Gone into labour

Pregnancy – labour - Better Health Channel

Labour is divided into 3 stages. The first stage is the dilation of the cervix, the second stage is the birth of the baby, and the third stage is the delivery of the placenta. For first-time mothers, labour takes around 12 to 14 hours. Women who have undergone childbirth before can expect about 7 hours of labour.

Recognising the start of labour

Braxton-Hicks contractions are sometimes mistaken for labour. These ‘false’ contractions usually start halfway through the pregnancy and continue all the way through. You may find these contractions visibly harden and lift your pregnant belly.

It is not known what triggers the onset of labour, but it is thought to be influenced by the hormone oxytocin, which is responsible for causing uterine contractions.

Symptoms of going into labour

Some of the signs and symptoms of going into labour may include:

• period-like cramps
• backache
• diarrhoea
• a small bloodstained discharge as your cervix thins and the mucus plug drops out (this is called a ‘show’)
• a gush or trickle of water as the membranes break
• contractions.

First stage of labour

The first stage of labour involves the thinning of the cervix and its dilation to around 10 cm. The first stage is made up of three different phases:

• The latent phase – Generally, this stage is the longest and the least painful part of labour. The cervix thins out and dilates zero to three centimetres. This may occur over weeks, days or hours and be accompanied by mild contractions. The contractions may be regularly or irregularly spaced, or you might not notice them at all.
• The active phase – The next phase is marked by strong, painful contractions that tend to occur three or four minutes apart, and last from 30 to 60 seconds. The cervix dilates from 3 to 7–8 centimetres.
• The transition phase – During transition, the cervix dilates from 8 to 10 centimetres (that is, fully dilated). These contractions can become more intense, painful and frequent. It may feel as though the contractions are no longer separate, but running into each other. It is not unusual to feel out of control and even a strong urge to go to the toilet as the baby’s head moves down the birth canal and pushes against the rectum.

Throughout the first stage of labour, careful monitoring and recording of your wellbeing and that of your baby, and the progress of your labour, is important. This is to ensure that labour is progressing normally and that any problems are recognised early and well communicated.

Second stage of labour

The second stage of labour is from when your cervix is fully dilated to the time your baby is born. The contractions during this time are regular and spaced apart. As each contraction builds to a peak, you may feel the urge to bear down and push. The sensation of the baby moving through the vagina is described as a stretching or burning, particularly as the baby’s head crowns (appears at the vaginal entrance).

At the time of birth, a doctor or midwife may guide your pushing to enable a gentle, unhurried birth of your baby's head. Sometimes the umbilical cord is wound around the baby's neck. If possible, the doctor or midwife will loosen it, loop it over your baby's head, or clamp and cut it to allow your baby to be born safely.

Once the head has emerged, your midwife or doctor will guide your baby’s body so the shoulders come out. The rest of the baby will then follow.

If this is your first baby, the second stage of labour can last up to 1 to 2 hours, particularly if you have had an epidural. If you have had a baby before, this stage is often much quicker.

Monitoring of your condition and that of your baby is increased during the second stage of labour. A long second stage of labour can result in risks for you and your baby. If your labour is not progressing, it is important that the reason is worked out and steps are taken to help you.

Third stage of labour

After the birth of your baby your uterus gently contracts to loosen and push out the placenta, although you may not be able to feel these contractions. This may occur 5 to 30 minutes after the birth of your baby.

The muscles of the uterus continue to contract to stop the bleeding. This process is always associated with a moderate blood loss – up to 500 ml.

In this stage of labour, one of the potential problems is excessive bleeding (postpartum haemorrhage), which can result in anaemia and fatigue. This is why the third stage is carefully supervised.

There are two approaches to managing the third stage:

• Active management – this is the common practice in Australia. After the birth of your baby, the midwife or doctor gives you (with your consent) an injection of oxytocin, clamps and cuts the umbilical cord, and then carefully pulls on the cord to speed up delivery of the placenta. Active management has been found to reduce excessive blood loss and other serious complications.
• Expectant management – the placenta is allowed to deliver on its own, aided by gravity or nipple stimulation only. In this approach the umbilical cord stays connected to the baby until the cord stops pulsating.

