How to Know When to Go to the Hospital for Labour Pains.
Your due date gives you a general idea of when your newest family member will arrive, but you can’t predict exactly when your body will begin true labour. Even when the contractions start you won’t necessarily rush straight to the hospital. If you head to the hospital too soon, you run the chances of getting sent home until your labor progresses further. Wait too long and you risk giving birth before you arrive or having to deliver without pain medications if your labour is too far along. Learn the signs of true labour to determine when to go.
Step 1
Discuss when to go to the hospital with your nurse or obstetrician before you go into labor. Ask her if you should call her first or go straight to the hospital. Determine how close she wants your contractions and other prerequisites for heading to the hospital or calling her.
Step 2
Drive the route to the hospital from your home to time the trip. If the trip is long, keep in mind you’ll want to leave for the hospital sooner to ensure you arrive in plenty of time.
Step 3
Time the length and spacing between contractions once they start, recording the times to determine if they are regular and closely spaced. Look for contractions that come consistently and get closer together, with each contraction lasting around a minute to identify true labor. Many prenatal care providers recommend calling when contractions are consistently about five minutes apart.
Step 4
Note the intensity of the contractions along with the timing. Strong contractions that increase in intensity are likely real contractions. As it nears time to head to the hospital, you may have more difficulty breathing through the pain.
Step 5
Watch for any vaginal discharge that indicates true labor is underway. Look for a slightly bloody discharge or a thick mucus discharge. Clear liquid either in a small stream or a larger gush indicates ruptured membranes. Head to the hospital or call your doctor right away if you suspect your membranes ruptured.
Step 6
Seek medical care immediately if you notice a decrease in your baby’s movements or if you bleed heavily with or without contractions.
** Tips
Seek medical care immediately if you notice a decrease in your baby’s movements or if you bleed heavily with or without contractions.
Understanding The Stages Of Normal Labor
The stages of labor are commonly broken down into three main phases. This is misleading, however, in that the first stage is comprised of three sub-phases and is what most people identify as labor. Stage I consists of early labor, active labor and transition. Stage II is the pushing stage and Stage III is the birth of the placenta.
STAGE I
EARLY
Early labour takes up the majority of the birthing experience. It is characterized by contractions that are regular but may not be very close together or last very long. The contractions may be 10 minutes apart and last only 30-45 seconds. This is the most comfortable of the stages of labor, easing the body into the process. In this phase, dilation is to a maximum of 4 centimeters.
ACTIVE
Active labor is more intense with longer, stronger, more intense contractions that may be 3-5 minutes apart and last up to 60 seconds. This is the beginning of the serious phase, where relaxation comes into play and the birth companion’s role becomes more prominent. Dilation is usually from 5-7 centimeters.
TRANSITION
Transition is by far the most challenging, although the shortest, phase of birthing. This can cause overwhelming sensations which might falter your focus. This is the phase usually depicted in mainstream media. These contractions are stronger and longer and finish dilating the cervix. They usually last 90-120 seconds with breaks of about a minute or two in between.Generally this phase only last for 30 minutes to 2 hours. A time distortion may also be experienced in this phase that makes it seem to pass more quickly and may make this period difficult to remember clearly after the birth. Experiencing grogginess or a mental fog are also common. Nausea can also set in as well as involuntary painless shaking from the intensity. Women are especially vulnerable to suggestion at this time, which can be used to enhance or to hinder the birth.
STAGE II- PUSHING
The pushing stage, the second phase of labor, begins once 10 centimeters has been reached. This will end with the much-anticipated birth of the baby. This stage can last a few minutes or several hours. In a natural birth, the pushing phase is typically much shorter than in a medicated one. Women commonly report this as the most empowering part of the birth experience and as the most motivating and comfortable.
Pushing is usually much more manageable than transition. The pushing contractions are of a different variety than those previously experienced. The body will push independently of intentional effort. This is the purpose of the uterine contraction, to first fully dilate and efface the cervix, and then to expel the baby from the uterus. True “pushing” is rarely required. The most effective course of action is to let your body guide your efforts by not pushing until an overwhelming urge is felt. Reaching 10 centimeters dilation alone does not necessarily mean the body is ready to push. The baby may not yet be in the best position or the tissues may not yet have had enough time to gently stretch on their own. Pushing too soon wastes energy and can lead to complications such as fetal distress, malpositioning, pulled ligaments, perineal tearing and forceps or vacuum extraction. If a lull in contractions is experienced, simply letting the baby drift down on its own is advisable. This preserves energy for you and the baby. It also makes for a slow, controlled delivery with less chance of tearing and can eliminate the sometimes-reported “ring of fire” when perineal tissues stretch rapidly to accommodate the baby’s head as it crowns.
