Labor in childbirth: when it starts and how to manage it

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Philippe Gloaguen
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  • 1 What is labor in childbirth
  • 2 The stages of childbirth 
  • 3 How long does the labor of childbirth last?
  • 4 Labor in childbirth and epidural analgesia 
  • 5 Labor of water birth 
  • 6 How to breathe during labor 
  • 7 What positions to take in labor for childbirth  
  • 8 Eating and drinking during labor
  • 9 Role of the partner in labor 
  • 10 How to start labor naturally 

Pregnancy is a path supported by many questions, especially for those who are at the first. And if there is one aspect that worries all expectant mothers, it is labor. Will I be able to tell if it has started? What does it look like? When should I go to the hospital? How do I know if they are the right contractions or not? Here are some of the many questions that each of us asks ourselves thinking about what will be the highlight of the 40 weeks of pregnancy. 

Of course, taking a pre-baby course is a great way to calm down a little and, in particular, to know in detail what will happen during labor. Arriving prepared means facing this very strong experience in a more conscious way, knowing what to do and what to expect. So let's see the most important aspects to know. 

What is childbirth labor

Quite simply, labor is the time before delivery. It is made up of various stages that lead to the birth of the baby. The symptoms and the intensity of labor are very subjective and things could change if the mother is a first-time baby (i.e. the first birth) or if she has already had others (multi-prone).

We talk about active labor when we enter the so-called dilating phase, that is, the one in which there is complete dilation of the cervix up to 10 centimeters. At that point the baby is ready to go out. Conventionally, labor is considered active after 4 centimeters of dilation. 

The stages of childbirth 

Prodromic phase 

It is a period of preparation of the body for childbirth, characterized by some symptoms that not necessarily all women experience. One of these, for example, is the loss of the mucous plug, i.e. mucus that closes the cervix. It is a gelatinous substance, it can be streaked with blood, but it does not necessarily mean that it gets lost before giving birth. During the prodromal phase, the first contractions are felt, but they are irregular and not particularly painful. On this topic you may also be interested in Contractions, how to recognize the "real" ones of childbirth. Gradually, the uterus begins to smooth out for delivery. 

dilatant phase 

As mentioned, active labor begins here, which will end with birth. And - let's face it - this is the most feared moment. As the term itself says, at this stage the cervix dilates to allow the baby to pass through the birth canal. How is it recognized? The contractions become regular, increase in intensity and duration, are closer together. If you are still at home and the contractions occur every 3-5 minutes, go to the hospital or at least contact your gynecologist or midwife. Often (but not always) membrane rupture occurs during the dilating phase. This too is an indication to go to the place chosen to give birth. 

Expulsive phase 

At some point in labor, you will perceive an urgent need, that is to push. It is the so-called premito. You should never start pushing if the dilation is not complete (the famous 10 centimeters we talked about above) because the risk is to cause lacerations in the perineum. When the midwife gives you the go, ready with the pushes. It will be very natural for you to do this: it is as if you had to evacuate, no more, no less. Take the position you prefer. Nowadays in almost no hospital the woman is forced to stay in a lithotomy position, that is, on her stomach lying on the gynecological table. Positions for childbirth there are many: just choose the one that makes you feel best.

Phase of the afterbirth 

After delivery, the uterus will contract a few more times to help expel the placenta. It is the afterbirth that usually occurs 15-20 minutes after delivery. However, if nothing happens within an hour, it may need to be surgically removed. 

How long does the labor of childbirth last

Everyone would like to know with mathematical certainty. Unfortunately it is impossible to predict. What seems likely is that in women in the second or subsequent delivery, labor is shorter, but even this is not an absolute rule. When you listen to the stories of those who have already been there, always take them with a grain of salt. We have seen that the actual labor, the active one, coincides with the dilating phase. Hence, 24 hour long labor is impossible. 

According to the guidelines of the British National Institute for Health and Care Excellence (NICE), for women with their first child, the dilation phase normally lasts about 8 hours and rarely exceeds 18. For multiparous women it ranges from 5 to 12. It is superfluous to say that these are estimates and of course we are talking about completely natural birth: an induced birth can significantly change these times. 

Labor in childbirth and epidural analgesia 

The introduction of childbirth analgesia was a real revolution in the way of giving birth. The possibility of considerably reducing the pain of labor is a great encouragement for women who are using it more and more. Epidural analgesia is the administration of analgesic drugs through a small catheter inserted in the back. 

When can it be done? At any time of labor. Previously there was a tendency to have an epidural only at an advanced stage, but now this is no longer the case. In fact, it is possible to administer additional doses of the drug should the effect wear off or wane. Ask for it when you feel the need.

