The 4 stages of childbirth: from prodromes to secondment

When you are pregnant, your head, your thoughts and your heart often go to the moment when you will have to face labor and readings on the subject, the stories of your mother and friends, the information, are never enough and never make a woman serene and prepared for that moment. The preparation for this new experience is never enough but read, read, read and talk to the midwives of the structure you have chosen to give birth because knowing can help you manage every phase of labor.

1. Initial phase: the Prodromal Period

During the first phase of labor, the prodromal period, the body prepares the baby to come into the world. At this stage there are preparatory contractions, which help the body to experiment, to understand and then enter into real labor.

At this stage:

• The cervix from a posterior position passes to an anterior position.
• The cervix thins and shortens
• The cervix takes on a soft texture
• The cervix begins to dilate
• The presented part of the child descends and engages in the pelvis

How long does it last?

The prodromal phase has very variable times as it can last weeks, days or simply hours because as you have just read, the things to do and to change are really many. Usually in the last visit with the obstetrician or gynecologist, at the vaginal examination, you may find a soft cervix compared to previous weeks. But this may not happen and you don’t have to worry at all. You may feel annoying contractions at various times of the day called Braxton Hicks contractions, and the woman is usually advised not to go to the hospital until they become regular and increase in intensity.

This phase of labor can be tiring, annoying, endless but do not get impatient. You continue with your usual daily activities, prepare the last things for the baby, prepare and cook healthy meals for the postpartum or for your partner while you are in the hospital and pamper yourself and make yourself beautiful, enjoying the waiting time by taking walks. When the contractions become more regular and intense, stop between one contraction and another, rest, eat.

The prodromes for some women can be days long, have patience and trust because children need time to come into the world

When the contractions begin to become unbearable, regular, it is useful to take a hot bath, go into the shower and stay there for at least a couple of hours. If you have a doula or a freelance midwife, now is the time to call her to seek comfort and relaxation.

Otherwise go to the hospital.

Both at home and in the hospital you can use massages, hot water and lavender as a remedy to lower the perception of pain from contractions.

Do not be frightened if the rhythm of contractions changes, if it presses or slows down. Follow what your body tells you to do.

The mucous plug

Many women show up at the hospital or call their midwife if they see spots of blood mixed with mucus.

Loss of the mucus plug can occur during the latent phase or days before it begins and is not a dangerous sign. It simply gives you a small hint that something is changing and that your neck of the uterus is changing but you can stay calm at home and wait for labor to start.

The rupture of membranes

On the other hand, it is different if there is a rupture of the membranes , “water loss”, in that case wear white cotton linen and a cotton sheet (a pillowcase for example) and observe if you continue to lose liquid and the color of this liquid.

Membranes can rupture at any time:

• before the onset of contractions and usually 70% of contractions begin 24 hours after the break
• during labour

Or they don’t break at all.

Once you arrive at the hospital they will make a tracing to check your heart rate, they will check your temperature, pressure, the amount of amniotic fluid and its color.

2. The dilatation

It is the beginning of active labor, when contractions act on the cervix and this begins its dilation.

Labor is so called when the contractions are regular, painful and the dilation exceeds 3 cm.

This phase lasts on average about ten hours.

You can behave as in the previous phase and continue to do what your body tells you to do: breathe, close your eyes and rest, move, change position, swing, use your voice, hot water, and breathe, breathe.

Let your partner pamper you with fruit juices, an iced or hot tea, water and sugar. They give energy. If you feel nauseous and put it back don’t worry, keep feeding yourself if you feel the need.

3. Expulsion period

At this stage the feeling of reward begins. You will spontaneously push your baby down through the vaginal canal until it is born. Once you reach
(10 cm) there is often a pause of 20-30 minutes before feeling a sense of reward that you must absolutely indulge in the way you want.

This is the time to gather all your energy, eat a little something if it’s okay, and drink liquids. Many women feel this urge to push that comes from the rectum, as when having a bowel movement. Once the head is in the vagina you will feel a strong burning sensation called a “ring of fire”. Breathing is very important in this phase as breaths must be short and fast so as to let the head push and disengage from the vagina until the baby is born.

Find the most comfortable position and follow the push. There is no right and wrong way to push. Trust the midwife present with you and your partner, let him support you and help you in the positions.

Once the head has come out there will be a small moment of pause, the energies are gathered and the child will make his last rotation settling himself with the shoulders and the rest of the body. At the next contraction usually the shoulders and then the whole body come out.

4. Secondarily

During this phase there will be the birth of the placenta.

After about a quarter of an hour from the birth of the baby, small uterine contractions occur that determine the detachment and therefore the expulsion of the placenta and its annexes.

With a little push the placenta is born and will be checked and examined by the midwife to make sure that everything has been expelled correctly and completely.

At this stage there is a modest loss of blood (according to the WHO it does not exceed 500 ml) which is controlled by the gynecologist or midwife.

Rooming-in

After secondment, if you and your child are well, you can stay undisturbed in the room for about two hours, even with the father. If you wish to breastfeed it is important to place the baby on the breast so that he can smell and lick it. This undisturbed skin-to-skin period helps the production of oxytocin which contributes to the reduction of the amount of blood that is lost.

The birth of a child is a moment of discovery, strength and surprise. because it knows how to do what it takes to bring the baby to birth and knows how to produce milk to feed it. The unexpected, problems can always arise but everything is faced step by step and only when this problem really arises.