As we have already said, this labor It is subdivided into three stages, ranging from childbirth to the expulsion of the placenta. The first stage consiste en la dilation of the cervix. The second stage is the birth of the baby in which the mother pushes the baby and the third stage is the expulsion of the placenta.
In the days before labor begins, you will begin to experience new sensations or several existing ones will be increased, which are caused by the simple effect of gravity, since the baby wants to descend to take its place in the birth canal.
Los Signs and symptoms The most common warning signs that labor may start at some point are:
- Pressure on the pubis
- Pain in the lumbar area
- Stitches or Vacuum sensation in the deep vaginal area
- Increased of vaginal secretions
- Brownish vaginal discharge or slightly bloody
- Expulsion of the mucus plug
- Break from the water bag
- Fitting or descent of the fetal head (sensation of a lower abdomen and relief when breathing)
- Diarrhea or more frequent and loose bowel movements
- Boost of nesting (sudden need to tidy up or clean)
The expulsion of the mucus plug can occur before labor begins, or it can happen a few days before. The rupture of your waters can also occur a few days before labor begins. You will feel like a hot liquid that runs down your genitals, as if you had urinated. If the liquid is greenish (possibly meconium) or with bad smell, requires assessment professional life.
Stages of labor and starting criteria
From a clinical point of view, labor is divided into three phases: dilatation, expulsive y delivery. To consider that the delivery has initiated, regular contractions are assessed (e.g., every 3–5 minutes), cervical dilation increasing (up to 10 cm) and effacement of the cervix (thinning measured in percentage up to 100%). Before, many women go through a phase of prodrome with irregular contractions without sustained cervical changes.
Phase 1: Dilation (latent, active and transition)
It is the most phase long. In the phase latent contractions become more frequent and irregular, the cervix becomes softens, shortens (effacement) and opens up. You may notice an increase in flow and loss of the plug.
In the phase active (approx. 6 to 10 cm) the contractions are more intense and regular (60–90 s), dilation and the descent of the fetal head through the pelvis. You can relieve discomfort with movement, warm showers, breathing and continuous support.
During this phase, the presentation descends through the pelvis following the Hodge plans and the team monitors maternal-fetal well-being through monitoring intermittent or continuous as the case may be.
Ecological: final stage of dilation up to 10 cm, with very strong contractions powerful gifts, rectal pressure, nausea, or tremors. Concentrate on your breathing and receive accompaniment helps to get through it.
Phase 2: expulsive (birth of the baby)
It begins with full dilation and ends with the birth of the baby. The desire to push in labor, and the coordinated thrusts with the contractions help with birth. The exit controlled of the head and shoulders protects the perineum; episiotomy It is reserved for specific indications and is not practiced routinely.
Time may vary from minutes to several hours. They are favored positions comfortable (squatting, sideways, on all fours) and contact skin to skin and non-immediate cord clamping when indicated to improve reserves of iron of the newborn.
Phase 3: Delivery (placenta and membranes)
The birth does not end until the delivery of the placenta, which usually occurs in minutes (usually within half an hour). Uterine contractions keep the controlled bleeding. It is common to give birth addressed with oxytocin to reduce the risk of bleeding. The placenta is checked to ensure it is happens and any damage is assessed and repaired, if necessary. tear perineal.
Signs to go to the hospital or call
- Regular and painful contractions every 5 minutes for 1–2 hours (or every 3–5 minutes if it's your first birth).
- Break of membranes (loss of amniotic fluid), even if you are not sure of the origin.
- Bleeding abundant or continuous vaginal discharge.
- Marked decrease in fetal movements or clinical concern.
- Fever, severe headache or discomfort that worries you.
Braxton Hicks contractions vs. labor contractions
The Braxton Hicks They are irregular, do not increase in intensity and usually subside with hydration, rest or a warm bath. Those of delivery become rhythmic, longer and stronger, and produce changes in the cervix.
- Regularity: During labor, the intervals are shortened (2–5 min).
- Duration: They usually last 60–90 seconds when it is labor.
- Perseverance: they do not give way when changing posture or walking.
- Intensity: They grow progressively and make it difficult to speak.
What happens upon admission and how it is monitored
They are taken Vital signs, the fetal position and presentation are assessed (most frequently cephalic), the cervix is ​​examined and the fetal heart rate. A line may be placed intravenous for fluids and medication. If anesthesia or a possible cesarean section is anticipated, intake is usually limited to clear liquidsThe amniotic fluid should be clear; if it appears meconium (greenish) requires specific monitoring.
Staff can control blood pressure, temperature, uterine dynamics, blood tests and urine. Fetal monitoring may be teacher or intermittent depending on risks and evolution.
Pain management: non-pharmacological options and anesthesia
- Drug-free: breathing, relaxation, visualization, massage, warm water, walking and position changes, heat/cold and birthing ball.
- Pharmacological: analgesics (opioids in evaluated doses) and regional anesthesia (epidural/spinal), pudendal block or local. The epidural relieves pain but can cause hypotension, so they are administered IV fluids; risks/benefits are assessed individually.
Induction of labor and assisted births
If required initiate or enhance labor, can be used prostaglandins, oxytocin or amniotomy. Common reasons: prolonged pregnancy, break of membranes without contractions, maternal conditions (e.g., hypertension), or restriction of for Growth fetal. In complicated births it may be required vacuum or forceps, and in the case of abnormal presentations or feto-pelvic disproportion, Caesarean section.
Mechanics of childbirth and positions
The baby progresses through descent, flexion, embedment, internal rotation, extension, external rotation and expulsionUpright positions and movement often improve the comfort and can shorten dilation; the posture is individualized according to to maximise security and your enjoyment. and preference.
Knowing these phases, signs and resources helps you face birth with more confidence. confidence. , to identify when to go and to understand what care and decisions may arise throughout the process.