Labour & Delivery Topics in Science

The Basics Childbirth occurs in three stages, Labour, Delivery, and Placenta Delivery. Labour is divided into 3 stages Early labour, active labour, and advanced labour Delivery – pushing and delivery Delivering the Placenta

Stage 1: Labour

Phase 1: Early Labour Longest and least painful type of labour Can last hours to days The cervix will dilate (open) about 3cm and thin out You'll experience mild to moderate contractions that last 30 to 45 seconds, though they can be shorter, and can be regular or irregular. They may be spaced 20 minutes apart, more or less, and become progressively closer together, but not necessarily in a consistent pattern (and you may not even notice them until the final two to six hours; if you're dilating gradually over a period of days or weeks, you probably won't feel them at all until labor starts in earnest).

Common signs include the following… Backache (constant or with each contraction) Menstrual-like cramps Lower abdominal pressure Indigestion Diarrhea A sensation of warmth in the abdomen Blood-tinged mucous discharge (also known as bloody show) Rupture of the amniotic membranes (i.e., your water will break), though it's more likely to happen sometime during active labor

Phase 2: Active Labour The active phase of labor usually lasts from two to three and a half hours (with, again, a wide range considered normal) Your cervix dilates to 7 centimeters. You'll usually be in the hospital or birthing center by this phase Contractions will grow more concentrated and increasingly more intense (in other words, painful). As they become stronger and longer (typically lasting 40 to 60 seconds) and more frequent (coming every three to four minutes).

Common signs include the following… You can expect to feel all of the following (though you won’t feel pain if you’ve had an epidural) Increasing pain and discomfort with contractions (you may not be able to talk through them now) Increasing backache Leg discomfort or heaviness Fatigue Increasing bloody show Rupture of the membranes if they haven’t already (or your membranes might be ruptured artificially now)

Take your blood pressure Time and monitor the strength of your contractions Evaluate the quantity and quality of bloody discharge Monitor your baby with a Doppler or fetal monitor Get an IV going if you’re going to want an epidural

Epidural Epidural anesthesia is the most popular method of pain relief during labor. Women request an epidural by name more than any other method of pain relief. More than 50% of women giving birth at hospitals use epidural anesthesia. The result will be that your belly feels numb, giving you very effective pain relief.

An antiseptic solution will be used to wipe the waistline area of your mid-back to minimize the chance of infection. A small area on your back will be injected with a local anesthetic to numb it. A needle is then inserted into the numbed area surrounding the spinal cord in the lower back. After that, a small tube or catheter is threaded through the needle into the epidural space. The needle is then carefully removed, leaving the catheter in place to provide medication either through periodic injections or by continuous infusion. The catheter is taped to the back to prevent it from slipping out.

Phase 3: Advanced Labour Most intensive phases of labor — your cervix will dilate from 7 to its final 10 centimeters. Fortunately it’s also the shortest, generally lasting from 15 minutes to an hour (though it can sometimes take up to three hours). Some women, particularly those who have given birth before, may experience multiple peaks. It’s because they're spaced only about two or three minutes apart, it may seem as though you barely get to relax before the next contraction begins.

Common signs include the following… During transition, unless you’re numbed by an epidural or other pain relief, you may feel: Strong pressure in the lower back and/or perineum Rectal pressure, with our without an urge to push or move your bowels An increase in bloody show as capillaries in the cervix rupture Feeling very warm and sweaty or chilled and shaky Crampy legs that may tremble uncontrollably Nausea and/or vomiting Drowsiness between contractions A tightening sensation in your throat or chest Fatigue or exhaustion

Stage 2: Pushing and Delivery

When it’s time to push! In all, delivery generally takes 30 minutes to an hour (second and subsequent babies usually pop out a lot faster than first ones), but it can be as short as a few minutes — or as long as several hours. During this stage, contractions should be more regular. They are about 60 to 90 seconds each but are further apart (usually two to five minutes) and possibly less intense, though sometimes they’re more intense.

Common signs include the following… Pain with the contractions, though possibly not as much An overwhelming urge to push (though not every woman feels it, especially if she’s had an epidural) Tremendous rectal pressure A burst of renewed energy (a second wind) or fatigue Very visible contractions, with your uterus rising noticeably with each An increase in bloody show A tingling, stretching, burning or stinging sensation at the vagina as your baby’s head emerges A slippery wet feeling as your baby emerges

C-Section delivery

Stage 3: Delivering the Placenta This last stage of childbirth usually lasts anywhere from 5 to 20 minutes or more. You’ll experience mild contractions that last about a minute each (though you may not even notice them, if you can believe it) that will help separate the placenta from the uterine wall and move it through the birth canal so that you can push it out. Next, your practitioner may: Help speed up placenta delivery by either pulling the cord gently with one hand while pressing and kneading your uterus with the other, or exerting downward pressure on the top of your uterus, asking you to push at the appropriate time.

Baby's placenta partially or totally covers the opening in the mother's cervix — the lower end of the uterus that connects to the top of the vagina. Placenta Previa can cause severe bleeding before or during delivery. Most babies are delivered through C-section when the mother is diagnosed with placenta Previa.

What happens next? All that’s left to do is for your practitioner to stitch up any vaginal or perineal tears (if you’re not already numbed, you’ll get a local anesthetic) and clean you up. You’ll likely get an ice pack to put on your perineum to minimize swelling (ask for one if it’s not offered). The nurse will help you put on a maxi pad or add some thick pads under your bottom, since you’ll still be bleeding a bit.