Written by tamara in Gravidanza, Parto e Post-parto.
This article is available in Italian and English.
Ecco la seconda parte, il parto.
If you get contractions or your water breaks before you have reached 37 weeks, it is called a premature birth. This means you give birth too early. You should then give birth at a hospital with a children’s ward.
Prematurely born babies need medical assistance during their first period of life. Both you and your baby will require more time and care than if your baby had been born around the due date.
You have reached the due date for birth and nothing happens. You and everyone around you become impatient. Take it easy – it is normal to give birth slightly before and slightly after the due date. If you have not given birth within two weeks after your due date, we say that you are overdue. Research has shown that many babies receive too little nutrition from the placenta if the overdue time is too long. Therefore the maternity ward will initiate the birth by means of medication. This is called birth induction. The effect of the medication is to start labour. The birth then proceeds normally.
It is safe to give birth in Norway. You will receive assistance from experts. All maternity wards have all the necessary equipment. Most common is to give birth in a hospital. If you live somewhere where there is a delivery room, you can give birth there. Then you must be healthy and your pregnancy must have proceeded normally. If you want to give birth in your home, you must enter into an agreement with a midwife who is willing to take on this task. Giving birth in a hospital or delivery room is free..
I dottori al reparto maternità hanno una formazione specifica nel settore delle malattie delle donne e nella nascita dei bambini. Loro sono responsabili per te se insorgono problemi.
Infermieri nel reparto maternità e nel reparto postnatale sono formati per provvedere all’assistenza durante la nascita. Sono anche qualificati per prendersi cura dei bambini ed aiutarti con l’allattamento.
Uno studente è spesso presente durante il parto. Potrebbe essere uno studente che studia per diventare un infermiere, un’ostetrica o un dottore. Sarai presentato allo studente quando arriverai al reparto maternità. Gli studenti hanno molto tempo e spesso sono disponibili a darti molta assistenza durante il parto.
The midwife receives you when you come to give birth and is responsible for all normal births. She is well trained and able to help you during the birth and during the postpartum period. The midwife is responsible for checking that everything proceeds normally. If something abnormal happens, the midwife will call a doctor.
The doctors at the maternity ward have special training in women’s diseases and delivering babies. They have responsibility for you if problems arise.
Children’s nurses in maternity wards and postnatal wards are trained to provide assistance during the birth. They are also qualified to care for children and to help you with breastfeeding your baby.
A student is often present during the birth. S/he may be a student studying to be a nurse, mifwife or doctor. You will be introduced to the student when you come to the maternity ward. Students have ample time and are often able to give you much assistance during the birth.
Most midwives and children’s nurses are women. In Norway both men and women are doctors. You therefore cannot assume that there will only be women present.
“Finalmente! E’ l’ora!” Potresti essere felice ed eccitata, ma forse anche un po’ spaventata.
Tu senti un dolore alla schiena come quelle delle mestruazioni. Ci può essere un po’ di deflusso di sangue, e muco mescolato con il sangue dalla vagina. Inoltre ci può essere del deflusso di liquido dalla vagina. Stà per nascere.
Cosa succede ora?
The start of the birth.
“Finally! Now it is starting!” You may be happy and excited, but perhaps also a bit afraid.
You feel menstruation-like pains in your back. There may be a little outflow of blood, and mucus mixed with blood from the vagina. There may also be some outflow of fluid from the vagina. The birth is starting.
What happens now?
A birth normally starts with contractions. These are a tightening of the muscles of the uterus. You feel that your stomach goes hard and firm. Many experience back pain when these contractions come. They initially last from 20 seconds to one minute. They should come regularly, with perhaps a 10-minute pause between them. Eventually they grow stronger and last for perhaps one minute. The pause are shorter, perhaps only two minutes. These contractions open the cervix and help your foetus down into the birth canal toward the pelvic floor.
Sometimes a birth starts when the foetal membranes rupture so amniotic fluid runs out. When this happens we say that your “water breaks”. The amount of water is not necessarily large. Amniotic fluid is normally colourless, but it may also be whitish or pinkish. If the fluid is yellow or green, you should go to the place where you are to give birth for an extra examination. After your water has broken, labour starts. Contractions occasionally start quickly, another times they may last for days. For some the water breaks after the contractions have started.
Tu puoi chiamare e parlare con un’ostetrica del reparto maternità. Lei vi darà consigli se sei in dubbio su qualcosa.
You can call and talk with a midwife at the maternity ward. She will give you advice if you are in doubt about anything.
Chiedi all’ostetrica o al dottore di che cosa avrai bisogno al reparto maternità. Le donne normalmente portano: accessori per il bagno, assorbenti igienici, scarpe leggere per l’interno, pantaloni leggeri ampi, top che si aprono facilmente per l’allattamento e un accappatoio. Chiedi in anticipo se il tuo bambino potrà utilizzare gli abiti del reparto maternità.
Remember to bring all the papers from your pregnancy check-ups.
