The successful culmination of a pregnancy is in labour and the birth of a baby. It is the final act of bringing a new life into this world. There are three stages of labour and these are
- The first stage
- The second stage
- The third stage.
- The first stage is further divided into
- the early labour stage
- the active phase and
- the transitional stage.
The Early Labour Stage:
In the early labour stage, women start having contractions and the cervix begins to thin out and dilate to 3 cms. These contractions will be mild and feel more like menstrual cramps. They usually will be at intervals of five minutes and last approximately forty seconds each. Most of the time, women are not even aware that they have gone into labour. They carry on with their routines and generally stay at home till the contractions become more noticeable. Though if you are not 37 weeks into the pregnancy, it is better to call the doctor and check if you are in pre term labour.
In a few cases, there could be a mucusy vaginal discharge, which may contain blood. This could be the first sign of labour. The one sure evidence of beginning of labour is the water breaking. This stage of labour could last as long as a few hours, even six to twelve for some. It usually depends on how fast the cervix dilates and also how strong the contractions are. The faster the dilation, the quicker the delivery.
It is best to stay hydrated and relaxed at this time. You can distract yourself by reading a book or watching a show. Also advisable is emptying the bladder at regular intervals. This helps the uterus contract efficiently and gives enough room for the baby to start moving down.
The Active Stage:
During the active phase of the first stage, the contractions become stronger and more frequent. Usually they come every five minutes and last for about a minute. The cervix dilates to about 8 cms. It becomes difficult to converse or do any normal activity. Women usually tend to focus on relaxing and also on their breathing at this stage. Some women feel mildly nauseated which is perfectly normal. In most cases the contractions become more frequent and it is advisable to go to a hospital at this stage. The active phase could last 4 to 8 hours. It could quicken if you have experienced a vaginal delivery earlier. It also could get delayed if you have taken an epidural injection or if the baby is bigger than normal.
Women tend to use pain management and relaxation techniques to help them cope up with the labour. If comfortable, you can walk around the hospital room, though during the contractions, you will feel like standing or leaning against something. If you are unable to walk, it is good to lie down and rest. A warm water bath helps relax too. The last part of the active labour is called Transition, where the cervix dilates from 8 to 10 cms.
The Transitional Stage:
The final or transitional stage is the active part where women start pushing. The cervix is dilated almost fully and at this stage, women most definitely need to be at the hospital or absolutely ready at home if it’s a home delivery. The contractions may not be as frequent but will be a lot more painful. Women tend to shake and shiver with every contraction. The pressure builds in the rectum with every push. Some women feel a need to move their bowels. Some vomit. The intensity of pain differs in each woman and in many cases, they are administered painkillers to get them through it. Transition could last between a few minutes to a few hours depending on whether there has been a previous vaginal delivery.
A change of position, a light massage, few words of encouragement, a gentle touch, some soothing music or a conversation are ways to keep you distracted and also help you cope up with this painful phase. Each to her own, though!
- The second stage is where the cervix is dilated fully. At this stage the nurse is urging you to push so that the baby comes out. There is no fixed time for this stage as it could last awhile. As the uterus contracts, it exerts pressure on the baby and so with every push, the baby moves down the birth canal. At the end of this stage, you can see the head of the baby. Once the uterus relaxes after a contraction, the baby’s head will recede and it will be like two steps forward and one backwards. But with each push, more and more of the baby’s head becomes visible. It is the head which emerges first. The shoulders come next. The nurse will then advise you to give a final push so that the baby is born.
Once the baby is out, it will be dried and wrapped to keep it warm. There will be a feeling of relief now that it’s all over. The umbilical cord will be severed and now mothers can hold the newborn. This stage of labour could take anywhere between a few minutes to a few hours. It varies from woman to woman.
- The third stage is the delivery of the placenta. Now that the baby is out, the contractions will resume. This is to deliver the placenta and the membranes. The nurse or doctor will ensure there are no remnants. They will also examine your stomach to check if the uterus is contracting and becoming firm. These contractions will be relatively mild and will ensure that there is no further bleeding. . In a few cases, there could be a tear in the perineum, which will be sutured by the doctor.
The period after this is extremely emotional. Women feel varied emotions, right from happiness to relief to nervousness to a fierce protective feeling. The bond between the mother and her baby gets strengthened. This is the time partners also bond because they have gone through this miracle called childbirth.