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Birth & More | What to Expect from Birth

Stages of Labour

I’ve come to learn that nothing in life is predictable. We love to plan everything, diarise important dates and make things happen in a way that suit our busy schedules. With something as delicate and wondrous as childbirth, there are no guarantees. Even though you may have your heart set on a natural birth, it will be wise to familiarise yourself with the procedures of a caesarean at the same time in order to be well prepared for whatever gets send your way.

Stages of Labour

  • The first stage is labour, and include three phases. Phase 1 is early thinning of cervix and dilation to three centimetres. The second phase is active and there’s dilation to seven centimetres. The third phase of labour is transitional and you will be fully dilated at 10 centimetres.
  • The second stage is delivery of the baby.
  • The third stage is delivery of the placenta.
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Stage one: Labour: Phase 1

The first stage of labour is the longest stage and sees your cervix open up in order to allow baby’s head into the birth canal. This stage can take up to 12 hours if it’s your first baby. Contractions will become more intense and longer as stage 1 comes to and end.

What you may feel physically

  • Menstrual-like cramps
  • Feeling of warmth in your abdomen
  • Backache
  • Bloody show
  • Diarrhoea

What you may feel emotionally

  • Excitement
  • Relief
  • Anticipation
  • Uncertain
  • Nervous

What you can do

  • If you feel hungry, eat light snacks as digesting a heavy meal will compete with the birthing process for body resources
  • Avoid anything acidic – such as orange juice


Stage one: Labour: Phase 2

What you may feel physically

  • More intense pain as the contractions become stronger (you might be unable to talk through them)
  • Increasing backache
  • Leg discomfort
  • Fatigue
  • Your membranes may rapture

What you may feel emotionally

  • You may find it difficult to relax and become more restless
  • You may become more focused as you’re eager to get this wrapped up
  • Confidence may take a knock and you may wonder whether you’re up for this
  • It’s now time for action

What you can do

  • When you feel overwhelmed by the pain of your contractions, start your breathing exercises
  • Drink some water
  • It’s asking a lot, but try to relax between contractions
  • If you can’t walk around, try to at least change positions
  • Go to the loo for a number one – even though you may not feel the urge to
  • Don’t be a martyr… if you need pain relief, demand some


Stage one: Labour: Phase 3

What you may feel physically

  • Strong pressure in your lower back and/or perineum
  • Rectal pressure – with or without the urge to push
  • Nausea and/or vomiting
  • You may feel hot and sweaty or cold and shaky, or even alternate between the two
  • You may experience leg cramps and your legs may tremble uncontrollably

What you may feel emotionally

  • You may feel overwhelmed (who wouldn’t?)
  • Impatient (at not being able to push yet)
  • Confused and irritable
  • The good news is that you may find yourself excited in the midst of all the stress

What you can do

  • Instead of thinking about the work that’s ahead, think of how far you’ve come and that you’ll be able to hold your baby soon
  • If you feel the urge to push, rather pant or blow or bite into a pillow, as pushing against a cervix that is not fully dilated can cause it to swell – which can delay delivery
  • Try to relax between contractions, switch to locomotive-mode and start those breathing exercises


Stage Two: Delivering your baby

Your cervix is fully dilated – congrats! You’ve made your way into the second stage without killing anyone! Yet… Moving from stage 1 to stage 2 is called transition, and can last anything from a few minutes to more than an hour. You may experience confusion or a sense of being overwhelmed at this stage as you’re no doubt wondering whether you are up for the task ahead.

If the hospital allows it, find a position that is comfortable to you or make yourself as comfy as possible on the bed. During the second stage your baby is pushed through your pelvis and birth canal. If the head becomes visible, you can ask for a mirror if you don’t want to miss this moment. The head will appear and disappear a few times between contractions, but don’t get discouraged. This process is all about two-steps-forward and one-step-back!

