Management of Labour

Throughout pregnancy, a woman’s body prepares for the birth. Ligaments of the pelvis relax, and in the few days before labour starts, the woman may feel discomfort in her lower abdomen or lower back as her uterus starts to have irregular tightening, sometimes called Braxton Hicks contractions. When the tightenings turn into regular and more painful contractions, the first stage of labour has usually begun.

First Stage Of Labour

Women generally go to their chosen birthing place when the contractions are coming every five minutes or so.

If the waters around the baby break before contractions start, contact your hospital to discuss this. If the fluid is green or brown, it may mean the baby has passed meconium (a bowel action), and you will need to go to hospital. If the fluid is clear or pink, the hospital may advise you to attend early or to stay at home for a while, depending on the circumstances and the hospital’s preference.

Gradually the contractions become stronger and more frequent. The cervix softens, its edges become thinner and it starts to open (dilate).

Second Stage Of Labour

Once the cervix is fully open (about 10cm) the baby’s head starts to move down into the lower vagina. This is defined as the second stage of labour and may last up to two hours for a first baby or one hour for a woman who has had a baby. During this time, pushing can be done whenever a strong urge is felt.

Third Stage Of Labour

After birth the placenta (afterbirth) is delivered. It is strongly recommended that you receive a drug by injection at this time to reduce the risk of severe bleeding (haemorrhage). The doctor or midwife will clamp the umbilical cord, and your partner can cut it if so desired.

End Of Labour

After the placenta has been delivered, the midwife checks your blood pressure, pulse, temperature and ability to empty your bladder. At the bedside, the midwife weighs the baby, measures the head circumference, and records the baby’s temperature.
The midwife also assists, if necessary, with getting the baby to attach at the breast. This helps to contract the uterus and control any bleeding.