The woman’s water bag breaks… she starts moaning and groaning in pain… Fast-forward three minutes and her baby is delivered and all is well. Most of us would probably have seen this stereotypical version of childbirth on TV.
But experts say while no two childbirths are identical, most labour stages follow a pattern. Here’s a stage-by-stage guide on what you might expect of your labour process.
As you wait with bated breath for your child’s arrival, you may notice that your body has already started “warming up” for actual labour.
In a normal pregnancy, an expectant mum can expect to go into labour any time between Week 37 and Week 42 of her pregnancy, says Professor Chong Yap Seng, senior consultant at the National University Hospital’s Department of Obstetrics and Gynaecology.
According to doula Ginny Phang, who is also a childbirth educator and hypnobirthing practitioner, it is not unusual for mums to experience a series of practice contractions, called Braxton Hicks contractions, from as early as Week 35.
“You may feel your uterus tightening now and then. Sometimes, these false contractions may even come in regular surges. But unlike real labour contractions, they do not become progressively intense and don’t bring on labour,” says Ginny.
Just before childbirth, you may also start experiencing loose bowel movements or a backache, she adds. Some mums may also experience a bloody show, when the pink- or red-tinged mucus plug is discharged.
Ginny says this can appear a few days before actual labour commences. It is also possible for the water bag (the amniotic sac surrounding your foetus) to break or start leaking before contractions start properly.
This is it: The first stage
After experiencing a series of Braxton Hicks contractions and false alarms, you may be wondering – perhaps rather impatiently – when labour will officially kick in.
A tell-tale sign that childbirth has begun is when uterine contractions start, following a “progressive pattern”.
“You’ll feel that each surge (contraction) becomes stronger, more intense and lasts longer,” says Ginny. This is when the cervix starts to dilate, to prepare for the arrival of Baby.
According to Prof Chong, the first stage of labour consists of a latent and active phase.
In the former, contractions begin and the cervix is dilated by up to approximately 3cm to 4cm. To allow for the birth of your baby, your cervix needs to be fully dilated to about 10cm.
Prof Chong says this early stage of labour may vary from person to person. For some women, it may last for only a few hours to up to two days.
“In the latent phase, the uterine contractions may not be very intense, and first-time mums may not even notice them,” he adds.
The pace picks up when you enter the active phase. This is when the cervix passes the 3cm to 4cm dilation mark. At this stage, says Prof Chong, dilation proceeds at about 1cm per hour.
Mums in their first labour generally progress slower than in their second and subsequent labours.
“This is generally thought to be due to a cervix that is stiffer, as it has not been dilated by a previous labour, as well as a uterus that is less coordinated in its contractions,” he explains.
Typically, the entire process of labour takes around 14 hours for first-time mums and around eight hours for those who have already gone through a childbirth, says Prof Chong.
During the active phase, you may feel overwhelmed by your contractions. This is the time to apply the relaxation techniques you learnt in your antenatal classes. They will help you cope with your contractions.
“Knowing that there is an end to this helps, too,” Ginny says.
“It’s like taking a driving test: You can’t really predict the weather conditions or the type of drivers you’ll meet on the road. Similarly, you will not be able to predict what will happen during labour. But what you can control is how you choose to manage the situation.”
If you opt to use an epidural, Prof Chong says it should be started as soon as you’re in the active phase of labour, when the cervix if 3cm to 4cm dilated.
At full stretch: The second stage
By now, you may have gone through hours or even a full day of labour. You may be frazzled and tired out by the whole process. But don’t fret. You are now entering the most intense stage and you will get to see your little one for the first time very soon.
At this stage, the cervix is fully dilated. You can take deep breaths and push your baby out each time you have a contraction.
“When his head is low enough in the birth canal, you will feel a strong urge to push or bear down. At this point, it can take anywhere from 15 minutes to over an hour before Baby is delivered,” says Prof Chong.
When your child is born, the umbilical cord will be clamped and cut. If there are no further complications, you can now bond with your new family addition.
It isn’t over: The third stage
Your baby is born, but labour isn’t quite over. According to Prof Chong, this last stage is the most painless and quickest one, usually taking no more than 30 minutes.
“This stage marks the end of the labour process, when the placenta that has nourished the child for nine months is expelled. While the placenta can be discharged out of the birth canal naturally, the gynaecologist usually helps to extract it,” Prof Chong adds.
So, congratulations! You’ve made it through the entire birthing process.
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