Labour: What to expect

Midwife and nursing professional Ruwaida Moola shares the stages of labour and what to expect.

“Labour is like a roller coaster ride – there’ll be laughs and there’ll be screams… But remember that there are no repeats. So ENJOY THE RIDE!”

This is a common saying to expectant mums to encourage them to take in every moment and enjoy the journey.

Everyone always overthinks labour.

Common thoughts are: “How will it be?” or “How will I manage?”

Many doubt themselves even before it has begun and get scared from horror stories.

With all these thoughts in mind, the journey to meeting your baby can be simultaneously exciting and daunting. The best is to put aside all that you have heard and make this your very own story, your own experience and your beautiful journey to share.

So, what is labour all about?

Well, here is a bit of insight into the stages of labour and the changes that will take place.

First stage of labour

This stage is divided into the latent (early phase) and the active phase:

The latent stage of labour could take the majority of the time. This is the stage where the contractions are mild, and still quite far apart, sometimes accompanied with a show (mucous vaginal discharge). This, for many mums, is the most exciting stage of labour as this indicates that their ‘soon to be long-awaited arrival’ will make its appearance soon.

This can also be the most frustrating part to mums, as some latent phases may take longer than the others. Sometimes, one may think that labour has started, only to be sent back home and told that it’s prodromal or false labour. This can be emotionally exhausting, especially for those mums who have been asked several times when their babies will be arriving.

Contractions in the latent phase may start every 30 minutes and over the course of the day move as close as 8 minutes apart.

According to literature, the latent phase could last up to 16 hours, however, it is fair to say that every labouring mum is a unique individual and will progress differently. A first-time mum will progress very different to a second or third-time mum. It is therefore important never to compare one labour to another and NEVER, EVER place a time limit if all is progressing well.

What to do during this time:

  • Take long brisks walks, drink a lot of clear fluids and remember to eat and snack as you may not have the appetite later.
  • Intercourse can help bring contractions closer.
  • Enjoy the last few moments of feeling the baby move inside.

If there’s any concern, go in to have the baby’s heartbeat assessed.

Once in the active phase of labour:

Contractions are rhythmic, have increased in intensity and are regular.

Remember that THIS IS THE MOMENT THAT YOU HAVE WAITED FOR – you are now 4cm or more!

Keep active, sway your hips, dance, and use the birth ball, not forgetting to breathe and to get sufficient rest in between.

Once reaching 4cm, dilatation of 1cm takes place every hour to hour and a half, however this also depends on the individual and how many births you have had before. If the contractions have increased in intensity, welcome them, because this is a sign that you have dilated a centimetre more and meeting your baby will be soon.

Hypnobirthing, re-focusing, the use of a doula, massage, and warm baths are phenomenal methods of pain relief.

During the active labour, there is a dance of hormones taking place in your body. With an increased surge of oxytocin (your hormone of love) bringing on contractions to push your baby into the birth canal and dilating your cervix, endorphins are keeping you smiling, relaxed and sleepy, and adrenalin is pumping through your veins to keeping you alert and energised.

Remember that YOU CAN DO IT!

Remember that you were made to do this… find your inner strength and keep the focus. Mental focus at this stage is very important. It is important to focus on the love you are surrounded by and that you have within you to push forward.

Your water may break at this stage (ruptured membranes), however many times the membranes may be ruptured by the care provider. When the membranes rupture, the water is known as liquor, this should be as clear in colour. If yellow, brown, or green, this indicates that the baby has had a bowel action in utero, which should not occur until the baby is born. This water is known as meconium-stained liquor and if this occurs, these babies cannot be born in water and should be monitored carefully.

Second stage of labour

The second stage of labour is when the cervix is fully dilated, and the baby’s head will start moving through the birth canal. You may feel exhausted at this stage and also happy to hear that this is the moment you have been waiting for.

I always tell mums to have realistic expectations, don’t overthink, let go and work your hardest at this stage.

Dim lights, soft music, prayer, and words of affirmation are wonderful at keeping the mum and birth environment calm and allowing synchrony in the release of the birth hormones. Oxytocin is generally at its peak, releasing in surges, and helps push the baby down. Endorphins are released, allowing you to rest and sometimes sleep between contractions and are, in fact, the best natural pain killer. Adrenalin, which is the ‘fight or flight’ hormone, generally gives you the strength to fight on and push through it all.

This is the end of your hard work and yes IT IS TIME TO PUSH AND MEET YOUR BABY.

Now here’s the trick to pushing: you need to push into the buttock muscles and don’t hold back. If you push using the correct muscles and have done your antenatal squats, it can decrease the pain during the contraction.

It can take a first-time mum much longer to push while second-time mums seem to have faster births. Once the baby’s head is out, the body is birthed much faster – be it in water or out of water.

When the baby is born and placed onto the mum’s tummy, the first meeting between the baby and the family takes place. Capture this precious moment while looking at the miracle in your arms.

The third stage of labour

The birth of the placenta is called the third stage. The placenta is the organ that has sustained the baby all through your baby’s growth and development in utero.

If the placenta is left at the hospital or birth centre, it is generally incinerated. Some customary practices are to bury the placenta, while placental encapsulation has also become quite a common practice too. A lotus birth is leaving the placenta attached to the baby, scenting it with essence and salt until it separates from the baby itself.

Fourth stage

Feeling of relief, excitement, and tears of joy may flood your emotions as you meet your baby for the first time.

This is the beautiful golden hour after birth, where breastfeeding, bonding, and staring into your miracles eyes takes place. Dads and siblings can also make skin contact. By placing the baby of your chest, they listen to the sound of your heartbeat and feel the warmth of your skin. This calms newborns even on days when they are having a restless day. Your health provider will be close by to ensure that all is well and offer assistance if needed.

One of the mums, Mel, has said it so beautifully: “The strength that women find to tap into during childbirth – a time when they’re at their most vulnerable, and when so much is at stake – is incredible, full stop. We women are strong!”

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