Childbirth

Most births occur between 38 to 40 weeks after the woman’s last period. If earlier than 36 weeks, the baby will be premature. The earlier the delivery, the more the risk of complications and death of the baby. On average, for a first child, labour takes about 16 hours. Women who have had children before can have a much shorter labour, and most will deliver within 12 hours. There are, however, wide variations.
 
Stages of labour
 
There are 3 stages of labour
 
Stage 1.
This stage involves the dilation of the cervix (neck of the womb), so that the baby can pass out of the uterus (womb). See Figure 10.1. It is difficult to say when labour commences exactly. The uterus will start contracting in a co-ordinated, regular pattern with some pains. A discharge of mucus mixed with blood may occur (the show). In the early part, the uterine contractions are relatively painless
and occur at 5–10 minute intervals. The membranes, which hold the fluid around the baby in uterus, rupture and the fluid flows out of the vagina. Usually about 250–500 mls. The contractions will gradually get more frequent and stronger.
 
Stage 2.
This stage involves the journey of the baby through the now dilated cervix, down the vagina (the birth canal) and into the outside world. The majority come head first. The pains and contractions will be much stronger, accompanied by a desire to push.
 
Stage 3.
This stage involves the delivery of the placenta (afterbirth).

After the birth, the mother needs to be able to wash, put on a clean night dress, and will need a sanitary towel. She should rest for the first 24 hours, and then she can start gently moving around.
Check her temperature daily, if it rises above 38 degrees centigrade, she will need antibiotics, either Ciprofloxacin 500 mg twice a day or Erythromycin 500 mg 3 times a day for 5 days. She can eat normally and needs to drink plenty of fluids. She may initially find it painful to urinate and open her bowels. This usually is overcome with encouragement. Trying to urinate initially in a warm bath is often successful. After 3 days if she has not opened her bowels, a mild laxative can be used.