LabourandBirth

These guidelines are based on a typical first, spontaneous labour with a well mother and baby. Your midwife may make adjustments to your plan depending on any risk factors you may have. Second or subsequent labour's will establish a lot quicker and your midwife will discuss with you when she would like you to contact her depending how your first labour/s have been, and where you will be birthing. 

EARLY LABOUR

0cm - 3cm dilated

  • Contractions are mild - moderate in strength (they may occasionally feel intense) and do not have a regular pattern. They may come and go over a few nights.

  • The purpose of early labour is to thin (of efface) the cervix from 3cm thick to paper thin.

  • A mucousy/bloody show, loose bowel motions, vomiting and backache are all normal.

  • Everyone's early labour is different, there is no time limit on it.

You can stay comfortable by using warm water such as a shower or bath, heat packs, massage, a TEN's machine, a swiss ball and relaxing music. Rest and stay well hydrated and have small snacks if you like. Try to ignore and underestimate what is going on and remain as calm as possible as this is conducive to the release of labour hormones. You will know when your labour establishes, if you are unsure it is likely that you are still in early labour.

There is no need to time your contractions at this stage. For the majority of women, the best place to be during early labour is at home.

ACTIVE LABOUR / FIRST STAGE

3cm - 9cm dilated

  • Your contractions will have a regular pattern- they will be the same length, same strength and have the same frequency.

  • They will be strong and you will be unable to talk through them or think about anything but being in labour.

  • To ensure minimal intervention when not necessary, and to help your labour progress efficiently, stay at home as long as you can manage it.

CALL YOUR MIDWIFE WHEN

  • You are getting 3-4 strong contractions within a 10 minute period

  • Each contraction lasts 60-90 seconds

  • Labour has been like this for a few hours

  • OR you are concerned about something and/or need your midwifes support

PLEASE DO NOT GIVE YOUR MIDWIFE A 'HEADS UP' CALL. CALL ONLY WHEN YOU NEED YOUR MIDWIFE OR IF YOU HAVE ANY CONCERNS. PLEASE DO NOT TEXT IN LABOUR.

Pain relief options for labour include all the same things as for early labour, such as massage, heat, TENS machine and movement. You may also try Hypno-birthing techniques, the birthing pool, Entenox gas or other medical pain relief options including Pethidine or Epidural. These can be discussed in more detail with your midwife.

TRANSITION

9cm - 10cm dilated

  • Your contractions become even stronger with minimal gaps between them

  • You may vomit or feel a little shaky

  • You may feel a lot of pressure in your pelvis as your baby starts moving further down

SECOND STAGE

10cm - Birth

  • Most women will experience and uncontrollable urge to push

  • Contractions may space out again and you may feel more focused and calm

  • With a first baby you may be pushing for up to 2 hours.

THIRD STAGE

Birth of the Placenta

  • Physiological third stage- the umbilical cord if left un-clamped and you push the placenta out with no intervention. This usually takes 15-30 mins.

  • Active third stage- the umbilical cord is clamped soon after the birth (usually allowing for at least 1 or more minutes of delayed cord clamping unless in an emergency). You receive and injection of oxytocin into your thigh. The placenta is then birthed with the aid of traction placed on the cord. This usually takes 5-15 minutes.

  • The third stage will be physiological unless contraindicated. Your midwife will discuss this with you whilst making your birth plan or as labour and birth unfolds.

WATERS BREAKING

  • Your waters will usually break spontaneously as you near full dilation. Your waters will not be broken artificially unless indicated, and only after discussion with you and with your consent.

  • If your waters break at home and you are not contracting or are having only mild contractions and the fluid is clear or pink- put a pad on, take note of the time, and call your midwife during the day.

  • If your waters break and the fluid is green/brown or bright red please CALL IMMEDIATELY 

Please take some time to read through the pamphlets linked for more information about labour and birth. There are also some good resources under the Useful Links page, especially the Home Birth Aoetearoa Website and the Your Labour Your Way website.

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