As your pregnancy progresses, it’s natural to have tons of questions about labour and delivery. Some pregnant women may even have pregnancy fears and may want to know how to overcome them so they can prepare for labour better.
Dr. Rinku Sen Gupta Dhar, Senior Consultant, Obstetrics & Gynecology answers labour & delivery FAQs to put your mind at ease and guide you along the way.
Labour & Delivery FAQs in First Trimester
Does my expected date keep changing as my pregnancy advances? Can that be determined by ultrasounds in the third trimester?
Your expected date does not keep changing as your pregnancy advances. Expected dates are only calculated from the date of your last missed period and ultrasounds up to 12 weeks.
If there is a discrepancy of more than a week, then we go by the 12 week ultrasound. The only time your expected date may change is if you develop a complication like high blood pressure or high sugars and therefore need to be delivered earlier.
The purpose of third trimester ultrasounds is to assess the growth of the baby and not to determine your expected date.
When will I go in labour? Please tell me so that I can plan my leave?
We can only give you the approximate time of your delivery as labour is expected to start any time after 37 weeks. Your expected date of delivery is at 40 weeks but only 4% women deliver on their due date. Others deliver before or after their due date. Childbirth is not a surgery for which admission can be planned in advance.
The more flexible you are about it, the better prepared you will be.
How will I know I am in labour? I stay far away, so will I be able to reach the hospital on time?
Every female species on earth is naturally endowed with the gift of reproductive instincts. This will help her to understand that she is in labour.
Human beings are luckier because they have their mothers and grandmothers to guide them.
Elephants are probably one of the few mammals in whom family participation and bonding plays a very important role in labour. In a wild herd of elephants, females gain birthing and maternal experience from a very young age by witnessing many births in the herd. By the time it’s their turn they are prepared for the event and have a support structure of older experienced females.
The active phase of human labour lasts 6 to 10 hours. This is preceded by a phase of latent labour which may last for 8 to 10 hours.
There will be occasional uterine cramping and occasional mucous or brownish discharge in this phase. This may alert you to the arrival of true labour after a day or two. Under natural circumstances you have enough time to reach the hospital even after true labour sets in.
True labour is marked by intermittent contractions or cramping coming regularly lasting for 30 to 45 seconds. These contractions start becoming more frequent and intense every five to ten minutes as labour progresses. Therefore once you are in true labour, the cramping will not stop or taper off and it will be more intense, longer lasting and frequent with time.
Labour & Delivery FAQs in Second Trimester
Will I have a normal delivery or a cesarean section?
This question cannot be answered by your doctor in the majority of cases before you go into labour.
Even after you go into labour, we can only periodically assure you whether labour is progressing satisfactorily. This does not necessarily mean that vaginal delivery is inevitable as in 5% women caesarean section can happen after full cervical dilatation or late labour.
So you cannot know the outcome of this test of labour without attempting it.
Of course in some situations such as a low lying placenta or a breech baby, a planned caesarean section may be better for the mother and baby.
How long does labour last?
The active phase of labour lasts for 6 to 8 hours. You will experience uterine contractions during this time that are perceived as painful and intermittent uterine cramps.
The active phase of labour for some women may be even shorter.
If your active labour continues for more than 10 hours, your doctor will take corrective measures or deliver you by caesarean section.
Is labour always very painful?
Pain is a very individual perception.
If you ask 100 postpartum mothers about the pain they experienced, there will be different perceptions and a large majority will tell you that the pain was moderate to severe but it was not intolerable and they have no regrets that they attempted a vaginal delivery.
How do I prepare myself for a normal delivery?
There are many ways in which you can prepare for a normal delivery. These include:
- Eating sensibly: You require extra 300 calories and 10 gm protein daily in the late second and third trimester. But that does not mean you start eating for two people. Eat lots of fruits, vegetables, fish, low fat milk and milk products, pulses, soya protein. Keep a check on your sweet and biscuits intake.
- Walk daily for at least half an hour as soon as your doctor allows exercise. Enroll yourself for antenatal exercises and breathing classes and follow the routine at least five times a week.
- Stay hydrated: Drink at least 10 to 12 glasses of water daily.
How can I help myself in labour?
The first thing to do is to be calm. Everything will be under control if you have faith in yourself and your medical caregivers.
The faith will create a bond which will help you and the medical team to work optimally towards a positive outcome. Here are a few tips to manage labour:
- Walk around initially and be comfortable in any position.
- Have lots of fluids such as nimbu paani, juice, water in labour.
- Once you are in active labour, you can try certain postures or jumping on the birthing ball that may be suggested to you.
