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The week you have been waiting for. You've been counting down the days and it's finally happened: your due date is this week! Very exciting of course, especially if it is your first child. There are probably all kinds of questions going through your mind and you see every signal as the big moment. If your baby doesn't feel like coming out yet, just go on with your normal life. He wants to meet you too, but he will choose the moment. In this blog we will discuss contractions, induction and tearing. Are you reading along?

The baby 'decides'

About half of all pregnant women give birth after their due date. No matter how much you want to bring your baby into the world, the baby chooses the right moment. Under the influence of the stress hormone cortisol that the baby secretes, all kinds of hormones are released in you as well. The contractions start and the delivery is about to begin (AMC). Let's go!

In general, the contractions at the beginning of labour are relatively short and painless. These so-called preliminary contractions or practice contractions often occur in the last weeks of the pregnancy. These contractions ensure that the cervix becomes more flexible for the delivery. Practice contractions turn into dilation contractions and these 'real' contractions often hurt a lot more, last longer and come more regularly than in the first phase. When you have enough dilation, the dilation contractions will turn into pushing contractions. At the peak of the contraction you will feel an enormous urge to push. When the baby's head has come out, the midwife will guide the baby further out. Hurray! Your little one is born (Pregnant Fit). 

No less important is the birth of the placenta. The midwife or obstetrician will ask you to push one more time and the uterus, membranes and umbilical cord will come out, with a little help from the midwife or obstetrician (The Midwife).

All the trimmings?

When your baby is born and both mother and baby are doing well, the midwife or obstetrician will do a number of more tests. They will check the vagina for ruptures, see if the placenta has come out completely - any remaining parts can become infected - they will keep an eye on how much blood you are losing and feel if the uterus is shrinking properly. Your baby will also undergo a number of tests. They will weigh him, test his reflexes and make sure that he is comfortable. last but not least: Is everything set?

Tearing out

Don't be alarmed, tearing is often not as bad as it sounds. During childbirth the skin and the muscles of the pelvic floor stretch more and more which can cause small cracks in the vagina, also called a rupture. This is perfectly normal and occurs in many women. Sometimes, when the vagina is under too much pressure, the gynaecologist or midwife will tell you not to push for a while and to hush the contractions to prevent them from tearing out (UZ Ghent). The gynaecologist or midwife will check the vagina for cracks after the birth and depending on the size of the cracks will decide whether or not a suture is needed. If the vagina comes under great pressure during childbirth, a so-called episiotomy, a cut, may be made to prevent it from tearing. This is almost always done during a contraction, as a result of which the skin is stretched so much that it is often numb (Pregnant Fit).

Weight

Babies come in all shapes and sizes. Most babies are born weighing between 2500 and 4500 grams with an average of 3500 grams. Girls are generally slightly lighter than boys and the first child is often lighter than the second. You will have several ultrasound scans during your pregnancy. These will give you a rough estimate of the birth weight and the birth length. At 28 weeks your baby will weigh about 1200 grams and will grow about 200 grams per week. The estimate is made based on the upper leg bone, the head circumference and the belly circumference. This estimation is important to prevent any complications at birth (The gynaecologist).

Come on, little one.

But about half of the women give birth around or before the due date. The other half have to be a little more patient; sometimes the baby is still a while away. About 20 percent of pregnant women give birth after week 41. No reason to worry right now! One only speaks of 'overtime' (serotonin) when you are past 42 weeks. Then you will be referred to the gynaecologist who will suggest an introduction (KNOV).

Inducing

Sometimes you may decide to induce labour. This may be necessary for instance when the health of you or your baby is at risk or when your baby stays put too long. When you choose for an induction the birth is started artificially and in general it will go faster than a natural birth which is often experienced as more painful (KNOV). This is almost always done in the hospital. It is very unpleasant when you would have liked to give birth at home, but the health of you and your baby is of course the most important thing! Common reasons for inducing the delivery are for instance insufficient growth of the little one, you are two weeks overdue or the placenta is not functioning properly (Pregnant Fit).

Rusk with mice

The labor is over; your baby is born. We are proud of you, mama! Now you and your little one can enjoy each other's company and get to know each other well. In the first few hours you will probably not be able to sleep because of all the adrenaline and you will probably be very hungry. Time for some cookies! 

When you think you have just got rid of them, the after-effects come. Usually these are not too bad after a first delivery, but after a second or third they can be more severe. Your uterus contracts and regains its original size. Especially when breastfeeding, the aftereffects can be worse because of the influence of hormones (Raising). A nice warm hot water bottle can help against the cramps. Regularly going to the toilet also helps. A full bladder can make the cramps worse.

Congratulations!

You're a mother. You are going to have a good time. Allow yourself, especially in the first week after giving birth, some time to allow your body to recover. You can take some time to recover from the birth and get used to your new role: mom.

Sources:

Hentzepeter-Van Ravensberg, H. D. (2008a). 9 The beginning of labour. Consulted from https://link.springer.com/chapter/10.1007/978-90-313-6304-9_14?error=cookies_not_supported&code=75c7dbc9-2fde-47a8-8e29-888ceaef35fd

Hentzepeter-Van Ravensberg, H. D. (2008). The birth. Consulted from https://link.springer.com/chapter/10.1007/978-90-313-6304-9_15?error=cookies_not_supported&code=dceac4a4-0095-406a-bad6-28acb08d68ac

KNOV. (s.d.). The placenta. Consulted from https://deverloskundige.nl/bevalling/subtekstpagina/140/de-placenta/

KNOV. (2019). Fact sheet Inducing labour. Consulted from https://www.knov.nl/serve/file/knov.nl/knov_downloads/2996/file/Factsheet_inleiden_van_de_baring_DEFINITIEF_OP_DE_WEBSITE.pdf

Aftermath. (2021, March 10). Accessed from https://www.opvoeden.nl/naween-2662/

NVOG. (2019, August 21). Growth ultrasound. Consulted from https://www.degynaecoloog.nl/onderwerpen/groeiecho/

Serotinality - KNOV - Royal Dutch Organization of Midwives. (2015, March 9). Accessed from https://www.knov.nl/vakkennis-en-wetenschap/tekstpagina/693-3/serotiniteit/hoofdstuk/1002/serotiniteit

Course of delivery. (2020, July 1). Consulted from https://www.uzgent.be/nl/zorgaanbod/mdspecialismen/verloskunde/Opname%20en%20bevalling/Paginas/Verloop-van-de-bevalling.aspx

Week 40 of your pregnancy. (2020, May 11). Accessed from https://www.amc.nl/web/specialismen/verloskunde/uw-zwangerschap/week-40-van-uw-zwangerschap.htm