Labor is probably the subject in your birth plan that you will spend a lot of time dwelling on and discussing with your doctor and mommy friends. You have probably heard it is best to stay calm, but how do you soothe your panic-inducing anxiety? You prepare by understanding what is happening with your body.
The process of labor and delivery starts with having contractions, which open your cervix so your baby can pass through. After the baby is out, you still need to expel the placenta.
How to know the difference between true and false labor
False labor or Braxton Hicks are contractions that happen during the latter part of pregnancy. They do not happen at regular intervals, and the intensity of the contractions does not feel stronger as time passes. The easiest way to check if you are having false labor is when the pain stops after you change positions or take a rest, says Dr. Maynila Domingo, M.D., a board member of the Bayside Council of Obstetrics and Gynecology and a clinical associate professor at the University of the Philippines-Manila
Regular uterine contractions, on the other hand, have short intervals and increasing intensity. “The discomfort is also not just localized in the lower abdomen, but rather it extends to the lower back,” Dr. Doming says, adding that these types of contractions are the ones that open up the cervix.
Head to the hospital if your baby stopped moving in the womb
There are four primary reasons to head to the hospital urgently: when you’re experiencing regular contractions; you had a bloody show or blood-tinged mucus-like vaginal discharge; you notice watery vaginal discharge; and when you feel that your baby is not as active inside your womb. (Read more about when to rush to the hospital if you’re pregnant here.)
The movies always show the breaking of the water bag as a big gush, but Dr. Domingo says it doesn’t always happen like that all the time. Sometimes, it can be like you peed in your underwear, and it can happen that you did not feel the leaked urine or the fact na “napaihi ka.” In fact, for some, they will only realize their water bag broke because felt the wetness of their underwear.
When it comes to fetal activity in the womb, “kayo ang nakakaalam kung ano ang baseline ng likot ng bata. Kapag hindi siya kasing likot, notify your doctor,” Dr. Domingo stressed.
Babies sleep in the womb, but they only do so only for about two hours in a day, so don’t wait until the next day to tell your doctor — even if you don’t have contractions, bloody show, or water discharge.
An extended stay in the labor room may mean higher chances of CS
When your doctor sends you home even if you’re having contractions and are 1- to 2-cm dilated, it means “the contractions are just not yet coming regularly, and we do not expect the patient to delivery immediately,” Dr. Domingo explains. This is the latent or early phase of labor. (Read more about the phases of labor here.)
The active phase of labor is when a pregnant woman is already 4- to 6-cm dilated. Doctors expect a specific rate of change in cervical dilation to occur every hour, and it can also depend on if it’s the woman’s first time to give birth or not. It is during this phase when pain medication is administered, if needed.
Push only when you feel the urge to push
Pain management, which you need to discuss with your doctor, is about lessening the pain, but you should still feel the contractions because that’s your cue to push and help your baby come out.
While an epidural has been tagged as “painless,” it is not because you will not feel anything. “Bawas lang yung pain. But you can still move your legs, you should still know that you are having contractions, so you can push,” Dr. Domingo explained. It’s why you get it in doses and given in full only when the baby and placenta are out.
“‘Pag true labor na, pain will not go away with sedation,” Dr. Domingo said, adding that a sedative may be an option during the latent phase of labor. During the active phase of labor, the patient will still wake up from sedation for every contraction and push.
When vaginal birth cannot happen
Doctors always hope for a vaginal birth for their patient. But for labor to be successful, two things need to happen: contractions to cause the cervix to dilate up to 10 centimeters and the descent of the fetal head towards the birth canal. If one or both fail to happen, then doctors need to intervene to help you deliver your baby safely. Fetal distress is a common reason vaginal delivery may not be possible.
Dr. Domingo explained that every time your uterus contracts, it lowers the oxygen supply of your baby. “A healthy fetus can survive that. Meron siyang natural na proseso na hindi siya mahirapan doon,” she assured. But if the baby has complications, then prolonged lack of oxygen supply during birth may have short- and long-term adverse effects on the baby’s brain.
If the baby is doing well, but the mother is not, say her blood pressure is shooting up, and the only way to improve the maternal condition is to deliver, then doctors have to to do surgery.
Doctors are advised and are willing to wait even if labor is prolonged. Research shows it’s better to let labor progress on its own, but only if the mom and baby are doing fine. Your doctor will know what to do, so find one you trust.