What to expect during labour!

No two women are the same; therefore, no two births will be the same even with your own subsequent pregnancies.

There is no text book that can tell you when you will go into labour, what you will experience and what the outcome will be.

Independent childbirth education is about preparing you for your labour and birth, and we can give you a broad outline of what to expect, but keep in mind that deviations from yours and your caregivers plans can and do happen.

When things start to deviate from how you thought it would be, or what you have written in your birth plan, don’t feel that “things didn’t go to plan” because with birth there is no plan – expect the unexpected and prepare yourself for any birth.

That means being educated, prepared, confident and excited about the birth of your baby no matter how they choose to be born.

There are 3 stages for labour & birth.

Stage 1 is made up of 3 parts:

• Warm-Up Phase (effacement and dilation up to 4cms dilated)
• Active labour (4cms plus dilated)
• Transition

Stage 2 is the birth of your baby.

Stage 3 is the birth of the placenta.

Stage 1 – Warm-Up Phase

Think of this as the first 15km of a marathon!

The warm-up phase is when you start to feel contractions, yet they are not regular, and may stop and start.

This can go on for days, but the average is 12 to 24 hours.

The warm-up phase is the period from your first contraction and less than 4cms dilated.

Some signs you may experience during the warm-up phase are:

• Thick mucous plug
• Loose bowel movements
• Membranes releasing – waters breaking
• Wet underpants from fluid
• Period pain cramping
• Back discomfort
• Mild waves of irregular contractions
• Very talkative – very excited
• Discomfort in the lower abdomen
• Diarrhea or constipation
• Pubic bone discomfort.

What to do during the warm-up phase:

• Walk around, go up and down stairs and be active
• Put your back against the wall and use the belly lift to encourage baby down into the pelvis
• Use OMP techniques to create space for baby
• Bounce and move around on your fit-ball
• Massage and acupressure points
• Get as much sleep as possible – conserve energy
• Watch funny movies to release oxytocin and endorphins
• Sit on the toilet with legs apart to encourage baby downwards
• Eat plenty of carbs like pasta to build up your energy stores
• Say positive birth affirmations and listen to relaxing music, sing and dance and move
• Get plenty of rest and sleep to prepare for the rest of the marathon.

 

Stage 1 – Active Labour

This is the 15km to 30km section of the marathon.

This is when you may start thinking about going to the hospital – but don’t go too early – stay at home for as long as you can, unless of course you are going to feel a lot calmer and safer at the hospital earlier.

At this stage of the marathon, you will be having strong, regular contractions (2 or 3 in a 10-minute period) and have been doing that for at least an hour.

Your contractions will be getting longer, stronger and closer together.

It is hard work, but you are mentally and physically strong and motivated.

It would be so much better for women if RANZCOG adopted the same dilation progress as the US and changed active labour being from 4cm to 6cm, which would give women so much more time before interventions is suggested, but unfortunately here in Australia active labour is considered from 4cm.

Some signs you may experience during active labour are:

• Thick mucous plug or bloody show
• Contractions lasting longer, and getting stronger and closer together
• Contractions feeling more intense, harder to talk through them
• You may feel like you need to go to the toilet more
• Increased pressure in your rectum
• Increase in body fluids and mucous being released
• Feelings of being stretched or baby moving down

What to do during active labour:

• Turn off the lights
• Shut the curtains or blinds
• Put on music or guided meditation / hypnosis
• Stay upright and slightly forward
• Move – rotating hips one way then other way – like in a figure 8 motion
• Breathing through contractions – long slow deep breath in, and long slow breath out, then start again
• Counter pressure on lower back
• Hip squeeze
• Movement and walking around
• Rock on ball
• Massage and acupressure points
• Positive affirmations and encouragement
• Focus on the five senses for tools & techniques
• Get in the bath or shower
• Eat small snacks to keep your blood sugar levels stable and avoid ketosis
• Stay hydrated
• Make sure you are weeing regularly
• Positive affirmations: “I CAN DO THIS”

 

Stage 1 – Transition

Think of this as the 30km to 40km stage of the marathon!