Episiotomies are no longer routine but they are not uncommon. It’s your choice whether you’d like to tear naturally or prefer medical intervention in the form of an episiotomy. If you choose to have one, a cut will be made at the entrance to the vagina as your baby is being born.

What you may feel physically

  • An overwhelming urge to push
  • You may feel a burst of renewed energy or you may feel tired
  • Tremendous rectal pressure
  • Very visible contractions
  • A burning or stinging feeling at the vagina as the head eventually crowns and a slippery, wet feeling as the baby emerges

What you may feel emotionally

  • Relieved as you can eventually start pushing
  • Self-conscious, inhibited, scared
  • Excited for what’s lying ahead
  • In a prolonged second stage it’s perfectly normal to find yourself more concerned with getting this over with than with seeing your new baby

What you can do

  • Give it all you’ve got
  • Don’t let inhibitions or embarrassment break your pushing rhythm – there is absolutely nothing that they haven’t seen or experienced before
  • Do what comes naturally
  • Try to rest between contractions – the end is in sight

So when do you get to hold your baby? This depends on the condition of mom and baby. If it was an uncomplicated birth, chances are your baby will find its way to your chest moments after entering this world, at least for a little while. His nose and mouth will have to be cleared of fluid, the umbilical cord clamped and cut. Baby will be dried quickly while being checked to make sure he is breathing adequately

A few minutes after birth your baby will be surveyed and get assigned an Apgar score. This test include categories such as appearance, pulse rate, response to stimulation, activity and respirations.

Don’t be in a hurry to feed – your baby’s probably got a lot of fluid in his system. Wait until you’re more comfortable so that you can sit back and take in the moment. Your birth plan should note that they must bring your baby to you for breastfeeding as soon as possible, and that he should not have a bottle under any circumstances. If you are bottle-feeding, however, supply them with your choice of bottles beforehand.


Stage Three: Delivering the placenta

Your baby’s arrival marks the end of stage 2 and the beginning of the third stage – namely delivering the placenta. The placenta will be eased out gently, assisted by your gynaecologist’s hand on your abdomen. You may be asked you to push at the same time, but relax – because all the hard work is done! The third stage can last up to twenty minutes, depending on each person. If you breastfeed immediately it will speed up the process as the suction action causes the uterus to contract. Amazing, hey?

What you may feel physically

  • Tired or energised
  • Very thirsty and hungry after a long labour
  • Cold
  • A bloody discharge called lochia, which similar to a heavy period

What you may feel emotionally

  • Sense of relief, talkativeness, happiness, excitement
  • New sense of responsibility
  • Impatience at having to push out the placenta or submit to the repair of an episiotomy/tear, when all you can think about is holding your new baby

Some new moms feel that they are struggling to bond with their new baby right away, some may even feel resentful (I can’t believe she made me suffer like this!), while other moms feel an immediate bond with their baby. It’s all normal – your motherly love will kick in soon enough, so be kind to yourself as you’ve been through a major experience.

What you can do

  • Help expel the placenta by pushing when asked to
  • Be patient while they are repairing your episiotomy or tear
  • Nurse or hold the baby once the cord is cut. In most hospitals a newborn baby is kept in an incubator for a while or your partner will hold baby while they are busy sorting out your placenta
  • Take time to pat yourself on the back – you’ve done an amazing job!
  • Remember to thank your partner as he was probably more stressed than you and may feel a bit overwhelmed, underappreciated or left out

Take these tips and make them your own by adding some personal flavour – such as your own choice of pain relief, extra pillows, an alternative like water birth etc. You should feel more at peace now, knowing what’s to come! Do whatever you have to in order to ensure that you are as comfortable as possible, and leave the rest up to Mother Nature. Soon enough you will be staring down at your beautiful, fragile, newborn baby – and it will all be worth it!

Reference:

  • G. Ezzo & R. Bucknam: On Becoming Baby Wise. 1998: Multnomah Books, USA.

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