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The Stages Of Labour


Discussions on "The Stages Of Labour" in "Labor & Delivery" forum.


  1. #1
    nlakshmi's Avatar
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    The Stages Of Labour

    What are the stages of labour?


    Labour is often described as the contractions you get leading up to the birth of your baby. It actually goes on until your placenta is delivered and it can be divided into three stages. Knowing how to recognise each stage will help you understand your labour and keep track of how the birth is progressing.

    The first stage of labour results in the opening of the cervix, the neck of the uterus. The second stage starts when your cervix has dilated 10cm and you start pushing your baby out. The second stage lasts until your baby is born and then the third stage kicks in, which is when the placenta is delivered. The first stage is often the longest, so it is further broken down into the early, active and transitional phases.


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    Last edited by nlakshmi; 1st Feb 2012 at 11:26 PM.

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    Re: The Stages Of Labour

    Early phase or pre-labour


    What happens
    The early phase is sometimes called the latent period or pre-labour. The uterus starts to contract or tighten regularly. The contractions gradually become more painful. Each woman has her own rhythm and pace of labour. You may not even be aware of the very early contractions and may be several centimetres dilated before you realise you're in labour. Other women have painful contractions from the start.

    As the cervix begins to open, its position in your pelvis changes. It moves forwards, softens and effaces, which means that it gets thinner and springier. Feel your nose: it's firm and muscular. Now feel your lips: they're soft and stretchy. Your cervix starts out firm, like your nose, and has to become soft and stretchy like your lips.

    What you can do
    If you feel up to it, walk around or take a warm bath. Relax as much as you can and have lots of snacks. Carbohydrate-rich foods that provide energy are best such as rice, chapattis, paranthas, idlis, bread, potatoes, pasta and raisins. If you find the contractions are hard work, try having a massage, or use some relaxation techniques. Experiment with different positions to find the most comfortable for you.



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    Re: The Stages Of Labour

    Active phase of labour


    What happens
    Doctors say you are in active labour when your cervix has dilated, or opened, to 3cm or 4cm. Your contractions will be getting stronger and more frequent. They're also getting longer. Eventually they may be coming as frequently as every 3-4 minutes and lasting 60-90 seconds.

    What you can do
    Your contractions may start to feel as if they are coming one on top of another. Try to work with your body. What is it telling you to do? Would you be more comfortable in a different position? Do you need a drink or some food to give you energy? Would it help to go to the toilet?

    Breathing exercises and relaxation techniques really come into their own at this point, and your doctor, nursing staff or your husband can help you. Consider taking a warm shower or bath as warm water can really help ease the pain of labour.

    Sometimes, women reach a point in labour when the rate at which their cervix is dilating slows or even stops. If your doctor tells you that it is the case, ask if you can walk down the hospital corridor. Being upright and mobile allows the baby's head to move right down onto the cervix which can help it dilate. Sometimes a good cry releases the emotional tension and helps you 'let go'. If your waters haven't broken yet, your doctor may decide to break them to see if this will speed labour up. Be aware though that you may find contractions tougher once the waters have gone.

    If you find that the things you can do to help yourself aren't making contractions manageable, ask your doctor for some pain relief.




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    Re: The Stages Of Labour

    Transitional phase of labour

    What happens
    During the transitional phase, the cervix dilates from 8cm to 10cm. Contractions may last for over a minute and come every 2-3 minutes. You might feel shaky, shivery and sick. Many women report that this phase is so intense they feel as if they're having an out-of-body experience.

    What you can do
    Make the most of the time between contractions to rest and relax. Keep your breathing as rhythmical as possible (breathe in through your nose and blow out through a soft mouth). Shout, groan or make a lot of noise if you want to! Try not to worry what others may be thinking about you. Doctors and nursing staff are accustomed to seeing women in labour and there may be many mums in the same situation as you in the hospital.



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    Re: The Stages Of Labour

    Second stage of labour


    What happens
    Once the cervix has dilated to 10cm, the second stage begins, when you push your baby down the vagina (sometimes called the birth canal). There's often a lull at the end of the first stage when the contractions stop, and you and your baby can rest for a while. When the contractions start again, you'll feel the pressure of your baby's head between your legs. With each contraction and every push, your baby will move down through your pelvis a little, but at the end of the contraction, he'll slip back up again! Don't despair. As long as the baby keeps on moving on a little further each time, you're doing fine.

