How to handle contractions in labour

How to handle contractions in labour

According to midwife Alison Brown, the definition of a contraction is 'regular painful tightening of the uterus /womb that lead to thinning out (effacement) and opening up (dilatation) of the neck of the womb'.

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The foetus is thereby pushed toward the birth canal. One of the first signs that you're in labour is that you'll experience what is known as a contraction. There are three phases of labour; early labour, active labour and hard labour.

Braxton Hicks contractions can occur earlier on in pregnancy and shouldn't be confused with genuine contractions. Brown comments that there are clear differences between the different types of contractions; whereas 'labour contractions tend to be nice and regular and all the same strength, Braxton Hicks tend to be irregular and whereas some are strong, others are not so strong.'

Although possibly a little uncomfortable, these contractions should not be painful. You will feel your uterus tighten and then relax. They do not usually last for a long time, perhaps a minute or so and they are also different to real contractions because they are very un-rhythmic and stop and start very randomly. If you think you are in labour, or are confused about Braxton Hicks, it is best

Labour Contractions

Contractions are one of the first signs of labour; if you're experiencing 1 or 2 contractions every hour then your labour hasn't yet begun, but once your contractions are coming more regularly than this, consult your doctor as they will advise you whether you're ready to go into hospital.

Early labour can last quite a long time; although you will be experiencing contractions, they will be bearable. In this early phase, your contractions might be spaced as far as twenty minutes apart. They are likely to become more intense and closer together over a 6-8 hour period. Don't feel that you need to rush to hospital the minute you experience a contraction, as it will probably be quite a while until your cervix is fully dilated.

If you have contractions 15-20 minutes apart that are mild, you're probably best to stay at home. Although it's easier said than done, try to relax and keep your mind occupied; read a good book, watch a favourite film or eat a light meal.  As Brown asserts 'Everyone is different; some women take days to establish and others just go for it!' Although you don't need to rush to hospital when you have your first contraction, it's probably worth phoning the hospital for advice and to put your mind at ease.

Brown comments that 'At any stage you feel you may be in labour you should phone the hospital and they will ask a few questions, make an assessment and advise you if you need to go in.' The same goes for your wellbeing. the general feeling is, head to the hospital when the pain gets too much to deal with at home and you may need gas and air or something stronger.

The above advice applies to anyone in early labour, but obviously once you're in the active phase of labour, your contractions will become more intense and occur more frequently. During this phase of labour, you will measure about 3cm dilated. Your contractions will last for longer; probably between 45-60 seconds and they may occur as often as every 2-3 minutes. It will be more difficult to relax during the active phase of labour due to its intense nature. Your contractions will be increasing in intensity and will be becoming more frequent as your cervix is dilating more rapidly.

Once you're in the second stage of labour, your contractions will change, as they might not be as often, but they will be more intense.

The third phase of labour is called transition or even hard labour. This phase usually lasts between one and two hours and is incredibly taxing for the body, as it's at this time that the cervix dilates to 10cm. Contractions will become very intense during this period and will last for longer - between 60 - 90 seconds - and be more regular, occurring every 2 to 3 minutes.

Contractions vary from person to person and whereas they might be merely uncomfortable for some, for others they might be extremely painful. Brown asserts that for some women, contractions 'feel like a very strong period pain that comes and goes. However, some women get an intense achey feeling in the top of their legs or lower back that comes and goes as well.'

Jenny, 38, from Warwick

'When I went into labour, I was surprised by how similar my contractions felt to period pain. Quite an intense period pain, admittedly, but it's definitely comparable to that. I think I was quite lucky, as I have friends who were quite overwhelmed by the pain.'

Laura, 24, from Edinburgh:

'I have to admit I wasn't prepared for how intense my contractions would be. Although when they began I just felt mildly unwell - I thought I'd picked up a tummy bug - my backache was pretty intense. I found that having a warm bath really helped - it took the edge off the pain.'

Ellie, 28, from Bristol:

'I found the first phase of labour was fine and I managed to keep myself occupied by reading a good book. I even made baked beans on toast for me and my partner and did the ironing! The active phase was a bit more tough, as my contractions became far more intense and painful. I felt as if something tight was being wrapped round my tummy and it was harder to relax - practicing my breathing technique really helped, as it gave me something to focus on.'

Tara, 38, from Bath:

'I went to hospital the minute I had my first contraction, which in retrospect I wouldn't have as I was told to go back home as I had hours yet! I went on a walk in a nearby park with my partner and then went to a local cafe. I wanted to stay in the area so that I was near to the hospital. We even did a bit of shopping! I'd definitely recommend finding any means of distraction while you're in the early phase of labour.'

Sally, 29, from South London:

'My contractions felt like a wave of pressure bearing down on me over and over again! I didn't think they'd feel like that and ended up having an epidural to help with the pain."

Molly, 24, from Dorset:

'Although my contractions weren't that painful, I was actually sick a lot directly after each contraction. I think being sick took my mind off the pain and thinking back, the whole experience wasn't that bad for me (although my poor husband had to watch me being quite sick!)'

Jo, 27, Tunbridge Wells:

'I can honestly say that my contractions weren't that bad! They started off feeling like a dull period pain and grew in intensity over time. My stomach seemed to tighten and harden with each contraction. I actually felt that it was a positive pain because it was brining me closer to meeting my baby!'

There are several steps that you can take to ease the pain of contractions. Brown suggests that 'the use of water whether in the bath or in a pool is very beneficial as too are relaxation/breathing/massage techniques to help you through. It is also important to note that what helps one minute might not help the next and you can always go back and try again.'

Try to focus on the excitement, rather than the nerves - remember that you're going to have a baby at the end and all the pain is worth it, even if it may not seem like it at the time! Brown suggests that you think positively about each contraction and always keep in mind that 'a woman's body is designed to have babies. When you go into labour you know it will not be long before you will see your baby.'

It might be useful to think about each contraction as bringing you closer to having your baby, and also that the pain won't last forever. Some women are surprised that after their babies and the placenta has been delivered the pain usually stops completely and they are able to enjoy meeting their new babies.

Delivery of the placenta

The placenta is expelled by the uterus once the baby has been delivered. Some women prefer to wait for the placenta to deliver naturally, which can take slightly longer than if drugs are used. If you put your baby to your breast or you empty your bladder it can help to speed things along. Blood loss can be a little heavier if you are having a natural stage 3, but this should not be a problem if you have had a straightforward delivery and are healthy. You may feel slight contractions, or one last push as the placenta is delivered.

You can also choose to be injected with a drug called Syntometrine, which contains oxytocin and ergometrine and is a synthetic hormone that encourages the uterus to contract and expel the placenta. You will feel a contraction and the midwife will gently tug on the cord until the placenta comes out. If you had an induction, an epidural or a forceps or ventouse delivery it may be advised that you manage the third stage with drugs. If you definitely do not want a managed third stage, remember to include this in your birth plan and let the midwives know.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

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