Labour and childbirth is different and unique to each woman and for each baby. Although many midwives will encourage new mothers to write a birth plan, outlining their thoughts and preferences for their labour, it’s more realistic to treat this as a guide rather than a strict plan. Labour is an unpredictable experience with no two birthing experiences being the same.
The process a woman’s body goes through during labour can be broadly divided into three stages:
- The show – During pregnancy the cervix (the neck of the uterus) is blocked with a plug of mucus that prevents infection. In early labour, this mucus plug will often come out, a few days or hours before established contractions are noticed, and this is often referred to as a ‘show’
- Diarrhoea -- The onset of labour may also be accompanied by an episode of loose bowels (diarrhoea). This is caused by the contractions of the uterus (which is close to the bowels)
- Many women feel pain in their lower back or abdomen in the early part and first stage of labour. Contractions often start 20-30 minutes apart, gradually becoming closer and lasting longer. As established labour progresses, the contractions become stronger and closer together until they’re just two to five minutes apart, and last around 40-60 seconds each.
- Established labour describes the stage after the cervix has softened. Contractions will have led to the cervix opening to more than three cms, eventually dilating to around 10cm wide by the end of this stage.
Various medications, equipment, techniques or positions can help manage labour and your midwife may encourage you to think about these things during pregnancy. A TENS (Transcutaneous electrical nerve stimulation) machine emits small electrical impulses that can block or reduce pain signals and can also stimulate the body’s natural painkillers, called endorphins. These (and birthing balls) are available to hire and midwives may be able to provide useful information about these.
- The second stage of labour is often called the ‘active’ stage. This is the ‘pushing’ stage, and at this time the contractions are very close together. This phase can last between a few minutes up to around two hours. If the baby isn’t delivered within two hours it may be necessary for medical intervention as the mother can begin to tire from the effort of pushing. Midwives will encourage pushing when a contraction is felt with resting in between to conserve energy.
- The final stage of labour is the delivery of the placenta. The midwife may offer an injection in the thigh which will help to speed up this process. It works by stimulating further contractions to encourage the placenta to detach from the wall of the uterus.
After the birth the midwife will check that the baby is in good health and alert, and will clamp the umbilical cord. Providing there are no complications, the midwife may ask the birthing partner if they want to cut the cord.
For mothers who wish to breast feed, the World Health Organisation recommends skin to skin contact with their baby within an hour of birth. This encourages early breastfeeding and increases the likelihood of exclusive breastfeeding, if desired, and over a longer period of time.
How to get the birth you want