After nine months of dedicated hospital visits and tracking baby’s progress at each stage, your due date finally draws near. You can hardly wait to finally hold baby in your arms and gaze at him with all your love and adoration.
It’s quite natural for you to also be anxious and nervous. “Will baby be fine? Will I be able to cope?” are typical questions to cross the mind of every expectant mother.
Making sensible preparations, understanding what will (or could) take place in the course of labour and delivery, and getting to trust your medical team will help you stay calm and focussed on giving birth to baby.
Pre-admission
Round about the time of your final ante-natal visit, you and your husband may need to fill in pre-admission forms for the delivery, pay a deposit and book a room, depending on your hospital’s procedures.You may also receive a briefing regarding your stay.
Admission
You should get admitted as soon as labour starts. The usual signs include spotting of blood, bursting of the water bags, or sudden contractions. Upon admission, you will be taken to the labour room. Here, your pulse, blood pressure and temperature will be monitored regularly. An Electronic Foetal Monitoring machine (EFA), otherwise known as CTG (cardiotocograph), will be strapped to your abdomen. It has two straps – one to record the strength and frequency of your contractions, and the other to record your baby’s heartbeat pattern.
Labour & Birth
Once you are in labour, your cervix will begin to work and stretch until it is fully dilated, reaching about ten centimetres in diameter, to allow baby to come through. This process, which may take anything from several hours to a few days, entails three stages.
The first stage consists of two phases. In the early or latent phase (when cervical dilatation is at less than 4 cm), contractions tend to occur as far apart as every 20 minutes. At the beginning of each contraction, breathe in and out deeply and slowly. This will help you stay calm.
In the active phase (cervical dilatation 4 to 10 cm), contractions start coming more frequently (every 2 to 5 minutes) with each lasting from 40 to 60 seconds. Try breathing more rapidly now. Each time you inhale, count “one two” before exhaling. Count “onetwo” again before taking another breath. Keep this up for as long as you need. Your doctor will be checking on the dilatation of your cervix and will tell you when you are actually ready to give birth. Even before that moment arrives, you might feel the urge to push. Resist it and start huffing and puffing (puff out your cheeks when exhaling) until the urge to push subsides. If it helps, lie on our side or sit up slight with several pillows under your back to improve baby’s blood and oxygen supply through the placenta.
Second stage. When your doctor teels you to start pushing, concentrate on inhaling deeply and then push for five to six seconds or longer at a time. When baby’s head eventually emerges, it will take a few more pushes before the rest of his body comes out! Your doctor will cut the umbilical cord and after a brief, initial inspection, baby will be wiped and handed to you to hold for a while. Baby will thereafter be weighed, measured and given Vitamin K and Hepatitis B vaccination jabs before leaving the delivery room.
Third stage. Your whole ordeal will be over when the placenta detaches from your uterus.You will feel exhausted and soon be sent to your room where you and your family can indulge in your new arrival. Now will be a good time to breastfeed baby as it is one of the best ways for the two of your to bond.
Pain Relief
There are several methods of pain relief in labour. Epidural is by far the most effective in most cases. It is highly recommended in instances where the mother suffers from certain medical conditions, for example high blood pressure and most types of heart diseases. Other methods of pain relief include inhalation of Entonox and injection of sedatives such as Pethidine. Knowing your own pain threshold and weighing it against the potential efficacy and side effects of these methods well beforehand is very helpful. This helps you choose a pain relief method before the onset of labour.
Assisted Births
Most women go through a normal delivery. Sometimes, however, baby’s position in the uterus or mom’s state of health may call for an assisted vaginal birth or caesarean section. The procedures are explained here.
Assisted Vaginal Births
- Episiotomy. This is where an incision is made into the perineum, towards the right side and away from the anus, to enlarge the vaginal opening. This facilitates the birth and helps prevent damaging lacerations in the area.
- Forceps delivery. The doctor may use a pair of metal blades attached to handles to cradle baby’s head so that he can be pulled out. A light abrasion to baby’s skin might occur but it will heal over time.
- Vacuum Extraction. This is where a soft cone-shaped suction cup (made of rubber, metal or plastic) is put on baby’s head, thereby allowing the doctor to gently ease him out. A little swelling on baby’s scalp may result but it usually disappears in one to two days.
Forceps and vacuum extraction are commonly used when the second stage of labour is prolonged or when baby gets distressed (indicated by abnormal heart rate pattern). The doctor will decide on which method to use, based on obstetric judgment of the situation and a variety of medical factors.
Caesarean birth
Caesarean birth may be necessary in certain situations. These include when baby is in a breech or other abnormal position, baby is potentially too big for mom’s pelvic size, labour is progressing poorly, baby fails to descend during labour, or if baby is distressed.
Caesarean section may also be required in some cases of multiple pregnancies (twins, triplets, etc) or when mom had had two or more previous Caesarean births. The doctor will administer an epidural, spinal or general anaesthetic depending on medical advisability as well as mom’s preference. After that, an incision will be made on the abdominal wall and into the uterus.
In almost all cases, a low transverse incision on the uterus is preferred, as there is less bleeding and it forms a strong scar to withstand future labour. Do expect a lengthy recovery and healing period compared with a normal vaginal delivery.
Until the moment arrives
Labour and birth are inevitable when baby is ready to pop into the world. In the meantime, make your pregnancy as relaxing and comfortable as you can. Clarify any doubts with your doctor. Speak to friends about their birth experiences but always remember that impressions and perceptions differ from one mom to another. Delegate chores or errands to family and friends. Rest and continue to eat well to conserve your energy for your coming delivery day. Treat yourself to warm baths, soothing massage and step into your walking shoes for some light exercise. Congratulations on your coming baby and enjoy him to the fullest!
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