Introduction
Giving Birth is one of the most life-changing and impactful experiences a family, specifically a mother, goes through. Considering the amount of time and effort put into supporting a pregnancy, the final moments of carrying a fetus in the belly can be potentially emotionally and practically overwhelming.
It is safe to assume that families aim to proceed through this stage as perfectly as possible, just like any other aspect of pregnancy. That is why we have chosen this topic to provide relevant information and help with your preparation for the final stages of pregnancy.
It goes without saying that your healthcare provider is the most reliable source of personalized advice tailored to your specific situation.
How do I know It’s Time
One of the earliest estimations of the delivery date (EDD) is usually calculated based on the mother’s last menstrual flow on the first or the second prenatal visit. Another early estimation is considered based on the fetal characteristics during the first ultrasound studies. Typically, these early estimates are the most accurate, as variations occur with fetal growth and the delivery progress.
Considering these dates and the gestational age of the pregnancy, labour is expected between the 37th and the 42nd weeks of gestation. However, it is not uncommon for women to go through labour at an earlier or more advanced gestational age (preterm or post-term, respectively), which might indicate a need for closer monitoring of the mother’s and the fetus’ well-being and higher risk of some fetal or maternal complications.
Signs of Labour
The earliest signs include contractions which typically increase in intensity and become more frequent with time. However, irregular contractions with no distinguishable progress are also common, known as the Braxton-Hicks contractions. They typically do not indicate labour and resolve with some rest and proper hydration of the mother.
Furthermore, as labour advances, the cervix prepares for the passage of the fetus. Labour progress is measured by the increasing intensity and frequency of regular contractions, and the progressive effacement and dilatation of the cervix through serial physical examination.
Additionally, rupture of the membrane may occur at any moment during labour, and it may vary significantly between individuals.
It is also important to pay attention to the fetal movements and report any sensation of decrease, as this may indicate stress on the fetus and require closer fetal heart rate monitoring.
Furthermore, if you experience any bleeding during labour (or at any stage during pregnancy) you need to seek immediate medical attention.
The Four Stages of Labour
Labour is divided into four stages based on clinical findings to help better track progress and distinguish the need for further investigations or interventions among people with different progress speeds from normal variations.
Any delay beyond the expected time may require assistance with vaginal delivery or consideration of cesarean delivery.
Stage I
Stage one includes increasing uterine contractions and the start of cervical dilatation and effacement. This stage is divided into the latent phase with slower progress and irregular contractions, as opposed to the active phase with more rapid cervical dilatation up to the full 10 cm, and more intense and regular contractions (typically one per 2-3 minutes, each lasting up to 60 seconds)
The duration of this stage varies depending on the mother’s previous labour experiences, with nulliparous women (first delivery) taking between 6 to 18 hours, and multiparous women (one or more deliveries before) typically taking between 2 to 10 hours.
Stage II
This stage starts with the full dilatation of the cervix and completes with the delivery of the baby. It usually lasts between 30 minutes to 3 hours in nulliparous, and between 5 to 30 minutes in multiparous women. The progress of this stage is assessed by the quality and rate of the descent of the baby’s presenting part.
Stage III
This stage starts after the birth of the baby and completes with the passage of the placenta. It typically lasts between 5 to 30 minutes in all women. Some medications may be used to induce uterine contractions and help stop the bleeding at this stage.
Stage IV
This is the first hour after the complete delivery of the baby and the passage of the placenta. This stage usually includes close monitoring of the baby and the mother, delivery of any remaining tissues, and the repair of any sustained injuries to the birth canal.
How Can I Prepare
Now that we can see how unpredictable labour can be, with uncertainty regarding the exact date of delivery and the progress lasting between a few hours to more than a day, we can think of some steps to better prepare for this big event.
Firstly, it is a good idea to stay in good physical shape throughout the pregnancy, due to the intense physical burden of labour. This can be achieved by building a habit of mild-to-moderate regular exercise. Additionally, pelvic floor (Kegel) exercises strengthen the pelvic floor muscles, which help with preparation for delivery. Women can consider these exercises long before even becoming pregnant to build healthy habits and prepare in advance.
Secondly, you can consider childbirth educational material, such as books, pamphlets, online resources, and classes, to learn about other’s experiences and find a community of expecting parents.
Thirdly, it is always a good idea to prepare a Birth Plan. This includes identifying the birthplace and planning for at least two routes to get there, in case one is blocked on a specific date. It can be useful to consider alternative emergency measures for unforeseeable situations (such as emergency contacts).
You can prepare a Birth Bag including comfort items like a pillow, music, massage oils, comfortable clothing, toiletries, snacks, and important documents (like ID, insurance info, etc.). You can add Snacks, a change of clothes, toiletries, chargers for electronics, and something to occupy time during labour. Remember to include the future baby’s clothing items, pillows, blankets, diapers, baby bottles, Pacifiers, etc. You can always revisit these items and adjust as you learn more. Remember to store this bag where it’s easy to reach, and hard to leave behind in times of emergency.
Other measures include contacting close family and friends, baby-proofing the house, preparing a baby room with an age-appropriate crib, and mental or emotional techniques such as meditation or breathwork.
Finally, you could consider contacting your healthcare provider in advance to prepare for a first well-baby visit for a few days after
Conclusion
In conclusion, labour is a physically, emotionally, and mentally intense process which may take more than 24 hours to complete. To minimize any risk of human error during this time, it is a good idea to prepare in advance through education, community engagement, and proper planning. Despite all that, unforeseeable situations may always arise which can be dealt with through the support of family and friends. It is also a good idea to stay in contact with your healthcare provider and ask for tips based on your specific individual situation.
