Show
Symptoms of going into labourSome of the signs and symptoms of going into labour may include:
First stage of labourThe first stage of labour involves the thinning of the cervix and its dilation to around 10 cm. The first stage is made up of three different phases:
Throughout the first stage of labour, careful monitoring and recording of your wellbeing and that of your baby, and the progress of your labour, is important. This is to ensure that labour is progressing normally and that any problems are recognised early and well communicated. Second stage of labourThe second stage of labour is from when your cervix is fully dilated to the time your baby is born. The contractions during this time are regular and spaced apart. As each contraction builds to a peak, you may feel the urge to bear down and push. The sensation of the baby moving through the vagina is described as a stretching or burning, particularly as the baby’s head crowns (appears at the vaginal entrance). At the time of birth, a doctor or midwife may guide your pushing to enable a gentle, unhurried birth of your baby's head. Sometimes the umbilical cord is wound around the baby's neck. If possible, the doctor or midwife will loosen it, loop it over your baby's head, or clamp and cut it to allow your baby to be born safely. Once the head has emerged, your midwife or doctor will guide your baby’s body so the shoulders come out. The rest of the baby will then follow. If this is your first baby, the second stage of labour can last up to 1 to 2 hours, particularly if you have had an epidural. If you have had a baby before, this stage is often much quicker. Monitoring of your condition and that of your baby is increased during the second stage of labour. A long second stage of labour can result in risks for you and your baby. If your labour is not progressing, it is important that the reason is worked out and steps are taken to help you. Third stage of labourAfter the birth of your baby your uterus gently contracts to loosen and push out the placenta, although you may not be able to feel these contractions. This may occur 5 to 30 minutes after the birth of your baby. The muscles of the uterus continue to contract to stop the bleeding. This process is always associated with a moderate blood loss – up to 500 ml. In this stage of labour, one of the potential problems is excessive bleeding (postpartum haemorrhage), which can result in anaemia and fatigue. This is why the third stage is carefully supervised. There are two approaches to managing the third stage:
Monitoring your baby during labourDuring labour, your baby's heart rate will be checked regularly. If you have had a low risk pregnancy and there are no problems at the onset of labour, your baby's heart will be listened to every 15 to 30 minutes using a small hand-held Doppler ultrasound device or Pinard (fetal stethoscope). This equipment can be used regardless of the position you are in. If you had problems during pregnancy or if problems arise during your labour, your baby’s heart rate may be monitored continuously using a cardiotocograph (CTG). A CTG involves having two plastic disks (receivers) strapped to your abdomen and held in place by two belts. The receivers are attached to a machine, which may limit your movement. Some hospitals have machines that enable you to move around freely while you are being monitored. This is known as telemetry. Care of the perineum during birthThe area between the vagina and anus is called the perineum. Once the baby's head starts to crown (appear) the perineum will tear if it can't stretch enough. These naturally occurring tears can be difficult to stitch and may not heal very well. In around 3–4 per cent of cases, the vagina tears right through to the anus. An episiotomy is an intentional cut of the perineum, using a pair of scissors. This clean cut is much easier to control and repair, tends to heal better than a tear, and is less traumatic to the underlying muscle and tissue. An episiotomy may be needed during the last part of the second stage of labour if:
If you are having your first baby, you may help prevent tearing by massaging the perineum during the weeks prior to the birth. Massaging the perineum during the second stage of labour has not been shown to stretch tissues and therefore does not reduce perineal injury. Episiotomies should be performed only if needed. They should not be 'routine' as they do not reduce the risk of severe perineal injury, urinary stress incontinence or trauma to the baby. Suggestions for preparing for labourSome women may find the following activities helpful in preparing for labour:
Early stages of labourBe guided by your doctor or midwife, but general suggestions for a woman approaching labour include:
Once you are in your intended place of birthSuggestions for labour once you are in your intended place of birth include:
Having a support personHaving a support person with you can help enormously during labour. Your support person can:
Where to get help
This page has been produced in consultation with and approved by: Department of Health - CHI - HSR&I - Maternity & Newborn Clinical Network This page has been produced in consultation with and approved by: Department of Health - CHI - HSR&I - Maternity & Newborn Clinical Network This page has been produced in consultation with and approved by: Department of Health - CHI - HSR&I - Maternity & Newborn Clinical Network
Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website. |