Labour And Delivery - What Happens Inside and Out?

Knowing what is physically happening inside your body during labour and delivery definitely helps you to endure the pain and discomfort. If you can imagine what is going on inside then you can understand better why you are going through such intense physical symptoms.

Basically, each contraction during the early stages of labour is getting your cervix ready for giving birth. Normally, your cervix is shaped like a narrow tube. For you to deliver a baby it has to become flat and dilate to 10cm. In early labour (also called the latent phase) you may have an intense backache and abdominal cramps as opposed to strong contractions. When your womb contracts, it is gradually pulling your cervix up into the right position. This takes quite a while, especially with your first baby.

With each contraction your cervix is pulled right up. When the contraction subsides it relaxes again, but doesn’t return fully to where it was before. So each contraction is very slowly getting your cervix ready for stage 2 of labour and delivery.

Labour and Delivery - Stage 1

Your contractions will start off further apart at the start, and will get closer together as your labour progresses. When your contractions are about 4-5minutes apart and are lasting for about 1 minute then it is probably about time to go into hospital, or get your midwife around if you are at home. Once your midwife has established that you are 4cm dilated you are in what is called the first stage of labour.

This stage can last for what seems like a long time. The average time for first time labours is 12 hours, but it can be longer or shorter than that. During this time your contractions will get stronger and more painful. They will get closer together and last for longer.

This is perhaps the hardest time, while things are progressing slowly, but try to keep positive, knowing that you are well into your labour and delivery will follow fairly shortly.

During stage 1 of labour your midwife should examine your cervix every so often, using her fingers, to check how dilated your cervix is.

The Transitional Stage

When your cervix is fully dilated you go through what is called a transitional stage, where your body recuperates a little before it is time to push the baby out. Many women experience strong emotions at this point or have a spurt of energy, which helps them to delivery the baby.

Labour and Delivery - Stage 2

Next come the most intense contractions, only 1-2 minutes apart and lasting at least a minute, with a strong urge to push down. This is the second stage of labour and usually lasts less than an hour. When you reach it you are extremely close to meeting your new baby.

Despite the strong urge to push, you must listen to your midwife and only push when she tells you to. If she says not to push you will need to pant through the contraction. The reason she may not want you to push is because, when your baby’s head is being delivered, it needs to come out very slowly. It is the largest part of your baby and is going to stretch you to the max.

If you ignore your midwife and push hard, you risk having a bad tear in your perineum, which will cause you much discomfort afterwards. When your midwife says for you not to push, she is trying to prevent you from tearing. When she says you can push, then go for it with all your strength. This is you aiding your baby down the birth canal and out into the world!

Labour and Delivery - Baby's Positioning

For your baby to be delivered as smoothly as possible there is a position which is definitely best. Baby's head needs to be down and it needs to be facing your spine. Your baby's back needs to be slightly to one side of the front of your tummy. In this position the baby’s chin will be down and the smallest part of the head will be presented to the cervix.

The posh way of referring to the correct position for delivery is ‘Occiput Anterior’. If baby’s back is to the left side of your tummy (this is the most common position) it is referred to as Left Occiput Anterior (LOA), and if it is to the right side it is Right Occiput Anterior (ROA), no prizes for guessing that one!

Things become a bit more complicated when your baby isn't in the right position. This can mean baby facing your tummy with it's spine the same side as yours. This position is called Occiput Posterior (OP) and results in a long and painful labour. I had this with Freddy and it meant his head wasn't putting enough pressure on my cervix, so my cervix wasn't dilating as it should. Thankfully he turned at the last minute.

An even more difficult position is the breech position. This is when baby's bottom is down in your pelvis instead of the head. Babies can be delivered this way, but it is very painful and more complicated. Often the professionals will recommend a caesarean if your baby is breech.

Labour and Delivery - Stage 3

The third stage of labour is after your baby has arrived, and involves delivering the placenta. If you choose to, you can have an injection whilst you are delivering your baby, which will help the placenta to detach itself from the lining of your womb and come out without leaving any bits behind.

Your midwife may gently massage your tummy in a downward motion and pull on the umbilical cord to get the placenta out. This stage you will probably barely notice as you will likely have your new baby in your arms!

You may wonder what signs you can look out for that indicate the start of labour. There are various things that can indicate that labour has started or that it is imminent.

Click here for early signs of labour

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