Labour and Delivery

Roughly speaking, vaginal birth, also called labour and delivery, is divided into three stages. The first stage of labour lasts from the time when you start having contractions until the time that your cervix is fully dilated, or open. The second stage is the “pushing” stage where the baby is actually delivered. The third stage of labour is the delivery of the placenta. Each woman experiences these stages differently, and the stages may differ from one pregnancy to another. Sometimes the signs of each stage may overlap.

There are a few considerations you may want to learn about before going into labour:

• If labour is not beginning or progressing as it should, your health care provider may want to induce or enhance your contractions.
• There is a variety of different pain medications available for labour and delivery. These include analgesics, tranquilizers, inhalants, local anaesthesia, regional nerve blocks such as epidurals and spinal blocks, and sometimes in the case of caesarean section, general anaesthesia.
• Although the use of external fetal monitoring is controversial, it still is used in the majority of births in North America . Many health care providers see fetal monitoring as a valuable tool for assessing the baby’s heart rate and the mother’s contractions.
• Sometimes, if the mother is having trouble pushing or the baby is in distress, assisted delivery with forceps or vacuum extraction is necessary. Forceps are tong-shaped instruments that can help ease the baby out of the birth canal. In a vacuum extraction, a suction cup is placed on the baby’s head, and the doctor uses this to guide the baby through the birth canal.
• Episiotomy is a surgical cut in the area between the woman’s vagina and rectum, which makes the vaginal opening larger and enables the baby to pass through more easily. Episiotomy is a very common procedure affecting about one-third of births. However, there is increasing evidence indicating that episiotomy should not be done routinely, but should instead be reserved for births where the baby is in distress.
• Some women who have a caesarean section may be able to have a vaginal birth in their next pregnancy. If you are considering vaginal birth after a delivery by caesarean section, commonly known as a VBAC, it is important to accept the possibility that you may still require a caesarean section after going through the trial of labour.