Monitoring your baby during labour

During labour, your baby's heart rate will be checked regularly. If you have had a low risk pregnancy and there are no problems at the onset of labour, your baby's heart will be listened to every 15 to 30 minutes using a small hand-held Doppler ultrasound device or Pinard (fetal stethoscope). This equipment can be used regardless of the position you are in.

If you had problems during pregnancy or if problems arise during your labour, your baby’s heart rate may be monitored continuously using a cardiotocograph (CTG).

A CTG involves having two plastic disks (receivers) strapped to your abdomen and held in place by two belts. The receivers are attached to a machine, which may limit your movement. Some hospitals have machines that enable you to move around freely while you are being monitored. This is known as telemetry.

Care of the perineum during birth

The area between the vagina and anus is called the perineum. Once the baby's head starts to crown (appear) the perineum will tear if it can't stretch enough. These naturally occurring tears can be difficult to stitch and may not heal very well. In around 3–4 per cent of cases, the vagina tears right through to the anus.

An episiotomy is an intentional cut of the perineum, using a pair of scissors. This clean cut is much easier to control and repair, tends to heal better than a tear, and is less traumatic to the underlying muscle and tissue. An episiotomy may be needed during the last part of the second stage of labour if:

• the birth needs to be quicker if you or your baby show signs of distress
• you need an assisted vaginal birth
• you are showing signs that you may tear badly.

If you are having your first baby, you may help prevent tearing by massaging the perineum during the weeks prior to the birth. Massaging the perineum during the second stage of labour has not been shown to stretch tissues and therefore does not reduce perineal injury.

Episiotomies should be performed only if needed. They should not be 'routine' as they do not reduce the risk of severe perineal injury, urinary stress incontinence or trauma to the baby.

Suggestions for preparing for labour

Some women may find the following activities helpful in preparing for labour:

• choose your support person – someone you are comfortable with and who will help you rather than distract you during the different stages of labour
• yoga
• relaxation exercises
• hypnotherapy (a state of relaxation)
• childbirth education – for you and your support person.

Early stages of labour

Be guided by your doctor or midwife, but general suggestions for a woman approaching labour include:

• Once you go into early labour, take the opportunity to rest and relax at home. There is no need to be in hospital until the contractions are regular and painful.
• Call your support person to let them know your labour is beginning.
• Once the contractions are around 7 to 10 minutes apart, start timing them. Do this by noting how many minutes elapse between the start of one contraction and the start of the next.
• If you are unsure whether to stay home or go to the hospital, ring and speak to one of the midwives. They will ask you a number of questions and help you decide what to do.
• Once your contractions are 5 minutes apart, or if you live a long distance from the intended place of birth (often the hospital), or if you no longer feel comfortable being at home, go to the intended place of birth.
• If your waters break or if you start bleeding from the vagina, go immediately to hospital.

Once you are in your intended place of birth

Suggestions for labour once you are in your intended place of birth include:

• Drink plenty of fluid (water, juice or iceblocks).
• Suck on sweets to keep up your energy.
• Vary your position to keep as comfortable as possible (standing, kneeling, lying down, straddling a chair, or on all fours).
• Have a bath or hot shower.
• Ask your support person for a back rub or massage.
• Try to relax between contractions.
• If you need or want it, discuss having some pain relief.
• Resist any urge to push until your cervix is fully dilated (your midwife will let you know when this has occurred).
• The pressure of your baby’s head helps to widen your cervix, so use gravity and walk around, stand or sit upright.
• Don’t feel embarrassed or inhibited by your appearance or behaviour – your midwife has seen it all before. If you want to grunt, yell or swear – go ahead.
• Remember that passing a bowel motion during labour is normal and nothing to be concerned about.

Having a support person

Having a support person with you can help enormously during labour. Your support person can:

• encourage you
• give emotional support
• help to make you comfortable
• help with breathing techniques
• provide ice to suck if you are thirsty
• provide a heat pack for your back or a cool face washer for your forehead
• massage your back
• celebrate the arrival of your baby with you.

Where to get help

• Your GP (doctor)
• Your hospital or birth centre
• Obstetrician
• Midwife

Signs that labour has begun

Know the signs

There are several signs that labour might be starting, including:

• contractions or tightenings
• a "show", when the plug of mucus from your cervix (entrance to your womb, or uterus) comes away
• backache
• an urge to go to the toilet, which is caused by your baby's head pressing on your bowel
• your waters breaking

The early (latent) stage of labour can take some time.

