Stages of labour

To start with you may have:

• Contractions which feel like period cramps (they may be irregular and more than 5 minutes apart)
• Ruptured membranes – there may be a gush of amniotic fluid or you may lose a little fluid every now and then
• A show (mucous discharge, which may be blood-stained)
• Loose bowel motions
• Low back pain

This stage may take many hours or pass quite quickly into the middle phase.

Things you can do

• If it’s night time, try to rest or sleep
• During the day, go for a walk or carry on with gentle activities
• Listen to your body, experiment with different movements and do whatever is most helpful to you.
• Sway and rock your pelvis , making noises may be helpful to you.
• As you feel contractions coming, relax. Think of your shoulders, your face, and your hands and make sure they are all relaxed.
• Eat light meals
• Drink plenty of fluid
• Talk to a supportive friend or family member
• Notify support people
• Check arrangements for childcare

Things for you to remember

• It’s important to save your energy for the more active stages of labour
• It may be comforting to have some company
• Discuss your wishes regarding such things as pain relief with your support people
• You can ring the hospital at any hour if you are uncertain what to do or if you feel anxious
• Try to stay calm – this is just the beginning

What a support person can do

• Be available to give support by phone or in person
• Help with last minute arrangements
• Understand and accept the wishes and preferences of the woman you’re supporting.
• Stay calm

If you think you are in labour, phone birth suite to speak to a midwife for advice about when to come to hospital.

• Contractions are more regular (3-5 minutes apart) and last longer
• Contractions become more painful
• It may become increasingly difficult to keep comfortable
• You may need to concentrate during contraction
• Back pain may continue to be a problem
• You may want to discuss having some pain relief
• You may have a show of blood and mucous or the membranes may rupture now

Things you can do

• Continue to drink plenty of fluid (water or juice)
• Suck on sweets to keep up your energy
• Vary your position to keep as comfortable as possible (standing, kneeling, lying down, straddling a chair, all fours)
• Have a bath or shower
• Ask for a back rub or massage

Things for you to remember

• Take one contraction at a time. Rest between contractions
• If you don’t want to be touched, say so
• Express your feelings as you wish. There’s no right way to do this
• Your needs may change as labour progresses
• Try out all your relaxation techniques

What a support person can do

• Help settle into the labour room
• Take your cues from the woman in labour. Her needs will change as time goes by
• Go with the flow. A woman in labour is in a different space
• Keep calm
• Remember you may need to eat and have a tea break occasionally

This is an intense stage of the birth.  You may feel impatient, tired, irritable and even angry and frustrated with your carer and your support person/people. This is normal and means that your baby is not far off.

Contractions are now about 2-3 minutes apart. They may come one on top of the other. You may feel:

• tired, anxious, tearful, irritable, shaky, hot and cold, nauseated and you may vomit
• increasing bowel pressure
• you need more pain relief
• a desire to push with contractions

Things you can do

• Change positions (you may need to be reminded to do this at this stage of labour)
• Listen to advice from your midwife and support people
• Try to relax and rest between contractions

Things for you to remember

• You’re nearly there
• Tell yourself you can do it
• Tell your support people clearly what you would like them to do

What a support person can do

• Give constant reassurance – this is the most important thing you can do
• Remind her how well she’s done
• Tell her she can do this
• Listen to the midwife – you need to work with her to give the most appropriate support

Your midwife is crucial at this stage of the labour. Your midwife will guide you with when and how to push.  The midwife can also assist you in trying different positions to find the one that feels best for you.

• Contractions may slow down
• Most women feel a strong urge to push with contractions
• You may feel pressure in your bowel and you may have a bowel movement
• You may feel baby moving down the birth canal
• You may feel a burning sensation as baby’s head and shoulders emerge
• Finally you see and hold your baby

Things you can do

• Push when you have the urge
• Relax and rest between contractions
• Listen to your midwife or doctor when they ask you to stop pushing and to start panting as your baby’s head is born. This helps to prevent tearing of the perineum

Things for you to remember

Upright positions such as kneeling, standing, squatting or sitting on a birth stool help to shorten second stage.

• If possible stay in an upright position
• Make use of the available aids e.g. kneeling mat/birth stool/ beanbag
• You may like to ask for a mirror to watch baby’s head emerging
• You can reach down and touch your baby’s head

What a support person can do

• Take responsibility for answering and making phone calls
• Take your lead from the midwife
• Give support in any way you’re needed
• Stay focused on what’s happening. This is a very special time

This stage of labour is from the birth of the baby until the delivery of the placenta and membranes

The third stage is routinely ‘actively managed’. This means giving you an injection to help to contract the uterus and expel the placenta.

You may experience more contractions to expel the placenta and a feeling of fullness in the vagina as the placenta is being delivered.

The midwife will normally pull on the cord to deliver the placenta.

You may be hardly aware of the third stage as you will be focused on your baby. You may feel shaky due to the adrenaline and the adjustments your body immediately starts to make.

In the Birthing Suite immediately after the birth of your baby

Your baby

• Skin to skin contact is encouraged for the first hour after birth to promote breastfeeding and to keep your baby warm
• The first breastfeed is initiated
• The umbilical cord is clamped and cut. This does not hurt your baby. Eventually the dried piece of cord turns black, dries up and falls off five to seven days later.
• The Apgar score is recorded. This is an assessment of your baby’s overall condition including breathing, heart rate and colour. This is done at one minute and at five minutes after birth. The Apgar score tells your carers how well your baby has made the transition from intrauterine life to extrauterine life.
• The baby’s weight is recorded
• Vitamin K and Hepatitis B injections are given with your permission.

You

• Will have your pulse and blood pressure taken frequently
• Will have your uterus checked. The midwife will gently push on your abdomen to feel that your uterus is firm and contracted
• May need stitches to your perineum
• Will be offered icepacks if you have had stiches
• Can shower and use the toilet
• Can be offered pain relief
• Have something to eat and drink