Heinz - Tinytums

Labour

1. I am past my due date when will I be induced?
2. How will the hospital induce labour?
3. How will I know if I am in labour?
4. How long does labour last?
5. What happens during labour?
6. What do contractions feel like?
7. What is cervix dilation?
8.  What is transition
9. What types of pain relief will be available to me?
10.  What will happen after the birth?

1.  I am past my due date when will I be induced?
It is perfectly normal to go beyond the expected or due date, 1 in 20 babies are born after 40 weeks gestation. Normally your health carer will keep a closer eye on you after this date, and they may want to wait 10-14 days before they consider doing anything to induce the labour.

2.  How will the hospital induce labour?
There are various things the hospital may do, these include:

• Gentle rupture of the amniotic sac – breaking your waters
• Use of prostaglandin pessaries
• An oxytocin drip

3.  How will I know if I am in labour? 
The three main signs are

• A show - when the plug of protective mucus in the neck of the womb comes away and passes down your vagina.
• Waters breaking - this can be a little trickle or a gush of amniotic fluid as your baby's amniotic sac ruptures.
• Contractions -  becoming stronger and closer together. They tend to start gently, build up to a peak of intensity then die away and form a pattern, e.g. every 25 mins.

4. How long does labour last?
Every woman's experience of labour is different and it is impossible to predict how long it will last.

The average labour for first time mothers lasts about 12-14 hours and about seven hours for subsequent labours.

5.  What happens during labour?
Labour is divided into three stages:

• first stage - during which muscular contractions work to pull open the cervix,
• second stage - where you will push your baby out,
• third stage - the delivery of the placenta.

6.  What do contractions feel like?
Every woman feels contraction pain differently. In early labour they may feel similar to period pains or be confined to mild backache.

When the muscle of your uterus tightens you may feel a cramping spreading around your lower abdomen like a tight band.

Very often a contraction feels like a wave of discomfort right across your abdomen which reaches a peak for a few seconds and then diminishes.

At the same time you can feel a hardening and tightening of the uterine muscle, which is held at the peak of its intensity for a few seconds before the muscle begins to relax.

7.  What is cervix dilation?
The cervix is a thick walled canal about 2cm long and which is normally firmly closed.

In the last few weeks of pregnancy, hormones will be softening your cervix in preparation for birth.

The intense contractions of first stage labour are needed to dilate and thin the cervix enough for your baby's head to pass through it.

Your cervix will dilate about 4cm during the latent phase, 8cm in the active phase and then pain increases as it becomes fully dilated during transition.

Eventually the whole cervix opens to become one with the body of the uterus, creating a continuous canal through which your baby can emerge.

8.  What is transition?
Transition is the most intense phase of the first stage of labour. Your contractions will be lasting around 60-90 seconds with intervals of only 30-90 seconds.

It is the stage during which you will feel most discomfort and when you may feel a strong urge to push. Do not do so, however, unless you are told that you are fully dilated.

9.  What types of pain relief will be available to me? 
The most popular choices are outlined below:

• Epidural - injection of local anaesthetic into the fluid surrounding the spinal cord. May require you needing to stay in bed, but some centres have new 'walkabout' type. Administered by an anaesthetist.
• Massage - usually firm circling strokes around the lower back, also kneading shoulders. Administered by a partner
• Water - birthing pool if possible, but a deep bath helps (even a shower aimed at lower back is useful). Relaxes, calms and the buoyancy helps. Anecdotal reports say it 'really helps take the edge off' and 'helped me cope', administration method is DIY.
• Deep breathing/relaxation -Administration method is DIY.
• Entonox (gas and air) - this is a mix of nitrous oxide and oxygen breathed in through a mouthpiece or face mask, administration method DIY
• Pethidine - this is an injection of a synthetic narcotic drug similar to morphine. Painkiller/sedative but it can have some unwelcome disorientating effects. Administered by a midwife.
• TENS - small machine worn strapped to the lower back, emitting low level electrical pulses.. Self-administered once you have hired a TENS machine.

10.  What will happen after the birth?
Within one minute of your baby being born, a doctor or midwife will assess your baby's welling with 5 simple tests. This is called the Apgar score and is used to evaluate the condition of a newborn baby. Scores are given out of 10 and a score of 7 or over indicates that a baby is in a good condition, while a baby with a low score (between 4 and 6) may need resuscitating or help with breathing. With a score under 4 a baby may need life-saving techniques to be carried out.

The tests carried out are as follows and for each test there is a possible score of 0, 1 or 2.

• Heart rate - absent, slow, more than 100 beats/minute
• Breathing - absent, slow, good/crying
• Muscle tone - limp, some tone, active motion
• Response to stimulus - none, some response, sneezes or coughs
• Colour of body - pale/blue, blue/pink, pink all over

If all is well you will be given your baby to hold straight away.  Don't be alarmed at how your baby looks after the birth as babies are often covered in blood and a little bruised from the journey when they first arrive.
 
Your baby may also have a strangely shaped head after the pressure of travelling down the birth canal, the bones on the top of the head (fontanelle) have not yet fused together so the head may be more 'pointy' than you expect.

The eyes are blue at birth and it is not until about 6 months that 'true' eye colour will be seen.

The first moments you spend with your baby may be a time you want to cherish as it may be something you, and perhaps your partner, remember forever.