Brief Overview of Labour
Here we are briefly going to go over the stages of labour and some alternatives that can occur during labour. There is a lot to talk about here and I am not a doctor so I am just briefly reviewing things that happen so they don’t seem to foreign to you if it comes up. I would recommend reading up on labour to allow yourself to become more prepared (maternity books) as well as take the Prenatal class the hospital or your midwife offers for you and your partner so you both can familiarize yourself with things that can pop up during ‘the day’ and some tricks and tidbits post labour.
Obstetrical Triage
Monitoring baby & I while they see if I am in active labor with first baby. Worried face because some lady only 3cm dilated was screaming ‘I’m going to die!’
STAGES of labour
Stage 1: When uterus is dilating and effacing to help get baby through birth canal
Phase1 Early: Contractions are irregular and don’t last for more than a minute. This phase could last for days and is the longest stage of labour. (0-4cm)
Phase 2 Active: This is when you should go to the hospital. Contractions are 5:1:1 (4-8cm)
Phase 3 Transition: When cervix is becoming completely dilated. Generally the most painful and shortest part of labour (8-10cm). You may start getting the urge to push - you must wait till you are fully dilated and doctor/midwife tells you to start pushing…
Stage 2: Delivery of baby
This is when you are pushing the baby out. For first time moms this could be a couple hours long. Or you can get lucky and only have it last for a few minutes. Generally you will get a strong desire to push. If you have an epidural, you won’t feel this and need to be coached by your nurse/doctor when to push. Once baby is out, baby’s umbilicol cord will be cut by health care professional or father if he chooses. Ask about delaying cord clamping. It is supposed to reduce chances of anemia and provides the baby with extra blood supply.
Stage 3: Delivery of placenta
No going to lie, this part is really gross. But you will barely even notice this phase as you will have baby in your arms (barring any complications) and you don’t really feel it coming out. But it is a crucial phase since any complications with this could cause major bleeding issues for you.
Things that can happen during labour:
Abnormal heart rate of baby: Heart rate keeps fluctuating especially more than normal during contractions. First they will help you switch positions or move around a bit to see if this will help. If not, an internal heart monitor will be inserted. It sounds scary, attaching a wire electrode to your baby’s scalp. But it is harmless and it’s used to get a more accurate reading than the external monitors. It just means they are paying extra attention to your baby’s needs.
Shoulder dystocia: Shoulder gets stuck on the way out. Doctors may resort to using a specialized vacuum which will be placed on baby’s head to help pull baby out during pushing so they don’t get distressed. Nurses may also help guide baby out by manually pushing down on your lower abdomen.
Emergency C-section: Labour is not progressing fast enough and baby is in too much distress (not getting enough oxygen, heart rate is erratic, worries of umbilical cord obstructing fetus etc).
Perineal Tears: Vaginal tears or surrounding tissue tears as a result of pushing or from necessary episiotomy (surgical cut to help assist delivery). If it is very minor your healthcare professional will allow to heal on its own. But if it is a bit larger, they will stitch it up for you.
Wrong position: Baby is in the wrong position for safe passage through the birth canal. Depending on the position, your doctor may suggest a C section or other methods to try to alter position of baby.
Post epidural
No pain, waiting for baby to come