From drugs to breathing techniques Here's what to know to make your labour as painless as possible.
Labour has three phases:
- The first stage is when the neck of the womb (cervix) opens to 10cm dilated.
- The second stage is when the baby moves down through the vagina and is born.
- The third stage is when the placenta (afterbirth) is delivered.
The first stage of labour: dilation
Before labour starts, your cervix is long and firm. During the first hours of labour, the muscles of the uterus (womb) contract and help shorten and soften the cervix, so that it can dilate (open).
For first-time mothers, this stage can last from six to 36 hours.
During this time you might experience:
Contractions - some can be quite mild, like a period pain; others can be sharp and strong. Initially the contractions will be short (between 30 to 40 seconds) and irregular. Once contractions are five minutes apart and a minute or more in length, labour is said to be 'established'.
A 'show' - the discharge of a plug of mucus that can be thick and stringy or blood-tinged. This may happen the day you go into labour, or up to a week before.
'Breaking of your waters' - this means the amniotic sac around your baby has ruptured.
Every labour is different. If you think you could be in labour, the first thing to do is relax and stay calm. The best place for early labour is at home.
Things to do and try at home:
Time - Once contractions become fairly regular, write down the time between each contraction, as well as how long each contraction lasts.
Aromatherapy - some essential oils are better than others, so ask your LMC.
Distraction - watch television or a DVD, play a board game, do crosswords.
Relaxation and visualisation - breathe in gently, sigh out slowly, think positive thoughts.
Stay mobile - go for short walks.
Massage - neck and shoulder to release tension.
A warm bath or shower.
Panadol, warm drinks, water.
Small frequent meals, such as fruit, nuts, carbohydrates (bread, pasta, rice, cereal), plus small amounts of sugary foods.
Sleep - try to rest and sleep in between contractions.
Heat - a hot water bottle or wheat pack can be helpful on your back and stomach.
TENs machine - these can be hired (discuss with your LMC).
Support people - have positive supportive people around you
When to ring your lead maternity carer (LMC) or our Labour & Birthing Suite (if you are giving birth at Auckland City Hospital):
Your contractions are coming every five minutes, lasting longer than 50 seconds and have been getting stronger for at least two to three hours.
You have severe or constant abdominal pain with a tight abdomen.
Your water has broken and it is clear or has a tinge of pink. Put on a sanitary pad and check it after an hour. If it is wet, please ring us.
Your water has broken and it is green or brown. Call us immediately - you will be advised to come into hospital.
If there is a change in the pattern of your baby's movements..
You notice any vaginal bleeding - bright red vaginal bleeding is not normal.
Things to do and try at hospital:
Try not to tense up during contractions. Your body is trying to release something, not tighten up.
Find positions that feel comfortable. Walk the corridors slowly, lean on the walls, use the Swiss ball and La-Z-boy chairs. Try to stay off the bed, unless for a short rest.
Water is great for relaxation and coping with contractions. If you don't have use of a pool, try the shower.
Bring music and a player, if it relaxes or calms you.
Bring an electric oil burner and use your aromatherapy oil.
Continue to take refreshments and drink small amounts frequently.
Phone calls are a distraction from your tasks of giving birth and looking after your new baby. Encourage family and friends to phone one designated person for updates.
The second stage of labour: your baby
The second stage of labour begins when the cervix is fully dilated (open) and the baby's head moves down out of the uterus and into the vagina (or birth canal). Your job at this stage is to push the baby through the birth canal, so you'll need focused determination and energy.
The birth of your baby may take 30 minutes to an hour or longer. This second stage could be further extended if you have an epidural.
A small number of women will require assistance with their births, either by forceps or ventouse (vacuum extraction). The obstetrician will choose which is best for your situation.
Find out more about your pain relief options and coping with labour.
The third stage of labour: the placenta
The final stage of labour is delivery of the placenta. There can happen in one of two ways listed below.
Your LMC can help you to decide which approach would be best for you, taking into considering your health, how your pregnancy has progressed and the type of labour and birth you experience.
1. Physiological management
Physiological third stage means waiting for your placenta to deliver spontaneously with your effort. This may take up to an hour following the birth; while you're waiting, skin-to-skin with your baby and a first breastfeed will be encouraged.
2. Active management
Active management involves injecting an ecbolic (contracting drug) into your leg as your baby's shoulders are born. The ecbolic speeds up placental separation and your uterus (womb) contracts down to reduce blood loss and ensure your womb remains contracted.