The longest stage of childbirth starts at home with the first signs of labour There are three stages of labour overall starting from your first contraction and ending with the birth of your baby and placenta. The first stage of labour consists of a few phases. It starts with the first uterine contractions and ends with complete dilation of the cervix. In the first phase of the first stage of labour, often referred to as the ‘latent’ phase, contractions are often not that painful and are like strong menstrual cramps. There is often much variability in the contraction length and distance between contractions. They do increase in rhythm, strength and duration until eventually they last as long as 60 seconds and come every few minutes. By this stage you may already be at the hospital.
Labour signs: what’s happening?
During the early stages of labour, your uterus and cervix, which together look like an upside-down pear, are rearranging themselves into the shape of a keg. The cervix, or neck of the pear, is getting shorter and dilating or opening so your baby’s head can get through. This change is called effacement. At the end of this stage of labour the cervix will dilate to about 3 centimetres.
When is it time to go to Hospital? The time at which you decide to go to the hospital will be up to you and your medical team. Stay in contact with your hospital for advice. The next phase of labour often prompts first time mums to touch base with the hospital. It is often referred to as the ‘active’ phase and is when your contractions increase in intensity and occur more frequently and regularly and your cervix dilates more toward 8cm.
During the last phase of stage one labour, your cervix dilates fully to 10cm and your contractions are strong and very frequent, it may even feel they’re one continuous. Once you’re at this stage it is not long now until it’s time to push with the contractions. Once you are ready to push, you are now entering the second stage of labour and you are very much an active participant in childbirth, bringing your baby into the world with the help of your medical team.
Try to relax
For your medical team, this is all in a day’s work – so try not to be anxious. When you arrive at hospital they will check your labour signs – including your blood pressure, your temperature, the dilation of your cervix and the position of your baby. They will monitor the baby’s state of health and especially its heartbeat. It is at this time also that your birth plan and pain relief plan may kick in.
As your labour progresses, your contractions will speed up, your cervix will continue to dilate and your baby will gradually descend. Once dilation of the cervix is complete, it’s time to push out your baby. The midwife will ask you to breathe in, followed by blocking your respiration to push regularly, after which you will draw another breath. Follow their instructions carefully – they will help you make each contraction more effective. Keep your birth plan in mind – and don’t forget what you have learned during your antenatal classes. This is the time to put it all into practice. You’ll get lots of coaching from your partner or support person and your medical team.
Near the end of childbirth, the baby’s head can be seen during and after a contraction. That’s called crowning. At this point in your labour the doctor may do an episiotomy – a shallow cut into the lower vagina to keep your tissue from tearing. Where necessary, the medical team may also make use of forceps. Now for the part you’ve been waiting for… Your baby will emerge head first, and give its first cry! That’s it: you’ve given birth. You’re a mother, Congratulations!
Here is a rough sequence of things that will happen immediately after your baby is born:
- The doctor may place your baby on your abdomen for skin-to-skin contact;
- Your newborn may take a first breath at that moment;.
- The doctor will assess your baby to make sure your baby is breathing freely;
- The umbilical cord will be cut. You or your partner may be allowed to assist here;
- The baby’s eyes will be treated to prevent gonorrheal infection;
- The doctor will evaluate the baby’s condition and may inject the baby with vitamin K to aid in blood clotting;
- The nurse or doctor will issue an ID bracelets – one for you and one for your newborn;
- Childbirth ends with the delivery of the placenta and this is the third and final stage of labour. Your contractions may have stopped but will restart, lasting for five to 20 minutes until the placenta is expelled. Your midwife will inspect the placenta to ensure that it is all intact and nothing remains inside you.