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Labour

The experience of labour and childbirth differs in every woman.  Common initial signs of labour include strong regular contractions, backache, draining of water (amniotic fluid) or sticky and mucous-like substance from the vagina.  The average length of labour is approximately 12-18 hours, but this varies widely between women depending on multiple factors.  The most common risks and complications that may occur during labour are discussed below:

Preterm Labour

Preterm labour is defined as labour beginning before 37 weeks of gestation.  The normal gestation period of pregnancy is considered to be 38 to 40 weeks.  A baby born prematurely is at a higher risk of complications such as immature lungs, respiratory distress, and problems in digestion.  This is because organ systems are not usually fully developed before 38 weeks gestation.

Your doctor will manage this situation with medications that stop labour and prevent infection where possible.  Sometimes it is not possible to entirely delay a premature labour and birth, in which case there are steps that can be taken to make the baby as healthy as possible at birth including medication to accelerate the baby’s lung development.  You will be advised to take bed rest, usually lying on the left side.  The appropriate intervention and treatment for preterm labour is evaluated on a case-by-case basis and you will be closely monitored by doctors and nurses in the hospital.

Prolonged labour

Some women, most often during their first pregnancy, may go through a labour that lasts for too long.  Prolonged labour may lead to infection if the amniotic sac has ruptured.  Antibiotic medications may be administered to prevent infection.

Abnormal Presentation                          

During labour, the baby normally moves to a head-down position with the back of the head ready to enter the pelvis. Sometimes, the baby may present with buttocks or feet first towards the birth canal.  This is called breech presentation.  In some cases, the placenta may block the cervix (known as placenta praevia) and cause abnormal presentation.

Abnormal presentation increases the risk of injuries to the uterus or birth canal as well as the baby.  Breech presentation may lead to a prolapsed umbilical cord which can cut off the blood supply to the foetus.  Your doctor will check the presentation and position of the baby with physical examination and ultrasound scan.  Assisted delivery methods may be adopted in such cases.

Premature Rupture of Membranes

Rupture of the membranes that surround the foetus in the uterus may occur prematurely leading to high risk of infection.  In these cases, an emergency delivery will be undertaken by your doctor.

Umbilical Cord Prolapse

The umbilical cord transports oxygen and nutrition to the baby.  An umbilical cord prolapse occurs when it slips into the cervix before the baby during labour.  The cord may be felt if it protrudes from the vagina.  This is an emergency situation as the blood flow to the baby through the umbilical cord may get obstructed and assisted delivery methods may be undertaken in such cases.

Umbilical Cord Compression

During labour, the umbilical cord may get compressed leading to decreased blood flow to the foetus.  This causes an abrupt drop in the foetal heart rate.  In cases where the foetal heart rate has slowed too much, or if there are signs of distress, your doctor may consider a Caesarean section.

Amniotic Fluid Embolism

Amniotic fluid embolism occurs when a small amount of amniotic fluid from the amniotic sac enters your bloodstream during a difficult labour.  This fluid may travel up to the lungs and cause constriction of the lung arteries leading to a rapid heart rate, irregular heart rhythm, cardiac arrest and death.

When to contact the hospital

Once labour begins you will need to contact the hospital in which you are booked to have your baby.  You will then be advised by the midwives in delivery suite when it is appropriate for you to go into the hospital.

If you are booked at St Vincent’s Private call 9411 7111

If you are booked at Epworth Freemasons call 9418 8188

If you feel fine and are coping with the contractions it is safe to remain at home for as long as possible. If you are unsure, or do not feel safe at home, contact the hospital and follow the advice of the midwives.

As a general guide you will normally be asked to come to the hospital when:

  • You are experiencing regular painful contractions every 5 minutes or less
  • Each contraction is lasting about 45-60 seconds
  • You need to concentrate and cannot talk whilst you are having a contraction.

You MUST ring the hospital:

  • If you feel the “waters” break or are leaking any fluid
  • Experience any vaginal bleeding
  • If you feel your baby’s movements are much less than what you normally experience

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