Urgent advice: Call your midwife or maternity unit if:

• your waters break
• you have vaginal bleeding
• your baby is moving less than usual
• you're less than 37 weeks pregnant and think you might be in labour

These signs mean you need to see a midwife or doctor.

Latent phase of labour

The start of labour is called the latent phase. This is when your cervix becomes soft and thin, and starts opening for your baby to be born. This can take hours or sometimes days.

You'll probably be advised to stay at home during this time. If you go to the hospital or maternity unit, they may suggest you go back home.

Find out more about the stages of labour and what you can do at home during the latent phase.

Call your midwife if you're unsure or worried about anything.

What do contractions feel like

When you have a contraction, your womb tightens and then relaxes. For some people, contractions may feel like extreme period pains. 

You may have had contractions during your pregnancy, particularly towards the end. These tightenings are called Braxton Hicks contractions and are usually painless.

Your contractions tend to become longer, stronger and more frequent as your labour progresses. During a contraction, the muscles tighten and the pain increases. If you put your hand on your abdomen, you'll feel it getting harder; when the muscles relax, the pain fades and you will feel the hardness ease.

The contractions are pushing your baby down and opening the entrance to your womb (the cervix), ready for your baby to go through.

Your midwife will probably advise you to stay at home until your contractions become frequent. 

Call your midwife or maternity unit for guidance when your contractions are in a regular pattern and:

• last at least 60 seconds
• come every 5 minutes or
• you think you are in labour

Read more information on when to go to hospital

Backache often comes on in labour

You may get backache or a heavy, aching feeling.

A "show" can signal the start of labour

During pregnancy, there's a plug of mucus in your cervix. This mucus comes away just before labour starts, or when in early labour, and it may pass out of your vagina. This sticky, jelly-like pink mucus is called a show.

It may come away in 1 blob or in several pieces. It's pink because it contains a small amount of blood.

If you're losing more blood, it may be a sign something is wrong, so phone your hospital or midwife straight away.

A show indicates that the cervix is starting to open. Labour may quickly follow or may take a few days. Sometimes there is no show.

What happens when my waters break

It's likely your waters will break during labour, but it can also happen before labour starts.

Your baby develops and grows inside a bag of fluid called the amniotic sac. When it's time for your baby to be born, the sac usually breaks and the amniotic fluid drains out through your vagina. This is your waters breaking. Sometimes when you're in labour, a midwife or doctor may offer to break your waters.

If your waters break naturally, you may feel a slow trickle or a sudden gush of water you cannot control. To prepare for this, you could keep a sanitary towel (but not a tampon) handy if you're going out, and put a protective sheet on your bed.

Amniotic fluid is clear and pale. Sometimes it's difficult to tell amniotic fluid from urine. When your waters break, the water may be a little bloodstained to begin with.

Tell your midwife immediately if:

• the waters are smelly or coloured
• you're losing blood

This could mean you and your baby need urgent attention.

If your waters break before labour starts, call your midwife. Use a sanitary pad (not a tampon) so your midwife can check the colour of the waters.

If labour does not start after your waters break

It's usual to go into labour within 24 hours of the waters breaking. You'll be offered an induction if you do not because, without amniotic fluid, there's an increased risk of infection for your baby.

Until your induction, or if you choose to wait for labour to start naturally, tell your midwife immediately if:

• your baby moves less than usual
• there's any change in the colour or smell of any fluid coming from your vagina

You should take your temperature every 4 hours when you're awake, and tell your midwife if it's raised. A raised temperature is usually above 37.5C, but you may need to call before this – check with your midwife.

There's no evidence that having a bath or shower after your waters have broken increases your risk of infection, but having sex might.

How to cope when labour begins

At the beginning of labour, you can:

• walk or move about, if you feel like it
• drink fluids – you may find sports (isotonic) drinks help keep your energy levels up
• have a snack, if you feel like it
• try any relaxation and breathing exercises you've learned to deal with contractions as they get stronger and more painful – your birth partner can help by doing these with you
• have your birth partner rub your back – this can help relieve pain
• take paracetamol according to the instructions on the packet – paracetamol is safe to take in labour
• have a warm bath

Find out what happens during labour and birth, and what you can do for pain relief in the early stages of labour.

