baby and you will need to contact your hospital immediately)
- an urge to vomit (it is quite common to vomit during labour).
In early labour, your body is preparing for birth.
Things you can do:
- stay at home for as long as you can
- have regular snacks so that you are building your energy reserves
- rest as much as possible; try and sleep/nap if you can
- try relaxing in a bath or a shower
- go to the toilet regularly and empty your bowels if you can.
Eventually, towards the end of the first stage of labour, you’ll start feeling a little more restless and tired and your pain will become more intense. The pain will come like waves, starting small and building to a climax and then falling away again. As you move closer to second stage, the time between each wave will be smaller.
Second stage describes the period of time from when the cervix is fully dilated to when the baby is born.
In second stage you may have:
- longer and stronger contractions, with a one to two minute break in between
- increased pressure in your bottom
- the desire or urge to push
- shaky cramps, nausea and vomiting
- stretching and burning feelings in your vagina.
Things you can do in the second stage:
- concentrate on your contractions and rest in between
- try to let go and allow your body to do what it needs to do
- try different positions – sitting, standing or walking
- if you feel hot, a cold face washer can be very soothing
- try a bath or shower to help you to relax and to manage the pain
- keep up your fluids and rest when you can.
When the urge to push arrives it can be overwhelming. The pushing phase varies for each woman but can last for up to two hours, usually less if you have had a baby before.
Aside from the urge to push, you are likely to feel:
- pressure and a strong urge to go to the toilet
- stretching and burning in your vagina
- the baby’s head moving down.
The best thing you can do during this phase is to try and breathe deeply, relax and follow your body’s urge to push.
Trust and listen to your midwife who will guide you.
The third stage begins after your baby is born and finishes when the placenta and membranes have birthed.
In the third stage you may have:
- more contractions to expel the placenta
- a feeling of fullness in your vagina.
Depending on your wishes for third stage (receiving oxytocin or not), the midwife or doctor will either assist by pulling on the cord to birth the placenta or observe you whilst awaiting the placenta to birth naturally.
Following the birth, your midwife will assess your blood pressure and other observations regularly whilst you bond with your baby.
How babies are born has a big effect on how well they can breastfed. Pain relief choices, length of labour, skin to skin contact immediately after birth and your baby’s first breastfeed are all important.
We go to extra effort to keeps babies happy until they can have their first breastfeed. Routine activities like weighing the baby, doing routine baby checks and giving babies their Vitamin K injections are all delayed to allow mum and baby the best chance to get off to a good start.