Vaginal birth · Marrakech
Understanding what happens during labour helps you approach it with less apprehension. In Marrakech, Dr Oussama Rachid, an obstetrician-gynaecologist, favours a birth that is as natural as possible, while remaining ready to step in when the situation requires. This page describes the main stages; it is informational and replaces neither antenatal classes nor your follow-up consultations.
Preparation starts during pregnancy care: antenatal classes (breathing, relaxation, positions), conversations with your doctor about your wishes and fears, choosing where to give birth, planning the journey and the bag. The presence of your birth partner in the delivery room is possible under conditions: it is better to know them in advance, from the clinic and the chosen hospital.
The clearest signs are regular contractions, getting closer together and stronger, which do not stop with rest or in a warm bath, and the waters breaking (a flow of clear fluid). Losing the mucus plug is common but does not mean birth is imminent.
A frequently given rule: set off when contractions come about every five minutes for an hour. Leave earlier if the journey is long or if in doubt, and straight away if you lose fluid, bleed or feel the baby move less.
The cervix thins and then opens to about ten centimetres. This stage has a slow phase followed by a faster one. Its length varies widely: several hours, often longer for a first baby. The baby's heartbeat and the contractions are monitored; walking, moving and changing position are encouraged when possible.
The cervix is fully dilated and the urge to push appears. You are guided to push at the right moment. This stage lasts from a few minutes to one or two hours, then the baby is born and can be placed on your belly, skin to skin, if both your conditions allow.
In the following half hour or so, the placenta is delivered and checked to make sure it is complete. A medicine is often offered to help the uterus contract and reduce the risk of bleeding. Your bleeding is closely watched during the first hours.
Several means can be combined:
The choice is yours, and it can change during labour.
Episiotomy, a small cut of the perineum, is never routine: it is kept for situations where it is truly useful. Spontaneous tears are fairly common, especially at a first birth; they are usually mild and are stitched under anaesthesia.
If the baby is slow to come or the heartbeat is a concern, an instrument (vacuum, forceps) may be used. If labour stops progressing or safety requires it, a caesarean may be decided during labour. This is not a failure: it is a safety decision, explained as soon as possible. See the page on caesarean section.
Induction is decided according to the file, for a medical reason (high blood pressure, diabetes, overdue pregnancy, waters breaking without contractions, a baby growing poorly…). It uses a gel or tablet, a small balloon and/or an oxytocin drip. It can take longer than spontaneous labour.
Skin-to-skin contact and the first feed are encouraged; breastfeeding is actively supported. On the ward, your bleeding, blood pressure, pain and perineum are checked. You usually go home after a few days if all is well. A check-up after the birth, around six to eight weeks, reviews your recovery, contraception and, if needed, pelvic floor rehabilitation.
Complications are rare but exist: significant tears, bleeding after the birth, the need for an instrument or a caesarean. In the longer term, urinary leaks or a feeling of pelvic heaviness may appear and respond well to rehabilitation. Your doctor explains the risks specific to your situation.
It varies widely. A first labour is often longer, lasting several hours. Every birth is unique.
It is offered to all patients. You decide, at the moment that suits you, with the team's advice.
No, never. It is only done when it is truly necessary.
Sometimes yes, depending on the scar and how the pregnancy goes. The decision is made at consultation: see the page « Caesarean or vaginal birth ».
The presence of a birth partner in the delivery room is possible under conditions, to be clarified in advance.
Informational content: it does not replace a consultation. No outcome can be guaranteed.