Get Start4Life pregnancy and baby emails

For information and advice you can trust, sign up for weekly Start4Life pregnancy and baby emails.

Video: How will I know I am in labour?

In this video, a midwife describes the signs that mean labour may be starting.

Media last reviewed: 1 November 2019
Media review due: 1 November 2022

Imagine: you are entering a new job, looking forward to great tasks, dreaming of meeting new colleagues. But already in the first hours, an anxious feeling appears: “What if I made the wrong choice?”

Example 1. Camille chose the company mainly because of the personality of the manager she wanted to work with. But on the very first day at a new job, I found out that the manager was leaving the company in a week.

Still lucky, if you figure out that everything is not as it seemed at the interview, you succeeded on the very first day before you made an entry in the work book. You can just leave and not remember this experience, regretting only the time spent. But what if strong doubts about the correct choice of work appear later - in the first week or first months, when you delve into the "inner kitchen"? It is psychologically more difficult to leave at this stage.

By the time you get a job, you are most likely already tired of the job search process, you may have passed several interviews in different companies. Finding a job is an energy-intensive task. It is usually hard to imagine that it needs to be started anew. Yes, and enthusiasm dries up, thoughts appear: “What if it won’t be better anywhere?”.

If you left another job for the sake of this job, having told your former colleagues what a wonderful offer you received, then it is all the more difficult to leave a new job right away. And it’s not always possible to figure out how justified the worries are. If you didn’t like the team, the leader, the internal arrangements, the load turned out to be greater than you expected, maybe it’s out of habit, and then “be patient - fall in love”, get involved and become easier?

According to many psychologists, sociologists and HR-specialists, on average, adaptation to a new job and getting used to the company's culture lasts six months. In the first month it is difficult to evaluate your impressions objectively, because literally everything is difficult in the first month.

Of course, such things as gross deceit, violation of rights, insults, crossing personal boundaries, should not be tolerated for a day. In the situations described above, these are examples 2 and 3. In example 4, there also seem to be signs of misleading, although it is possible that Anton himself did not fully figure out at the interview stage what conditions he was called into. The company shows signs of trouble (frequent team changes), but perhaps there is room for growth.

But it is not worth keeping silent about less egregious reasons for discomfort, as well as about the fact that your expectations, which were formed in the process of agreements, diverged from reality. The first months of your work in the company are adaptation. In serious companies, managers and HR specialists understand this. Tell them about your discomfort, doubts, suspicions. In companies with a strong corporate culture, you will be supported. And if you receive a negative reaction in response, this will become an additional basis for conclusions.

Alina Mudraya, Operations Director of the Values ​​Value recruitment agency, recommends first of all to admit that you, like any person, have the right to make mistakes.

For herself, Alina identified two important indicators of self-awareness, which should be guided by when deciding whether to leave or stay in the hope of adapting.

Think of your acquaintances and friends who work in places where you could not spend a single day. Your impressions may be radically different from those of your friend, despite the fact that the company may be the same and the working conditions do not change. Keep track of what's happening to you.

The expert recommends tracking how your emotions, thoughts and feelings change in the first days, first weeks and months in a new place:

• Are you making progress and are you becoming more comfortable (clearer, calmer) in a new company? So the challenge is accepted - you have enough resources to master the new experience.
• Is it only getting worse, more stress and frustration? Looks like quitting is the best solution.

But before you leave the company, why was it so important for you to find reasons to leave or stay? If the reason for the dissatisfaction was absolutely unacceptable to you, would you probably leave right away? If the difficulties are surmountable, then Alina the Wise recommends remembering the saying "Whoever wants, he is looking for opportunities, who does not want - looking for reasons. "

Try to objectively compare the conditions that you did not like in the company with those of other employers. Ask your friends from your professional circle how they are, read what is happening on the labor market in your field, what are the trends.

Watch your colleagues and your environment in general. What kind of relationship do you have with them? How do they (mostly) feel about the conditions in the company?

Ask new colleagues and management for feedback - what is their impression of you and your abilities and potential? Also remember that you have every right to clarify all doubts and inaccuracies in the agreements, and when the agreements are violated, be sure to signal this!

