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The Birth Process ... Some period-type sensations... Mucousy discharge ('show')... Irregular contractions that stop and start... A sign that your body is probably moving your baby down a bit, helping them get into a good position and helping your cervix to thin out and begin opening. Established labour could be weeks, days or hours away.
Pulses of oxytocin from the brain cause strong, regular contractions that come every 2-3 minutes and last 45-60 seconds on average... Contractions, rushes or surges are when the muscles of the uterus lift upwards to pull open (dilate) the cervix – the neck of the womb. Dilation is aided by the baby being in a good position so their head is firmly applied against the cervix. With each contraction your baby is also being squeezed gently downwards. Some blood-tinged discharge (show/mucous plug)... A sign that your cervix is opening more You gradually 'zone out' and may want to become less talkative... A sign that your endorphins are working effectively and putting you into an altered state of consciousness, making it easier to switch off your neocortex and hand control over to the more primitive parts of the brain. Transition... You might suddenly feel fed up... A sign that your cervix is fully, or almost fully dilated. Adrenaline is released to soon bring on the automatic urge to push. Some experts think that adrenaline at this point may also help your baby's systems cope with the journey down the birth canal. There may be a lull in contractions... Adrenaline may reduce your release of oxytocin at this point temporarily, making your contractions space out for a while (Some call this the 'rest and be thankful' stage!). They will pick up again when your body is ready to involuntarily push. If all is well with you and baby, there is normally no rush. 2nd stage (automatic pushing) lasting approx 30 mins to 2 hours... You may feel lots of pressure as if you want to sit on the toilet and do a big poo. Beginning at the height of contractions, you feel a gradually growing involuntary urge to push... This automatic fetal ejection reflex is stimulated by the pressure of the baby's head on nerves deep within the pelvis. If all is well you can listen to your body and push when and how you feel like it. Having a very quiet, private space enhances this reflex. There is no evidence that forced pushing improves outcomes in a natural birth (link to midwifery article on directed pushing) You might instinctively adopt more upright postures... These use gravity to help your baby move down and rotate through the pelvis and the vagina. Furthermore, with the effects of the hormone relaxin, the joints of the pelvis are able to open wider. Leaning forward or squatting widens the pelvic outlet by up to 30%.
Once the whole of your baby's head has been born, you are usually waiting for the next contraction to fully deliver your baby... Your baby's shoulders rotate internally and their head turns to the side before they are able to be born.
After a while you experience a few milder, expulsive contractions that prompt you to involuntarily push again and deliver the placenta... A completely natural 3rd stage means leaving your baby's cord intact until you have at least delivered the placenta. This means your baby receives their full blood supply (around 30% of their total circulating blood volume). You still need a quiet, private environment at this point.
Benefits for you... At least one hour of quiet uninterrupted skin-to-skin contact with your baby gives you time and space to bond and continues oxytocin release that helps contract your uterus down. This helps placental separation and reduces blood loss. Benefits for your baby... early skin-to-skin increases breastfeeding rates, relaxes your baby as they can hear your familiar heartbeat, breathing and voice, helps them regulate their temperature, colonises their skin with your friendly bacteria and is a gentle introduction to the world. Babies possess many natural reflexes to find their own way to the breast and latch on, usually within the first 45 minutes of being born. Birth Rights, Communication and Preferences A pregnant woman has the right to make her own choices about her care, and, legally, every procedure carried out during childbirth must involve her informed consent. Healthcare professionals, including midwives and doctors, provide the woman with up to date evidence based information to support her to make a fully informed choice. Decision making... Having a good birth experience means being at the centre of decisions, no matter how or where you have your baby. You may find that healthcare professionals make suggestions about your care during pregnancy, labour and in the postnatal period. To help you make informed choices, remember the BRAINS acronym when asking questions: If you encounter problems - Most people receive high quality midwifery care, but If familes are facing difficulties with having their informed choices supported they can contact a supervisor of midwives. Experienced independent midwife Mary Cronk advises:- "An assertive approach is worth cultivating. You may care to commit the following phrases to memory and practice them frequently in front of a mirror... Open Mary Cronk's Phrasebook (Word.doc). AIMS is an independent body offering further information, support and guidance on these issues. Birth preferences example - This isn't given as an example of the 'perfect' choices - there are no rights or wrongs as everyone is different - but it may hopefully provide some food for thought and give you an idea of the language, layout etc... Feel free to copy and adapt whatever you like, however.
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