Labour is simply the series of contractions that initiates dilation of the cervix. The aim is to enable the release of the fetus through the vaginal canal. Labour is divided into three major stages: 

Stage 1

Contrary to what we see on TV, labour doesn't start with screams and pains. It begins long before then. The first stage is divided into 2 phases:

Latent stage

At this phase, your cervix softens and gets thin while preparing for dilation. It is also characterized by mild irregular contractions and dilation of the cervix. 

The duration of this stage is quite uncertain as it may last for hours or even days. But it may shorten in subsequent deliveries. 

Once you start noticing mild contractions, consult your midwife or doctor so they can check for complications or abnormalities. If there are no complications, they'll most likely tell you to remain home till the full establishment of your labour.

Your main focus should be to remain as relaxed and comfortable as possible during this period. Some of the best ways to achieve this is by: 

• Taking a warm bath
• Changing your position till you find a comfortable one
• Practising breathing exercises
• Taking a walk 
• Rolling on a birthing ball (a large rubber ball)

Your water may break

Active Labour Stage: Established labour

This is the point where you scream, everyone panics and you are rushed to the hospital. At this stage, your contractions get more regular and stronger and the dilation of your cervix will increase from 6cm to 10 cm. The pain and discomfort also increase, and if it gets too painful, your midwife may prescribe pain relievers.

This stage may last for  4-8 hours or more. The average dilation of the cervix is 1cm per hour. 

Your midwife will examine you to check:

• How frequent you have contractions
• Your temperature and blood pressure
• Your hourly pulse rates
• Your baby's heartbeat
• She'll also carry out vaginal examinations regularly

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Sometimes the established labour stage may delay and your midwife or physician may speed up the delivery process by:

1. Breaking your water:

Your physician will break the membrane containing the fluid surrounding your baby(amniotic fluid). This can be done during vaginal examinations. This will most likely cause your contractions to grow stronger, more frequent and more painful. This procedure is also known as Amniotomy

2. Oxytocin drip:

This should suffice if breaking your water doesn't do the trick. The doctor will inject oxytocin(link) into your system through a drip that goes into your vein in your wrist or arm. This drug will cause stronger, more frequent and painful contractions. 

Electronic monitoring and regular vaginal examination will help keep an eye on your baby and your contraction.

Stage 2: Baby time!!! 

Before the main action begins, your midwife will help you find a comfortable position to give birth in. You could sit, lie on your back, kneel or even squat. Just choose whichever one you're comfortable in. It's best to try some of these positions with your partner's assistance before labour. 

Next step, PUSH!

Once your cervix is fully dilated, your fetus will project downwards toward your birth canal at the entrance of your vagina. Then you'll feel a strong urge to push. It should take about 2-3 hours to get this done. I'll warn you, this is where the hard work lies but with the support of your partner and midwife, you should be fine.

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At some point, you'll be required to push lightly or to stop pushing at all. This will allow your perineum some time to stretch. You'll also be asked to take short breaths.

An episiotomy may be required if you have too much difficulty pushing. Once the head is out, the rest of the body is pushed out during the next 1 or 2 contractions.

Stage 3: Placenta birth

After birthing your baby, the placenta and amniotic sac which protected the baby during gestation period is still in your uterus. You'll have to deliver them too

This could happen in two ways:

1. Your midwife can inject you with oxytocin in your thighs (during or after birth to make your womb contract). Most times, the midwife doesn't cut off the umbilical cord
2. Or you can simply push out the placenta lightly. Your doctor or midwife will inspect the placenta to be sure there are no fragments left in your womb.

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Watch out for this: 

1 Possible tears: The vaginal canal expands to fit all sizes and it may tear in the process of delivery.

Bottom line

Childbirth is a lot of work which requires physical and emotional preparations. It's best to get yourself ready for the experience. Even at that, it's an unpredictable process. 

However, interacting with other pregnant women or mothers for support and advice.

Most women also say that drawing a birth plan with their partner helped. If you create one, ensure you share it with your health professional.

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Now that you have your baby, what next? Be grateful for safe delivery and get ready for omugwo!

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