| When we think about the process of childbirth, what our body needs to do is pretty simple: Labour is triggered by our baby and our body responds by creating contractions which move baby into the pelvis and which causes the muscles of the uterus to do its thing – the long muscles shorten, causing the cervix to dilate and then contractions become expulsive, guiding baby down through the birth canal. |
It can certainly be as simple as this but labour and birth is also a fine balance of hormones which can help make contractions effective and manageable. And while every labouring woman will have her own pattern of labour, there can be familiar characteristics.
What is happening…Your cervix is softening, thinning and opening – this can take a few hours or a few days and your contractions may vary from being completely mild and manageable to more uncomfortable and painful. Your baby can also be settling into position in your pelvis.
What it can feel like…It is normal to feel excited, worried, apprehensive, relieved, anxious, in need of support and company, empowered, happy, sore, tired, unsure of what to do, emotional, in need of some space, energetic, fidgety and in need of some distraction. Contractions can move from being mild, short and sporadic to more intense, longer and regular.
What it can look like…women in early labour tend to be alert & present, talkative and chatty, asking questions and being responsive. You may be active, walking about easily, your eyes will be open and you can be in & out of labour mode as your contractions intensify.
Hormones…Your body creates oxytocin and as this increases, your contractions will strengthen. Your cortisol and endorphin levels will also increase to relieve pain. In early labour you will also produce some adrenaline to keep you alert so you can get organised and to your safe space to birth. If you produce too much adrenaline – due to fear and anxiety – your labour may stop until the balance is restored again, when you feel safe and calm.
To be calm, safe and supported
To respond to and trust your body
To understand that this can take several hours, maybe days, to move into established labour with more powerful contractions.
What is happening…The long muscles of your cervix are shortening, your baby is settled in your pelvis, your cervix is dilated. This can last between 8 – 18 hours.
What it can feel like…The contractions of established labour will intensify, moving from about 1 minute long to about 90 seconds long with transition, when you are almost fully dilated. The pause in-between contractions will be unique to your labour. These contractions will demand your focus as they intensify.
As your baby moves lower in your pelvis, it may feel uncomfortable to sit down and your walk may become slow and more like a waddle.
What it can look like…As the contractions intensify you can move into your own world so you are less responsive and communication is brief. Your eyes might be closed and you may want to bury your head more to feel safe. You may be standing, wandering and kneeling more in one space to be comfortable – instinct kicks in and takes over.
In transition, when your contractions are stronger and longer, you may reach our for more support and reassurance. You may need to hold on to your partner or your midwife. There is more adrenaline in transition, ready for birth, and this can create fear, panic and a sense of feeling overwhelmed.
Hormones…Increased oxytocin creates strong contractions, which creates higher levels of endorphins to relieve pain. When contractions become strong and powerful, it is unlikely to stop. Any stress now could create the fetal ejection reflex, so a baby would be born quickly.
A calm environment
To feel safe and supported
To work with your body
To focus on calm, relaxed breathing
Using positions that feel comfortable and instinctive for you
To feel unrestricted
What is happening…Your body is opening up for your baby, which is now rotating and moving down through the pelvis and birth canal.
What it can feel like…Contractions are now expulsive, they are pushing & guiding your baby. There will be more pressure in your lower back and bottom, as your baby moves down.
As your baby is being born, you will feel your perineum stretching, it may feel tight and hot. Stay calm – your baby is almost in your arms.
What it can look like…After being quiet and trance-like during labour, you will now start to become more alert. You may be communicating more, eyes may be open. You may not want to move about – as your pelvis opens, you may want to be using a more grounded position.
When your baby is about to be born and your perineum is stretching, you may start to make noise, a shout or a scream. You may need to lean and to grip on to someone. Some women feel panicky at this stage, becoming tense, closing their legs – try to relax and let your baby be born.
Hormones…As contractions become more expulsive, and the tissue of the birth canal needs to stretch, more oxytocin is released. When a baby is almost born your body will produce increased levels of oxytocin, prolactin and adrenaline to enhance alertness and bonding.
the right environment and support, calm support, be guided by your body, focus on your breathing, move into positions that feel right for you, gentle/firm support to help you to refocus, physical support for reassurance and movement.
What is happening… Both mum and baby seek and want to be with each other for interaction and bonding.
What it can look like…Initially you may look and feel shocked but then you will want your baby, who will most probably be alert and seeking your face. You may be totally focused on your baby.
What it can feel like…You may be tired and emotional but hormones can also make you alert and euphoric, focusing on your baby.
Hormones…There’s a beautiful cocktail going on just as a baby is born – you and your baby will be swimming in endorphins, oxytocin and adrenaline for love, bonding, alertness and reward. You will also create prolactin, which will be enhanced by skin-to-skin to encourage milk production.
What helps…feeling safe, comfortable and warm and having undisturbed time together. Some parents delay their baby being weighed so they can have this time together.
It’s also important to remember that labour and birth can have it’s own pace – it can be short or it can last for several hours, into days, and the pace can also quickly change. The key is to relax as much as possible, to go with it and not fear it and to be well supported. It’s also about being honest with yourself – if it is tough and you feel like you are struggling, get the support you need, which may need different decisions about pain relief. Labour and birth is unique and there isn’t one right way of doing it for everyone.
Janine Smith – a specialist in pregnancy, birth & early parenting