Posted on
01 June 2010, under
Dad-To-Be; More Dad-To-Be articles...
They think it's all over...!
Is it Starting?
It is quite common that your partner will have some contractions over the last few months of pregnancy. These are known as Braxton Hicks contractions, are more uncomfortable than painful, are not regular and do not gradually increase in intensity. The pains in labour will occur with increasing frequency, and become gradually longer and more painful.
She may also have a “show” – this is where the mucous plug at the neck of the womb is released, and labour normally follows within 24-48 hours of this.
The other indicator of labour is when her waters break – this is where the sac surrounding the baby bursts and the fluids enclosed in this sac are released – this may not happen until well into the labour. The one advice I would give you is that if you are not sure whether your partner is in labour or not then you (or if you partner is able!) should contact the maternity ward and discuss things with the midwives.
Breathe, Breathe, Breathe.... PUUUSSH!
So this is what the past nine months have been all about. Once labour has become established, then the cervix (neck of the womb) will gradually open with each contraction – this is what the “x centimetres dilated” refers to. The cervix typically dilates at an average of 1 cm/hour (although this varies hugely), and your partner will only start to push with the contractions when the cervix is fully dilated at 10 cm. The progress of the cervix will be monitored by the midwife (or obstetrician) performing vaginal examinations.
There are many types of pain relief used during labour as detailed here. You may feel as useful as a chocolate teapot during the contractions, and your role is to support your partner, do whatever she tells you to do, and to instantly forget any abuse aimed in your direction. The baby will be monitored intermittently by applying sensors on to your partner’s abdomen. These monitor your baby’s heart rate and the contractions of the womb.
Once the cervix is fully dilated then your partner will be instructed to push with each contraction. You are now less than an hour away from seeing your baby. At this stage just do what you are told by the midwife and your partner. Your main role is usually to support your partner through the painful contractions and the pushing. After a while the baby will “crown”, and you will be able to see the top of the head – almost there now! Within a few minutes baby will have been delivered and you might get the opportunity to cut the umbilical cord.
The midwife will clean the secretions off baby, and present the proud parents with the fruit of their loins. Baby may still be covered in some secretions, and it is quite normal for the skull to be a little misshapen due to the trauma of the journey down the birth canal, and this will resolve over the next few weeks. Baby is usually put in against their mother’s chest to rest after their arduous trek.
If baby is not progressing fast enough towards the end of the labour, especially if they show any signs of distress, then the midwife or obstetrician may need to intervene. A suction cup may be placed on top of baby’s head, and this can be used to increase traction to help baby out (a “vacuum” or “ventouse” delivery).
Alternatively, two blades of a forceps are put either side of baby’s head and these are used to pull baby out head first (a forceps delivery). If either of these methods are used then baby may well have some bruising around the head but this will settle over the following few weeks. If baby is getting stuck as he exits from the birth canal, there is a risk that your partner will tear and the midwife may perform an episiotomy to prevent a bad tear. This involves cutting the perineum (skin beside the labia) which will then be stitched after labour is complete.
After baby has been delivered the placenta is still in the womb, and this is delivered over the hour or so after baby has been born. The midwife will also do an examination of your partner to see if any tears are present or if she needs to have any stitches. You can both now relax and enjoy your new baby.
Caesarean Section:
About 20% of births in Irish hospitals are performed as caesarean sections. These can be planned sections performed on a date scheduled prior to the onset of labour due to anticipated problems such as multiple births, several previous caesarean sections or problems with the position of the placenta. Some births start as regular vaginal deliveries, but if the labour does not progress as expected especially if baby shows signs of distress, then the decision is made to change to performing a section. Once this decision is made then the section is performed as soon as possible.
The Caesarean section is performed in an operating theatre. The father is usually allowed to sit in on the procedure but will need to change into surgical scrubs or put on a gown over his clothes. The procedure can be done using an epidural anaesthetic, which means that mum is awake through the whole procedure. If there is not adequate time for an epidural to be performed then sometimes a general anaesthetic is used. The skin incision is made from left to right across the lower abdomen near the bikini line, and the obstetrician then cuts down to the womb and makes an incision to remove the baby. There will often be a Paediatric doctor also present to give baby the once over after he arrives.
Today is the First Day of (the rest of) your Life:
There is no going back now. The extraordinary adventure of parenthood has now started, and things will never be the same again. One parting pearl of wisdom to share with you – get in as much sleep as possible before the event, because this soon becomes a distant memory. Actively enjoy every last lie-in – feel free to write reflective essays on long sleeps or to video them for posterity – as you will soon forget what that feels like. Needless to say it will be worth every second of it, and as was said to me after the birth of my first son “Now you know that you’re alive”.
Dr. Sean Hogan is a General Practitioner working in Waterford City. He went to college in UCC, and trained initially in Cork in a variety of medical speciallities. He then moved to Waterford, where he worked initially in hospital medicine before completing specialist General Practitioner training. His clinical interests include prevention of heart disease and diabetes, men's health and dermatology.
He feels strongly about the use of appropriate everyday language to explain medical terminology properly to patients, as he feels that this allows them to become more involved in their own healthcare. His other main qualifications for writing on fatherhood are Darragh (approaching his third birthday) and Ewan (aged six months).
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