Labour Instructions

Labour can take several days or several hours. If this is your first baby, chances are labour will be at least 2 days, including pre-labour. Prepare yourself and your support people by reading this information carefully several times, and keeping them handy.

PRE-LABOUR:

  • Works on ripening your cervix, toning your uterus and helping the baby flex its head into a good position, and descend into the pelvis ready for birth.
  • It can last for several days, so don’t waste your energy, and don’t worry about it or try to speed it up. It is safest and kindest for the baby to ease into labour this way.
  • It could involve having a bloody show, more vaginal discharge, and frequent contractions. The contractions are like waves of power surging through your body. They may be a little painful, but are mostly just uncomfortable, like strong period pains. Ignore them for as long as you can.
  • During this time be encouraged that your baby is going to be born soon, so relax and enjoy the build up to labour. Eat a healthy, high protein meal, drink plenty of fluids, and take two panadol every 6 hours. Don’t walk around at this point, or use your labour positions yet, instead, go to bed and rest, rest, rest! Sleep if you can. You need to fuel and rest your body for the BIG EVENT!


ACTIVE LABOUR:

This is counted from when your contractions are long, strong and regular, around 4-5 minutes apart and 90 seconds long.

Your cervix is now dilating and your baby is slowly moving down into the birth canal.

Contractions may remain at 5 minutes apart or they may get a little closer to 3 minutes apart. The good news is that they only last 90 seconds and then you get a break from the pain!

They will be painful – but not TOO painful. It is a normal, healthy pain, the only time when pain is not caused by injury. You CAN cope with this pain as your body is made for this process. Do your deep breathing when you get a pain: in through the nose, and out through the mouth like you are blowing the pain away, down through your feet, long, slow, and controlled. This breathing not only helps with the pain by oxygenating the uterus, but it also gives your baby more oxygen and keeps him/her calm and unstressed.

While you are doing your breathing, stand with your legs apart, knees slightly bent and rock your pelvis in lovely big circles like doing a “hoola hoop”. This helps rock the baby gently downwards, calms the baby, and eases the pain for you.

As your contraction eases off, relax your body, and slow your breathing back to normal. Start walking – even if its round and round your living room. When the next wave of contraction comes, stop and open your legs, do your hoola hoop rocking and your deep breathing. Blow that pain away.

Don’t be afraid of the contractions, and don’t anticipate pain. Just let the surge of power from your uterus wash over you, imagine you are in a boat riding a wave, gently floating to the top of the wave, then peacefully floating back down again.

Visualize your body opening up and feel positive and powerful! Welcome your baby, welcome the surges that will bring your baby to your arms. This is the way your baby needs to be born and your body is very good at it. Keeping calm and relaxed means the baby will also feel safe and reassured. Labour can be frightening for babies because they have no idea what is going on, so if you get scared and release adrenaline, your baby will become very distressed. Keep yourself calm, relaxed and positive. Focus on the things and people you love, remind yourself you are a STRONG woman, and your body is AMAZING and POWERFUL.

During active labour you need to drink plenty of water, at least one glass every 15 minutes. Sip away at your water bottle regularly. Suck on some sweets or have a teaspoon of honey every now and then to keep your energy up. Eat if you want to, but many women feel nauseas or vomit in labour so lose their appetite.

Now is a good time for your support people to be around you, quietly and positively encouraging you, reminding you to drink, and do your deep breathing and rocking. They can walk with you between contractions and breathe with you as your rock.

During active labour you MUST NOT LIE DOWN! You need to be active and upright. Walk, walk, walk. Rock, rock, rock. If you get tired, straddle a chair for a little while (with the chair backwards), or rest on your hands and knees leaning into a pillow on your sofa. But only for 20 minutes at time to restore your energy, ready to walk and rock again.

If you are comfortable, some flat footed squatting during contractions is very helpful even though it will make the pain feel a little more intense – it will make labour go faster. In between pains, again, go walking, then sink down into a squat to breathe the pain away.

REMEMBER: Labour takes time. This is not the time to lie down or rest, this ist he time to be upright, active and STRONG. You CAN do this. Keep positive, trust your body, and be calm. Visualize your baby moving downwards and welcome the pain to bring your baby into your arms Don’t be afaid of the pain, it is only a few hours and so worth it for the beautiful new life you will soon be holding!

BIRTH:
SECOND STAGE/PUSHING

Some mothers find just before they are fully dilated at around 9cm that they feel panicky and afraid, unable to go on or cope anymore. This is called TRANSITION. Things feel overwhelming and you may want to give up. Of course you CAN do it, but you feel like you can’t. With support, encouragement and love from me, your family and support people, you will get through this part. It usually only lasts a few minutes and is a wonderful sign that your baby is almost here. I can give you some homeopathics in your water that can help you feel more in control and calm, and together we will get through this bit.

