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Labour and Delivery

Normally labour and subsequent delivery occurs 38 to 40 weeks after the last menstrual period. If labour occurs before 37 weeks of pregnancy, it is considered premature and after 42 weeks, is termed post mature (postterm) labour. Labour can be divided into three stages: The first stage is from the earliest contractions up to the time of birth. It is generally the longest and hardest and involves the effacement (thinning out) and dilation opening up) of the cervix to 10 centimetres (5 fingerbreadths). Stage one has 3 phases.

Stage 1 of Labour:

Phase 1 (Active Phase)

Phase 2 (Active Phase)

Phase 3 (Transition Phase)

Stage 2 of Labour

  1. This stage of labour lasts 1 to 3 hours and includes the birth of the baby.
  2. Contractions continue about every 2 to 5 minutes and lasts 60 to 90 seconds. Pushing down is done between contractions.
  3. The baby is moving down through the birth canal aided by the mother’s pushing. Depending on how the labour progressing and the baby’s position, different position for the mother might be tried, such as squatting or kneeling.
  4. A surgical incision (episiotomy) may be made in the perineum 9area between the vagina and rectum) to widen the birth opening. This procedure may require a local anaesthetic or other anaesthetic option such as spinal, epidural, pudendal, Para cervical or local in the perineum.
  5. Toward the end of this stage, the perineum begins to bulge with the baby’s head pushing against it (crowing).
  6. The baby’s head emerges and then the shoulders; the rest of the body emerges quickly.
  7. The umbilical cord will be clamped and cut. The baby is often placed on the mother’s abdomen while this is done.
  8. In some cases, an immediate evaluation of the newborn is necessary. A special nurse or doctor will assess his/her status.
  9. In some locations, umbilical cord blood is collected and stored so it can be used for a variety of tests and purposes.

Stage 3 of Labour

  1. The afterbirth (placenta) is expelled as it separates from the wall of the uterus; this usually takes 30 minutes.
  2. A final examination is conducted to be sure the entire placenta is out and there are no tears in the vagina or cervix.