LABOUR: A GUIDE FOR COMMUNITY HEALTH WORKERS AND MIDWIVES

By Dr Peter Onoja

INTRODUCTION

Labour is a natural process that happens when a pregnant woman is about to give birth. It is one of the most important times during pregnancy. For community health workers and midwives, understanding labour helps you know how to support the woman and when to refer her if there are any problems. This post explains labour in a simple and clear way.


WHAT IS LABOUR?


Labour is the expulsion of the product of conception after 28 completed weeks of pregnancy. This means the baby, placenta, and membranes come out of the womb, usually through the birth canal, after the pregnancy is old enough for the baby to survive.


Before 28 weeks, if a pregnancy ends, it is called miscarriage or abortion, not labour.



TYPES OF LABOUR


There are different types of labour:


Spontaneous labour – labour starts on its own


Induced labour – labour is started by a health worker using medicine or other methods


Augmented labour – labour has started, but needs help to continue well


Preterm labour – labour starts before 37 weeks


Post-term labour – labour happens after 42 weeks



SIGNS OF TRUE LABOUR


These are signs that labour has really started:


Regular and painful contractions that get stronger and closer together


Back pain or pressure in the lower abdomen


Show – a mucus discharge with blood


Water breaks – fluid comes out when the membranes rupture


Feeling the baby is moving down


Cervix is opening (dilating)



Note: Some women may have false labour, which has irregular and painless contractions. False labour does not open the cervix.



STAGES OF LABOUR


There are three main stages:


First Stage


From the beginning of true labour until the cervix is fully open (10 cm)



Second Stage


From full opening of the cervix to the birth of the baby



Third Stage


From the birth of the baby to the delivery of the placenta and membranes



DANGER SIGNS TO WATCH FOR


You should refer the woman quickly if you notice:


Labour lasting too long (prolonged labour)


Excessive bleeding


Baby is not moving well


Cord is coming out before the baby


Fits or high blood pressure (pre-eclampsia/eclampsia)


Signs of infection (fever, bad smell from vagina)


Difficulty pushing or baby not coming down



YOUR ROLE AS A COMMUNITY HEALTH WORKER OR MIDWIFE


Identify labour signs early


Use a partograph to monitor progress


Keep the delivery area clean and safe


Support the mother emotionally and physically


Know when to refer to a hospital


Educate pregnant women on what to expect



ADVICE TO GIVE PREGNANT WOMEN


Go for antenatal care regularly


Know their due date


Prepare transport ahead of time


Deliver only in a clinic or hospital with skilled health workers


Report to the clinic immediately when labour signs start


CONCLUSION

Labour is a natural process, but it can become dangerous if not properly managed. As a community health worker or midwife, your quick action, good knowledge, and ability to refer at the right time can save the life of both mother and baby. Let’s continue working together to make every delivery safe.

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