Pregnancy and Parenting education
(Antenatal classes/childbirth education)
Plunket’s pregnancy and parenting education gives pregnant people/whānau, their partners, support people and families/whānau the opportunity to:
- learn more about what will happen to them and the care they are likely to receive during labour and birth.
- develop strategies to assist them through labour.
- understand what happens after their baby is born.
- meet other parents-to-be.
Choosing Where to Labour and Birth
Over the past few decades studies have revealed that the birthing environment has a significant impact on a whānau during labour and birth. This research shows that where a pregnant person/whānau labours influences both the progress of their labour and their birth outcome. For more information talk to your LMC about your birthing options, come along to one of our pregnancy and parenting classes or click here to order a copy of the maternity services consumer council pamphlet, "Choosing where to have your baby".
Preparing for birth
Every birth is different, and babies vary in when they arrive and how long they take to do so. Your LMC can answer any questions you might have about your labour and the birth and how you should prepare.
Your LMC will provide information to help you develop a birth plan:
- where to have your baby.
- who you want to be with you.
- what sort of environment you want and what position you may want to be in for giving birth.
- choices for monitoring your labour, interventions that may be needed and treatment for things that don’t go to plan.
- how to get breastfeeding started.
- how long to stay in the hospital (if you go there) and plans for going home.
- handling of placenta/whenua according to your wishes and culture.
- support options for you after the birth and risk factors for postnatal depression.
Think about who you would like to support you at your baby’s birth. You may wish to have only your partner with you, or you may like other members of your family/whānau. You may have special cultural or spiritual practices that you wish to have for labour and at the birth, such as prayers/karakia.
You may wish the placenta/whenua to be kept and returned to you according to Māori tikanga and kaupapa. Make this and any other preferences known to your LMC as part of your birth plan or birth preferences.
Click here for more information on your options for care during labour and birth.
The stages of labour
There are three main stages in labour. The time taken for each stage will vary from person to person. In the first stage the cervix opens, in the second stage the baby moves down through the vagina and is born, and in the third stage the placenta/whenua comes away from the wall of the uterus and is pushed out through the vagina. The membrane that holds the amniotic fluid and your baby (often called ‘the waters’) can break at any time. Often this happens near the end of the first stage or at the beginning of the second stage of labour. Sometimes the waters are deliberately broken to help get labour started.
When you think you are in labour, tell your LMC. They will then advise you what to do next. Your LMC may visit and assess you in your home or meet you at the maternity hospital, or they may make some other suggestion(s).
Variations in labour and birth
No two births are the same.
Start thinking about what pain relief you want during labour and the birth. Some strategies, such as relaxation and breathing techniques, keeping upright and mobile, a warm bath or shower, a birthing pool or a TENS machine, can be helpful. Medicines/rongoā, massage/mirimiri and prayer/karakia can also be helpful, as can homeopathy or aromatherapy. As you prepare for labour and the birth, discuss with your LMC any questions you have about relieving pain in labour through these strategies or book into our pregnancy and parenting education to find out more. Click here to order a copy of the maternity services consumer council pamphlet "birthing in the water".
However, you may need extra help at your baby’s birth.
Medical pain relief
Gas, injections of drugs, or epidural or spinal anaesthetics can be used if necessary, all drugs have strengths and limitations with some forms of medical pain relief increasing the likelihood of needing other medical interventions and some passing through the placenta to baby. Talk to your LMC about the options available to you or you can find out more through a pregnancy and parenting class or click here for more information and to order a copy of the maternity services consumer council pamphlet on "epidural'.
Medical assistance for birthing
Induction/augmentation of labour
Induction is when labour is started artificially. Induction can be done by using the following:
- Taking a prescribed solution that you drink, which is used to soften and start to open your cervix (opening of your womb).
- A small soft plastic tube (balloon catheter) is inserted through the cervix and a tiny balloon is inflated. This puts pressure on the cervix and gradually releases natural prostaglandins. The balloon is usually left in place for 12-18 hours – you may be able to go home during this time. You will receive information about what to do if contractions start, or the waters break, or the balloon falls out early.
- Placing a medicated hormone gel close to the cervix, which works to soften and open the cervix.
- A hormone which mimics one of your own natural hormones. It is given through a drip (IV line) in small amounts until contractions become strong and regular. .
Inductions are more likely to lead to other interventions, such as a ventouse or forceps birth or a caesarean section, but maybe recommended to hasten the birth.
Augmentation (assisting a labour that has already commenced) can be done by using the following:
- Artificial rupture of membranes When the waters are artificially broken with a tiny hook during a vaginal examination. This can only be done if the pēpi’s head is low and the cervix is open enough.
- a hormone drip to strengthen the contractions.
Ventouse or forceps birth
Ventouse or forceps may be used to help deliver your baby. A ventouse is a suction cap that is placed on the baby’s head and, through firm pulling and you pushing, helps the baby to be born. The same method is used for a forceps birth, with the forceps being placed around the baby’s head.
A caesarean section is the removal of the baby from the uterus by surgery. This should only be done when there are medical reasons, like any surgery, as there are strengths but also possible limitations for the whānui and the pēpi. An epidural or spinal anaesthetic is generally given. A general anaesthetic may be used when an emergency caesarean section is needed. After the operation, stitches or clips are used to close the wound. These either dissolve or are removed about five to eight days later. Click here for more information and to order a copy of the maternity services consumer council pamphlet on caesarean section.
The third stage of labour:
After your baby is born the placenta and membranes must be born, you should be able to enjoy some lovely cuddles with your new pēpi while you all adjust to life as a whānau. There are still lots of care options to consider at this time the first of which will be the birth of the placenta. The majority of healthy pregnant people can expect the natural process of labour to result in the birth of a healthy pēpi, followed by the birth of the placenta/whenua (or “afterbirth”). The time between the birth of the pēpi and the birth of the whenua is referred to as the third stage of labour and is a crucial time in the development of the bond between the whānau and thier new pēpi. For more information about this you can talk to your LMC or click here for more information and to order a copy of the maternity services consumer council pamphlet on the third stage of labour.
For more information on the stages of labour and what to expect talk to your LMC or visit the links below: