The Rotunda Hospital Dublin

Stages of Labour

These signs may indicate that you are about to go into labour. However, there is also a chance that everything will stop and you may carry on being pregnant for a while longer. It is important not to get exhausted in the early part of labour so rest is very important. If you are getting period-like pains, have a warm bath and go to bed for a few hours. Even if you cannot sleep, just relaxing and listening to some music may help you later on.

Early Labour

Don’t forget to eat – labour is hard work for your body so you will need food to keep going. Eat what you feel like. You may find that you would like pasta, bananas and other carbohydrate rich foods. Even if it is the middle of the night, cook some pasta and sauce if you fancy it.

If you don’t feel particularly hungry, then try some cereal and milk or toast and honey. And don’t forget about fluids. It is so important not to get dehydrated during labour. While at home, keep a bottle of water near you and keep sipping it.

Stages of Labour

Stage 1 of Labour

During early labour some women find a warm bath helpful. Listening to soft music or going for a walk can also help. Simple, over-the-counter drugs like paracetamol can be taken, particularly if you have backache. Walking and using upright positions can improve your comfort too. In the early part of labour, you may have some light food.

Signs of true labour include:

  • contractions occurring regularly;contractions getting longer, stronger and closer together;
  • walking around or changing position does not make your contractions go away

The length of the first stage of labour can be different for every woman. If it is your first labour, the time from the start of labour to full dilation of the cervix (10 cm) is usually 6 – 12 hours. If it’s not your first labour, the time is usually shorter. The midwife will monitor the progress of your labour by continuously assessing the frequency, strength and length of your contractions. They will check every few hours to see how your cervix is dilating, what way the baby is presenting and how the baby is moving down through the pelvis.

More on Stage 1 of Labour

Generally, as labour progresses, your contractions will become gradually stronger and more painful and come closer together. The bag of water (liquor) may still be present or may break at any time during this period.

Throughout your labour, the midwife provides emotional support, including reassurance and encouragement. They will tell you what is happening and help you to communicate your needs to other members of the team and help you to make choices that work for you. If you need any medical help to ensure your own safety and your baby’s safety, the midwife will explain the reasons for it.

Towards the end of the first stage of labour, you may feel like pushing during the contractions. The midwife will let you know when the cervix is fully dilated and when it is safe to push.

Stages of Labour

Stage 2 of Labour

The second stage of labour starts when your cervix is 10 cm dilated. This will be confirmed by an internal (vaginal) examination. Up to an hour may pass before you will be asked to start active pushing. During this time, the baby’s head will come down through the birth canal. The urge to push is caused by the pressure of your baby’s head on your back passage. Sometimes, this feeling of pressure can make the bowels open.
Getting familiar with pushing may take some time, especially if it is your first baby. If you don’t have an epidural, find a position that is comfortable and effective for you. You may wish to stay on the bed supported with pillows or to kneel, squat, stand or sit. These positions can be adopted on the bed or on the floor.

As the baby’s head descends further through the birth canal, the contractions get stronger and so does the urge to push. If you have an epidural, you may not be aware of these sensations. During each contraction, the midwife is there to support you during this time. This stage is hard work and it is important to rest and relax between the contractions. After each contraction the midwife will listen to your baby’s heart rate and will keep you informed of your progress. Your birth partner will also encourage you and may offer you sips of water and help support you in your chosen position.

More on Stage 2 of Labour

As your baby’s head moves down to the vaginal opening, the baby’s head will become visible. At a certain stage, the midwife will tell you to either stop pushing, to push very gently or to pant (blow in an out quickly through your mouth). This is important so that your baby’s head can be born slowly, giving the skin and muscles of the perineum time to stretch without tearing. (The perineum is the area between the vagina and the back passage.) Sometimes the skin won’t stretch enough and may tear or it may be necessary to perform an episiotomy, which is a cut in the skin to widen the opening. The perineum is numbed with a local anaesthetic before an episiotomy is done (unless you have an epidural).

After your baby’s head is born, the hard work is over. With one more contraction, your baby’s body will be born and your baby will be placed onto your tummy, so that you can feel and be close to each other immediately and you can start getting to know your son or daughter.

Soon afterwards, the umbilical cord is clamped and cut and the baby is dried. Sometimes, some mucous needs to be cleared from the baby’s mouth and nose. If your baby needs oxygen or any other care immediately after birth, they will be placed on a radiant warmer, which is like an open cot with a heater overhead, in the birth room. Your baby won’t be kept away from you any longer than is necessary. As soon as possible, your baby will be returned to your arms for another cuddle.

Stages of Labour

Stage 3 of Labour

The third stage of labour starts after the birth of your baby and ends once the placenta (afterbirth) is delivered and the bleeding is controlled. At the Rotunda, we recommend using an injection to help complete the third stage. The injection makes the womb contract which helps to separate the placenta. This reduces the risk of excessive bleeding.
Some women choose to deliver the placenta without the use of drugs. We can help you to do this if you:

  • are not at risk of any complications of bleeding;
  • had no drugs administered during labour;
  • have discussed this option with your doctor or midwife during your pregnancy and in early labour.

Once the placenta is delivered, the womb normally stays contracted, which helps reduce the blood loss. On average, women will lose 100 – 200 mls of blood at birth. Your body has been preparing for this and you should not feel any side effects.

Sometimes, a detailed laboratory investigation on the placenta is recommended. This may identify certain factors that may relate to your pregnancy or the wellbeing of your baby. If your placenta is sent to the laboratory, the hospital will dispose of it once any tests are completed. If you have any specific requests relating to the placenta, please discuss them with your midwife or doctor.

Stages of Labour

Pain Management

There are several ways of helping you cope with pain in labour.

Relaxation and breathing techniques and walking are some of the self-help techniques. Some women find gentle massage, using warm water in the shower or bath helpful. It is difficult to know before labour what will work best for you.

The midwife will be able to provide you with additional information to help you choose what suits you. Here are some facts about the main methods of pain management available in the Rotunda.

Natural methods of pain relief

  • Anti-burst gym ball
  • Massage
  • Breathing techniques
  • Music
  • Gas and air (entonox)
  • TENS machine
  • Warm or cold pack

Analgesia in labour

  • Pethidine
  • Epidural
Learn More About Pain Relief