Labour is not called labour for nothing. It involves a lot of work – but when you consider what is going on inside your body, labour is truly a miracle.
Your body is constantly prepping and getting you ready for the thralls of labour. The difficulties and discomforts you endure in the last weeks of pregnancy prepare you for the challenges of labour. It puts you in a frame of mind where you actually want labour to start.
Then, the hormones that are secreted during labour provide a mother with powerful natural painkillers. The love hormone oxytocin is also released. This is a feel good hormone and is the same hormone that causes orgasms.
On top of all that, adrenaline is released to get you through the last tough part of labour. These hormones help you and your baby tolerate labour, as well as set the stage for quick attachment once baby is born. They also assist with the start of breastfeeding.
But even if your body is prepared for labour; is your mind? Here are the answers to the most common concerns and questions pregnant moms have about labour, so you can be educated and confident.
What will labour feel like?
One of the hardest questions to answer is to describe the sensations that labour brings, because it is such a subjective experience. There are elements of agony and ecstasy involved. So many things will in fluence what happens on the day.
Things like – when did you last eat? Perhaps you started labour after a long day and you are already tired. How active have you been during your labour? Your baby also has a part to play. What position is he lying in? Is his head engaged or not? All of these things will in fluence how you experience labour.
How will I know I am in labour?
When a three kilogram baby (or more) starts to make its way into the world – you’re going to know. However,
one of the first signs that a woman may be in labour is the fact that she denies it. As the cocktail of the hormones described earlier starts to seep into your body, they will cause a mother to enter a trance like state known as the “birth zone”.
She will tune out of the world and into her body. Time and details mean nothing to her. Even answering simple
questions is an effort. This is a delicate state and easily disturbed. Every effort should be made to protect this time with minimal interference.
Partners need to understand and recognise this phase and not panic when she starts to act “weird”. The loss of a blood stained discharge from your vagina may be another sign. This is called a show and consists of the mucus plug, which has been sealing off the cervix, becoming dislodged as the cervix starts to widen.
Also read: Woman gives birth in under a minute
Contractions that become longer, stronger and closer together and that do not disappear when a mother lies down or takes a bath are a sign that labour is well on its way.
When the amniotic bag opens (waters break) most caregivers will advise a mother to get to the hospital as soon as they can. Labour can progress quickly in some cases once membranes release, while other women have no sign of labour starting at all.
When should I go to hospital?
When your contractions become regular and much closer together or the pain begins in the small of your back and radiates around to the front of your belly above your pubic bone, call your caregiver. Once you are experiencing two to three contractions in 10 minutes, it’s probably a good time to think about leaving for the hospital. If you are unsure, call the labour ward for advice.
What will it feel like when my waters break?
This happens when the membranes surrounding your baby and containing the warm amniotic uid rupture, allowing the fl uid to leak or seep out. It doesn’t hurt, but some women feel a distinct popping sensation. It may feel like a great gush, but it is much less than you think. About a cupful is released.
As mentioned you may not necessarily be in labour if you have a trickle of fluid; some women have a small tear weeks before labour starts and an early leak often repairs itself. Always check with your caregiver if you are anxious. When the sac breaks open, it may occur with a large tear or perhaps with just a small split.
This will determine whether you have a quick gush of fluid, or a confusing intermittent trickle. A purposeful rupture done by the doctor or midwife is more uncomfortable as it is a very invasive and sometimes painful procedure.
How painful is labour?
The pain of labour comes from many sources and not only from the contractions of the uterus. Fear exacerbates pain, as will hunger, thirst, feeling cold or lack of support and companionship.
The position of the baby, as well as the position of the mother, can help or hinder the progression of the labour and infl¬uence how much pain she will feel. Rest assured – labour is very manageable. The following can make a difference for you:
- Be as active as possible and assume positions that are comfortable for you and will also assist with the descent of your baby (upright positions).
- Stay as calm and relaxed as possible – tension (often caused by fear) will put the brakes on labour. Make sure you have peace and quiet around you. Noise, bright lights and too many people around you can amplify pain.
- Coping skills including breathing and movement can change the perception of pain.
- Touch or massage, warmth or even cold can all assist in changing how you feel.
- Having someone to support you on labour day makes all the difference.
Will I be in pain all the way through labour?
Most of labour is actually pain free. But pain shrinks time – it is the painful bits that ll your consciousness. There are many moments and minutes where there is no pain whatsoever. Celebrate these pauses – this is your body’s way of giving you time out to recover before facing the next one. Don’t focus on the painful episodes – focus on the moments when you will have no pain at all.
When is the best time to have an epidural?
An epidural is one of the most powerful, effective and reliable forms of total pain relief. It works by blocking the pain signals that would normally travel from your contracting uterus to your brain.
Many women get to the final throes of labour without an epidural and as they enter the last, very short, but intense phase they request one. If you are fully dilated, it is too late to have one as it takes about 30 minutes to take full effect and the baby would have been born at that point. The ideal is to have an epidural in the active phase of labour between fi ve or six centimetres dilated.
Having one too soon (in the early latent phase of labour) may knock you out of labour, which means further intervention to get labour going again. Every women is different and you can request one when you’re ready.
Compared to the intensity of labour, the administration of an epidural is almost painless. Most women comment on feeling the burning of the local anaesthetic into the skin where the epidural needle will be placed and that is the last thing they feel.
You may feel a bit of pressure as the epidural needle goes in. What may be more challenging is the need to keep really still during the procedure. This may prove dif ficult during a contraction and the doctor will wait for the contraction to pass before continuing. When it comes to pain relief, keep an open mind.
You don’t know what labour will bring. It may be easier than you anticipate or harder and more overwhelming than you thought. You don’t know how you are going to feel until you are actually there.
Will I tear?
Unless you are lucky, the chances are you’ll either have a small tear or episiotomy (a small cut to make the vaginal opening larger). The most important factor in preventing this is to avoid pushing too soon or to avoid pushing for too long.
You should also try pushing with your tummy muscles, and not your full lungs. By adopting an upright position and pushing slowly with your body urges, there is a greater chance that your perineum (area between the anus and vagina) will remain intact.
The vagina is a muscle and can stretch tremendously given time and good positioning in labour. Pregnancy itself takes a toll on your pelvic fl¬oor so make sure to do your Kegel exercises.
What happens to the placenta?
The delivery of the placenta occurs between five to 20 minutes after the birth of baby. This is more uncomfortable than painful.
As baby’s head is born you will be given an injection in your thigh that causes the uterus to contract down and shears the placenta off the uterine wall. The placenta will be closely examined by your doctor. He will make sure all the bits are there and that nothing has been left inside of you.
What happens once my baby is born?
In many hospitals, whether you have a vaginal delivery or a caesarean delivery, labour ward staff are promoting immediate skin on skin contact between mother and baby.
There is much research to show that this has huge implications for early attachment, which leads to better breastfeeding and increases the ability of the mother to bond with her baby.
Baby also settles quickly and the APGAR score (the scoring that rates the baby’s physiological condition at one minute, fi ve minutes and 10 minutes after birth) can be done with baby lying on the mother. In almost all cases this score is better and baby and mother are happier when placed together.
In the case of an emergency, immediate skin on skin may not be possible, but can be done at a later stage. Within the hour, both mom and baby will have had all vital signs checked, mom will be fed and watered, washed down and changed into clean clothing.
Where possible, request that your baby go with you (in your bed) to the maternity ward where you will spend the rest of your stay in hospital.