Active labour and delivering your baby (second stage of labour)
Once you are in established active labour, you will receive one-to-one care from a midwife. If you’re planning a home birth, you can have as many birth partners as you wish. For a hospital birth, we ask that you have no more than two birth partners present during labour.
During active labour, your midwife will regularly monitor the frequency of your contractions and your baby’s heartbeat. There are two ways this can be done:
1. Intermittent Auscultation: Your baby’s heartbeat will be checked using a Doppler device, and your midwife will monitor your contractions by gently feeling your abdomen with your consent.
2. Continuous Monitoring: This involves two belts—one placed around the bottom of your abdomen to monitor your baby’s heartbeat, and another around the top of your bump to monitor contractions. While the monitor provides continuous information about the baby’s heartbeat, it does not measure the strength of your contractions. To assess contraction strength, your midwife will rely on your descriptions and her ability to feel them through your abdomen.
The first stage of labour ends when you are fully dilated (10 cm), meaning your cervix is fully opened and your baby is ready to be born. At this point, you may feel an overwhelming urge to push, or sometimes, you may not feel the urge immediately. If that’s the case, a brief period will be allowed to let the baby’s head move down and give you time to feel the urge to push.
Pushing can take varying amounts of time. During this stage, you may experience a “two steps forward, one step back” sensation, as the baby moves forward with each push but may slide back slightly when you rest. This is completely normal. Gravity can help move the baby through the birth canal, so it’s important to be mindful of your position during pushing and listen to your body.
Labour can be tiring for both you and your baby. If you are not fully dilated and labour isn’t progressing, a caesarean section may be necessary. If you are fully dilated, but the baby’s head is not positioned well for delivery, we may need to intervene to help speed up the process. This could involve:
. Episiotomy: A small cut in the perineum (with your consent) to help with delivery.
. Instrumental Delivery: A doctor may assist with delivering your baby using an instrument, working with your pushes to guide the baby out. The doctor will discuss your options and recommend the safest instrument for delivery.
In some cases, an instrumental delivery may require a move to the operating theatre. If this happens, only one birth partner is allowed to accompany you into the theatre.