Every Labour is different, but in a normal vaginal delivery there are three stages of labour. The first two stages end with the wonderful event of your baby’s birth, while the third stage is the delivery of the placenta.
The long, but not yet so hard road
The first stage of labour begins with the onset of regular contractions. It continues until your cervix is fully dilated to about 10cm to enable your baby to travel down the birth canal. On average this stage lasts between 10 to 12 hours for first-time mothers and seven hours for subsequent births.
During the first stage, the muscles in your womb contract to dilate and draw back your cervix (the neck of the womb). The cervix has been closed throughout pregnancy to protect your baby. Contractions usually begin slowly and may feel something like a period pain. As labour progresses the contractions get more frequent arid stronger, lasting about 30 – 60 seconds each, ranging from between five to 20 minutes apart, slowly opening the cervix.
The fluid-filled amniotic sac that has surrounded and cushioned your baby throughout pregnancy may already have broken, releasing some of the fluid or water. Some mothers experience this as a rush of liquid, while others simply feel a trickle.
In the active phase of stage one, contractions become more painful as the cervix continues to dilate. They may be about two to four minutes apart at this point. Pain relief can be considered now.
This is the phase between first and second stage labour. The contractions may be coming every minute or so now, and probably last between 45 and 60 seconds. The urge to push down is extremely strong, but you need to wait for full dilation to 10cm, to minimise the risk of tearing. At this very intense time, many women get surprisingly vocal, often screaming out a variety of colourful words and phrases, many directed at their partner!
Push Push PUUUUUUSSH!
Once the cervix is fully dilated it’s time to deliver the baby. The contractions are usually stronger, last longer (around 60 to 90 seconds) and are less frequent (every two to four minutes). As your baby’s head is pushed downwards, you’ll feel an overwhelming urge to push with each contraction. Let your body tell you what to do and push when you feel the need.You may want to choose a birthing position to take advantage of gravity such as kneeling, standing or squatting, rather than giving birth lying down. It’s quite normal to involuntarily urinate or pass a stool – but this is nothing to feel embarrassed or concerned about and your midwife or nurse will have this cleaned up in no time.. Breathing techniques can be a great help during this stage. Try to relax as much as possible between contractions to conserve energy.
Pushing out the head is probably the hardest part of the labour, but it doesn’t last long. As the head emerges, it stretches the mouth of the vagina until the skin is almost paper thin, and you may feel a stinging or burning sensation before the area numbs. Trying to breath will distract you from the stinging sensation and some short, quick breaths will help stop you pushing when you need to control how fast your baby’s emerges.
After the head appears, the rest of the baby comes out quite easily – usually after one or two more contractions. The umbilical cord will be clamped and cut soon after the birth. Straight after the birth your baby’s breathing rate, heart rate, skin colour, muscle tone and reflexes (Apgar Test) will be assessed and repeated five minutes later.
After the Birth
Onnce the baby is born, the separation and delivery of the placenta follows. This can take anything from 10 minutes to an hour. Commonly, an injection of syntocinon is given to encourage a quick delivery. The midwife then pulls gently on the cord until the afterbirth emerges. It is then examined to ensure it’s complete, as any remaining within the uterus can result in infection. You’ll be checked to see if you have any vaginal tears and, if you need stitches, these will probably be administered shortly after the third stage is over.
Jasmine is one of the owners of Mybaby.net.au, a WAHM and prolific baby and parenting writer.