The three stages of labour
Every woman experiences labour differently, but all will generally go through these three stages.
This is when the cervix dilates. It starts with regular, mild contractions and finishes when your cervix is fully dilated at 10cm. It is divided into three phases: the latent phase, the active phase and the transition.
In the latent phase your cervix thins out and dilates to 3cm. Contractions are usually 10-20 minutes apart and last for 15-20 seconds. They gradually move closer together until they occur every five to seven minutes and last 30-40 seconds.
The latent phase may last eight to nine hours in a first delivery and about five hours in subsequent deliveries, although these times vary widely. It should’t last more than 20 hours.
In the active phase your cervix will dilate from 4cm to 8cm. It will take about an hour to dilate each centimetre, faster in women who have had a baby before. Contractions will now be moderate to strong, coming every two to three minutes and lasting about one minute.
In the transition your cervix dilates from 8cm-10cm. Your contractions will be strong, coming every two minutes and lasting 60-90 seconds. This is the time when you might feel anxious, desperate, even angry, due to the extra adrenalin coursing through your body.
The pushing stage
The cervix is dilated to 10cm. Once your LMC has given the all clear, it’s a huge relief to be able to push the pain away with each contraction.
You will feel your baby’s head moving down the birth canal with each push though in subsequent births, the baby can seem to shoot down quite quickly. As your baby crowns at the vaginal entrance, you may feel a burning sensation as the tissues are stretched to their utmost. Your LMC may advise you to ‘pant’ or breathe fast and shallow, which helps prevent you pushing for a few seconds. This will allow your skin to stretch a little further, and hopefully prevent tearing or an episiotomy (a cut made to the vaginal entrance and perineum that must be stitched after delivery).
This stage usually lasts less than two hours with a first baby, and less than an hour with subsequent babies.
During this stage, the placenta comes away from the wall of your uterus and is delivered. This stage is handled in one of two ways:
Once your baby’s shoulders have been delivered, you are given an injection, which causes your uterus to crunch down on the placenta to it peels away from the uterine wall. Your baby’s cord will be clamped and cut as soon as she is delivered.
Physiological third stage
This is when nothing is donw and you wait for your body to expel the placenta in its own time. It can take up to an hour. The cord is left alone and cut only when it stops pulsing.
Active management has been found to reduce the chance of postpartum haemorrhage, but there is an increased chance of nausea, vomiting and hypertension, depending on the type of drug used.
Keeping tabs on baby
During labour your LMC will monitor your baby’s heart rate, listening in every half hour in the first stage of labour and more frequently in the second stage. If worried about anything, she might start continuously monitoring the heart rate.
If continuous monitoring is called for, a cardiotocograph (CTG) machine will be used. Two wide elastic bands go around your middle. One sensor picks up the baby’s heartbeat, while another measures contractions. The baby’s heart rate and the strength and timing of contractions are printed out on graph paper.
The only truly accurate way to tell whether a baby is in difficulty is by foetal blood sampling. During a vaginal exam, a doctor nicks the baby’s scalp and takes a blood sample to test for acidity.
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