Insiders’ Guide to Labour, Birth and Recovery

Waters breaking

What happens?
The amniotic sac that your baby has developed inside breaks open and the fluid he’s been surrounded by escapes. It’s not as dramatic as it sounds so don’t worry.

When does it happen?
Usually in established labour and often at the height of a contraction. Some women’s waters break before the contractions start.

How does it feel?
Not like a balloon bursting! The sensation is usually subtle and often the first sign is simply the fluid escaping – usually in a trickle rather than a gush. The fluid is straw-coloured, rather like urine, but with a slight almond smell. There’s usually the equivalent of a wine bottle full.

What do I do?
Contact your midwife, who can verify that your waters have broken. But there isn’t necessarily a rush, because labour might not start for another 36 hours.

Contractions or ‘first stage’

What are they?
Contractions are the muscular forces that help to open up your cervix.

About your cervix:
*It’s the part of the womb that sits at the top of your vagina.
*It feels like a little tube with a dimple in.
*In labour, your cervix becomes bigger and flatter, like a stretched piece of bubble gum with a hole popped in the middle. The hole expands as labour progresses, which is called ‘dilation’.
*Your cervix is ‘fully dilated’ when the opening is about 10cm wide.
*Using her fingers, your midwife can examine the size of the hole between contractions to see how dilated you are. This is called ‘an internal’.

An ‘internal’ vaginal examination is often not necessary as your midwife will see other signs of labour progressing:
*Your anus starts to bulge
*You may feel nauseous or actually be sick
*There will be short pauses between contractions

Pain

At risk of being shot down in flames for saying this, labour does hurt, so instead of trying to find a cure, you should think about ways of coping.
The pain hits at the peak of each contraction and subsides between each contraction.
The pauses between each contraction decrease as labour progresses, from around 20 minutes early on to two minutes as the birth nears.
You need to make the most of the breaks to relax your body. Measured breathing is one of your best tools.

Birth or ‘second stage’

Although this is what everyone talks and thinks about, it’s usually the quick bit. It happens when the expulsive contractions peak. As the baby moves down through the vagina, the vaginal muscles stretch with the force of the baby’s head moving through. At some point during the labour and birth you’ll usually get a feeling of needing to ‘bear down’ as your baby’s head presses on your rectum. This will make you feel like opening your bowels.

Opening your bowels

The thought of this worries a lot of women, but it’s natural and helps to clear the bowels before or while the baby’s born. It’s very common, and often happens when your baby’s head is almost visible. Your midwife will:
*Be prepared for and very used to it.
*May hold a pad against your back passage to catch whatever comes out.
*If you are birthing in water, scoop the stool out of the pool with a sieve.
*Clear up any bloodstained mucous that you also produce.
*Do it all routinely and discretely so no one (even you) need know.

Delivery of the placenta or ‘third stage’

This stage is from the birth of the baby to the delivery of the placenta and membranes (or amniotic sac). It’s the last stage of birth when all that’s left to do is expel the placenta from the body.

Natural or managed third stage?
This is usually a joint decision made with your midwife or obstetrician. After a natural and straightforward birth, there’s no reason for medical management of the third stage. But if you’ve had intervention during the labour or birth, a managed third stage is often advised.

If you do it naturally:
*You just wait for the contraction that naturally pushes the placenta and membranes out of your body.
*It will happen after the baby’s cord has stopped pulsating and been clamped and cut.
*You will feel a period-type pain before the placenta plops out.
*It can take up to an hour.

If it’s managed:
*You’ll have an injection of an ‘oxytocic’ drug into your thigh that forces the uterus to contract.
*Everything will be over in 5 minutes.
*The drug may make you a little sick afterwards.

For more expert advice on pregnancy, birth and baby care, don’t miss Practical Parenting magazine each month