Labor of water birth 

This is a nice solution to reduce the pain of contractions: do water labor. More and more structures are equipped to give this possibility and the number of women who take advantage of it is also growing in Del Paese. In water you can be part of labor or remain submerged until delivery. It is a choice in which you will be guided by the midwife or gynecologist. 

The benefits of water are many, but one is very important during labor: the reduction of pain. Clearly the contractions do not disappear (they must not stop, otherwise the birth moves away and you have to proceed with other methods, for example the administration of oxytocin), but the heat of the water (about 37 degrees) softens them. As a result, they become more bearable and manageable and often the mother can relax between contractions. 

However, it is not always possible to choose this technique. For example, if the mother has some pathology (gestosis, hypertension, gestational diabetes) or if there is fetal distress or an irregular heartbeat of the baby. In these cases, more careful monitoring is required and the tub may not be recommended. Always rely on the advice of those around you in the delivery room. 

How to breathe during labor 

This aspect is fundamental and occupies a substantial part of practically all preparatory courses. Breathing must accompany the contractions and be deep, while the mother concentrates. It's called diaphragmatic breathing and it's a little different from everyday spontaneous breathing. In short, you need to train during pregnancy. A yoga class could be of great help.

In MyModernsParents' pre-birth course there is an entire module dedicated to how to breathe during labor and delivery. We recommend that you take a look and, as the birth is nearer, refresh your memory a little by trying the exercises proposed by our midwife. 

What positions to assume in labor for childbirth  

The indications of the World Health Organization are clear: a woman in labor must be left free to stay in the position that makes her feel better. She standing, squatting, lying on her side, on all fours, sitting on a ball, but also walking. Each must be able to experience what makes her feel more comfortable than her. Clearly in respect of other mothers-to-be in labor like her.

Unfortunately, all of this may not happen if, for some reason, the mother has to be connected to the tracker. A sort of belt surrounds the abdomen and two probes are applied: one detects the fetal heartbeat, the other the contractions. In some cases it may be necessary to check these parameters during labor and, at that point, all that remains is to remain stretched out. 

Eating and drinking during labor

Also in this case it was the WHO that gave its very authoritative opinion: if she wishes and feels it, a woman in labor can eat and drink. Obviously this does not mean bringing beer and lasagna to the delivery room, but having water, tea and something energetic to take to stock up on energy. 

For some it is the least of their thoughts. The intensity of the contractions can cause nausea or vomiting, so the food is absolutely out. Others may wish to have a drink or something to eat. Why is it sometimes discouraged? To avoid vomiting due to pain and because it can never be ruled out that the birth will end in the operating room, therefore with an anesthesia that involves fasting. The advice is to bring something light with you (crackers, candies, sugar cubes) and in any case to inquire at the facility where you give birth. 

Role of the partner during labor 

Whoever is close to a woman in childbirth has a very delicate task. Whether it is the partner, the mother, the sister, it doesn't matter: it is better to know what to do and how to do it. At least to avoid an insult! It could happen that, taken as she is by the moment, by the pain, by the emotions, the mother is very tense and nervous. Her common sense would tell you to stay away from her, but that's clearly not the case. And the midwife will be able to help out in any circumstance. 

So what to do in order not to annoy, but rather to ease the tension a little? It depends. The partner (or whoever for him) can make a massage in the lumbar part of the back when the contraction arrives or support the parturient if she is standing. Depending on the situation he can try to distract her with a joke, quite simply hold her hand gently and encourage her or remind her of the breathing techniques. 

Dear dads, do not worry if she will be angry with you, if she will say - in the throes of labor - that it is all your fault and that she condemns you to eternal chastity. These are labor-related utterances, she's not really mad at you. In any case, try to indulge her, even staying in a corner if that's what she wants: giving birth to a child is a very demanding undertaking and extremely subjective reactions. 

To be really useful in the delivery room, it is recommended that future dads take part in the pre-birth course. It is right that they too know how to move, how to behave and above all what happens to the body of their partner. Some may not feel like entering the delivery room, but you don't have to take it and you don't have to force them. Childbirth is the stuff of strong stomachs, so it may not be for everyone. You will surely find a worthy replacement and, as soon as the baby has uttered his first cry, even the father will be ready to welcome him in his arms. 

How to start labor naturally 

Towards the end of pregnancy, especially as soon as the third trimester ends, a particular thing happens: on the one hand the fear increases, on the other hand the emotion and the impatience to finally see the face of your baby live. And so we would like to give birth as soon as possible, despite the normal and understandable anxiety. So how to stimulate childbirth in a natural way? We talked about it in depth HERE. Find out what can be really effective. 

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