Labor is the term used to describe the process of childbirth. It
consists of the contractions of the wall of the womb (uterus) which
force the baby and, later, the afterbirth (placenta) into the outside
world. Labor is divided into three stages. Its duration varies greatly
in different persons and under different circumstances.
During the first and longest stage, the small opening at the lower end
of the womb gradually stretches until it is large enough to let the
baby pass through. The contractions (tightening) of the uterus, which
bring about this stretching and move the baby along into the birth
canal, cause pains known as labor pains.
These pains, usually beginning as an aching sensation in the small of
the back, turn in a short time into regularly recurring cramplike pains
in the lower abdomen. By placing your hand on the mother's abdomen just
above the navel, you can feel each tightening of the uterus as an
increasing firmness or hardness. It lasts for 30 to 60 seconds. The
pains disappear each time the uterus relaxes.
At first these pains occur from 10 to 20 minutes apart and are not very
severe. They may even stop completely for a while and then start up
again. The mother should rest when she is tired but need not be lying
down continuously. She may sleep between tightenings if she can. She
can take a little water or perhaps tea during the entire labor process.
She should urinate frequently during labor so the bladder will be as
empty as possible at the time of birth.
The skin in the vaginal area of the mother should be sponged
occasionally with soapy water. Special attention should be given to
cleaning the inner sides of the thighs and the rectal area with heavy
lather. Soap or water should not be allowed to enter the vagina.
A slight, watery, bloodstained discharge from the vagina normally
accompanies labor pains or occurs before the pains begin.
For first babies, this stage of labor may continue for as long as 18
hours or more. For women who have had a previous baby, it may last only
2 or 3 hours.
The end of this first stage is usually signaled by the sudden pressing
of a large gush of water (a pint or so), caused by the normal breaking
of the bag of waters which surrounds the baby in the mother's womb. For
some women, the bag of waters breaks before labor begins or perhaps as
the first sign of its beginning. This should not cause the mother or
those helping her any concerns. It usually does not seriously affect
the birth.
Through this first stage of labor, the mother does not have to work to
help the baby be born. She should not try to push the baby down, but
should try to relax her muscles. She can help do this by taking deep
breaths with her mouth open during each tightening.
[Illustration: A. At full term, or after 40 weeks of pregnancy, the
baby is ready to be born. The cervix through which baby must leave the
uterus is shown clearly here, still closed. The contractions of the
muscles of the uterus will open the cervix, and force the baby down
through the vagina, or birth canal, to the outside.]
[Illustration: B. At the end of the first stage of labor the cervix is
completely open and the baby's head is beginning to come down through
the vagina. Contractions begin in the lower back and later are felt in
the lower abdomen. At the time shown here contractions are probably
coming every 2 minutes, lasting 40-60 seconds and very strong.]
[Illustration: C. The first stage of labor usually lasts several hours
and is hard work. The mother needs to relax, rest, and be reassured.
Give her water and fruit juices. In this picture the second stage of
labor is well along. It is shorter than the first stage and the mother
will now be pushing down with each contraction, helping to force the
baby into the world. ]
[Illustration: D. The head of the baby has been partially born. This
shows the usual position with the face down and the back of the head
up. The bag of waters in which the baby is enclosed throughout the
pregnancy may have broken at the beginning of labor, before or during
the first stage. It may break now, or have to be torn with the fingers.]
[Illustration: E. Here you see the baby's head turned to the right as
is usual. The shoulders are about to be born. The head must turn so
that the baby's body can fit into the birth canal and come through more
easily. After the birth of the baby there will be further uterine
contractions and the placenta will be separated from the uterine wall
and expelled.]