The Stages of Labour

The process of birth is purely physiological.

It ebbs and flows, stops and starts, peaks and troughs, and basically moves to its own rhythm.
Fear surrounding birth and the powers that be do measure birth so they can assess when to intervene. Intervention is sometimes necessary and in some cases, will save lives,

Interventions happen because hospital guidelines, policies and protocols drive it rather than it being necessary for the individual.

Birth is nothing like the media depicts it to be … although this clip does make me smile as the scientist questions the information … 

 

  • Progress based on how dilated the cervix is
  • Cervix dilated 4 – 5 cm = ‘established’ labour.    The new 6cm
  • This is just snapshot of information, it shows what is happening at that particular moment – Doesn’t tell you what has or will happen
  • Reed, (2015) cervical examinations only happened if labour wasn’t progressing and they needed to confirm it.
  • NOW cervical examinations are ‘offered’ routinely every 4 hours.
  • When do I go in? Some will often end up going in far too early = unnecessary intervention or being sent home.
  • A partogram plots the progress of labour ( ‘The Friedman’s Curve’, (1950)) requires a vaginal examination, to check cervical dilation If not dilated 4cm or more = being sent home unless there has been an event.
  • Admitted you are expected to dilate an average ½ cm per hour. VE every 3-4 hours to check progress. If slow progress or no change labelled ‘failure to progress’ which will then ‘require’ intervention.      Fear Tension Pain
  • A large study in 2010 (Zhang J et al) 62,500 maternal records, research found a wide variation in cervical dilation. The average women began active labour at 6cm and the average time it took to dilate during active labour was about ½ cm per hour. Despite the research, the original Friedman’s Curve is still used.