Stages of Contraction at Childbirth
Did you know that contractions are divided into different stages? By understanding the stages of this contraction, expectant Father/Mother is expected to be calmer.
In this article, we will discuss the stages of contraction before the birth of the baby. And anything that Mother might experience. So it has physical and mental preparation as well.
So, after entering the last weeks towards the end of pregnancy, you may begin to experience contractions. So, let's examine all the things about contractions and the birth process as follows...
In fact, contraction literally means shrinking/abbreviation. In English, contraction refers to the forms of English words that are often shortened/enhanced in the usage. An example: Are not, did not, I'm, etc.
In Indonesian, hear the word contraction we immediately imagine pregnant women who are pushing during childbirth, isn't it?
Stages of Contractions at Childbirth
Contraction of uterine muscle
While the contraction in childbirth is the movement of tightening/repetition of the uterine muscle in repeated. So the actual contraction of childbirth is a process of uterine muscle contractions repeatedly, in preparation for the birth of a baby.
The actual contractions have already begun or will come soon if you experience symptoms such as:
- Pressure rises in the womb
- a change in energy level
- bloody mucus
The contractions will most likely begin immediately when the contractions become regular and painful.
False Contractions or Braxton Hicks Contractions
Many women experience irregular contractions sometime after 20 weeks of pregnancy. Known as Braxton Hicks contractions, they are usually painless. At best, they are uncomfortable and irregular.
Braxton Hicks contractions can sometimes be triggered by increased activity of the mother or baby or full bladder. No one really understands Braxton Hicks's contraction role while pregnant. They can increase blood flow, help maintain uterine health during pregnancy, or prepare the uterus for labor.
Braxton Hicks contractions do not cause the cervix to dilate. A painful or irregular contraction is unlikely is Braxton Hicks Contraction. Instead, they are the kind of contractions that should make you call your doctor.
First Contraction Stage
Contractions and birth processes are divided into three stages. The first stage of labor involves the onset of labor through complete cervical dilation. This stage is subdivided into three stages.
This is the beginning of labor when the cervix begins to soften and widen to 4cm. Initial contractions are usually controlled, inconsistent and less painful so far. Once the cervix has expanded to 4cm, the contraction is called "steady". No need to be in the hospital during this early contraction stage and you should try and rest. But if the contractions are only a few minutes away, your water has broken or there is a sign of blood, you should go to the hospital without delay.
Contractions vary during this phase and can range from mild to strong, occurring at regular or irregular intervals. Other symptoms during this phase may include back pain, cramps, and bloody mucus. Most women will be ready to go to the hospital at the end of an early childbirth. However, many women will arrive at the hospital or labor center while they are still in labor.
The contractions become stronger and more painful because the cervix is gradually widening to 7cm. Although some mothers may want to start pushing in this phase, this should be avoided until the cervix is completely enlarged.
Because gravity helps the widening of the cervix because the pressure of the baby's head cushion down, walking or being vertical can help speed up the contraction process. Take the opportunity to use the toilet before progressing to the next contraction stage.
Contraction of Transition
The contractions will be very close and strong as the cervix widens to the full 10cm required to enter the second stage of labor. The urge to go to the toilet as the baby pushes its head toward the opening of the cervix and rectum is common. Many women are afraid of having a bowel movement in this phase of labor - but midwives, nurses, and doctors are all used to this and are ready, do not worry!
Pethidine or epidural will greatly reduce pain at this stage, but may also slow down contractions, or increase intervention with forceps or vacuum suction. This is because this medicine can reduce your instinctive reflexes to push. As an alternative, though, if the drug makes a woman feel less anxious, this can help progress more smoothly.
Second Contraction Stage: Birth
Contractions will recede and fade during the second stage of labor, allowing you to relax for a moment between the two. Feeling the constant need to push will accompany this stage of labor, and the contraction will continue to move the baby through the birth canal to the entrance of the vagina. Then you may feel the sensation of stinging or burning when the baby's head appears (this is known as the crown).
