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Childbirth - what to expect

You will become a mum any day now. You can't wait, but you are also terrified at the vision of long and difficult labour, particularly if you are expecting your first child. Knowledge is your best ally. Find out what is going to happen and you will be ready for (almost) everything.
Paulina Heromińska | 11 March 2014

Pregnancy is one of the most beautiful times of your life. Nine months of waiting, joy, preparing a layette. But also of sacrifices, anxiety and uncertainty. All these will soon be transferred into a new dimension. Your baby will be real person, you will be able to touch him, cuddle and feed him. However, first the baby must be born and you will both need to make a great effort during the delivery. Do not, however, worry in advance. Remember, millions of women before you went through this and you will succeed as well.

Labour is usually divided into three stages:
 

Stage I - from the beginning of the labour until full cervical dilation of 10 cm.

Stage II - delivering the baby.

Stage III - expulsion of the afterbirth, that is the placenta, the umbilical cord and fetal membranes .


Preparations

About 2-3 weeks before delivery your belly drops significantly. The baby positions himself for the delivery - with a head directed towards the birth canal. You will find breathing easier, but you will visit the toilet more often. It is a time when many women feel a strong nesting instinct, they like to arrange the baby's room and dream about what is going to happen. Concentration on the upcoming delivery is often associated with slight euphoria or irritability. It is hard to concentrate on intellectual development these days. In short, this is not a good time to defend your PhD thesis. This is the time to concentrate on your body and the signals it sends to you.

Remember: Lie down quietly once a day and count the baby movements, there should be at least 10 of them per hour. Remember, the baby also has his sleep and rest times, so choose the time of a day when you know he is active.


Is that it? - First stage of labour

If this is your first child, the odds that you will give birth on your way to the hospital are really close to zero. This is also true in case of other children, as being an experienced mum you already know what to do and you can recognize the signals sent by your body. Remember, the due date is in fact an approximate date. The baby follows his own path and he will be born when ready. Usually, the delivery within two weeks before or two weeks after the due date is absolutely normal. What are the symptoms of upcoming delivery?

  • The appearance of a large amount of gelatinous, brown, pink or red mucus on your underwear - this is probably a mucous plug, the "cork" that closed the cervix.

  • Waters break - violent or trickling. Most women will give birth within 72 hours since their waters break.

  • You can experience vomiting, diarrhoea, or shivers.

  • You may also feel backache, dull and pulling, similar to that during a menstrual period.

  • The contractions intensify when you change your position, are regular, their frequency and intensity increase, and they last longer than 30 seconds.

Remember, no two women are the same, you may not experience all the above symptoms or not all of them at the same time.


Keep calm

These symptoms do not mean that you must head for the hospital right away. It is usually a dozen or so hours from the beginning of the labour until full cervical dilation (10 cm), or a bit less with the next babies. It is better to spend this time at home, rest and relax. Go to the hospital if:

  • The contractions are very strong and less than 5-7 minutes apart.

  • Your waters have broken. Go to the hospital immediately, when the waters are greenish - this means the baby passed the meconium. This may be due to stress, often caused by the baby's hypoxia or genital tract  inflammation.


At the hospital

Find out in advance what rules apply in the hospital your chose for the delivery. The first stage of labour may be difficult, as it lasts for a long time, the situation is changing very slowly, and the contractions are quite painful. However, there are ways to alleviate the discomfort. You have probably read about them or learned about this during antenatal classes.

Check with the hospital you are going to give birth in, whether it is possible to take a shower, eat and drink or whether they offer birth balls. You never know what may bring you relief at this difficult moment, so it is a good idea to have a few options. You can also ask for anaesthesia. This should be applied when the cervical dilation is between 2-3 cm and 7-8 cm. However, before you ask for a pharmacological intervention, try natural methods: a massage, breathing exercises, changing a position, walking, a bath or warm shower.

Remember to take the maternity notes, insurance policy and your ID with you. At the hospital you may expect a detailed medical interview, gynaecological examination and CTG, that is a test assessing the baby condition.  

If the labour does not progress and the cervix does not dilate, the doctor may order oxytocin administration. This is a hormone that initiates and ends the labour, it is also excreted during orgasm, and when cuddling or breastfeeding the baby. When the delivery is finished, the uterus starts to shrink back.


Second stage of labour - active phase

This is the time from full cervical dilation until the baby's arrival.  It is characterized by pushing contractions, found by many women to be less burdensome than those in the first stage. Finally, you can influence the situation and you can actively help your baby to arrive. Listen carefully to the midwife and try to follow her advice. At this stage of labour most women feel a natural, overwhelming need to push. Each contraction will move the baby down the birth canal. If he is in a correct presentation, his head will come out first. This is the greatest effort and the highest risk of perineal laceration. Remember you may disagree to have your perineum incised, but in some cases, when the risk of severe perineal tear is high, it is well justified (e.g. when the baby is big and the mum has already experienced perineal tear during a sexual intercourse).

Now comes the easy part. The rest of the body should come out after a single contraction. It is important that the child is placed on your belly just after that, it will be your first "skin to skin" contact. If there are no medical contraindications, this is a very important moment of creating a bond and the feeling of security. The baby will hear your well known heartbeat and will calm down. Try to attach the baby to your breast right away. Do not worry if the first breastfeeding is unsuccessful, the first contact and intimacy matter most. Weighing, measuring the length and other procedures may be postponed for a short while.


Third stage of labour

After a short while the uterus starts to contract again. You will expel now so called afterbirth, that is the placenta and fetal membranes. It is important that they are expelled as a whole.

If your perineum has been incised or torn spontaneously, it will be now stitched and dressed. It is the time of uterus shrinking. You may experience blood pressure drop, weakness, your limbs may start to tremble. You have made it through a long and exhausting passage. You will be experiencing its effects for many weeks, and your body will slowly go back to its normal state. However, you won the main prize: long-awaited, beloved baby whom you can cuddle at last.

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