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Afl. 8: weeën, ontsluiting, persfase, oxytocine & adrenaline | Amstermam Verloskundigen
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Episode 8: contractions, dilation, pushing phase, oxytocin & adrenaline

I am in labor

Your water has broken or you're having irregular contractions. The baby is on the way!

Call your midwife when:

  • The contractions are coming every 3-4 minutes and lasting about 60 seconds for 1-2 hours.
  • If your amniotic fluid is green or brown in color.
  • You are losing more blood than during a menstrual period while having contractions.
  • You are worried or need us for any other reason.

Please note:

  • If your water breaks, the amniotic fluid is clear, the baby was positioned low at the last check-up, and it's nighttime:
  • Get some rest; chances are that contractions will start soon.
  • If you haven't started having contractions, please let us know around 09:30 in the morning.
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Dilation

Contractions often start irregularly and are short. They naturally become stronger when you relax, or they may subside and resume after a few hours or days. During this initial phase, called the latent phase, your cervix shortens and begins to dilate. While contractions are irregular, it's best to do things you would normally do on a relaxing weekend day. This conserves your energy for later.

The active labor phase begins when contractions intensify, occurring every 3 to 4 minutes and lasting about 60 seconds each. From this point, labor typically does not exceed 24 hours. On average, this phase lasts 10-12 hours for a first child and around 4 hours for a second. The cervix, which had thinned out, continues to dilate up to 10 centimeters: full dilation. Meanwhile, the baby descends deeper into your pelvis and rotates with its back towards the front.

To the hospital

When you want to give birth in the hospital, we will move there when you have strong contractions and are dilated between 4 and 7 centimeters. If we leave earlier, there's a chance the contractions may stop due to the adrenaline from the new situation. Your midwife will call to check if there's a spot available at the hospital, and she will explain where you can park, etc.

Oxytocin and adrenaline

The labor hormone oxytocin increases steadily during labor, giving women powerful contractions. The presence of adrenaline counteracts oxytocin. Ensure as much oxytocin and as little adrenaline as possible by:

  • heat (turning up the heating and wearing warm socks!)
  • soft sounds & dimmed light
  • love: cuddling
  • turn off the sound of the phones
  • seeking a quiet environment with few people

The pushing stage

At the end of the dilation period, during the peak of a contraction, you feel like you need to have a bowel movement. You let this happen, and it naturally lasts longer each time. When you feel throughout the entire contraction that you need to push the baby out, you will go along with it. The pushing stage begins!

During the pushing phase, you still have contractions with pauses in between. These pauses often become longer. You and your baby can rest during these pauses. You push the baby through the pelvis and pelvic floor. This typically lasts about an hour for your first child and 20 minutes for a second child. The position you choose for pushing is determined at the moment itself, together with the midwife.

After the baby is born, we always place them on your belly because that keeps the baby warmest. We'll ask if you or your partner would like to cut the umbilical cord. If there's a need for stitches, we do this while the baby is with you, possibly already breastfeeding. Only after that do we thoroughly examine and weigh the baby. We recommend giving every newborn 6 drops of vitamin K after birth, which promotes blood clotting. After a week, you'll start giving vitamin K to the baby yourself. Read more about this in episode 9 'I have just given birth'.

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Transfer of care

To the gynecologist

During childbirth, there may be reasons to involve a gynecologist. For example, if the baby has passed meconium (stool) in the amniotic fluid, if labor is not progressing, or if you request pain relief. You may find the most anxiety-inducing reason for transfer is due to your child's condition, though fortunately, this type of transfer occurs the least (<1%).

Initiative

When your midwife transfers care to the hospital, she will leave once you are settled. In the hospital, there won't be continuous support. Therefore, take initiative to stay active. Sitting on a birthing ball, standing beside the bed, or using a birthing stool are also suitable in a medical setting. At OLVG-West, you can even choose to give birth in a bath if you wish.

Pain during childbirth

Nearly all women experience labor pain as intense. How to cope with it physically and mentally is covered in episode 7:'I am preparing for childbirth.' Pain relief options are also discussed there.

Hospital bag

If you go to the hospital, take the following items with you.

  • papers/midwife folder
  • ID card and insurance card
  • clothing for yourself
  • clothing for the baby (long-sleeve onesie, pants, sweater, hat)
  • baby blanket
  • car seat (Maxi-Cosi)
  • photo camera
  • phone charger
  • clothing + toothbrush for partner
  • coin for the wheelchair
  • You don't need to bring the maternity package, diapers, muslin cloths, and towels.
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and more..

For partners

  • Help remind her that every contraction passes, especially when she finds it tough at the peak of one.
  • Make sure to keep eating and drinking yourself.
  • When you are fit yourself, you can coach and support better.
  • Trust that you know your girlfriend or wife best, making you the best coach she could wish for!

Listening tips

  • Hypnobirth CD Marie Mongan
  • Playlist ‘hypnobirth’ op spotify
  • Doula-app
  • Playlist amstermam

To do:

Keep breathing. Every contraction will pass, really!

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