Ask the midwife or doctor what you will need in the maternity ward. Women normally bring: Toiletries, sanitary pads, light indoor shoes, light wide pants, tops that open easily for breastfeeding and a bathrobe. Ask in advance whether your baby will be able to use clothes from the maternity ward.
Dopo aver finito questi esami discuterai se dovrai rimanere al reparto maternità o andare a casa per aspettare.
L’ostetrica è responsabile per te non appena entri al reparto maternità. Non può stare con te tutto il tempo, all’inizio, ma la puoi chiamare in ogni momento. Chiedile di venire se sei ansiosa, hai dolore o hai bisogno di consulenza e assistenza. Durante la fase finale del parto sarà sempre con te.
Spesso è accompagnata da un’infermiera e occasionalmente da uno studente.
The midwife will receive you and ask you how you are feeling. The most common examinations she will perform will be to:
After finishing these examinations you will discuss whether you should stay at the maternity ward or go home to wait.
The midwife is responsible for you as soon as you enter the maternity ward. She cannot stay with you all the time to begin with but you can summon her at any time. Ask her to come if you are anxious, in pain or need advice and assistance. During the final phase of the birth she will be with you constantly.
She is often accompanied by a children’s nurse and occasionally by a student.
Unfortunately we cannot tell you how long the birth will take. Each woman has her own birth rhythm and the time it takes for the birth will vary. If you have given birth previously, your next birth will normally take less time than the first one.
Remember that contractions are muscle work, hard body work. The muscles of the uterus contract and relax, contract and relax, for hours on end. This very hard work is tiring and may take a long time. But remember, contractions are not harmful or dangerous.
Giving birth is fantastic, demanding and tiring. Strong forces are at work and this awakens strong feelings. You may vomit, or go to the toilet repeatedly. Many are afraid of losing their self-control. When you are giving birth you must follow your instincts and not try to stay in control. Trust your body.
It is up to you whether you wish to stand, sit or lie.
The midwife can often give good advice on how things can be made easier for you. Change your position often. Be active.
La seconda tappa è la fase attiva. Le contrazioni ora sono molto più frequenti, ed è di solito il momento di chiamare l’ospedale. Ci dovrebbero essere da 2 a 5 minuti da una contrazione all’altra. Ciascuna contrazione dura circa 1 minuto. La cervice è dilatata. Il feto è sceso nel bacino. Questo è un lavoro fisico molto duro. Bevi e mangia un po’. Questo ti darà forza e coraggio durante questa fase. Rimani attiva, muoviti nella stanza, cambia posizione di frequente. Le contrazioni spesso potrebbero essere più fastidiose quando sei sdraiata.
Sentirai che il feto sta premendo contro la cervice ed il tuo retto. L’ostetrica ti esamina e ti dice quando ogni cosa è pronta per far uscire il bambino. Ora puoi aiutare il tuo bambino premendo attivamente durante le contrazioni. Questa fase dura circa un ora. L’ostetrica ti aiuterà a trovare una buona posizione così che puoi usare il tuo corpo nel modo più efficace. È necessario spingere delicatamente verso il basso per evitare di ferire il tuo bambino. La testa e le spalle del bambino sono più larghe e hanno bisogno di più tempo. Il resto del corpo esce facilmente.
La terza tappa è la fase dell’espulsione della placenta. Dopo che il tuo bambino è nato la placenta deve uscire. Sentirai ancora contrazioni. L’utero si contrae per spingere fuori la placenta. Si sente come se fosse grande, ma è morbida, e di norma esce facilmente.
The inital stage is the latency phase. During this phase you are at home, not in the hospital. This phase may last for hours or days. Remember to eat and drink. Your contractions are irregular – around 15 to 20 minutes may pass between each contraction. They may also disappear for some hours. The contractions are not very bothersome in this phase. There may be some blood and mucous from the vagina. Stay active, walk around. Sleep and rest when the contractions take long pauses. You should feel that the baby is moving. Eat and drink to keep up your energy.
The second stage is the active phase. Contractions now come more frequently, and it is normally time to contact the hospital. There may be from two to five minutes between the contraction. Each contraction lasts around one minute. The cervix dilates. The foetus drop further into the pelvis. This is hard physical work. Drink and eat a little. This will give you strength and courage during this phase. Be active, move around in the room, change your position frequently. The contractions may often be most bothersome when you are lying down.
The pushing down phase. You will feel that the foetus is pressing against the cervix and your rectum. The midwife examines you and tells you when everything is ready for the baby to come out. Now you can help your baby by pressing actively during contractions. This phase lasts around one hour. The midwife helps you find good positions so you can use your body effectively. You must push down gently to avoid injuring your baby. The baby’s head and shoulders are largest and take the most time. The rest of the body comes out easily.
The third stage is the phase when the placenta comes out. After the baby has been born the placenta must come out. You will then feel contractions again. The uterus contracts to push out the placenta. It feels big, but is soft, and getting it out is normally easy.
