Labor last approximately eight to sixteen hours in a first pregnancy and four to eight in subsequent ones. When to go to the hospital depend on how far away you live. When you go to the hospital or to a doctor’s clinic, the doctor will ask you the frequency of your labor pains and their duration. He/she will check your blood pressure and examine you to find out the position of the baby and listen to his heart. The examination will also include a vaginal examination. An enema is then given to empty the rectum of stool. This is important otherwise with each labor pain, some stool is also passed and the delivery table becomes contaminated. If the pains are not very strong and the labor not advanced, the doctor may prescribe a sleeping dose so that you do not get exhausted. Gradually the pains become stronger and more frequent, and the bag of water breaks, followed by a rush of water from the vagina.
The contractions now occur every one or two minutes and are stronger. There is an increasing feeling of fullness and pressure in the rectum similar to the feeling of the passing stool, and the desire to push is very strong. Gradually, the baby pulses itself out – first the head, then nose and face and lastly, the mouth and the chin. Baby’s eyes are wiped, and during the next contraction the baby comes out and you hear a loud cry. Many obstetricians are going back to the old custom of delivering a woman in a squatting or sitting position or positions are better than lying on her side. There is increasing evidence that these positions are better than lying on the back, which really seem to be more for the convenience of the obstetrician!