When labour starts there are no flashing lights to say this is labour. With some people it can take awhile for the fact that they are in labour to sink in, as it can just start with a few cramping pains like period like pains and for others it can start in a rush and you go straight into full on strong contractions.

Signs and Stages of Labour

There are three signs of labour, which can happen in any order:
• Contractions: become more frequent and often are in a regular pattern, usually painful and do not go away with rest.
• Show: When the cervix (the neck of the womb) opens a plug of mucous, sometimes with a small amount of blood, may be passed. A show may happen during labour or up to 2 weeks before contractions start.
• Rupture of membranes: Usually there is a small gush if your waters break by themselves and the head drops down to act like a plug, and you will continue to leak small amounts of sweet smelling clear fluid. In 15% of labours waters break before labour. Let your LMC know if the fluid is green in colour as this is from the baby doing a bowel motion/poo (meconium) which is a sign of being distressed.

First Stage of Labour (early, established and transition phases)

Early/Latent Labour

How you may feel:
• Unsure this is labour
• Restless

Physical changes:
• Contractions begin then become more regular (10-30mins apart)
• Start off feeling like period like cramps then get stronger, like a tight rubber band getting pulled around your abdomen.
• Some people feel it in their back also.
• Cervix is thinning (effacing) and starting to open (dilatation)

Established labour

How you may feel:
• Hot and sweaty
• Find it hard to get comfortable
• Want to move around
• Need reassurance and support

Physical changes:
• Contractions are stronger more painful and closer together (5 minutes apart)
• Your body will be working hard, like climbing up a mountain with a heavy backpack (in this case a heavy frontpack!). Try to use visualisation eg:
• Think of the wonderful view you get from the top of a mountain.
• Think of the contractions as waves on the ocean.
• Think of your wonderful baby you will see at the end of this.
• Cervix is opening more 3-4cm+

Transition

How you may feel:
• You may feel you are rowing up stream and not getting anywhere.
• This is time when you become fed up and annoyed.
• Do not want to do this any more!!
• Very verbal or quiet
• Feel can not cope, as there is little time to relax between the contractions
• Need reassurance and support

Physical changes:
• Contractions more painful and last longer (60 seconds)
• Your body may shake; legs cramp and you may have waves of nausea.

Second Stage of Labour

The Pushing Phase

How you may feel:
• Urge to push and feeling of pressure in your bottom.
• Some people find pushing feels productive.
• Find it hard work, are tired and want to rest but unable to.
• Realization that you will soon see your baby

Physical Changes:
• Cervix is fully dilated (10cm)
• Push with contractions
• Lots of pressure in your bottom, like you are constipated and need to go to the toilet!
• Stretching/burning feeling as the baby’s head pushes on the perineum just before the head is born

Birth

How you may feel:
• Amazed at this beautiful baby
• Deep emotions
• Relief that the baby is out
• Feel happy on a natural high
• Exhausted as if you have just run a marathon
• Want of touch hold and feed your baby
• A Birthday party, your babies Birth Day!

Third Stage of Labour

The Placenta

Physical Changes:
• Placenta separates causing bleeding
• Uterus Contractions to slow down bleeding

Labour Aids

It is a good to work with your body during labour. One of the ways you can do this is to try to remain in an upright position, thus gravity will help the contractions push the baby into the birth canal.

Think about the things that help you cope when you are feeling stressed or uncomfortable and use these during your labour. Eg music, warm baths, massages, dim the lights, and heat packs.

Partners will find it hard to see the person who they love in pain, but by being there you are helping.

Labour often starts with period like cramping pains and these become stronger and closer together. As they get stronger you will have to stop what you are doing during a contraction and be in a supported position. You will have to concentrate on breathing through the strong contractions. You do this by focusing on your breath; you may find it helpful to breathe in through your nose and slowly out through your mouth. Think about relaxing yourself as you do this. Some woman find it helpful blowing out through pursed lips.

Remember there will be an end to the labour and the pain of the contractions do not harm the labouring woman. In between the contractions you will be able to rest, as you will feel tired. Think about what the contractions are doing, they do have a purpose. The human body is the most amazing thing, we have to have trust in its ability and remember woman have been giving birth for 1000′s of years. Also think about your beautiful baby you are going to see at the end.

The animation below shows the cervix shortening (effacement) and opening (dilation) and how a baby has to rotate to move through the pelvis to be birthed. It shows this with the mother in a position lying back. Research has shown it is better to birth in more upright positions such as standing, sitting on a birth stool or kneeling.

Article by Helen Pulford (Midwife and Childbirth Educator) owner of:

www.babywebnz.org
Directory for pregnancy, childbirth and parenting web sites.

www.birthresources.org
Childbirth education resources.

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