Dr Krishnaveni Nayini

Normal Deliver & Benefits

Beginning with the division of cells at the microscopic level, childbirth is a miraculous journey of formation of another little human over nine long months. As this journey comes to an end, the body starts signalling the mother-to-be in various ways, labour pain being the final stage which ultimately results in childbirth. Normal delivery is the delivery of a baby naturally through the vaginal canal. It starts with the inception of labour pain and culminates with the delivery of the child.

What is labour pain?

Labour pain is the recurrent pain felt by a woman during childbirth. Different women may narrate different tales of labour as the experience of labour pain is complex and subjective.  Several factors affect a woman’s perception of labour making each experience unique. Many pregnant moms wonder how labour will feel, how long it will last, and how to know whether it’s the real deal or a false alarm. Though it’s hard to predict the answers to all those questions, since every birth is different, but knowing what labour is and what signs to look out for is certainly a great help to find when it’s almost time to meet your baby.

Signs of labour that you should look for

As you approach your term and begin going into labour the body starts signalling for it in various ways. These begin as pre-labour symptoms which one may experience first and then progress to early and active labour.

The very early signs also known as the pre-labour symptoms are as mentioned below:

Baby drops: This sign which is more evident in first-time pregnant women appears due to the descent of the baby into the pelvis. The baby once ready to come out through the vaginal canal, descents and engages its head in the cervical canal. With this sudden drop which may happen 2-4 weeks before the time of delivery, you may experience several changes. With the baby occupying a lower position breathing and eating becomes better, but the urge to pee may increase, and walking may become more difficult. This “lightening” may not be experienced by all and is even rarer in second and subsequent time moms.

Cramps and increased back pain: These appear and are experienced because the muscles and joints are stretching and shifting in preparation for birth.

Loose-feeling joints: You may feel that the joints all over your body are a bit less tight and more relaxed. This occurs due to the surge in relaxin hormone in the body and is nature’s way of opening up the pelvis to make way for the passage of the baby.

Diarrhoea: This too can be present because of the relaxation of the muscles in the rectum. Diarrhoea presented at such a time is normal and one should only take care to stay hydrated. 

Weight gain stops: By the end of pregnancy, your weight may just level to a constant or even fall a little bit. This does not affect the baby’s weight and may present due to increased activity by the end of pregnancy.

Nesting instinct/ Sudden urge to bring order to your home: Some mothers to be may experience a sudden urge to organise and clean their home. This nesting instinct is good, as long as one doesn’t overdo it.

Other signs: Other than the above heavier vaginal discharge, mood swings, and disturbed sleep can also present as a very early sign of labour.

Active labour

Loss of mucus plug and vaginal discharge changes: Mucus plug seals off the uterus from the outside world like a cork. This mucus plug may be lost as a single thick piece or as lots of little ones. The thickened pinkish discharge is a good sign and indicates that labour is about to begin or has already begun.

Stronger more frequent contractions: With true labour start true contractions. While one may already be experiencing practice contractions or Braxton Hicks contractions for weeks or even months before delivery, true contractions differ from these. The frequency, length, and intensity can help you figure out whether you are in true labour or not. Below are some points about each contraction that can help you discriminate between the two.

Braxton Hicks contractions (Practice contractions/False labour)

  • Are infrequent, and usually happen no more than once or twice an hour, a few times a day.
  • These often stop if you change your activity. For example, change sides if you are lying down and these may stop, or walk if you have been sitting for too long and they may go.
  • These are usually irregular, or if they are regular, they stay that way for a short spell.
  • Won’t last long, they are usually less than a minute.
  • Continue to be unpredictable and non-rhythmic.
  • Don’t increase in intensity.
True labour contractions
  • Are noticeably longer than Braxton Hicks contractions.
  • Are more regular.
  • Are more frequent: Frequency doesn’t always increase in a regular pattern, but it does gradually increase.
  • Increase in intensity: as time goes on, these often fall into a regular pattern. Each contraction won’t necessarily be more painful or longer than the one before it, but the intensity tends to build over time as labour progresses. Braxton Hicks contractions come and go without getting more intense over time.
  • These don’t go away when you rest, sleep or change positions unlike how it is with Braxton Hicks contraction.
  • Early real labour contractions could feel like strong menstrual cramps, stomach upset, or lower abdominal pressure. Pain could be in the lower abdomen or both there and in the lower back, and it could radiate down into the legs. The location of the pain isn’t as reliable an indicator of true vs. practice contractions, though, because Braxton Hicks contractions can also be felt in all those places.

Water break

This is leakage of amniotic fluid with a gush or trickle, upon the rupture of membranes. Your water breaking is one of the final signs of labour most women experience — and it happens naturally in only around 15 percent of births or fewer. At whichever stage one experiences this, one should call the doctor and let them know about it.

When should you call your doctor?

You should always call your doctor when:

  • You experience any bleeding or bright red discharge
  • Your water breaks — especially if the fluid looks green or brown. This could be a sign that meconium, or your baby’s first stool, is present, which can be dangerous if your baby ingests it during birth.
  • You experience blurred or double vision, a severe headache, or sudden swelling. Such signs are typical of pre-eclampsia which is characterized by pregnancy-induced high blood pressure and requires medical attention.
  • Your baby is moving less than usual.
  • Your contractions are coming every five minutes and last for a minute each.

Ways to cope with labour pain

  • Practice rhythmic contractions: Practicing specific breathing techniques can be a great way to deal with labour pain. It’s advisable to breathe fully in a slow rhythm with contractions. A slow deep breath should be inhaled with each contraction, paused, and then one should breathe out slowly.
  • Take help of imagery and visualization: Take help of something that you find good looking at, this can help divert your attention and make you feel better.
  • Listen to your favorite music: Plug your earphones and indulge in some music you like. You can consider having a labour playlist ready for this time.
  • Take a warm shower: This can relax your body and make you cope with early labour pain.
  • Consider taking a soothing massage: Any sensation of touch helps release oxytocin in the body thereby relaxing you. A gentle massage or just holding hands with loved ones can help.
  • Walk: Moving around can be more comfortable than sitting or lying down in one position. Try different postures, one will be better than the rest.
Painless normal delivery

Natural delivery can be painful, opting for epidural anaesthesia eases out the labour pain and helps one deliver painlessly through the vaginal canal. An epidural is used to block nerve signals -the ones responsible for feelings of pain, from the lower part of your spine. It’s administered through a catheter that is run through a large needle inserted into the epidural space that surrounds your spinal cord. The catheter remains in place during labour and delivery to continue delivering the medication. Depending on the health of the baby and your pregnancy, epidural may be an option for you.

Dr. Krishnaveni has vast experience and has conducted multiple painless deliveries under epidural anaesthesia.

Benefits of Normal delivery

Some benefits associated with normal delivery are-

  • It prevents any risks associated with an open c-section delivery.
  • Lower risk of infection in mother and child and associated with natural delivery
  • The mother recovers quickly and the hospital stay is reduced as opposed to a c-section
  • The natural microorganisms of the vagina transferred from mother to child boost the baby’s immune system.
  • Babies are at lower risk for respiratory problems since the labour contractions help prepare the baby’s lungs for breathing
  • Normal delivery helps stimulate lactation

Dr. Krishnaveni Nayini has vast experience of over two decades in conducting natural and painless deliveries. She is a senior obstetrician and gynaecologist practicing in Hyderabad, India.