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What to expect in labour

What to expect in labour | Annabel Karmel

You’ve waited for this very moment for what feels like an age but now it’s here you might suddenly feel not so sure that you’re ready! But nerves are natural and the months of anticipation have come to an end – it’s your incredible body’s time to shine!

Here’s a little on what to expect when the big day arrives…

Signs of labour

You have your due date but remember that this is merely a rough estimate and your baby could arrive up to 3 weeks early or 2 weeks late. However, whether your baby decides to arrive early or late, there are a few key signs which signal that you might not be too far off welcoming your newest family member to the world!

  • You may begin to have contractions or ‘tightenings’ which can cause uncomfortable or painful cramps in your lower abdomen and back.
  • You might notice discharge or a ‘show’ which is when mucus from your cervix comes away and is released.
  • Your waters breaking – you might either feel this as a gush of water or it can be more difficult to detect in the form of a leak or trickle.
  • You might also feel the urge to go to the loo and this is because the baby’s head is at this point pressing down on your bowel.

So these are some of the key tell-tale signs, but the early stage of labour can take some time so when is the right time to head to the hospital? Call your midwife or maternity unit at the hospital when:

  • Your waters break
  • Your contractions have been coming every 3 minutes regularly for more than an hour (if it’s your first baby, wait as long as you can or until you strongly feel the need for pain relief)
  • You’re bleeding, or there is any yellow or green colour in your waters (if this is the case then go to hospital urgently)
  • You are less than 37 weeks pregnant and think you might be in labour

Stages of labour

As with your pregnancy, labour is divided into stages and phases and unfortunately, the whole process is not always as quick as you might hope. But you’ve waited this long and you really are at the final hurdle so stay positive and stay strong – you’ve got this!

The first stage of labour is divided into three phases – latent, active and transition.

Latent

The latent phase signals the start of labour and this is often the longest phase too. During this time you will experience some contractions (which might be as much as 20 minutes apart) which are helping the cervix start to dilate, soften and thin in preparation for your baby to be born. Contractions at this stage will likely not be too painful and might feel more like mild cramps or period-pain.

You will have probably heard the stories of mums (very nearly) to-be, heading into hospital in this early stage only to frustratingly be sent home. This is very common. It can take hours or even days to pass through this initial phase of labour so prepare to be patient. However, do of course call your midwife if you are unsure or worried.

Active

During the active phase you should now ensure that you travel to the hospital or if you are having a home birth then stay put and call your midwife if you haven’t already.

The cervix will now begin to dilate more rapidly at this stage and your contractions will be much more noticeable and more frequent. This ‘active’ phase is your body preparing for birth and your cervix will continue to open from around 3cm until fully dilated at 10cm.

Whereas in the latent phase you might have been able to get on with everyday activities to a certain degree without much pain, during the active phase your contractions will become stronger and more intense. During these you will need to focus on your breathing and resist the urge to push down, as your doctor or midwife will ask you to wait until you are fully dilated.

Transition

During the transition phase your cervix will transition from around 8cm dilated to fully dilated at 10cm. Contractions will now be more painful (this is when you might need some pain relief) and will be roughly every 3 – 4 minutes and you’ll be ready to PUSH! We promise, the end truly is in sight at this stage and it won’t be long until you’re holding your new beautiful babe in your arms.

 

Right, so now it is time to push and your doctor or midwife will give you the OK to do so. It’s a combination of your pushing and the contractions which will get that baby out! Pushing will come naturally we promise but your midwife will guide you through this so don’t worry. They will also tell you when to stop pushing as the head is crowning and this is to stop you tearing.

Eventually the head of the baby is delivered and with the next contraction and push the baby’s shoulder and body appear together. You will feel instant relief as your baby is put onto your skin.

Soon after your baby has been delivered, your midwife or doctor will ask you for one more push so that they can help to deliver the placenta. After this all the hard work is over and you are done! Now it is most certainly time to rest.

After the delivery is over, you may be moved to the postnatal ward and you will have a baby check by a doctor or midwife. Once mum and baby are doing well, you will then be discharged home.

As each pregnancy is different and varies from woman to woman, so too does labour. The time spent in labour will vary, but often if it is your first pregnancy labour will be slightly more on the longer side of things. And, for some women labour doesn’t start on its own and you may have to have an induction of labour at the hospital or at home.

If your healthcare team are concerned, they may advise you to have a caesarean or an instrumental delivery to deliver the baby sooner.

 

Pain Relief

You don’t get a medal for doing it all totally au natural so don’t be ashamed to ask for help. The following options may be available to you;

Transcutaneous electrical nerve stimulation (also known as TENS)

This is a popular in early labour and uses mild electrical currents to block pain.

Gas and air

Officially known as Entonox is half oxygen and half nitrous oxide gas. This is a popular method of mild pain relief as you are in control of when you want to use it and consequently how much you’re using.  You’ll be given a mask or mouthpiece which you hold yourself and breathe in the gas when your contractions start. However, it can make some women feel a little nauseous or sleepy and unable to concentrate so just see how you go.

Pethidine injections or diamorphine

Both of these will help you to relax and have a calming effect. However, this method will take about 20 minutes to kick in (and results last roughly 2 -4 hours) so are not recommended if you are close to Stage 2 of labour.

Epidural

This is a special form of local anaesthetic and so will always be carried out by an anaesthetist, so it won’t be available if you have a home birth.  It works by numbing the nerves from the birth canal to the brain and for most women is a form of complete pain relief. An epidural will be administered by your anaesthetist who will insert a very fine tube into your lower back with a needle where pain relief can be fed through. Epidurals can be particularly helpful for women who are experiencing a very long or painful labour.

For lots more support and advice, visit @the_mother_box on Instagram.

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