Happy Labour Day

Article contributed by:

Raffles Medical Group

 

So it’s D-Day.  You are going into labour.  Understand the labour stages and what you need to look out to have an unforgettable delivery experience.

 

Every labour experience is unique – an unforgettable experience that you can proudly recount to your child when he/ she grows up.

 

On this page: ► Simple Pre-labour Signs ► Labour Is Painful ► Delivery Stages	► Post-delivery ► Surviving Your Wife’s Delivery

 

According to Dr Koh Gim Hwee, a Specialist in Obstetrics and Gynaecology, Raffles Women’s Centre, childbirth can take just a few minutes or many hours.  “The signs of labour can be unique to different individuals,” said Dr Koh.  According to him, the simple pre-labour signs you should learn to recognise before rushing down to the hospital are:

 

1.	Persistent lower back or abdominal pain, often accompanied by a crampy premenstrual feeling
2.	A vaginal bleeding called “show” (a brownish or blood-tinged mucus discharge).  If you pass out the mucus plug that blocks the cervix, labour could be imminent or days away
3.	Painful contractions that occur at regular intervals, each lasting only 30 seconds
4.	Clear water flowing from the vagina (broken water bag), but you’re in labour only if it is accompanied by painful contractions

 

You should contact your doctor immediately if:

 

 

These may signal an emergency and would require immediate medical attention.

 

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Labour Is Painful

We have all heard stories of how painful the labour process is.  Thankfully, with the help of modern medicine, mothers can get pain relief.

 

“In my practice”, shared Dr Tan Yew Ghee, Specialist in Obstetrics and Gynaecology, Raffles Women’s Centre, “epidural analgesia is the most common method, accounting for 70 to 80% of all deliveries and showing an upward trend over the years.  This trend is largely due to the safety record and by word of mouth recommendations”.

 

As with every procedure, including epidural analgesia, there is a one to two per cent risk.  Serious risks from he use of epidural include possible infection, severe headache and drop in blood pressure.  The medical team will adjust the dosage such that there is no complete numbness and you can push naturally under close supervision for a natural vaginal birth.

 

There are many alternative pain relief methods.  Here are some of them:

 

Breathing and Relaxation

Use learnt breathing patterns to aid your relaxation.  You would consciously release tension in your body, allowing your uterus to do its work without additional effort or energy wastage.  To be able to relax during labour would require some practice though.

 

Hydrotherapy

Some studies have shown that hydrotherapy, when used correctly during labour, can be safe, reduce pain, enhance progress, and reduce the likelihood of tearing in your perineum (the area between your vagina and anus).  A shower is beneficial almost anytime during labour.

 

TENS

Transcutaneous Electronic Nerve Stimulation uses electrical current to numb areas of the body, blocking pain signals to the brain and stimulating endorphin production.

 

Acupuncture

You will require several treatments in the last few months of pregnancy, and this may result in a smoother, less painful birth.

 

Acupressure, Massage and Counterpressure

These specific touch techniques help relieve pressure or pain and enhance relaxation and release endorphins.

 

Hot and/or Cold Compresses

Applied to the lower back, these help relieve back pain.

 

Aromatherapy

The use of aromatic substances can trigger other chemical responses in the body to help relax.

 

Music

Sound can help reduce our perception of pain and enhance relaxation. Different types of music are useful at different stages of labour.  Music masks the distracting sounds in the hospital environment to create a more personal atmosphere to labour in.

 

Movement, Positioning, and Position Changes

Your baby’s position contributes directly to the pain and length of labour. You should follow your body’s cues to move and change positions frequently.  Some helpful movement and position changes for labour include walking, swaying, slow dancing, squatting, lunging, and hand-knee positioned pelvic rocking.

 

Companionship and Support

Labour support provided by a professional Doula, or birth companion, may improve birth outcomes, reduce the numbers of Caesarean sections, epidurals and other medical interventions, while promoting bonding and successful breastfeeding.

 

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Delivery Stages

Childbirth can be divided broadly into three main stages.  Dr Cordelia Han, Specialist in Obstetrics and Gynaecology, Raffles Women’s Centre, explains what happens during the three stages and what you need to do during each stage.

 

The first stage begins with contractions.  Contractions are regular painful uterine tightening that causes progressive changes in your cervix and ends when your cervix is fully dilated.  This stage is divided into two phases: latent and active phase of labour.

 

During the early latent stage of labour, your cervix gradually effaces (thins out) and dilates (opens).  During active labour, your cervix begins to dilate more rapidly.  During the active phase of labour, contractions are stronger, closer and more intense.  This last part of active labour is also referred to as the “transition stage”.

 

The second stage of labour begins once you’re fully dilated and ends with the birth of your baby.  It is sometimes referred to as the “pushing” stage. This is where mothers are encouraged to push when contractions are present.  An episiotomy may be required for the majority of first-time mothers.  This is where your doctor makes a small cut to widen the outlet for an easier delivery.  This will subsequently be repaired.

 

The third and final stage begins right after the birth of your baby and ends with the separation and subsequent delivery of the placenta.

 

The length of labour can vary from individual to individual.  “First-time others may experience longer labour; sometimes as short as six hours and others as long as 20 hours,” said Dr Han. Usually, the duration of labour gets shorter with each subsequent birth,” she added.

 

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Post-delivery

After birth, your doctor will check your pulse, blood pressure, and uterus contraction to ensure everything is fine.  Your baby may be given a dose of Vitamin K and will have an APGAR test (covering your baby’s appearance, pulse, grimace, activity and respiration).  You should check with your doctor on a regular basis to understand what you can or cannot do.

 

“Breastfeeding mothers will notice that abdominal cramps similar to those experienced during menstruation occurs after breastfeeding,” said Dr Han. “This is due to the oxytocin released during breastfeeding in the first few days.”

 

A final word of advice from Dr Han: “every mother has an inborn strength to deliver and nurture a child.  Use it and enjoy this beautiful experience.”

 

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Surviving Your Wife’s Delivery

Nowadays, wives expect their husbands to be in the delivery room, and for good reasons. Dr Jazlan Joosoph, Specialist in Obstetrics and Gynaecology, Raffles Women’s Centre, shares tongue-in-cheek advice on how you can stand by your wife, and not faint, as you welcome your little one to this world.

 

 

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Article contributed by:
Raffles Medical Group

Dated: August 2011

 

 

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