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First stage of labour



 
THE STAGES OF LABOUR

Labour usually starts slowly and then speeds up. The birth begins when the labour contractions start getting intense, frequent and of sufficient duration to cause the cervix to open. There are three distinct stages to labour. In the first stage the cervix gradually opens up (dilates). In the second stage the baby is pushed down the vagina and is born. In the third stage the placenta gets separated from the uterine wall and is pushed out of the vagina.

Your obstetrician will probably say that you are not in labour until you have reached active labour, when the contractions are strong and frequent, and your cervix is dilating well. Anything before this is seen as build up of labour and is called the latent phase. Established labour can take around 6-12 hours; you may feel that you have been in labour a lot longer if you count the latent phase as well. The total length of labour, if you count the latent and active phases, depends on whether this is your first baby, the position the baby is in and when you first notice contractions. If you manage to sleep through the first few hours of latent labour, it will seem much shorter than if you wake up at the first twinge.


DIFFERENCE BETWEEN TRUE AND FALSE LABOUR

Contractions of true labour:

1)  Contractions occur at regular intervals

2) Intervals gradually shorten

3) Intensity gradually increases

4) Discomfort is in the back and abdomen

5) Cervix dilates

6) Discomfort is not stopped by sedation.


Contractions of false labour

1) Contractions occur at irregular intervals

2) Intervals remain long

3) Intensity remains unchanged

4) Discomfort is chiefly in lower abdomen.

5) Cervix does not dilate

6) Discomfort is usually relieved by sedation


Going to hospital

Before you go to hospital, ring your doctor and tell him what has been happening to you.  He may suggest you stay at home longer or ask you to come to the hospital straight away.

Once there your doctor will first check when your contractions began and how often they are coming. He will do an abdominal examination to check the position of your baby and to be certain that baby is coming head first. The doctor will then do an internal examination to see how much the cervix has opened. Before labour begins, your cervix is about 3 cm long and closed. He can then from this assessment how far in labour you are and proceed accordingly.


First stage of labour

The first stage of labour also referred to as early labour, is the longest phase and can range from a few hours to even a few days. Regular contractions take place during this stage. These contractions are different from the Braxton Hicks contractions in the sense that they are more intense, frequent and regular. The cervix needs to open about 10 cm for your baby to pass through. This is called fully dilated cervix. Contractions at the start of the labour will help to soften and shorten the cervix, so that it gradually dilates (approx. 4 cms). This can take up to 6-10 hours. From here on, the cervix will continue to open in a normal labour at approx. 1-2 cm per hour, until it is fully dilated (approx. 10 cms). Towards the end of the first stage of labour, your contractions may be as frequent as every one minute.

During labour, it is important you don’t start pushing before you are fully dilated, because there will be a danger of tearing the cervix. Your doctor will tell you to try not to push until your cervix is fully open and the baby’s head can be seen. To help yourself get over the urge to push, try blowing out slowly and gently or, if the urge is too strong, in little puffs. Some people find this it easier lying on their side, or on their knees and elbows, to reduce the pressure of the baby’s head on the cervix.

Once your cervix has fully dilated, the first stage of labour is completed. The first stage generally lasts up to 12 hours in a first labour and seven hours in subsequent deliveries, but each labour is different. Your baby’s heart rate will be monitored throughout labour. Your doctor will watch for any marked change in your baby’s heart rate, which could be a sign that the baby is distressed and something needs to be done to speed up the delivery.




Ways to cope with early labour:
  • Try to keep busy at home if you can. Labour will pass more quickly then.
     
  • If it’s the middle of the night, rest!

  • If it’s daytime, keep upright and be active, but don’t exhaust yourself

  • Keep yourself hydrated

  • Eat little and often to keep up your energy levels.

  • Empty your bladder regularly

  • Check that you have got everything ready

  • Try relaxation and breathing exercises that you have been practicing during your pregnancy.

  • Ask someone to rub your back as it may help to relieve pain.

  • Try to rest and relax in different positions


5 ways to cope with backache during early labour:

If you have backache in early labour, try these self-help tips:
  • Hold a covered hot water bottle against your lower back, or try an ice pack to numb the area.
     
  • Get in the bath or shower and direct the shower head over the painful area

  • Ask someone to massage your back with firm steady movements

  • Kneel on all fours, lean over the seat of a chair or sit cow boy style on a chair, using pillows to make yourself comfortable.

  • Drink plenty to avoid dehydration

  • Be patient; ask your doctor for advice on ways to cope

In the very early part of the first stage you may have short contractions every 20 minutes or so. As labour progresses, the contractions will get longer and stronger and closer together and may come every ten minutes. Towards the end of the first stage you may have them every four or five minutes and, finally, every two to three minutes
 

 

 



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