When you go into labor, you normally go through the following main stages:
- Early Stages: Dilation Begins
When you go into labor, your cervix gradually begins to dilate (open up). Contractions help to soften and open up the cervix gradually. This can take several hours. You should try to relax and rest at home during this stage. Try walking around gently if you feel like it- this will help you relax and help your baby move downwards. Make sure you keep yourself well hydrated and try to have a small light snack to keep you energized during the rest of labor. This would also be a good time to get a backrub from your partner and to practice deep breathing exercises. When your cervix has dilated about 3 cm, it’s time to head to your nearest hospital or chosen birth centre.
- Established Labor
This is the period during which your cervix dilates from 3 to about 10 cm. During established labor your doctor or midwife will check in on you regularly and monitor your baby’s heart using a handheld ultrasound monitor, a CTG (cardiotocograph) or in rare cases, a clip inserted through your vagina to fit over your baby’s head. You will be advised to avoid pushing during this stage. Practice deep, slow breathing or puffing out air in small breaths to help resist the urge to push. You may find it comfortable to lie on your side or on your hands and knees. To be “fully dilated,” your cervix should have opened up to about 10 cm to allow your baby’s head to pass. When you have reached full dilation your doctor or midwife will ask you to start pushing. If this is your first birth, full dilation could take up to 6-12 hours. In subsequent pregnancies your cervix dilates faster.
- Time to Push!
This is the time from full dilation to the birth of your baby. During this stage you should find a position to give birth in, and then push during contractions until birth is complete.
You could try some of these positions to make labor easier. Trying them out in advance will help you decide which positions you feel most comfortable in:
- Lying/sitting up in bed with your back propped up by pillows
- Standing, squatting or kneeling
- Lying on your side (especially if you’re very tired)
- Kneeling on all fours (especially if you have had trouble with backache during pregnancy)
When you are fully dilated you will be asked to push during contractions. Your doctor or midwife will be able to guide you on when to push. The following tips may help during the pushing stage:
- Take deep breaths as the contraction starts and push down during the contraction, taking another breath when needed. Continue pushing until the contraction ends.
- Rest in between contractions to get your energy and strength ready for the next push.
The pushing stage can last up to an hour normally.
- Actual Birth
Throughout the pushing stage, your baby’s head would have moved down towards the vagina. When your baby’s head can be seen, your doctor or midwife will ask you to stop pushing, and to instead exhale sharply and rapidly through your mouth. This is so that your baby’s head can pass gently and slowly, without tearing and injuring the skin and muscles in your vaginal area. While the skin between your vagina and anus normally stretches during birth, sometimes to avoid injury or to speed up birth, your doctor may make a small cut (episiotomy) in this area during birth under local anesthesia. Once your baby’s head has passed out, most of your hard work is over. With a couple more gentle pushes, your baby’s body will also pass through easily, and your baby will be born.
- Passing of the Placenta
This is the final stage of the labor and birthing process. After your baby is born, more contractions will push out the placenta from your body. Sometimes you may be given an injection to speed this up.
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