- If you are comfortable, some intramuscular pain-relieving agent may be offered.
- If you are still uncomfortable and labour is anticipated to be long, you may opt for epidural analgesia.
Labour & Delivery FAQs in Third Trimester
I am not gaining weight and my due date is near, what if I have a small baby?
The mother’s weight gain is not directly proportional to the baby’s weight gain, so it is not necessary that you will have a small baby if you are not gaining weight. An Indian baby at term is anything between 2.5 to 3.2 kg on an average. Most of the weight you gain is due to other physiological changes. A baby of weight 2.3 kg may be perfectly healthy if it is a constitutionally small baby. Your doctor will suggest whether the baby needs to be delivered before term due to any growth lag.
After how much duration of pain should I come to the hospital?
There is no fixed yardstick about when you should reach the hospital. You are usually in true labour when you have contractions every 5 to 10 minutes lasting for 30 seconds for atleast an hour or so. We generally ask mothers to come to the hospital if you are getting regular contractions accompanied with or without blood stained mucoid vaginal discharge.
Doctor, will you be there for my delivery?
Once you are booked with a doctor, the doctor or one of her core team members will always be there for your delivery.
But it is important to understand that labour and delivery are not like surgeries where a fixed time and slot are allotted for the same and it is done in a stipulated time by the doctor.
Labour whether induced or spontaneous requires patience and time. A single person or persons cannot accompany you all the time. Therefore the hospital is equipped with trained labour room medical and paramedical personnel including doctors at all times of the day or night.
They work in coordination with your consultant at all times. Your consultant will take all the medical decisions and will be there for your delivery. But over and above that, you need to be provided continuous care in the birthing room and you will be taken care of by a vigilant and caring team.
Is some family member allowed with me in the birthing room?
Yes! We encourage the presence of a supportive family member with you during labour.
But just as a positive companion can do wonders for you in the labour area, a panicky or nervous person can make things difficult for not only you but also the medical team looking after you.
Therefore, we encourage your labour companion to accompany you in the pregnancy workshops and try to make him/her understand his role.
What if I suddenly start leaking per vaginum in the office?
There is nothing to panic if you suddenly start leaking. Just use some sanitary pads and reach the hospital. If you are already full term, the labour contractions will start spontaneously or your doctor will induce labour.
One of my friends had preterm labour at 32 weeks and her doctor could not anticipate it. Why?
Preterm labour is delivery before 37 weeks. It happens in 10 per 100 women.
The baby may have to stay in the nursery or under specialised baby care if your labour begins before 34 weeks. The baby is borderline term between 34 and 37 weeks, and majority of the time, needs only routine care.
A large majority of preterm labour is idiopathic, that means we do not know the cause.
Mothers who have twins or have excessive liquor (fluid) surrounding the baby are more prone to preterm labour.
What should I do if my mucous plug comes out?
Absolutely nothing! Your cervix will release a tremendous amount of white, thick mucus as the pregnancy progresses. It does not mean you are going into labor anytime soon. An unscented panty liner will help keep your underwear dry.
Vaishnavi Pandey’s Labour & Delivery Journey
Vaishnavi consulted us when she was five weeks pregnant. She was anxious about her pregnancy and wanted to ensure she was doing everything right for her baby’s well-being.
Though her worry made her more cautious about attending all her appointments on time, it also brought upon the undue stress of anticipating all kinds of situations as she talked to people around her.
At Dr. Dhar’s suggestion, she jotted down her questions and attended pregnancy workshops and Lamaze sessions where she was encouraged to ask about top pregnancy fears, natural birth and labour and delivery.
“I was pregnant and scared of my life changing of course, but more than that, I was afraid of labour pain, being unable to reach the hospital on time and delivering mid-way, being unable to breastfeed – what not!” shares Vaishnavi.
“My doctor understood that I needed a lot of time and in-depth counseling, and gave me that. She explained how my pregnancy was progressing and ensured that I prepared as much as I could for a normal birth. It is because of her faith in me that I could deliver vaginally and can go back home with a healthy baby today.”
Conclusion
“Expecting mothers should be aware that a lot of the information they hear from friends and relatives may be based on personal experience, which may greatly vary from individual to individual. As such, a lot of concerns and fears in pregnancy may happen because of false beliefs and unusual expectations,” says Dr. Dhar.
“We counsel women and their partners and address their pregnancy fears in a way that restores their faith in themselves to endure childbirth with the least medical interventions.”
Medically Reviewed by Dr. Rinku Sen Gupta Dhar
MBBS, MD
25+ years of experience
Book an appointment by calling us/sending a whatsapp message on +919810404057.