In this video, midwife Katrine Ellegaard from Hvidovre Hospital talks about the time before, during, and after labour.  

Where would you like to give birth?

You have the option to give birth either at home, at the maternity clinic or at the maternity ward?

At home:

• Low risk pregnancies
• Home birth team
• Home birth café

Maternity clinic:

• Low risk pregnancies
• Smaller unit, within the hospital
• Designed to be as home-like as possible

Maternity ward:

• Low risk pregnancies with a need for medical pain relief
• Highly specialized pregnancies

Discuss with your midwife what is important to you when giving birth.

Due date

Babies arrive on the day, they are ready. On average, first-time births start four to seven days later than 40 weeks. Only five percent of mothers deliver after exactly 40 weeks. 95 percent deliver before or after, and lots deliver after. It's a perfectly normal pregnancy if it lasts from 37 to 42 full weeks.

How does labour start?

Labour kan start in basically two ways

• Waters breaking: Labour starts with the waters breaking in c. 10 percent of cases.
• Contractions: For the majority of women, labour starts with contractions.

The "prelude" of labour

In the initial phase of labour – the prelude – you can experience back ache, Braxton Hicks contractions, period pains, bleeding, a bloody show.

During the prelude it is important to activate your body's relaxation system, which predominates when you are relaxed, feel safe and are given affection and intimacy. This hormonal system is your friend during labour. The partner plays an important role in helping the woman activate her relaxations system and making her feel safe.

What to do during the prelude?

• Rest
• Eat and drink
• Use a heating pad
• Take a warm bath
• Breath deeply
• Watch a good movie
• Perhaps take a gram of paracetamol (two tabs)

You can't miss your own delivery, so if you feel like something is about to start, the best you can do is to relax.

What happens during labour?

When you start having contractions the cervix gets softer and shorter, the mouth of the uterus begins to dilate. The contractions grow in strength, duration and number. When the mouth of the uterus has dilated 10 centimeters the baby's journey begins. You can't tell how dilated you are. The midwife will check it when you arrive.

When to call the delivery ward?

• Always call us if your waters break. The admission would like to know when and know the colour of the water.
• Phone with three contractions every ten minutes. Each must last c. 60 seconds and have been uniform for a couple of hours.
• If you are worried

Call us if you experience

• Bleeding that's more than just a spot but more like period bleeding
• If you baby isn't as lively
• A constant intense pain
• If you feel discomfort and doubt

Admission

The midwife will meet you and estimate the size and position of the baby. The midwife will also listen to the heartbeat of the baby and do an internal examination of you to see how much you have dilated.

The midwife will check whether you are in the initial phase of labour or if you have reached the active part of labour.

If you are in the early stage of labour, perhaps you will need pain relief, go for a walk or go home again.

If you have reached the active phase of labour, you will be transferred to a delivery room, and perhaps you will get pain relief and an enema.

Handling the pain

Do your breathing to create relaxation during tension. Think of the pain as a constructive pain, as it helps you deliver your baby, and remember contractions are not dangerous.

The midwife can help you with:

• A "cocktail" – a mixture of a pain killer, a sedative and a muscle relaxant
• Morfine
• Massage
• Acupuncture
• A heating pad
• A bath tub
• TENS
• Sterile water injections ("bee sting")
• Oxygen
• Rebozo
• Pudendus block
• Epidural

You can always ask the midwife about different kinds of pain relief, how it works, side effects and alternatives.

The role of the partner during labour

As a partner you play an important role in supporting and encouraging the woman.

It is also important that you remember yourself. Being in a delivery room is intense, so remember to get outside and breathe.

You can help the woman by:

• Massaging the lower back
• Holding hands
• Helping her remember the breathing technique
• Provide food and drinks, a cold cloth for the forehead, a heating pad
• Helping her out to the bathroom and helping her move

If the contractions stop or take a break

Don't worry if the contractions stop. At first you should enjoy the break, rest and get something to eat and drink. When it is time to restart the contractions, getting you up and about may help. Food and drink and acupuncture can also help. If that doesn't work, we may poke a hole in the foetal membrane or offer you an IV fluid to induce contractions.

The last part of the dilation phase

In the last part of the dilation phase, the mouth of the uterus have dilated 8-9 centimeters. For some this is the most painful part of giving birth. The baby's head is close to the pelvis floor, and you will start to feel a growing urge to push. In the last part of the dilation phase, the baby will begin to move its way through the pelvis.

The pushing phase

When the baby's head has passed the narrowest place in your pelvis, you will start to feel an urge to push. It feels like the need to go to the toilet. The mouth of the uterus is 10 centimeters open. The baby's head is on the pelvis floor. You must push actively when you are having contractions. For this phase the midwife and the mother-to-be must cooperate closely. We ask you to alternate between panting and pushing. The midwife will support the area between your vagina and anus as the baby's head is born to minimize tearing.

After birth

You will get the baby in your arms.

We give them an APGAR score based on five parameters.

You will be offered a Syntocinon injection. It is artificial oxytocin and helps to prevent major bleeding after birth (excess of 500 ml). The baby is offered an injection of vitamin K.

Afterwards you will be delivering the placenta. It may take an hour. It doesn't hurt. We offer the partner to cut the umbilical cord.

Tearing

The midwife will examine you vaginally and anally to see how much is broken.

8 out of 10 first-timers tear when they give birth. Most of you will have first or second degree tears. Your midwife will sew them up in the delivery room. You will be given a local anaesthetic to prevent any pain. The stitches will dissolve within 8-10 weeks, and the tear will heal within a month. Contact us if something doesn't feel right.

Monitoring devices during labour

During labour the midwife monitors how the baby is doing by using a CTG and a scalp-ph.

A CTG measures the baby's heartbeat and your contractions. A scalp-ph is a tiny blood test taken from the baby's head.

If we think the baby is better off outside the womb, we can offer to help them out using a vacuum cup.

Caesarean

If you need a ceasarean section, you will be taken to the operating theatre and get a spinal. The operation takes about 30 minutes, and your partner can come with you. After the caesarean you will be wheeled to the recovery room, where you will be for a couple of hours before being transferred to the maternity ward.

The needs of the newborn

Once the baby is born, it needs as much skin-on-skin contact as possible. Give your baby rest, closeness and warmth. This will give your baby the best beginning of life.

When will we go home?

If mother and baby are doing well after an uncomplicated birth, you can go home after 4-6 hours.

Some choose to stay at the maternity unit. You can stay here for one or two nights, and midwives and nurses will help you if needed. Your partner must pay a small amount. The visiting hours are open.

2-3 days after birth

2-3 days after birth you need a checkup at the hospital. We will check how mother and baby are doing, ask how the nursing is going, and do a PKU-test and hearing screening of the baby.

Hvidovre Hospital wishes you a good birth.