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Nine Months : First Stage of Labour - Dilation of Cervix

What happens in this stage?

In the first stage of labour, the cervix dilates from a closed position to 10 cm/4 inches when it is said to be fully dilated

* The cervix is closed all throughout pregnancy and begins to efface(thin out) and then dilate(open up) when it is ripe and the baby is ready to be born.

* Although your waters may have broken or you may had a show, officially, labour is said to be established only when the cervix has dilated to a minimum of 3cm.

* Most hospitals take you in if you are in established labour. If you are less than 3cm dilated, you may be given an option of going back home and relaxing and coming back to the hospital when the contractions get more intense. However, this routine may vary from one hospital to another.

* It may take upto 12 hours or more (from established labour) for the cervix to become fully dilated.

* Sometimes the labour may need to be speeded up. The first attempt at doing so is to break the waters(if not already broken). This helps to speed things up. If further acceleration is required, the doctor will recommend oxytocin intravenously so that contractions can be speeded up. You will be offered explanations at all stages.

* The end of the first stage called 'transition' is the most difficult time in labour. It lasts for upto an hour and contractions are strongest at this time.

Which positions are best at this stage?

Most hospitals encourage moving around in early labour. You may want to adopt one of the positions learnt in your antenatal classes during these early contractions. If you feel the pain of labour in your back, rocking your pelvis rhythmically in one of the forward positions may help.

Some common positions include:

* sitting against a table relaxing forward

* kneeling against a chair or piled pillows relaxing forward

* On all fours

* Leaning against your partner

* Standing, leaning your back against a wall with feet well forward

* Sitting the wrong way round astride a chair relaxing forward onto the back (you may wish to place a pillow in front of your tummy)

What can I do to help myself?

* Ensure that you have someone with you during labour.

* Choose a comfortable position and go through your relaxation.

* The contractions will get stronger and more painful. Think of them as the 'hills' or 'waves' which you have to ride over on your journey towards the baby.

* Try to take your mind off the contractions and distract yourself by talking, singing or even reading.

* When the contraction starts, give a long sighing breath out, keep relaxed with natural easy breathing throughout the contraction.

* As the contraction builds up you may find the pace and level of breathing alters - just keep it low key.

* End each contraction with a long sighing breath out.

* Immediately check through your body mentally (with the help of your partner), and get rid of any tension so that you start the next contraction completely relaxed.

* If at the peak of the contraction you feel you are about to tense up, switch to the "S.O.S." breathing ("Sighing Out Slowly") learned in your class. It helps if your partner does this with you.

* Pass water often to keep your bladder empty and preventing it from coming in the way of your baby.

* If your labour is long and difficult, be ready to accept further pain relief if and when you need it, in consultation with your midwife

How can my partner help?

Your partner (or other supporter) can help in the following ways:

* Encouraging you to relax and breathe calmly

* Rubbing your back

* Suggesting a change of position

* Cooling your face with a wet flannel

* Offering sips of water

* Giving you emotional support and encouragement

* Acting as a mediator between you and the hospital staff if you are not up to it.

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