With a few more contractions, your cervix will open fully (10cm) and you will have a strong desire to push. I may need to quickly check you to make sure everything is ready to go. Wait until you absolutely cannot stop pushing, then go for it. It is a bizarre feeling at first, and some women don’t like it much, but it’s the only way to get your baby out. For many women it is SO powerful and amazing to get to push the pain away, and feel your baby moving downwards. Embrace this as your finale. You control the process now and its all up to you! The harder you work, the quicker your baby will be born.

Pushing can take 1-2 hours for a first baby, but many mothers can do it much quicker if they focus completely and put 200% effort in. All your preparation, active birthing and beautiful breathing will now pay off. Gather your strength, dig deep within yourself and harness your “Stroppy Woman” to get the job done. Tell yourself “I CAN do this” Your baby is only minutes away from being in your arms and gazing into your eyes. You have waited many months for this moment, so seize it and go hard!

Work with your contractions, don’t fight them. Be stubborn and stroppy to renew the energy to push your baby out. Take a deep breath and hold it – relax your face and push down like you are doing a huge pooh. Ideally you can get three good pushes in each contraction.

I will guide you and suggest different positions to push in. Moving and changing positions is very helpful. Walking to the toilet for a few pushes is fantastic and often moves baby under your symphysis bone ready to be born.

As your baby descends into the birth canal your tissue starts to stretch and this can feel weird. Most women find it easier to cope with than labour contractions, because you can push the pain away.

As the baby rocks under the symphysis bone it feels like you are working so hard and getting nowhere, but you are! This process is gently helping baby’s head to mould and fit through, and your tissues to slowly thin out and stretch. It is normal and healthy for this part to take some time. I will be monitoring your baby’s wellbeing closely at this stage.

Once we see baby’s head, things are really happening and your baby is almost here. Slowly, over a few contractions, the head will advance, stretching your vaginal opening. I will talk you through slowing down your pushing now so the widest part of baby’s head comes slowly and gently. I may put hot compresses on your vaginal opening, and may use gentle oil massage to help the process if needed. With me talking your through it, you will breathe baby’s head out gently and calmly.

You will need to be calm and quiet at this time so you can hear my instructions. Screaming will terrify your baby, making it distressed, and you won’t be able to hear what I am saying.

Once baby’s head is born, s/he turns to one side and lines up ready to be born. With one more push, baby slips out into the world and your loving arms. Baby will be put straight up onto your chest, and very gently dried with warm blankets. It is best for baby and you to be skin to skin at this time. Baby will open her eyes and look at you and your partner, immediately bonding with you. You are now parents! Look when you are ready, to see if you have a boy or girl, looking into those perfect eyes and enjoy the amazing moment of birth!

Unless your baby is in trouble or not breathing, I don’t clamp or cut the cord until it has stopped pulsing or the placenta has been born. It is best for baby to get the extra blood from the cord. Your partner/support person is welcome to cut the cord when it is time.

THIRD STAGE:

This is the easy part because it requires very little effort and virtually no pain. The third stage is from when the baby is born until the placenta/whenua is born. There are no bones in the placenta and it is soft and easy to push out. Your body will give another contraction when the time is right and you may feel a mild backache. This means it is ready to be born, and I will ask you to give one more push. The placenta will plop out easily with no interference from me. This may take from a few minutes to an hour. We have no need to rush and can trust your body to do this.

If there is any concern or risk factor, I will discuss it with you and ask your consent to give you an “ecbolic” – a drug that will make you have some big contractions expel the placenta quickly. If there is heavy bleeding you may need an IV line and further drugs, but this is relatively uncommon, so don’t be concerned. I will keep you safe and only interfere if its really necessary.

Once your placenta is birthed, I will check it and make sure everything is healthy. It has nurtured and protected your baby for nine months, and is a very interesting organ. You may like to have a look at it. Many women take it home to bury under a special tree, or have a ceremony with – I can parcel it up safely for you if you wish.

The last thing I do is have a quick check inside your vaginal to see if there is any damage requiring stitches. It is a bit stingy when I look, but its important to get a good view to make sure there are no problems. If you need stitches I will give you plenty of local anaesthetic to make it numb before I stitch. Very rarely the tear is bad enough to need a specialist Obstetrician to do it, and this is done in the operating theater. You will get plenty of pain relief for this, but remember it is very rare, so unlikely to happen to you.