During my short practice, I have come across different types of pregnant women from different ethnic background all with the same expectations of carrying the fruit of their womb in their hands, loving and caring for the child until the child attains independence!

These would-be mothers usually enroll for antenatal care in a health facility for proper care so that they can have a landslide victory at the expected date of delivery, they attend all the ‘fixed classes’ as prescribed by their health providers and carry out all the assignments but as usual, the exam day (delivery day) is a different ball game altogether.

There is an old adage that says, 'we reap the fruits of our labour'. Co-incidentally, labour is also used to describe a series of events that lead to the expulsion of the foetus and placenta from the vagina. It is a multifactorial process which involves the mother and the baby. Unfortunately, information about labour is not really detailed during the antenatal sessions, making this glorious event look very difficult for first-time mothers. (Primigravida), I'm sure those who passed through this phase of life have lots of stories to share.

This write-up will serve as a ‘behind the scene’ in the events that lead to the delivery of a new-born which is medically known as Labour.

THE LABOUR STORY

Before I start, it is important as usual to lay some foundations for people who may not be medically inclined. When we see a pregnant woman, we see a protruded abdomen, but do you know that beneath that abdomen is a compartment (a room) called the ‘uterus’ which houses the baby until the day of labour? Inside that room, is a door which is medically called cervix, this door can only be accessed only once lol. (Don’t worry; this room doesn't have a window!) So the next time you see a pregnant woman, bear it in mind she is carrying a hidden room with a door inside her which houses the unborn baby.

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After all the antenatal classes, a pregnant woman would have in mind the date of her delivery. This is called the EDD or expected date of delivery. In some women, the EDD may come earlier than predicted; it may be earlier by a couple of days or even weeks. I have seen a woman whose labour came in 2 weeks earlier. However, in others, the EDD can be delayed!

Before a woman starts labour, she must have experienced some symptoms, the one worthy of mention is called SHOW! This is a bloody discharge seen from the vagina. This bloody discharge originates from the cervix. Remember that door I talked about earlier? When this door slowly opens, it is beckoning on the foetus to exit from the Uterus! This means that any blood seen around the expected date of delivery is an indication for labour.

The labour proper is usually divided into three stages for ease with reference to the foetus (unborn baby)

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STAGE 1

These are the series of events that precede the door opening (cervical dilatation). The medics divided this into a latent phase and an active phase; I do not think you should worry about this! But the take-home lesson from the first stage of labour is that when the door is about 4 cm wide to about 10cm wide, a woman is said to be in an active phase of labour. Please note that 10cm is the maximum the door can open. This usually takes a lot of time for first-time mothers. It is estimated to last for about 8 hours! It has been proven that this door opens at the rate of 1cm per hour until it is wide open.

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STAGE 2

This stage starts counting from when the door is fully open (10cm) up to the point that the foetus makes a debut appearance outside the room. Research shows that this event takes about 30mins to 2 hours to be completed. Imagine having the knowledge that your relatives' flight would take max 2hrs before landing; you waited at the airport and did not see the flight. Obviously, something may have gone wrong. If the foetus does not get expelled during this calculated time, then it may be a cause for alarm.

STAGE 3.

This is the final phase of labour, it starts immediately after the foetus makes his appearance and ends when the lunch box (Placenta) emerges from the cervix.

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Oops, I forgot to mention the placenta! By the way, how did you think the foetus survived 9 full months locked up in that room? It’s obvious with the support of the placenta that nourished the foetus during the imprisonment. This 3rd stage has a very short duration. It should not last more than 30 mins.

Having had a bird's eye view about labour, it is also important to know the factors that have an influence on labour! The 4-P's mnemonic can suffice :

• Power
• Passage
• Passenger

POWER

Remember the room the foetus was housed? It was medically called uterus! The uterus is actually made up of muscles which are supplied by different nerves. These nerves control the contraction of the uterus. This contraction is perceived as pain by a woman in labour. When the contractions are not adequate, it may affect the normal course of labour.

PASSAGE

Sometimes, the foetus can overgrow inside its room, and may not be able to pass through the door. This would definitely pose a problem during the second stage of labour. The contractions may be adequate, but the foetus may not eventually exit the door!

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PASSENGER

This simply refers to the foetus we have been talking about. The lunch box (placenta) could also fall into this category. Like it was earlier mentioned, the size of the foetus can affect the progress of labour.

PSYCHOLOGY

This refers to the mental status of the woman in labour. There are some women who may doubt their ability to sail through the labour experience. These women have to be encouraged at all stages!

CONCLUSION

It is important to note that every labour may not necessarily happen the same way; women have different stories of how theirs went. The interesting part of the story is that all events happened exactly as I described above.

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My behind the scene narration of labour should give expectant mothers a guide on what to expect during each stage of labour.

Thanks for reading.

REFERENCES

• Stages of labour (giving birth) information | myVMC
• Normal Labor and Delivery
• wikipedia-Childbirth

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