The confusing stages of labour

Most women are still confused about the stages of labour even though they had previous deliveries. Let's demystify the labour process.

• Labour is traditionally compartmentalised into 3 stages

• Stage #1 has a latent phase (dilatation of cervix to 3 cm)  and an active phase (continued dilatation of cervix to full dilation at 10 cm)

• Stage #2 — delivery of the baby

• Stage #3 — delivery of the placenta​ 

Stages of labour​ varies for different women. The active phase of labour can be as fast as 2 hours or as slow as 16 hours especially in your first pregnancy. Labour is shorter for subsequent pregnancies. 

What is engagement? When will it happen?

Engagement is when your baby’s head drop into the pelvic cavity before labour commences. It usually occurs at 37-38 weeks. During engagement, your bump may seem smaller as the baby enters the birth canal. You may also feel heaviness in your pelvic joint and some back pain. Your long-awaited labour is one week away! Congratulations!

My baby is breech. When can I expect baby to turn?

For natural delivery, a head-down position is preferred. We expect most babies would have turned to head down by 37 weeks. In only 5% of cases, the babies are breech (butt down) at time of delivery. But after 37 weeks, if the baby is still not in head down, it is very unlikely to turn. A C-section is most likely to happen.

What problems can occur after a delivery?

Immediately after a seemingly uneventful vaginal delivery, some common problems may arise in the immediate postnatal period.

• Excessive bleeding due to​ a poorly contracted womb — requiring medication (oxytocin) to help contractions.

• Retained placenta due to a failure to separate — requiring a surgery for removal under anesthesia. 

• Vulva swelling — in cases of edema, simple icing is sufficient. In cases of hematomas (blood clots), surgical drainage in the operating theatre may be required. 

• Fever — this is usually due to the epidural or prolonged labour. Fever will settle with antipyretic medications

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