LABOUR & DELIVERY

Understanding Labour

Labour processes and experiences vary from woman to woman and can last from 12 to 24 hours. It may become shorter for subsequent pregnancies.

 

How Do I Know I Am In Labour?

Labour may start at any given time between 37 weeks to 41 weeks gestation. The following signs are indicate that your labour will begin very soon:
• A mucus plug which is released from the cervix before or at the onset of labour that is brownish or pinkish in colour
• Contractions (though you may experience periodic contractions several days before your baby is actually born)
• Water breaking (in which the amniotic fluid sac in the womb ruptures and leaks out from your cervix and vagina either during early or active labour)

You will experience mild, irregular contractions about 15 – 20 minutes apart in the early stages of labour. They will gradually become more frequent and your cervix will begin to dilate up to 3cm.

 

What Should I Do?

Continue resting at home or try out light relaxing activities if the labour pains are bearable. Remember to stay hydrated and eat during this period. Ease early labour discomfort with breathing exercises and by testing out various positions. Should your contractions become more painful (a contraction is considered strong if you are unable to talk through it) and occurring regularly about 10 minutes apart, or if you notice any vaginal bleeding or leakage of water you should head to the hospital.

 

From Active Labour to Birth

Your cervix starts to dilate more rapidly from 4cm to 10cm in the active labour stage. Your contractions will start occurring around every 5 minutes and lasting about 60 – 90 seconds long each. Active labour may last from 1 hour or up to 8 hours and some may experience nausea and shakiness at this stage. In the event of intense pain, you may opt for pain relief an epidural or practice natural pain management techniques. You and your baby’s heartbeat will be closely monitored throughout. The doctor will encourage you to start pushing when your cervix has fully dilated (10cm) until your baby’s head and body emerges. The whole process may take from 1 – 2 hours. Your doctor may make an incision called an episiotomy to widen the vaginal opening and assist the delivery of your baby if necessary.

What Happens Now?

Congratulations, your baby has arrived! Upon delivery, the amniotic fluid, mucus and blood will be suctioned from your newborn’s mouth and nose, placed on your chest for skin-to-skin contact and the umbilical cord will be cut. You may also feel lighter contractions starting again as your placenta detaches itself. Your doctor may gently pull the umbilical cord, massage the uterus to facilitate the process and then clean and stitch up the wound. Over the next few hours, you will also be monitored to ensure the uterus is contracting back in size and no excessive bleeding is taking place.

 

The Delivery Methods

Thanks to medical advancements, there are several delivery methods which can safely bring your baby into this world.

 

Vaginal Delivery

The most common form of delivery is vaginally. Your obstetrician will usually recommend a vaginal delivery unless a pre-existing condition or unforeseen complications during labour makes things dangerous. A vaginal delivery leads to shorter hospital stays, quicker recovery periods, lower infection, allows the mother to establish skin-to-skin contact and start breastfeeding earlier than in the case of a Caesarean section. Some stitches may be required due to tearing of the skin and tissues during a vaginal delivery. Repeated deliveries may result in weakened pelvic floor muscles which may result in urinary incontinence in later age. However, that can be managed through various treatments such as vaginal rejuvenation.

 

Assisted Vaginal Delivery

Your doctor may apply a vacuum pump or forceps to the baby’s head to help guide the baby out of the birth canal during the course of a vaginal delivery. The forceps will be inserted into the vagina and positioned around the baby’s head. While the mother pushes during labour, the forceps apply mild pressure to guide the baby’s head out. On the other hand, the vacuum pump acts as a suction cup. It is inserted into the vagina and placed on top of the baby’s head. While the mother pushes during labour, the vacuum pump applies mild traction to guide the delivery of the baby’s head.

 

Caesarean Section (C-Section)

A caesarean section (C-section) is a surgical procedure where an incision is made in the mother’s abdomen and uterus to deliver the baby. A C-section can be done under general anaesthesia or epidural anaesthesia (where the mother’s body is numbed below the waist and she remains conscious during the procedure). Events where a C-section is required:

• Multiple pregnancies
• A very large baby
• A baby in a breeched position
• A baby in distress or
• Pregnancy conditions such as low placenta (placenta previa) or high blood pressure (pre-eclampsia)

 

Though C-section is safe, it is still a major surgery and there may be increased risk of heavy bleeding, infection, and injury to other organs. The recovery period is also longer and more painful as compared to a vaginal birth as the surgical scar requires time to heal.

 

Vaginal Birth After Caesarean (VBAC)

If you have had a C-section during your first birth, you may be able to deliver vaginally subsequently (VBAC). However, this is dependent on several factors, such as the reason for your initial C section, number of previous C-sections and the type of incision made during your first C-section.

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