Birth Jargon decoded

Mucus plug

The mucus plug seals your cervix during pregnancy to protect your unborn baby from infection. When your body is gearing up to give birth your cervix starts to change shape, which may release the mucus plug as a show – mixed with blood from small broken capillaries in your cervix.

Rupture of membranes

Or, more simply put, your waters have broken. The membrane they’re referring to is the amniotic sac around your baby – the gush, spurts or trickles of water that can sometimes accompany rupture of the membrane is the amniotic fluid.
If you have premature or prelabour rupture of the membranes, this means your waters have broken but you’re not in active labour. If you think your membranes have ruptured early, contact your midwife or GP as soon as possible. You‘ll need to be monitored in case of infection or the risk of premature birth.

Dilation

To see if you’re in labour the midwife or obstetrician will see how far your cervix (neck of the womb) has dilated or opened. The cervix is normally closed but it can start to dilate in the last couple of weeks of pregnancy. You are regarded as being in labour once your cervix is 3cm dilated. If you want a water birth, it’s good to get into the pool at around 5-6cm – any earlier could slow dilation. Dilation speeds up once you are in active labour, and your cervix should have opened to 10cm in diameter by the end of the first stage of labour. You may hear the term effacement, which is when the cervix thins as the baby moves down the birth canal.

Meconium

Essentially, this is baby poo – the first bowel movement from your baby. The thick, tar-like substance is normally passed in the first 24 hours after birth but up to one in five babies passes it during labour, especially if they are overdue. It can indicate fetal distress, but doesn’t necessarily mean there’s a problem. It may prompt induction to prevent the baby inhaling meconium in the womb, which can lead to serious problems.

Induction

Labour will only be artificially started or induced if there is a medical reason – if you’re overdue or have a condition that puts you or your baby at risk. At 41 weeks you’ll be offered a membrane sweep, where the midwife sweeps a finger around the neck of your womb to separate your cervix from the membranes around your baby. This can trigger your body to release prostaglandins – hormones to kick-start your labour. If this doesn’t work, you may have a tablet of prostaglandins placed in your vagina to ‘ripen’ your cervix to dilate. Next, the doctor may give you an injection of oxytocin to induce contractions.

Episiotomy

Just before your baby is born, the weight of his head presses on the perineum – the area of skin between the vagina and rectum. As the perineum stretches it’s at risk of tearing. You can minimise this risk by slowing your pushing, but sometimes the obstetrician will need to surgically extend the vaginal opening to allow the baby’s head through and minimise the risk of more extensive tearing. An episiotomy may also be made to help the obstetrician place forceps or a ventouse (see below). Your obstetrician will stitch any cuts or tears after the birth.

Operative vaginal delivery

If your baby’s head is in the birth canal but it looks unlikely you’ll push your baby out without assistance or the baby needs to be delivered quickly, the obstetrician may use forceps or a ventouse.

Forceps are a pair of curved spatula-like instruments that are placed on either side of the baby’s head. A ventouse is a suction cup placed on the top of your baby’s head. If you haven’t already been given an epidural you should be given a local anaesthetic first. An episiotomy may be needed to make room for the instruments to be inserted. You’ll be asked to keep pushing until the head is out. The forceps or ventouse will then be removed so you can push the rest of your baby out yourself. Your baby may have marks and bruises on his head if forceps have been used and a ventouse can result in a ‘cone head’, but these will go over time.

Failure to progress

‘Your contractions are slowing’ is possibly one of the most disheartening things to hear during labour, especially as the contractions will still be just as painful. If your labour lasts a long time, the contractions may become weak and irregular. Your labour may also not be progressing if the cervix is not dilating or your baby isn’t moving down the birth canal. Walking around and keeping active can help move things along naturally, or oxytocin may be given to stimulate contractions.

Fetal heart rate

Your baby’s heart rate will be monitored during labour to gauge how well she’s coping. It may be done throughout pregnancy or intermittently depending on if you have any complications and hospital policy. The baby’s heartbeat should be 120 to 160 beats per minute. You may hear the word bradycardia if the heartbeat slows or tachycardia if it becomes a bit quick.

The cord is around the baby’s neck

This sounds scary, but it’s common and usually nothing to worry about. Once the head is delivered, the midwife will use her fingers to check for the cord. If necessary, she’ll usually loop it over the head before you deliver the rest of the body. If this isn’t possible, the cord will be clamped and cut.

You have a beautiful baby!

The words that make it all worthwhile.