THE FIRST STAGE
In the first stage of labour, your cervix dilates to about 3cm, but it still has a long way to go — it has to dilate to 10cm before you get to the second stage of labour! “Your baby’s head is pushing down onto your cervix,” explains midwife Claire Friars. “As a result, your cervix is simultaneously forced open and dragged back until there’s nothing left in the way of your baby’s exit route.”
Sounds painful? It certainly can be. But it’s pretty rare for your contractions to be unbearable from the beginning, they often are described as like period cramping. Of course, they get worse and more intense — especially when your waters break — and you may not be able to focus on walking. We have heard descriptions that include “need to poop”, “being beaten” and “very bad cramping”.
Your cervix dilates at a rate of about 1cm per hour, meaning that this is usually the longest stage of labour, but it isn’t necessarily unbearable between contractions.
Between the first and second stages of labour, there’s a period of transition. Some women go through it without noticing. Others get a lull, as if the body is having a break before it starts to push. “Quite often, mums say they feel fine and will come back tomorrow!” Friars laughs.
It’s also possible that rather than getting a break, your contractions will all run into one long, agonising surge. Transition can do funny things to your state of mind, making you aggressive, overwhelmed, disorientated or frightened.
THE SECOND STAGE
Once you’re fully dilated, it’s time to push. Friar explains, “Rather than trying to dilate your cervix, the pressure of the contractions is now forcing your baby downwards and out.” Most women compare pushing to attempting the biggest poop ever with descriptions like “sh*tting out a melon” and “felt like it would explode my bottom”.
Friar notes that with each contraction, your baby’s head moves down, but in between, it goes back up a little. This means pushing can be slow, hard work, usually taking one to two hours.
Some babies buck the trend and come shooting out — with mums using phrases like “I got the urge to poop and minutes later, my daughter was born!” Whether it happens quickly or slowly, eventually your baby’s head will crown. “This is where the widest part of his head comes out,” Friar explains. And if you’ve not opted for epidural, it’s often the most painful part of labour.
At this stage, it’s important to listen to your gynae. “Pushing too quickly might mean you tear,” Friar warns. Your gynae may make a small cut in the perineum (the area between the vagina and the anus), known as an episiotomy, so that baby has more room to get out.
With the head “free”, your baby’s body will follow swiftly. You may not forget the pain instantly, but at that point, you’ll know it was all worth it.
THE THIRD STAGE
Delivering the placenta
“It usually takes one really big contraction to separate the placenta from the inside of the womb,” says Friar. “Then the doctor will put one hand on your tummy while he gently tugs on the cord to pull it out.” Most women have an injection of a drug ¾ Syntometrine ¾ to speed up the process. Delivery usually takes five to 10 minutes.
Some women decide that they will deliver the placenta naturally. “This can take up to an hour and you may feel afterpains as your womb tries to contract,” Friar informs. Whichever way it comes out, once you deliver the placenta, your labour is well and truly over. At last you can put the pain behind you, and get on with getting to know your baby. Phew!
Go straight to the labour ward if…
● Your contractions are coming regularly ¾ about every five minutes.
● They are becoming stronger and more frequent.
● They last at least 45 seconds.
● Your waters have broken.
It might still be a while if…
● Your contractions are still more than 15 minutes or more apart.
● They don’t always come at regular intervals.
● They are less than 30 seconds long.
● You’re able to talk through the pains.
● You’ve had a show (a bloody/gooey discharge).
Take your time if…
● There’s no real pattern to your contractions.
● They’re not increasing in strength or frequency.
● They keep stopping and starting.
● You’re only feeling the pain at the front of your bump, rather than all round.
Come back for part two of our story on labour pains.