What to expect on labour day
Your expected date of delivery is approaching (only 5% of women go into labour on their actual due date) and you’re likely to be excited and nervous in equal measures at the prospect of what labour will be like, and eager to meet your newborn.
But what can you expect to happen before and during labour? What are the typical signs that your baby is preparing to leave the warmth of your womb and start the next stage of life?
A unique experience
Every labour is different and giving birth is unique each time, even for mothers who have given birth before. Whilst the physical process of giving birth is essentially the same for each mother, it is the experience of it that varies tremendously. Some mothers labour for minutes or hours before giving birth, while others can take a couple of days.
It’s important to mentally prepare yourself for childbirth and it will help to understand what is going on in your body and why; and how it is preparing you for labour and birth. The process can be divided into four stages.
During pregnancy you will have practice contractions or ‘Braxton Hicks’. These are tightenings of the muscles of the uterus (felt in your abdomen) that are usually felt more intensely in the final weeks of pregnancy. You may see your tummy tightening and lifting slightly during these practice contractions.
Sometimes, they can be so intense and uncomfortable they are mistaken for ‘real’ contractions. If they are Braxton Hicks, taking paracetamol and moving around will usually make them disappear.
Shortly before birth, your baby will drop down into your pelvis and become ‘engaged’ (usually head first), making breathing and eating more comfortable. You may also notice that your baby’s movements change as there is reduced room in which to move. If you are worried about any reduction in the frequency of your baby’s movements, go straight to your maternity hospital or contact your health professional. Never go to sleep ignoring a reduction in your baby’s movements.
NESTING AND MOOD CHANGES
Some women experience an unexpected burst of energy often referred to as the ‘nesting instinct’.
It’s also common to experience mood swings, to be more emotional and experience feelings akin to pre-menstrual symptoms.
An obvious sign that labour may be imminent is the appearance of the mucus plug sealing the opening of your cervix during pregnancy. As the cervix starts to thin and soften, the plug is released and passes down through your vagina.
You may see ‘the show’ as a pink, brown or blood-stained blob in your knickers, or in smaller amounts. Although labour can begin any time after the show, it could be hours or even weeks.
A dull ache in your lower back, an uncomfortable throbbing, period-like pain or feelings of constipation are all signs that labour may be imminent. You may not experience any of these but some women have them all.
Tummy ache and diarrhoea are common signs that labour is imminent. Pre-labour diarrhoea is thought to be caused by the rectal muscles loosening in preparation for birth. It’s also commonly thought to be nature’s way of emptying your bowels to provide more room for your baby during birth.
THE FIRST STAGE
During the first stage of labour contractions will start in earnest. Contractions cause the cervix to dilate and thin until the cervix is fully dilated. Contractions last around 30-60 seconds becoming more frequent and increasingly painful as labour becomes established.
You may find it helps to imagine your cervix as a flower bud with each contraction opening the flower just a little more. Find a position you feel most comfortable with: squatting or semi-sitting can make contractions easier to cope with as it utilises gravity to help in labour, and can minimise backache.
The amniotic sac contains the fluid surrounding, nourishing and protecting your baby. During labour this usually ruptures and the waters either gush out (in which case you will know about it) or trickle out slowly.
Your waters can break before labour starts or anywhere and at any time during labour – or they may not ‘break’ at all. Sometimes the amniotic sac remains intact until your baby’s head emerges. If your waters break, contact your labour ward straightaway.
THE SECOND STAGE
By now, your cervix will be fully dilated and your baby is ready to be born. At this stage contractions will help your baby move down the birth canal and through the vagina. This can take anything from a matter of minutes to a couple of hours. If your waters have not yet broken your midwife may carefully rupture them.
You will undoubtedly have the urge to push but listen to your midwife who will advise you to stop pushing at certain points, and encourage you to pant and breathe to minimise the risk of tearing.
Your baby’s head will ‘crown’ when it stretches your vagina prior to birth and you may feel an intense burning or stinging sensation. This is often called the ‘ring of fire’ and if you remember this when it actually happens it can help you cope with the pain.
Once your baby’s head is born, one or two more pushes will deliver the rest of your baby. After nine months you can at last hold your baby and see what he or she looks like! The cord will be cut (many hospitals now advocate that the cord should not be cut until it has stopped pulsating if all is well) and, assuming all is well, you can enjoy your first precious moments with your newborn.
A HELPING HAND
Statistically 10-15% of women will have an instrumental (assisted) delivery and around 13% will have a caesarean section, despite being in labour. The NHS Choices website at http://www.nhs.uk/conditions/pregnancy-and-baby/pages/ventouse-forceps-delivery.aspx explains how an assisted delivery is where forceps or a ventouse suction cup (ventouse) are used to help deliver the baby’s head. This can be because there are concerns about the baby’s heart rate, your baby is in an awkward position or you’re too exhausted. Both ventouse and forceps are safe and only used when necessary for you and your baby.
If your obstetrician has any concerns, you may be moved to an operating theatre so that a caesarean section can be carried out if needed, for example if the baby can’t be easily delivered by forceps or ventouse. This is more likely if your baby’s head needs turning.
Sometimes, as the baby is being born, a cut (episiotomy) may be needed to make the vaginal opening bigger. Any tear or cut will be repaired with stitches.
THE THIRD STAGE
After the birth, the placenta that has sustained your baby for nine months comes away from the wall of the uterus. This might happen within a few minutes or up to half an hour later. You will have the option to have an injection to help you deliver the afterbirth quickly (this may not be available for a home birth) or you can deliver it naturally, which can take a little longer.
You will experience a final contraction to expel the placenta from your body and your uterus will then contract.
About the Author
Mum of four Nicola Laver is an author and freelance journalist who writes regularly for business and lifestyle titles.