For many pregnant women the idea of giving birth can be daunting, especially for first time mothers, or those who have previously experienced a birth that didn’t go to plan.
Whilst you can’t always prepare for every situation in labour, having an idea of what you would like to happen (such as a birth plan) can help ease anxiety and provide you with a sense of control.
The stages of labour
Knowing when you are in labour isn’t always easy. The early stages of labour can be different for every woman, however below are some common signs to help you determine how far along in labour you are and when you should call Dr Hong or go to the hospital.
There are three stages of labour:
- Stage one – involves a latent phase (also known as early labour) and an active labour phase.
- The latent phase is up to when you cervix is fully effaced (i.e. it is paper thin) and is 3 to 4cm dilated.
- Active labour is from a fully effaced cervix that is 3 to 4cm dilated to when your cervix is fully dilated to 10cm.
- Stage two – commences when your cervix is fully dilated to 10cm and ends when your baby is born.
- Stage three – commences once your baby is born and finishes when the placenta is delivered.
During early labour (latent phase), your cervix will start to soften, shorten and dilate. You may experience the following:
- Lower back pain.
- Period-like cramping.
- Short contraction, where the muscles of your uterus expand and contract in preparation for delivery of your baby.
- During the first stage of labour contractions tend to be shorter in duration (approximately 15-20 seconds).
- Contractions also tend to be irregular, with no set timing between them.
- A ‘show’ (blood-stained mucus discharge from your vagina).
- During pregnancy your cervix is sealed by a mucus plug to help protect your baby. As your cervix dilates and softens during the labour process, the mucus plug will come away.
- Your waters may break (where you have a gush or trickle of amniotic fluid from your vagina).
- It should be straw-like in colour. If it is brown or green, you should contact your doctor immediately as it could be a sign your baby is in need of urgent medical attention.
Ideally you want to stay at home as long as you can during the latent phase of labour. As you move towards the active labour of stage one, your contractions will:
- Become more painful and rhythmic in nature – with each contraction starting mildly and then building in intensity to a peak.
- Become regular and able to be timed.
When your contractions are regular and approximately 5 minutes apart, it is time to go to the hospital.
However if you are concerned at any stage during labour, it is recommended you call Dr Hong, your doctor or midwife.
Once your cervix has dilated to 10cm, you are in the second stage of labour. During this stage you will deliver your baby and you may experience some of the following:
- An urge to push.
- Increased pressure as the baby’s head moves down the birth canal.
- A stretching, burning sensation in your vagina.
- Vomiting and nausea.
Once your baby is delivered, the umbilical cord will be clamped and also cut.
If there are no concerns for either you or your baby, your baby will be placed on you for skin-to-skin contact, which helps to establish bonding and breastfeeding.
If there are concerns, your baby will be assessed by the specialist team and given additional medical support if needed.
The third stage of labour begins after your baby is born and finishes with the delivery of the placenta. During this stage of labour you may experience:
- More contractions as your uterus delivers the placenta, although these contractions will not be as strong as the second stage of labour.
- Dr Hong or a member of your specialist birth team may gently pull on the umbilical cord to help guide the placenta down the birth canal.
- Dr Hong or a member of your specialist birth team thoroughly examine the placenta to ensure it is complete and intact.
Some women may wish to take the placenta home with them for cultural or health reasons. You should discuss this with your specialist birth team prior to delivery.
When should you call the hospital or seek medical advice?
At any stage in your pregnancy, it is recommended you immediately either contact the hospital directly or Dr Hong if you experience the following:
- You are having blood loss and it is bright red.
- Your waters break.
- Your contractions are painful and are at regular intervals.
- Your baby’s movements have decreased, or you are concerned about your baby’s movements.