The baby cries to open its lungs and start breathing on its own. As soon as the baby has been born the midwife will examine it to ascertain that all is well. The baby will then be put into your arms. It is good for the baby to be in close contact with you and to lie close to your breast after birth. The baby has been through a long birth and needs rest and warmth.
Now you can try to breastfeed your baby. Many babies suckle immediately after birth. Look at your baby. The baby will look at you with a strong stare. The midwife and children’s nurse will help you so that your baby is warm and safe and can breathe freely.
You will stay at the maternity ward for the two first hours after giving birth. Then you will be moved to the postnatal ward. The midwife looks after you and your baby. Some bleeding from the vagina is normal after birth. You and your baby must be warm and snug. It is normal to be awake and fit even if the birth was tiring. Now you can rest and get to know your baby. You will receive food and drink and you may shower if you wish. Some women want their closest family to visit them.
Quando il bambino esce ci possono essere delle lacerazioni all’apertura della vagina. Occasionalmente il dottore o l’ostetrica farà un taglio chirurgico alla base della vagina per permettere al bambino di uscire più velocemente. Lacerazioni o spaccature devono essere cucite immediatamente dopo la nascita. Ti verrà dato un anestetico. Sia il dottore che le ostetriche sono qualificati per cucire lacerazioni e spaccature.
Rifts and tear, cuts and stitching.
When a baby is coming out there may be tears in the vaginal mouth and in the vagina. Occasionally the doctor or midwife will make a surcigal cut at the base of the vagina to get the baby out quickly. Tears or rifts must be stitched immediately after the birth. You will be given an anaesthetic. Doctor and midwives are qualified to stitch tears and rifts.
Quando ti rilassi il tuo travaglio sarà meno doloroso. L’ostetrica e gli altri che sono con te saranno disponibili ad aiutarti. Tutte quelle che mettono alla luce un bambino hanno bisogno di incoraggiamento e supporto.
A normal birth is not like an operation. You may have an easier birth if:
When you relax your labour will be less painful. The midwife and the others with you will be able to help you. Everyone who is giving birth needs encouragement and support.
Anestesia epidurale ha un buon effetto anche per il dolore del parto. Un anestesista ti farà l’epidurale. Sarai cosciente ma non sentirai dolore quando avrai le contrazioni.
Anche l’agopuntura ha effetto per i dolori del parto. Molte ostetriche sono qualificate per fare l’agopuntura.
Pill? Regular medication used against pain often has a poor effect against birth pains. Your baby is influenced by the medication you take, so only some medicines can be used against birth pains.
Epidural anaesthetics have a good effect against birth pains. An anaesthetist can give you epidural anaesthetics. You will then be conscious but will not feel pain when you have contractions.
Acupuncture also has an effect against birth pains. Many midwives are qualified to give acupuncture.
The midwife will summon a doctor if problems arise during birth. If the baby has to come out quickly, or you cannot manage to push down enough, the doctor can help you. The doctor will use instruments such as forceps or vacuum suction to help the baby out. This will not injure you or the baby.
Durante i 2 o 3 giorni seguenti ad un cesareo avrai bisogno di qualcosa per il dolore. É importante tenersi in movimento e camminare per prevenire la trombosi. Puoi allattare normalmente il tuo bambino. Potresti rimanere al reparto maternità per 4 o 5 giorni dopo aver avuto un taglio cesareo.
A caesarean section is only performed when it is necessary for your or your baby’s health. The doctor determines whether a caesarean is required, either before the birth has started or after it has begun. A caesarean is an operation that must be performed in an operating theatre, not at the maternity ward. You will stay some hours in a special ward before going to the postnatal ward. If the caesarean has been planned during your pregnancy, you may receive epidural anaesthetics. You will then be awake but feel no pain. If the caesarean is decided after the birth has started, you will often be given a full narcosis. You will then sleep during the operation.
During the two or three days after a caesarean you will need something for the pain. It is important you keep moving and walking around to prevent thrombosis. You can breastfeed your baby normally. You may stay in the maternity ward for four or five days after having a caesarean section.
Se il bambino viene esaminato dopo la nascita, qualche volta è possibile stabilire la causa della morte. La tua prossima gravidanza e parto potranno essere completamente normali per te ed il tuo bambino. Ti verranno offerti degli esami extra per la gravidanza.
In Norway it is rare that a foetus dies during pregnancy. If something is wrong, you might notice that the baby is very calm or does not move. Call the doctor, midwife or maternity ward if you feel there is something wrong. The doctor or midwife will then examine you using ultrasound and other techniques to determine whether your baby is alive or dead. It is not always possible to know why a baby dies. The birth should nevertheless occur in the regular manner.
Many feel this is strange and want the baby to be removed by caesarean section. A caesarean is nevertheless more risky for you because it is an operation. A regular birth is best and safest for your body. You will be given medication against your pains. After the birth you may stay in the maternity ward and receive assistance with your needs.
If the baby is examined after the birth, it is sometimes possible to determine why it died. Your next pregnancy and birth may be entirely normal for you and your baby. You will be offered extra pregnancy check-ups.