1. Preparing for labour

2. Most pain in labour is felt during the first stage
Most pain in labour is felt during the first stage. 1st stage usually longer for first babies.
About 5% have little labour pain, while 60% experience severe intolerable pain.
Pain in labour arises from the uterine contractions which produce the opening of the cervix.

3. Fernand Lamaze, developed a technique to control labour pain by making the mother an active participant.
Women using this method take control of birth by using breathing and pushing techniques.

4. Pain relieving drugs A) Nitrous Oxide ( laughing gas) via breathing
B) Demerol- via injection
C) Epidural Block – via cannula ( hollow) needle.

5. Most hospitals will encourage a women to have at least one person with her during labour and birth. Emotional support.
Partner encouraged to attend childbirth classes with partner.

6. Researches have concluded that the fear of pain actually produces true pain through tension, called the fear- tension-pain syndrome.

7. Pre-labour symptoms Engagement ( fetus moves deep into pelvis)
Easier to breath
Increased urination ( compressed bladder)
Increased pelvic pressure
Feel tired and anxious to give birth
Diarrhea or several soft stools
Baby’s movement diminishes
Discharge a ‘ bloody show’ ( the mucous plug which has been sealing the cervical opening comes loose, it breaks some of the small blood vessels in the cervix.

8. The First stage of labour
1) Engagement: is often the first sign of labour.
Before pregnancy uterus was about 4inches by 40th week 12inches
Uterus grows in response to growing fetus.
The muscles surrounding the uterus are elastic and will return the uterus to its pre- pregnancy size in about six weeks after delivery

9. Engagement means that the baby moves deeper into the pelvic ring, and opening made by the pelvic bones.
When baby moves down so does the baby ( the baby drops) Baby can drop as early as 4 weeks before delivery.

10. 2) Changes to the Cervix:
Before birth 2 major processes have to occur in the uterus
1) The thick uneffaced cervix ( 1 inch, 25mm) must be compressed or thinned to 3mm.
2) the narrow passage of the cervix must be dilated to 10 cm or wide enough for the head to pass into the vagina.

11. Oxytocin plays major role in starting labour
Cervix begins to dilate in response to contractions of the uterus.
Contractions come at regular intervals. Early in first stage will be minutes apart and by the end of this stage will be 2-3 mins
Contractions cut off blood supply to the baby and rest periods restore the blood supply.
As a result of contractions the cervix is thinned ( effaced) and opened ( dialted) by the downward pressure of the fetus.
A fully dilated cervix marks the end of the first stage of labour.

12. Fist stage can be 12-15 hours long for first babies and 6-8 hours for subsequent births