#DOULADIARIES Natural Delivery 101
June 4, 2018
(Disclaimer: This blog is representative of my experiences as a doula. I have come to realize that every single birth is unique and different. There is no blog post that can cover all the different variations. Just like there are billions of different women out there, there are billions of different births.)
Am I in Labour? First thing’s first. When are you considered to be in labour? Your healthcare provider will discuss the signs of labour and when you should go into hospital. Usually, the general advice is that if your contractions are less than 5 minutes apart and lasting 45 seconds to one minute, you are in labour. A lot of women come in too early and end up being sent home again. Travelling while in pain will not be pleasant for you, so try to be sure before you make the trek to the hospital. If you’re not sure, call the hospital and they will advise.
Some women can be in early labour for days, this is called the latent phase. Find ways to cope with the contractions at home and try to rest. You will know it’s early labour because the contractions will not be regular, and might even stop. If you’re not sure, call your healthcare provider. Every scenario is different. Sometimes you need to go to the hospital right away.
Going to The Hospital :Depending on what stage of labour you are in, here are a few scenarios that might happen when you arrive at the hospital. You might be:
-sent back home and told to return when your contractions are more regular.
-asked to walk around close to the unit to get your contractions more regular and strong.
-admitted to a labour and delivery room!
If you’d like to avoid medical interventions such as an IV, epidural or medications to speed up your labour, you should try to stay home as long as you can. Of course, this isn’t feasible all the time, so if you are unsure call the hospital. Labour is different for every woman. Some feel very strong contractions right from the beginning, others have milder contractions but are still in active labour. It will all depend on your health care team and you.
Triage – Obstetrical Assessment: When you come into triage, the nurse will ask you questions to do a quick assessment. For example, you’ll be asked whether your water has broken or if you are bleeding. The nurse will gather some general information about your medical health and pregnancy. In addition, your contractions and baby’s heart rate will be monitored, depending on the hospital’s policies. Usually, the nurse has to feel your belly to time and feel the strength of your contractions.
Most often a doctor will assess you as well and examine your cervix. Get ready to answer the same question multiple times! If no doctor is available and you are in active labour, the nurse might perform the examination. Based on that assessment, you will either be admitted to the labour and delivery unit or sent home and asked to come back.
Everything You Need to Know About The Cervix: The cervix’s function is to hold your baby in the uterus until birth. During pregnancy, it is long and closed but once you go into labour it starts to thin and open up. Picture it like a tube. Once it starts to thin out it will start to open as well. The way the cervix is measured is in centimetres. Before you go into labour it is closed. When you are fully dilated, the cervix is ten centimetres open. The doctor or nurse will perform a vaginal exam to check your cervix. It can be uncomfortable but it doesn’t take very long for a vaginal birth, your cervix needs to thin out and open up
Usually, two exams two hours apart is the best way to determine whether you are in labour or not. If you are having regular contractions and your cervix is changing, Congratulations! You are in labour!
I am in Labour! Now What? What comes next is highly individualized depending on your wishes and the hospital’s policies and practices. You may or may not want an epidural. You may want to be involved in your care or leave it mostly up to the healthcare team. Most likely a nurse will be assigned to take care of only you until the baby is born. Also, you’ll be in a private room.
Birth Plan: It is important that you, your birthing partner or doula make your wishes and birth plan very clear from the beginning. Once you are in very active labour, it will be hard for you to articulate what you want. Some women like to write out a birth plan that explains their plan for labour and delivery in as much detail as possible. This can be written beforehand and websites have templates that can simplify the process. Your nurse is there to support and advocate for you, so utilize her expertise and discuss your wishes.
If this is your first baby be prepared for a long labour. The average is about 12 hours, but up to 24 hours is normal as well. That is why it’s important to stay in a comfortable environment for most of it, like your home or another familiar place. There is evidence that a comfortable space will help ease the pain and progress your labour. Once you’re fully dilated you might push for two to three hours. So you’ll need lots of energy!
There is no way to know exactly how long it will be until your baby is born. You probably want to ask, but neither the doctor nor the nurse knows the exact answer. Typically, once you’re in active labour, your cervix will dilate about one centimetre an hour. If you’ve had a baby before, you might push less than 2 hours, but there is no way to know the exact timing. Try to be patient.
Most hospitals do not allow women to eat while they’re in active labour, you’ll only be allowed clear fluids. Have a small meal before going to the hospital. This is a very controversial subject and policies might vary from one hospital to another. Ask your health care provider what the norm is where you are delivering. The reason why you are asked not to eat is that of the risk of c-section. If you have to be put under general anaesthesia for the surgery, it is riskier if you have eaten.