Natalia Dubinnikova, career consultant, advises not to delay the decision in the following cases:

Non-fulfillment of agreements by the employer. Most often this concerns wages and registration. “Work with us for a couple of months, if we see that you are suitable, then we will issue it officially, increase the salary, assign a bonus,” if the employer is talking like that, Natalya advises boldly to say goodbye and leave. This is a hopeless story. But if everything turned out to be not quite as you imagined, although no one promised you otherwise (for example, you thought that the load was less, but the functionality was more interesting), then here you need to proceed from how fundamentally important it is for you to what you set up.

When Natalya got a new job, everything turned out to be “a little different”: although the cherished line “department head” appeared in her work book, she did not have any team. According to the HR manager, the team was to be recruited in about six months. The promised salary was divided into salary and a quarterly bonus. It turned out that Natalya did not gain anything from the transition. In addition, the new company had stricter rules than those to which she was accustomed: she had to come to work strictly by 9:00, regardless of what time the working day ended yesterday - at 18:00 or at 22:00.

You cannot establish contact with the team and the leader. We spend most of our lives at work, so it is very important that relationships with people and the atmosphere inside are comfortable. Were you, as a newcomer, met with pointedly unfriendly? Do you see that there is a difficult conflict situation in the team, from which it is impossible to ignore? Does the leader have a very difficult character? And all this is a lot of stress for you? It is unlikely that you will get used to such an unhealthy environment, and you should not do this.

Corporate culture disgusts you. “This is something that you can immediately feel,” explains Natalia Dubinnikova. - In my practice, there were cases when every working morning began with a construction. It was necessary for all employees to line up at a certain time and wait for the arrival of the head (this was a Korean company). Not everyone is ready for this."

Sometimes in a situation where there is not the slightest doubt that you made a mistake in choosing a job, the fear of being branded as a "flyer" who does not know what he wants, or who failed the probationary period, prevents you from leaving quickly. It's no secret that employers are suspicious of candidates with a short period of work. How to look for a new job with such a “spot”, if it is no longer possible to return to the previous one?

Leaving probation is not a disaster. Career consultant Ekaterina Troitskaya, in response to such concerns, recommends remembering: the very concept of a probationary period implies that not only the employer evaluates you, but you evaluate him.

According to the Labor Code, in case of dismissal during the probationary period, it is enough for you to notify the employer three days in advance, and not two weeks in advance, as usual. And this rule appeared not just like that.

“Unfortunately, not everything about the job and the features of the company can be formulated in the job description and told at the interview. There is information that is simply inappropriate to bring out, and there are things that are not spoken out because they are considered insignificant, although for some of the applicants they are important, they affect the work process and personal results, says Natalia. — Even if the future employer does not deliberately deceive or distort information, applicants still have a rather large “gray” field. Inside it, there may be factors that are critical for deciding whether to work for this company. The probationary period exists, among other things, in order to look around on this field. The sooner you realize that this place is not for you, the better. Your career will not benefit from being here for a long time.

This is not a spot on a career. Don't worry too much about a bad job history. Every adequate employer understands that anyone, even the best employee, can find themselves in a situation where expectations diverge from reality. This is no reason to consider your professional reputation tarnished.

“Don't be embarrassed by the short period of work in the company,” Natalya Dubinnikova agrees with her colleague. - To be honest, I would not even mention it in my resume. A potential employer is interested in your results, not a formal list of jobs, but you can hardly talk about results in 1-2 months. If you are asked a question at an interview about this period of time, then answer honestly, but carefully. Believe me, it would be much stranger to the next employer that you endured a hateful job for a year just for the sake of a line on your resume and did not bring any results.

What to say if you were asked about that experience. “Of course, you need to start from each specific case and there is no universal advice,” says Ekaterina Troitskaya. — But there are two principles that are important for any interview: to be honest, but also not to say too much. If you voice the real reason for your departure, then this will serve as a kind of insurance against the fact that the situation will not happen again in the next place. To a new employer, this story immediately shows what exactly you will definitely not tolerate.

