What is it about ?
Labor is the time before childbirth, when a woman’s body prepares to deliver the baby and the placenta. Contractions are typical of labor.
How does the work go?
The mucous plug (often smeared with blood) breaks off from the cervix just before labor begins (usually in the week before delivery).
The work itself takes place in three stages:
- The first step is that of the dilation of the cervix. During this phase, the contractions become regular and the cervix opens 10 cm. The baby’s head (or buttocks if it is breech) gradually descends into the pelvis. During a first childbirth, this phase can last from 7 to 9 hours. It is usually shorter at a subsequent delivery. The water bag usually breaks spontaneously during this phase.
- the second stage begins with the complete dilation of the cervix and ends with the birth of the baby. As soon as the child has descended into the birth canal, the mother feels the need to push. If this phase lasts more than 1 hour 30 minutes, the mother can become exhausted. In this case, birth aid devices, such as a suction cup, can be used.
- During the third stage, the placenta and the fetal membranes (which made up the water sac) are expelled spontaneously. If the expulsion has not occurred within an hour of giving birth, they are removed manually.
In most cases, a spontaneous vaginal birth takes place under the supervision of a doctor or midwife. For their first childbirth, more than 9 in 10 women need pain relief during the first phase of labor.
Sometimes the delivery is assisted by the use of a vacuum pump (6 times out of 100) or a forceps (1 time in 1000), for example when the child presents in breech (1 time in 100 ). In Belgium, a caesarean section is performed about 1 in 5 times. Although the caesarean section is scheduled in a large part of the cases, it must sometimes be performed due to unforeseen complications.
How do I know if the labor has started?
Towards the end of your pregnancy, you will experience transient contractions, which can sometimes last for a few hours (Braxton-Hicks contractions or false contractions). These contractions do not necessarily mean that labor has started. The onset of labor is recognized by the gradual increase in the frequency and intensity of contractions. They last for example 40-60 seconds every 10 minutes. Labor therefore begins when you have contractions at regular intervals. The rupture of the water bag also marks the beginning of labor. The mother can then be admitted to the maternity ward.
How is the work monitored?
During labor, the sounds of the fetal heart are checked with a fetal stethoscope, Doppler ultrasound or cardiotocography. Cardiotocography helps monitor the fetal heart and the contractions of the uterus through the mother’s womb. In rare cases, monitoring is carried out via an electrode placed on the scalp or the seat of the fetus (STAN monitoring).
What can you do ?
The main thing is to know in what situations you need to go to the maternity hospital:
- when the contractions become regular and stronger,
- if you suddenly lose a lot of fluid or bright red blood,
- if your child moves less,
- if you are worried for some other reason.
To better cope with the pain during childbirth, try to relax as much as possible. For example, you can change your position at regular intervals, have a massage or listen to soothing music.
What can your doctor do?
The doctor will induce labor if the term is exceeded, for example, or if certain complications occur (in the fetus or in the mother). A childbirth that does not progress can be speeded up with a suction cup or forceps.
In the case of breech presentation, the doctor will attempt to turn the baby between the 35e and the 36e week of pregnancy, but this attempt is not always successful. When the baby presents by breech, we will try to preserve spontaneous labor, but under the supervision of experienced professionals.
When giving birth to twins, natural childbirth is supported as much as possible, but the mother is often given medication to strengthen the contractions after the delivery of the first child. Sometimes the second child is born by emergency cesarean section.
Want to know more?
- Childbirth: between nature and medicine – mongeneraliste.be – SSMG – Scientific Society of General Medicine
- My baby is in seat – Hôpital Erasme
- Childbirth – Being born and growing up
- The version by external maneuver, here, Where to find on this page of Cliniques St Luc UCL
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