Labour and Delivery
Pregnancy and childbirth is a wonderful journey and being knowledgeable and flexible will empower you and your spouse to gracefully welcome the little bundle of joy to the world and the long wait of nine months is over. Your bags are packed for the hospital and you have a birthing plan discussed with your doctor. While you are getting ready for the big day, we will discuss some basic terms and management of labour and delivery.
Lightening is when the baby's head settles deep into your pelvis. Your upper abdomen gets relief and gets less full and lower abdominal discomfort increases. This can happen anywhere from a few weeks to a few hours before labour begins.
Contractions are when your womb muscles harden and then relax. In the last few months of pregnancy you may experience Braxton Hicks contractions which are irregular and painless.
False labour pains
You may experience irregular contractions of uterus, which may stop if you change positions, walk or rest. In doubt reach the hospital.
True Labour pains
These are regular, progressively increasing contractions and do not stop even on changing positions, walking or resting with each contraction lasting 30-60 seconds.
Show – many women experience blood tinged mucus plug discharge at the starting of labour.
You should immediately reach the hospital when
- You have regular contractions
- Baby is moving less
- There is watery discharge or blood stained discharge
- Anything which worries you
Stages of labour
Your cervix will soften and contractions may be very slight. It may last for many hours. You may eat, drink, sleep or walk around, whatever is comfortable.
First Stage of Labour
Once labour is established and cervix (mouth of the uterus) is 3-4 cm dilated, you and your baby will be examined by the doctor more frequently. You may discuss your pain relief options with your doctor. It may take 6 - 12 hours in a first-time pregnant lady and lesser in next pregnancies. You may walk around or be in a comfortable position and have liquids during this time.
If your labour is slow the doctor may offer speeding up labour by oxytocin drip or artificial rupture of bag of membranes. Your baby’s heart beat will be monitored frequently.
Second Stage of Labour
This happens when the cervix is fully dilated (10 cm) and thinned out (effaced).
You may experience bearing down/pushing sensation. It may take upto 2hours in first time pregnant lady and lesser in next pregnancy It may take longer if epidural pain relief was taken.
The doctor will give you a local anaesthetic medicine and may give a controlled cut in perineum called episiotomy.
This stage of labour may be difficult but your doctor, nurses and partner will encourage you.
Once the baby is born skin to skin contact and early breast feeding will be encouraged. The paediatrician will assess and help the baby. Delayed cord clamping is encouraged if feasible.
Third Stage of Labour
Most of the hard work now is already over. In this stage your placenta will deliver. Episiotomy and tears will be stitched and bleeding will be controlled.
Fourth Stage of Labour
It is the 1-2 hours after delivery in which you will be observed for bleeding and will be encouraged for passing urine.
Pain Relief in Labour
Labour is a painful process. Here are some tips for you to cope with pain and relax
- Attend antenatal birth preparation classes with your spouse to be more prepared
- Breathe deeply, relax and stay calm
- Moving around by walking, kneeling, rocking may help
- Having a spouse/relative/doula may help
- Back massage, hot water bag may help
- Epidural Analgesia by an injection given in the back by the anaesthetist is an effective option and can be discussed during pregnancy and labour
Your birthing will be monitored and tailored according to your needs and safety. Wishing you a safe and happy motherhood!