There are three main stages of labour:
1. the cervix (neck of your uterus) gradually opens up to 10cm (fully dilated)
2. the baby is pushed down the birth canal and is born
3. the placenta (or afterbirth) is delivered vaginally.
Only when the cervix is fully dilated and the baby’s head can be seen, you will be encouraged to push. If you arrive at the hospital and are not fully dilated, you might be asked to go home and come back later or will have to wait until the cervix opens up fully. If you decide to stay, a midwife will be checking your progress – this might take a few hours if it’s your first child (between six and 12). So if you feel more relaxed and comfortable at home, consider going back. In some cases it’s difficult for you to know when the labour starts as you might have ‘fake’ contractions, called Braxton-Hicks, so be guided by your healthcare professional.
During labour your baby’s heart will be monitored. If your labour is slow, your doctor might recommend acceleration, which basically means breaking your waters (if it hasn’t happened already) during a vaginal examination. Or you might be offered a drip with a hormone to stimulate your contractions.
During the second stage the midwife will guide you, so listen to her suggestions and stop pushing if she asks you. First of all, find a good position that is comfortable for you and allows your midwife to monitor your baby’s heart.You might want to remain in bed if you are very tired (on your back or lying on your side), kneel, squat, go on all fours... Ask the midwife and your partner to help you get comfortable.
As a rule of thumb, you push every time you have a contraction. Take a deep breath and push down. In between contractions, rest to get strength back. This stage can take an hour or more and it’s tiring. Ask your partner to bring you drinks of water as pushing is thirsty work. When half of your baby’s head can be seen, your midwife will ask you to push gently.
Sometimes the skin in the perineum (the area between the anus and the vulva) might tear. You might be advised to have an episiotomy, a cut to allow your baby’s head to come through (local anaesthetic will be applied to the area beforehand). If necessary, forceps or a ventouse will be used to help delivery, but don’t worry, your baby won’t bear any lasting mark. Once your baby’s head is out, the rest is easy. The baby will be born, the cord will be cut and you will meet your little one. After a cuddle, the baby will be whisked away to be cleaned, weighed, measured and checked over. Two bands will be attached with your name on them to your newborn’s legs or arms.
The third stage is the dull bit. You will be pushing the placenta out, which can take up to an hour, or less if you have an injection to speed up this stage. If you had an episiotomy, you will be stitched up under anaesthetic.