In this case, Ekaterina calls any value judgments about the past employer, the transition to personalities, as well as attempts to appoint someone to blame as superfluous information. Self-flagellation will also be inappropriate. “Even if you think that you yourself made a mistake that time, well, draw conclusions and do not repeat the mistakes. Yes, it is important to tell the truth and be open during an interview, but you should not confuse it with a confession, ”concludes Ekaterina.

Look at this story as an experience - now you know even better what works for you and what doesn't. Successful search!

Refresh CV

Resigned without difficulty – Kommersant Samara

Nikolai Sveshnikov, Head of the Labor and Employment Department of the Samara Region, resigned yesterday. He wrote a statement of voluntary resignation, having worked in office for about eight months. It is noteworthy that the official made such a decision shortly after the federal authorities made critical statements about the unemployment situation in the Samara region. The regional government does not comment on the resignation of Mr. Sveshnikov. According to observers, the departure of the head of the department is unlikely to fundamentally change the situation on the labor market.

On August 20, Governor of the Samara Region Vladimir Artyakov dismissed Nikolai Sveshnikov, head of the regional department of labor and employment. According to the press service of the regional government, Mr. Sveshnikov wrote a letter of resignation of his own free will. “The reasons are not indicated in the statement,” the ministry said. It was not possible to contact Nikolai Sveshnikov himself yesterday. Since August 21, Nikolai Zverev, who previously was deputy to Mr. Sveshnikov, has been temporarily acting as head of the department.

Mr. Sveshnikov held the position of head of the Department of Labor and Employment for about five months. It is interesting that he began his career in regional authorities in the employment service, heading the main department of labor in the region in 1997. In 2004, the official became the Minister of Industry and Technology of the Samara Region, and in 2006 - the Minister of Industry and Energy, in July 2008 he was appointed Deputy Minister of Industry, Energy and Technology, and in early 2009year headed the Department of Labor and Employment.

The regional government does not officially comment on the results of Nikolai Sveshnikov's work. “I wouldn’t want to scold, but it would also be strange to praise,” said one of the high-ranking officials.

According to the government of the Samara region, for 7 months of 2009, about 100 thousand citizens applied to the employment service for assistance in finding a job. Since the beginning of the year, the number of registered unemployed in the region has increased from 24 thousand to 45.7 thousand people, and its growth continues, albeit at a slower pace. The current unemployment rate, according to official figures, is 2.56%, while the Russian average is 2.6%. About 1.7 thousand people are on leave without pay. In Togliatti, in connection with the transition of AvtoVAZ from September to a shortened week, the authorities expect the release of about 110 thousand people. According to experts, the level of hidden unemployment may be about six times higher than the official figures.

Nikolai Zverev did not suggest what could be the reason for Nikolai Sveshnikov's departure. “The department has been really criticized lately,” Mr. Zverev noted. — Basically, the criticism was from the government of the region. He was not satisfied with the slow implementation of measures that were supposed to improve the situation on the labor market.” According to Mr. Zverev, this had "both objective reasons and reasons of an organizational nature." The interlocutor also noted that now he has to find reasons to "correct the situation."

According to observers, the regional leadership could convince Nikolai Sveshnikov that his voluntary resignation would be the most acceptable option for all parties. “The optimal candidate for a switchman has been found, who, on the one hand, can be held responsible for a critical situation that even the federal authorities are not happy with, on the other hand, the same fact of resignation can be reported, they say, measures have been taken,” believes the chairman of the Samara regional branch of the party "Apple" Igor Ermolenko. According to Vladimir Zvonovsky, President of the Social Research Foundation, the resignation of Nikolai Sveshnikov is mostly "work for Moscow." “From here, this decision looks illogical and unreasonable,” Mr. Zvonovsky believes. In his opinion, the situation on the labor market and the manifestations of the crisis as a whole are assessed differently in the region itself and in the federal center.

Learn more

• 
  How to tell if a child is wheezing
• 
  Hard time eating during pregnancy
• 
  Can you have a miscarriage on your period
• 
  How do you know if your child needs stitches
• 
  What food is good for pregnancy
• 
  How to restrain a child without hurting them
• 
  Are babies born with immune systems
• 
  2 month old baby with green poop
• 
  A child is about how tall
• 
  Are nosebleeds common in pregnancy
• 
  What can i give a 2 week old baby for constipation