This is the point when many women hit a brick wall.

You may need your birth support right there alongside you and giving you words of encouragement and keeping your mind focussed on the prize ahead.

This is when mums will usually ask for drugs or epidural.

They may say “I can’t do this anymore”.

Birth support team will say “Yes you can do this, because you are doing this.”

This is where the mum will need the most support, encouragement and loving words to feel safe and supported.

Some signs you may experience during the transition phase are:

• Nausea or start vomiting
• Irrational, angry or demanding behaviour
• Feel hot or cold
• Start verbalising or making primal noises
• Start shaking (this is the adrenalin giving stamina and energy to push)
• Sweating
• Lots of discharge, mucous and perhaps blood
• Sometimes women get a purple line in the bottom crack
• Toes may curl up while kneeling or standing on toes while standing upright
• May start to doubt her body
• Asks for drugs or epidural
• Uncontrollable urge to push or bear down
• Feeling like needing to do a poo

What to do during the transition labour phase:

• Don’t talk or ask questions – just focus
• Positive affirmations
• Drop down the shoulders – release and let go
• Relax the jaw – rest tongue on roof of month
• Remember to breathe
• Go to the toilet for a wee
• Get into the birth position that feels the most comfortable
• Trust and believe

Stage 2 – Birth

You are now almost at the finish line to claim your prize.

• This is where the head will appear – perhaps just peeking through so we may just see the top of the head and a bit of hair, and then it disappears again after the contraction stops – this is normal and is stretching and opening your perineum gently and in time with your body.
• You may get a burning sensation around the perineum as it stretches, however with your slow birth breathing and relaxation of all the muscles this will help to reduce the intensity of the burning and help the perineum to stretch gradually and gently.
• You will get an overwhelming desire to bear down or push.
• Breathing is important to relax muscles and get oxygen to baby.
• Low deep noises, grunts or groans (no high-pitched screaming).
• Visualise the perineum opening wide to allow baby to move out gently.
• You may even do a poo at this stage as baby’s head is being pressed against the rectum and this is normal – don’t try and hold it in, as you need those muscles to be loose and limp to allow baby out easily. Don’t worry, the midwives will just wipe it away and majority of the time you won’t even know it has happened.
• Your birth partner may also see large haemorrhoids coming from the anus if you have experienced this through your pregnancy – just so they are prepared for that visual, which again is very normal.

Stage 3 – Birth of the placenta

Once your baby is born, the third stage is to birth the placenta.

• Your contractions will start up again but usually not as intense, and sometimes mums don’t even notice as they are too caught up having skin to skin contact with their newborn baby and experiencing that rush of oxytocin and prolactin bonding.
• These contractions will help the placenta to gradually peel away from the wall of your uterus.
• You may get the urge to push again.
• The placenta and membranes will drop to the bottom of your uterus and out through your vagina.

Many hospitals routinely give you the syntocinon (synthetic oxytocin) injection, which makes the placenta come out faster.

This is called a managed third stage and if you prefer to have a physiological birth of your placenta you will need to put this in your birth plan.

Your midwife will examine the placenta and membranes to make sure that nothing has been left behind. She will also feel your tummy to check that your uterus is contracting hard to stop the bleeding from the place where the placenta was attached.

You may want to have a look at the placenta and also take some photos as it is a beautiful organ that has been your baby’s lifeline through your pregnancy. You could even look into doing Placenta Encapsulation for your placenta rather than discarding it.

Bonding of mum and baby with immediate skin-to-skin contact is recommended particularly during that first hour after birth so baby feels safe and calm.

 

If you would like to know more on how to prepare for your birth so you feel confident, while having tools and techniques to help you cope through your labour and birth without fear and avoiding interventions and caesarean, then send me a message using the contact form.