    Your doctor, nurses and even the hospital
    aayas may encourage you to push stronger and harder during the contractions. Sometimes they may even yell or shout at you. Do not feel that you are not doing a good enough job, they do it thinking that the pressure of someone shouting at you might make you push harder. If you get annoyed or hassled by it, ask them to tone things down. This is the birth of your baby so feel free to do it in a way that you are comfortable with. Sometimes doctors also pat the thighs or backs of women in labour to urge them to push harder.

    When your baby's head is far down in your pelvis and stretching the opening of the vagina, you'll probably feel a hot, stinging sensation and your doctor will tell you that your baby's head has 'crowned'. As your baby's head begins to be born, your doctor may ask you to stop pushing and gently pant. This makes sure that your baby is born gently and slowly, and should reduce the risk of tearing your perineum.

    If you have had a baby or babies before, the second stage may only take 5 or 10 minutes. If this is your first baby, it may take several hours.

    What you can do
    You will probably be told to push when you feel the urge to do so, and you may be able to push several times with each contraction. Your doctor will suggest the best position for you, probably lying on your back or in a semi-reclined position with your head and trunk raised while pushing the baby down. The more upright you can be, the easier it is to push. If you've had an epidural, your doctor will tell you when to push. She may suggest not pushing until she can actually see your baby's head.



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    Re: The Stages Of Labour

    Third stage of labour

    What happens
    In the third stage, you will deliver the placenta. Contractions will start again a few minutes after the baby is born, but they will be much less intense. These contractions cause the placenta to peel away from the wall of the uterus and drop down into the bottom of your womb. You will probably feel that you want to push. The placenta, with the membranes of the empty bag of waters attached, will pass down and out through your vagina.

    Delivering the placenta usually takes less than 15 minutes, but it can take up to an hour. It depends on whether you have a managed or natural third stage.

    Your doctor will carefully examine the placenta and membranes to make sure that nothing has been left behind. She will feel your tummy to check that your uterus is contracting hard in order to stop the bleeding.

    What you can do
    You may hardly be aware of the third stage, as your focus has probably shifted to your baby. Some hospitals will immediately hand your newborn baby to you. Seeing and handling your baby, and offering him, or her, the breast will stimulate hormones that help the placenta to separate.

    Now that the birth is over, you may feel shaky due to the adrenaline in your system and the adjustments your body immediately starts to make, or you may be very emotional, sleepy or hungry! Some women find it hard to pay attention to the baby if they have had a long labour, or if they've had painkilling drugs like Pethidine. If you feel exhausted, take your time. After a rest you will be much more interested in getting to know your baby.

    Admire your new baby. Count the fingers and toes. Hold him or her close to your body, on your chest, preferably skin to skin. Offer the breast as soon as possible. Don't worry if your baby doesn't seem very interested. Even if he's only touching and nuzzling you, this will help you begin breastfeeding.



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    Re: The Stages Of Labour

    Hello Lakshmi,

    I am wondered about 'epidural'. If you give more information like the side effects, how is that injected, is that for C section or also applicable to Normal delivery, it will be very helpful. Thank you in advance

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    Re: The Stages Of Labour

    Dear Durga, Epidural anaesthesia is given at a certain stage of labour when the dilatation is sufficiently progressed but still a while for the birth .......

    Anaesthetic medication is injected into the epidural space and it can be topped up for the duration of labour .....The mother will not feel any pain ..... It is a fairly safe procedure which is commonly and routinely offered to a woman in labour ...... There are certain risks involved but in expert hands it is just a formality to warn you of those risks ......So dont worry much about it .......

    The anaesthetist will discuss in detail at the time the pros and cons of epidural ....
    Also if it is C- section Spinal anaesthesia is Usually given , unless it is an emergency and in which case a general anaesthesia is given ....
    In some cases an epidural may be converted to a spinal anaesthesia if C- section is required ......

    I have had a spinal for my C-section and am well with absolutely no side effects ....So dont read too many scary stories on the net and start worrying about it .......

    Last edited by PriyagauthamH; 4th Apr 2014 at 12:10 AM.
    sumathisrini likes this.
    Priya


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    Re: The Stages Of Labour

    Thank you Priya


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