Childbirth Labour

Labour refers to the process which leads up to childbirth. Generally speaking, it can last between 10-20 hours, but since all women are different, it can last for a longer period of time or be over much sooner.

Labour is divided into three stages

  • First stage
  • Second stage
  • Third stage
The First stage

This stage, otherwise known as "early labour", is subdivided into two phases:

  • Early labour (where the cervix thins and starts to dilate)
  • Active labour (where the cervix opens at a faster rate while contractions are faster, stronger and longer.)

Contractions during early labour gradually start to increase in length. At first, they may occur for 30 seconds every 10 minutes, but eventually they will occur every five minutes and last for up to a minute in length. These contractions tend to be mild in terms of pain and some women are able to cope with them. Some choose to do so by trying a number of different relaxation methods, such as having a bath, taking a short walk or having a nap.

During this stage, vaginal discharge that contains blood may appear and is normal. However, if there is too much blood, women are advised to consult their caregivers. They should also do so if their water breaks before they've started experiencing contractions.

At the end of early labour, a woman's cervix will have dilated to four centimetres. After this, the labour process starts to increase in speed.

Second stage

During the second stage, the cervix will have become fully dilated. This is when the mother has to start pushing for the baby to be born. At this point, most women find that their contractions are easier to deal with since bearing down makes the birthing process a little easier.

Each contraction forces the baby to move down the birth canal. It is easier for the mother to let her uterus do most of the work, waiting until she feels that she has to push. This helps to lessen the amount of effort on her part, preventing her from tiring too early.

The speed of descent of the baby may be fairly fast. If it is the mother's first baby, however, then the baby will descend at a more gradual pace. As the baby moves further down through the combined effort of the contractions and the mother's pushing, the baby's head will eventually appear. At this point, the mother may try manoeuvring her body in a number of ways for the rest of the baby's body to be born. The appearance of the baby's entire body marks the end of the second stage.

The second stage may last between several minutes to a few hours although the average time for first-time mothers is about an hour while those who have had children previously are quicker.

Third stage

The third stage relates to the delivery of the placenta. It begins with contractions from the uterus, causing the placenta to separate from the wall of the uterus. The mother then has to push to deliver the placenta. This stage lasts between five and ten minutes.

Pain relief methods

Labour is a process that is more painful for some women than others. Before childbirth, mothers should consider all the available means of pain relief available to them. The following options are available to those mothers who wish to ease the process of childbirth:

  • Local anesthetic: Local anesthetic may alleviate some of the pain of childbirth but it does not ease discomfort. It is applied by the mother's health care provider to painful areas or in areas after childbirth if stitches are required.
  • Epidural (regional anesthesia): An epidural, otherwise known as spinal anesthesia, is a method of pain relief that "blocks" the nerves of the lower back, restricting the feeling of pain. It is a very effective form of relieving pain and is also used in caesarean births.
  • General anesthesia: This type of anesthesia is only used during emergencies and puts the mother to sleep during the birth process. It is a safe option but it also prevents the mother from seeing the child immediately after birth.

Anesthetics can also be injected into particular muscles or veins to help ease discomfort. Anesthetics have the effect of making the mother and child sleepy.

While mothers can request various types of anesthesia, it is ultimately the healthcare provider's responsibility to decide which form is best. The medical history of a mother is reviewed by an anesthesiologist (the person who administers and monitors a patient when they receive anesthetic).

It is also the healthcare provider's responsibility to determine when is the best time to administer anesthesia during childbirth. It has been dete4rmined that anesthetic is safe for babies so mothers do not need to worry about any long-term effects. Mothers may find that while pain may be relieved, pressure may increase during their contractions.

After the birth, mothers who had anesthesia administered may feel unable to sit or walk. If they are keen to do so, mothers can request a 'walking epidural' from their healthcare providers.

While anesthesiologists try to ensure that complications do not occur, mothers who choose regional anesthesia may any of the following side effects:

  • Headaches: In this case, pain medication can bring relief. If the headache does not clear, mothers are urged to request additional medication from their anesthesiologists.
  • Lower blood pressure: The possibility of this occurring is prevented by monitoring the mother and administering intravenous fluids.
  • Local anesthetic reaction: This rarely happens but they can be serious. Mothers who become dizzy or experience ringing in their ears are encouraged to notify their anesthesiologists as soon as they occur.

Labour usually begins within 37 and 42 weeks of pregnancy though it is different for every woman. Expectant mothers have a number of childbirth options available to them when they enter labour. Mothers may choose to have their baby through any of the following procedures:

Vaginal birth

 Most women are able to deliver their babies through this method. A number of additional procedures are performed in order to ensure that the delivery is successful.

These include regular monitoring of the vagina to determine how much progress is being made, administering an enema to prevent defecation during birth and the administration of intravenous painkillers. An external ultrasound is also used to determine the baby's state of health in case the cervix has not fully dilated.

Assisted delivery

  • This method of delivery is further divided into a number of different procedures. These are:
    Vacuum extraction: Where a suction cap is attached to the baby's head, making it easier for the baby to be pulled out.
  • Forceps: This is a type of tool that is used to grasp the baby's head and gently pull it out of the birth canal.
  • Episiotomy: This involves a small cut being made while the mother is under anaesthetic to enlarge the vaginal opening.
  • Induced labour: This method involves tearing the amniotic membrane with a small hook or by taking medication to force the mother into labour. This method is only used if the mother suffers from diabetes, high blood pressure or a previous miscarriage.

Home birth

Some mothers may choose to have their children at home. This option requires that a nurse or midwife be present and that they are equipped with the correct portable equipment for the birth. The nurse/midwife should also be able to reach the mother's home in a short period of time when they are needed.

While the mother may find that being in an environment she is familiar with will help make her feel more comfortable with the birth, the risk exists that if complications arise, no specialist will be on hand to assist her.

Water birth

This form of childbirth can be performed at home or at a hospital. Some women find that giving birth in water helps to alleviate pain, however, some believe that water births present an opportunity for infection to take place, either in the mother of the baby.

Caesarean section

This is a surgical form of childbirth that sees the baby being delivered through the abdomen. There are two types of caesarean section: elective and emergency. Elective caesarean sections are planned during pregnancy in case a potential medical complication is found that could prove dangerous for the baby. Emergency caesarean sections are performed during labour when an unexpected complication occurs.

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 Last Update: 15 March 2010