The Typical Labour



What is labour?
It is when the baby, placenta and the membranes leave your body.

Stages:
There are three stages in labour. First, second and third.

First stage:
Dilation of cervix. It begins with the rhythmic contractions and ends with your cervix being dilated at 10cm. This stage is further divided into three more phases, the latent, active and transition.

Latent:
Cervix thins and dilates to 3 cm. The contractions will be every 10 to 20 minutes and will last about 15 to 20 seconds each. The length of time that this phase will last will be between 5 to 9 hours. During this phase your baby will be monitored.

Active:
Cervix dilates from 4 to 8 cm. Your contractions will be significantly stronger and will last longer. They will occur about every 2.5 minutes and will last one minute.

Transition:
Your cervix will dilate the final amount to 10 cm. Contractions will be every 2 minutes and will last 60 to 90 seconds. This stage can last between one and three hours. It is common for anxiety levels to rise during this period; therefore support is crucial during this phase. This is the phase of anger outburst and feelings of sickness that may lead to vomiting. Consider this phase for changing positions and finding one that is going to be comfortable for you.

WALKING
STANDING AND LEANING OR JUST LEANING
STANDING OR KNEELING
ON ALL FOURS
Perhaps trying them all will relieve stress and help find comfort.

Second stage:
Your baby will be born in this stage. This is the pushing stage. It is advisable to wait until you want to push rather than listening to others, they are support not instructors. Contractions are the best time for pushing. Position is important for pushing, and everyone is individual for what they find most beneficial. Monitoring of your babies heart is vital during this stage. The birth of the head is often considered the most taxing. Keep mindful that when the head reaches the perineum a pause is required as the tissues stretch, as you want to avoid tearing this area. Once the head is delivered your baby will turn and the shoulders will be delivered with the next contraction, the body usually comes out within one push.

This stage shouldn't last more than two hours, and can even be over within an hour. Listen to your body; it helps tell you the best time for pushing.

Possible Positions for birth:
LYING ON YOUR SIDE
SQUATTING
SITTING
STANDING OR KNEELING
LYING BACK

Third stage:
The delivery of the placenta, after it has separated from your body. In New Zealand there are currently two choices for this stage.

Medical intervention
An injection of artificial oxytocin can be given during the delivery of the shoulders. This causes your uterus to press on the placenta, causing it to separate. With this option your babies cord will be cut immediately after delivery. This will last between 5 and 15 minutes. Often the cord will be pulled to assist its delivery.

Risks:
Nausea, vomiting, high blood pressure, pain when breast-feeding or the risk of having an operation to remove the placenta as it has become trapped.

If you are rhesus (Rh) negative this may be the better option, as you want to minimise the amount of blood in the cord reaching the baby.

There is debate regarding the tugging of the cord for delivery, some health practitioners believe it is invasive and unnecessary.

Without medical intervention
No injection is given; instead you wait for the natural delivery of the placenta with the delivered baby left connected to the cord. This wait could last an hour. Breast-feeding is a natural way to promote the production of oxytocin.

Risks:
•Postpartum hemorrhage.
•There must be no remaining placenta or membrane left behind as this can cause infection.
•With circumstances such as induced labour or if your labour was speeded up by syntocinon, medical intervention is advised as your body will not be prepared to produced oxytocin (a hormone required to deliver the placenta).




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