Labour and Delivery

• The second stage of labour involves the baby’s birth and lasts about 1 to 3 hours.
• The third stage of labour consists of the expulsion of the afterbirth (placenta) and takes about 30 minutes.
• There is no way to determine how labour will be for any woman, but with careful preparation and adequate prenatal care, there is no reason to be afraid. The delivery procedures that you have chosen and practiced will help assure a safe and satisfactory birth experience.

Stage 1 of Labour:

• This first phase (early labour) of stage 1 takes about 8 to 12 hours (occasionally longer); the cervix begins to efface and dilates to 3 centimetre. This phase may begin with contractions, the rapture of the amniotic fluid (bag of water), or the passing of the thick, blood-tinged plug of mucus (bloody show) that protects the mouth of the uterus during pregnancy. This plug may pass hours or sometimes several weeks before contractions begin.
• Contractions are the rhythmic, squeezing muscular activity that affects the walls of the uterus during labour. They usually start out lasting 30 to 45 seconds, may be almost imperceptible and come on an irregular basis (up to 30 minutes apart). They then become more regular as time passes.
• During this first phase of stage one, a woman usually remains at home where she can move around, eat lightly, take a walk or shower.

Phase 1 (Active Phase)

• This is the active labour phase. Contractions start coming every 3 to 5 minutes. The cervix dilates 3 to 8 centimetres and is effaced close to 100%.
• At this time, a woman should be at the location chosen for delivery  (hospital, birth centre). A physical examination will be done to see how far the cervix is dilated.
• Depending on the severity of the pain, the patient’s desire and doctors advice, pain medication (analgesic) may be considered or a regional (epidural) anaesthetic is administered by an anaesthesiologist.
• Generally an intravenous drip of glucose (sugar water) is administered to women in labour. The glucose provides energy and the IV is available for an anaesthetic if an emergency caesarean becomes necessary.
• Pitocin, a drug used to stimulate labour, may be used if labour stalls, or if there is a medical need to speed it up.

Phase 2 (Active Phase)

• This is the active labor phase. Contractions start coming every 3 to 5 minutes. The cervix dilates to 3to 8 centimeters and is affected close to 100%.
• At this time a woman should be at the location chosen delivery (hospital, birthing center). A physical examination will be done to see how far the cervix is dilated.
• Depending on the severity of the pain, the patient’s desire and doctor’s advice, pain medication (analgesic) may be considered or a regional (epidural) anesthetic is administered by an anesthesiologist.
• Generally an intravenous drip of glucose (sugar water) is administered to women in labour. The glucose provides energy and the IV is available for an anesthetic if an emergency caesarean becomes necessary.
• Pitocin a drug used to stimulate labor, may be used if labor stalls or if there is a medical need to speed it up.

Phase 3 (Transition Phase)

• Transition is probably the most difficult part of labor and lasts about an hour. The cervix usually becomes fully dilated (10 centimeters) contractions switch from the type that pen the cervix to the pushing-down type meant to expel the baby.
• Other symptoms may occur-nausea vomiting, shivers and irritability. It is the time of self-doubt where a women feels she cannot go on through labor. A good supportive birth coach and helpful medical team can aid in overcoming these feelings.

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.