STAGE III – THE PLACENTA DELIVERY
When the baby reaches your arms, the final of the stages of labor, the placenta delivery, often receives little attention. It begins with the birth of the baby and ends with the arrival of the placenta. On average, it takes roughly 20 minutes for the placenta to detach from the uterine wall, although it can safely be longer.
The placenta will detach from the uterine wall and then be expelled through the birth canal. The care provider will determine when the placenta is ready to detach by a small gush of blood or a lengthening of the cord
Induction of labour
An induced labour is one that is started artificially. It’s fairly common for labour to be induced. Every year, one in ten labours are induced.
Sometimes labour can be induced if your baby is overdue or if there is any sort of risk to you or your baby’s health. This risk could be if you have a health condition such as high blood pressure for example, or if your baby is failing to grow.
Induction will be planned in advance. You’ll be able to discuss the advantages and disadvantages with your doctor and midwife, and find out why they think your labour should be induced. It’s your choice whether to have your labour induced or not.
Most women go into labour spontaneously by the time they are 42 weeks pregnant. If your pregnancy lasts longer than 42 weeks and you decide not to have your labour induced, you should be offered increased monitoring to check your baby’s wellbeing.
• if you are overdue
• if your waterbag has broken
• if you or your baby have a health problem
If you are overdue
Induction is offered to all women who don’t go into labour naturally by 42 weeks, as there is a higher risk of stillbirth or problems for the baby if you go over 42 weeks pregnancy.
If your waterbag breaks early
If your waterbag breaks more than 24 hours before delivery, there is an increased risk of infection to you and your baby. You may need a cesarean, and your baby may be vulnerable to problems associated with being premature if your waters break before 37 weeks of pregnancy.
If your waters break before 34 weeks, you will be offered induction only if there are other factors that suggest it’s the best thing for you and your baby.If your waters break between 34 and 37 weeks, your doctor and nurse should discuss your options with you before you come to a decision about having an induction.They should also discuss the neonatal (newborn) special care hospital facilites in your area with you.
If your waterbag breaks at 37 weeks or over, you should be given the choice of induction or expectant management. Expectant management is when your healthcare professionals monitor your condition and your baby’s wellbeing, and your pregnancy can progress naturally as long as it’s safe for both of you.
If you have a health condition or your baby isn’t thriving
You may be offered an induction if you have a condition that means it will be safer to have your baby sooner, such as diabetes, high blood pressure, or obstetric cholestasis.
If this is the case, your doctor and midwife will explain your options to you so you can decide whether or not to have your labour induced.
Before inducing labour, you will be offered a “membrane sweep”, also known as a “cervical sweep”, to bring on labour.
During an internal examination, your midwife or doctor sweeps their finger around your cervix. This action should separate the membranes of the amniotic sac surrounding your baby from your cervix. This separation releases hormones (prostaglandins), which may kick-start your labour.
Having a membrane sweep doesn’t hurt, but expect some discomfort or bleeding afterwards.
If labour does not start after a membrane sweep, you’ll be offered induction of labour. Induction is always carried out in a hospital maternity unit. You will still be looked after by midwives, but doctors will be available if you need their help.
If you’re being induced, you’ll go into the hospital maternity unit.
Contractions can be started by inserting a tablet (or pessary) or gel into the vagina. Induction of labour may take a while, particularly if the cervix (the neck of the uterus) needs to be softened with pessaries or gels.
If you have a vaginal tablet or gel, you may be allowed to go home while you wait for it to work. You should contact your midwife or obstetrician if:
• your contractions begin
• you have had no contractions after six hours
If you’ve had no contractions after six hours, you may be offered another tablet or gel.
If you have a controlled-release pessary inserted into your vagina, it can take 24 hours to work. If you aren’t having contractions after 24 hours, you may be offered another dose.
Sometimes a hormone drip is needed to speed up the labour. Once labour starts, it should proceed normally, but it can sometimes take 24 to 48 hours to get you into labour.
