It is not known what triggers the onset of labour, but it is thought to be influenced by the hormone oxytocin, which is responsible for causing uterine contractions.

Some of the signs and symptoms of going into labour may include:

  • Period-like cramps
  • Backache
  • Diarrhoea
  • A small bloodstained discharge as your cervix thins and the mucus plug drops out (this is called a ‘show’)
  • A gush or trickle of water as the membranes break
  • Contractions.

Please call our maternity ward on 55 300 726 if you think you might be in labour.


We will make the time to address
any concerns you have.

Labour and Birth

Labour is divided into 3 stages. 

  • The first stage of labour is the slow opening of your cervix (neck of the womb), which happens with regular contractions of your uterus. 
  • When your cervix is fully opened (dilated) the delivery (birth) of your baby follows. This is known as the second stage of labour. 
  • The third stage of labour is the separation and delivery of the placenta from your uterus.

The second stage of labour starts when your cervix is fully dilated and you will usually soon have a strong urge to push because of the pressure your baby is placing on your pelvic area. This is the time to push your baby out. 

  • For women having their first baby the second stage averages about 1–2 hours. 
  • The second stage is usually shorter for women who are having their second or later baby. 
  • This is only a guide and the birth may be shorter or longer than these times.

There are a few different positions you can be in for the delivery and you can learn about these during your antenatal classes.

As your baby’s head descends, your perineum (the area between your vagina and anus) begins to stretch (this often feels like a burning sensation) – this is when your baby’s head is ‘crowning’. 

You may need an episiotomy (a cut through the perineum) when for some reason, related to your baby or you, the second stage needs to be shortened. Mostly this will not be known until you get to the second stage.

At the birth of your baby, you may like to guide your baby onto your abdomen or chest so you can enjoy your first cuddle.

Your baby’s umbilical cord will need to be cut. Your partner or support person may like to do this.

Pain Relief

Whether you decide to use pain relief during labour, there are a number of techniques that will help you be more relaxed, which can help you to cope with the pain.

  • Learn about labour – this can make you feel more in control and less frightened about what’s going to happen.
  • Learn how to relax, stay calm and breathe deeply.
  • Keep moving – your position can make a difference.
  • Leaning forward over a beanbag or sitting back-to-front in a chair may take the pressure off your back and abdomen.
  • Bring a partner, friend or relative to support you during labour, but if you don’t have anyone, don’t worry – your midwife will give you all the support you need.
  • Ask your partner to massage you (although you may find that you don’t want to be touched).
  • Have a bath.
  • Place a hot water bottle or hot pack on your back or lower abdomen.

The choice of pain relief is yours. The options are:

  1. Gas

This is a mixture of oxygen and nitrous oxide gas. Gas and air won’t remove all the pain but it can help to reduce it and make it more bearable. Many women like it because it’s easy to use and they control it themselves.

2. TENS machine

A TENS machine is a device that delivers small pulses of electrical current that can assist in reducing pain during labour.

3. Opioids

Opioids are painkillers that work to decrease your perception of pain.

4. Epidural

An epidural is an injection that numbs the nerves that carry pain from the birth canal to the brain. For most women, an epidural gives complete pain relief.

Dr Sem encourages you to discuss pain relief options during pregnancy.

Assisted Delivery

Obstetric forceps are sometimes needed to help deliver the baby. 

  • Forceps are specially designed to fit safely around the baby’s head and guide it through the birth canal. 
  • Sometimes the forceps may leave small marks on the baby’s cheeks that will disappear in a few days.

Ventouse is a suction cup that fits on the baby’s head and is sometimes used instead of obstetric forceps. 

  • It is used in a similar way to forceps, to guide the baby through the birth canal. 
  • When ventouse is used, the baby may have a soft tissue swelling for a few days where the cup was.

If your baby requires either forceps or ventouse to help them be born, Dr Sem will discuss this with you at the time.

Caesarean Section

A Caesarean is an operation where an incision (a cut) is made through the abdomen and uterus to deliver the baby. When there is a complication during labour, an emergency caesarean may be required to safely deliver the baby.

Some of the reasons for an unplanned (emergency) caesarean birth include that:

  • Your baby’s head does not move down or ‘fit’ through your pelvis during labour.
  • Your labour does not progress – your contractions are not strong enough and your cervix opens too slowly or not at all.
  • Your baby shows signs of distress or their health is being compromised.
  • The umbilical cord, which provides important nutrients and oxygenated blood to your baby, has fallen down (prolapsed) through the cervix and into the vagina after your waters have broken.

Caesarean sections are usually done under spinal or epidural anaesthesia, however when your baby needs to be born very quickly, general anaesthesia maybe required.

Your partner or support person will be able to accompany you during the caesarean, unless a general anaesthesia is required.

Induction of Labour

Mostly labour will begin by itself, but if there is a risk to the baby or the mother, then labour may be induced. 

  • An induction of labour is when labour is ‘brought on’ (started earlier than would otherwise happen). 
  • Before beginning an induction, Dr Sem will explain the reasons why he thinks you need to have it and what it involves.

There are different methods used to induce labour. These include: 

  • inserting prostaglandin gel into your vagina 
  • breaking your waters (artificial rupture of membranes) 
  • using a hormone in a drip (Syntocinon).

Your labour will not be induced without your consent and Dr Sem will fully discuss the process of induction with you before any intervention.