34 LABOUR AND BIRTH The start of labour The start of labour is latent and occurs when the cervix (entrance to the uterus) becomes soft and thin and starts opening for the baby to be born. This can take hours or sometimes days, and mothers are not aware of these changes. However, when some of the following signs appear, labour might be starting: Sometimes labour must be induced, i.e. started artificially, especially when the baby is overdue, if the waters break early, or if there s any risk to the baby s or the mother s health. contractions; the plug of mucus from the cervix (aka the show ) comes away; backache; an urge to go to the toilet, which is caused by the baby s head pressing on the bowel; waters breaking. When and where does the expression C-section come from? Labour Labour goes through different stages meant to prepare the mother s body for delivery. During this stage both mother and child are constantly monitored. Pain is part of this process, and hormones usually make it tolerable, however there are many strategies to manage it either more naturally (emotional support, comfortable position, lights, music, water, relaxation techniques) or pharmacologically (epidural analgesia). Types of birth Depending on the conditions mother and baby are in, there are three different types of delivery possible. bowel: viscere delivery: parto midwife: ostetrica to outweigh: superare stitch: punto chirurgico tear: strappo womb: utero 80 BABIES AND CHILDREN Vaginal birth takes place naturally only with the support of the midwife. Sometimes, a tear occurs at the point of birth, which will need stitches to heal; occasionally, a surgical cut (episiotomy) will be necessary if the baby is unwell and needs to be delivered quickly. Assisted vaginal delivery occurs when there is very little progress despite pushing well during the delivery stage of labour. It can be done in two different ways. Vacuum extraction is done with the help of a Ventouse extractor, a rubber or metal cap that a doctor attaches to the baby s head using suction provided by a small machine; forceps delivery is performed with a metal tool much like large spoons that are placed around the baby s head. In both cases the baby is gently guided through the birth canal and the tool is immediately removed once the baby s head is born. Vaccum delivery Forceps delivery Caesarean Section, or C-section , is a surgical operation performed by a doctor in an operating theatre where the baby is born through a cut in the abdominal wall. This type of birth is either planned in special circumstances or used in case of emergency, when the risks of a vaginal birth outweigh those of a Caesarean section. After the baby is born, the womb contracts and the placenta must come out through the vagina, either physiologically or actively.