At this point, the urge should be more controlled, so that the vaginal and perennial muscles can stretch around the baby's head, reducing the risk of tearing. The doctor or midwife will then maneuver the baby so that it can be born.
The labor can also slow down at this stage if there are problems such as the position of the breech baby, weak contractions or shoulder dystocia.
If the first stage of labor takes more than 18 hours, or the second stage of labor continues after two hours, labor is considered prolonged. It is said to be more common in the first pregnancy or in older women.
If there is an indication that labor is not going as fast as it should, doctors or midwives can manually break the amniotic fluid (if this has not happened), or they may decide to intravenously induce contractions with a hormone called synctocinon, through droplets or using gel to speed widening rate.
An emergency cesarean section will be performed if the mother or baby's health deteriorates.
Third Stage Contraction: Remove Placenta
During this stage of labor, the placenta and membranes are removed. The uterus will contract lightly to loosen the placenta before releasing it. Many hospitals use injections and pull the umbilical cord to ensure the final stages of labor, but breast milk immediately stimulates the placenta to release naturally. The third stage of labor is often unknown to some women.
There will be less blood loss, but the doctor or midwife will monitor this to ensure it does not cause postpartum hemorrhage, and also check the placenta to make sure nothing is left inside (which can lead to a condition known as retained placenta).
Postpartum hemorrhage is more likely to occur if birth is very difficult or if the woman has conditions such as placenta praevia, preeclampsia or operative labor (with forceps or ventouse). The cracked placenta stops the uterus from returning to its normal size and increases the chance of uterine infection but is rare. Both doctors and midwives are trained to deal with these complications during the third stage of this work and will intervene when necessary.
Stitches to repair an injury or surgical wound (episiotomy) will occur after the placenta is released.
Pain relief during birth
Modern medicine can provide various options to overcome the pain and complications that can occur during labor and delivery. Some of the available drugs include the following.
Narcotic drugs are often used to relieve pain during labor. Their use is limited in the early stages because they tend to cause excessive maternal, fetal, and neonatal sedation.
Narcotics are generally given to women who work with intramuscular injection or through an intravenous line. Some centers offer patient-controlled administration. That means you can choose when to receive the drug.
Some of the most common narcotics include:
Inhaled analgesic drugs are sometimes used during labor. Nitrogen oxide often called laughing gas, is most commonly used. This can provide sufficient pain for some women when used intermittently, especially in the early stages of labor.
The most common method of pain relief during labor and delivery is the epidural blockade. This is used to provide anesthesia during labor and delivery and during cesarean section (cesarean section).
The pain-relieving result of injecting anesthetic drugs into the epidural space lies just outside the layer that covers the spinal cord. The drug inhibits the transmission of pain sensations through the nerves that pass through the epidural space before connecting to the spinal cord.
The combined use of spinal-epidural or epidural walking has gained popularity in recent years. This involves passing a very small point-pencil needle through an epidural needle before placement of an epidural anesthesia. Smaller needles advance into the space near the spinal cord and a small dose of local anesthetic or narcotics is injected into space. This affects only the sensory function, which allows the patient to walk and move during labor. This technique is usually used in the early stages of labor.
Natural Pain Relief
There are many options for women seeking non-medical pain relief for labor and delivery. They focus on reducing the perception of pain without using drugs. Some of them include:
- Transcutaneous electrical nerve stimulation (TENS)
Induction of Contraction
Labor can be induced artificially in several ways. The method chosen will depend on several factors, including:
- How ready is your cervix for labor
- this is your first baby
- how far you are in pregnancy
- if your membranes have been broken
- induction reasons
Some reasons your doctor may recommend are:
- when pregnancy has entered the 42nd week
- If the mother's amniotic fluid ruptures and labor does not begin soon after
- If there are complications with the mother or baby.
Labor induction is usually not recommended when a woman has a previous cesarean section or if the baby is breech (head above).
Hormone drugs called prostaglandin, a drug called misoprostol, or a tool can be used to soften and open the cervix if it has been long and has not softened or begun to widen.
Stripping the membranes can cause contractions in some women. This is a procedure in which your doctor examines your cervix. They manually insert a finger between the membrane of the amniotic sac and the uterine wall. Natural prostaglandins are released by separating or stripping the bottom of the membrane from the uterine wall. It can soften the cervix and cause contractions. Peeling membranes can only be done if the cervix is sufficiently dilated so that doctors can insert their fingers and perform the procedure.
Drugs such as oxytocin or misoprostol can be used to induce labor. Oxytocin is administered intravenously. Misoprostol is a tablet placed in the vagina.
Your doctor regularly monitors your baby's position during prenatal visits. Most babies turn into head position below between week 32 and week 36. Some do not turn at all, and others turn into the position of the foot or head first. Most doctors will try to change the breech fetus to the head position below using an external cephalic version (External Cephalic Version = ECV).
During ECV, doctors will try to gently move the fetus by using their hands to the mother's abdomen, using ultrasound as a guide. Babies will be monitored during the procedure. ECV is often successful and may reduce the likelihood of birth by Caesarean section.
The average birth by Caesarean section has increased dramatically in recent decades. Cesarean section is often the safest and fastest birth choice in difficult deliveries or when complications occur.
C-section operation is considered a major surgery. The baby is excised through an incision in the abdominal wall and uterus, rather than through the normal vaginal discharge. Mothers will be given anesthesia prior to surgery to sedate the area from the abdomen to below the waist, known as anesthesia of the waist down. The incision is almost always horizontal, along with the bottom of the abdominal wall. In some situations, the incision may be vertical from the midline down the navel.
The incision in the womb is also horizontal, except in certain complicated cases. Vertical incisions in the womb are called classic cesarean section. This makes the uterus muscle less able to tolerate contractions in future pregnancies.
Baby's mouth and nose will be sucked after delivery so they can draw their first breath, and the placenta will then be removed as well.
Most women will not know whether they will undergo Caesarean Surgery until labor begins. A cesarean section may be scheduled in advance if there are complications with the mother or baby. Another reason that needs to be done by Operation Caesar. is:
- The previous cesarean section with a classical vertical incision
- fetal disease or birth defects
- Mothers have diabetes and their babies are estimated to weigh over 4,500 g
- placenta previa
- Maternal HIV infection and high viral load
- breech or transverse position of the fetus
Cesarean section is often known as C-section, especially among medical practitioners.
Vaginal Birth After C-section
Once thought that if you had a cesarean section, you would always need it for your next baby. But now, repeating cesarean section is not always necessary. The birth of the vagina after Caesarean Surgery can be a safe choice for many people.
Women who have a lower (horizontal) uterine incision from cesarean section will have a good chance of delivering a normal baby via the vagina. Women who have a classic vertical incision should not be allowed to try this way. Vertical incisions increase the risk of uterine rupture during vaginal birth.
It is important to discuss your pregnancy and previous medical history with your doctor, so they can assess whether VBAC is an option for you.
Help For Childbirth
There are times when near the end of a stage of encouragement where a woman may need a little extra help in getting the baby out. Vacuum or forceps can be used to aid delivery.
The episiotomy is a downward drop at the base of the vagina and the perineal muscle to increase the opening for the baby to come out. Ever believe that every woman needs an episiotomy to give birth to a baby. Episiotomy is now usually only done if the baby is depressed and needs help to get out quickly. They are also performed if the baby's head is delivered but the shoulder is caught (dystocia).
An episiotomy can also be done if a woman has been pushing for a very long time and can not push the baby past the very bottom of the vaginal opening. Episiotomy is generally avoided if possible, but the skin and sometimes muscles can tear. Skin tears are less painful and heal faster than episiotomies.