Childbirth preparation is an essential component of pregnancy that helps expectant mothers and couples face the birth process with knowledge, confidence and peace of mind.

Generally, it is recommended to start preparing for birth during the second trimester of pregnancy, around 20 weeks gestation.

This is often an ideal time because most mothers are over the common complications of the first trimester and tend to feel physically more comfortable.

Importance of early preparation

• Body adaptation: starting early allows your body to gradually adapt to the exercises and practices recommended for childbirth.
• Information and knowledge: you have more time to learn about the birth process, explore your birth options and make informed decisions about your birth plan.
• Stress and anxiety management: early preparation can help you manage any anxieties or fears you may have about childbirth, allowing you to address these emotions proactively.

Recommended activities

• Childbirth preparation classes: these classes offer information on the birthing process, breathing techniques, pain management options and relaxation strategies.
• Moderate physical exercise: practices such as prenatal yoga, pilates and walking can improve your fitness and prepare your body for childbirth.
• Prenatal consultations: maintain regular communication with your health care provider to monitor your baby's and your own health, and discuss any concerns or questions you have about the birth.

Preparing for childbirth is not just a matter of attending classes or reading about childbirth; it is a holistic process involving the mind, body and emotions.

Taking the time to prepare properly can make a big difference to your birth experience.

Starting childbirth preparation is an important decision for mothers-to-be and their families.

Ideally, it is recommended to start this process in the second trimester of pregnancy, around week 20.

This period allows the mother to adapt to the physical and emotional changes of pregnancy, while gradually and unhurriedly getting informed and prepared for the birth.

Importance of early preparation

• Education: Taking the time to learn about the birth process, pain management options and common medical interventions can help you make informed decisions.
• Physical strengthening: participating in activities such as prenatal yoga or pilates can strengthen muscles essential for childbirth, as well as improve breathing and relaxation.
• Emotional connection: starting early offers the opportunity to develop a deeper connection with your baby and your partner as you share this stage of preparation together.

Resources for preparation

• Childbirth preparation courses: Many hospitals and health centres offer courses ranging from breathing and relaxation techniques to newborn care.
• Professional advice: consulting a specialist, such as a midwife or obstetrician, can provide personalised guidance and answer your specific questions.

Starting your childbirth preparation early will allow you to face this time with greater confidence and peace of mind, making it a more positive experience for both you and your baby.

Recognising the signs that your body is preparing for labour is crucial to understanding the process and feeling more confident as the big moment approaches.

Here are some indicators:

Physical signs

• Descent of the baby: As labour approaches, you may notice that your baby "latches on", moving down into your pelvis. This can happen a few weeks or days before delivery and often results in easier breathing and less pressure on your stomach.
• Braxton Hicks contractions: these "practice contractions" can become more frequent and stronger as labour approaches, helping to prepare your uterus for actual labour.
• Expulsion of the mucus plug: you may notice a thick, jelly-like discharge, sometimes with streaks of blood, known as the mucus plug. Its expulsion indicates that the cervix is beginning to dilate in preparation for labour.
• Emotional and behavioural changes
  Nest: it is common to experience an urge to organise and prepare everything for the baby's arrival, known as the nesting instinct.
• Mood swings: you may experience emotional fluctuations, from excitement and energy to anxiety and introspection.
• Physiological changes
  Dilatation and effacement of the cervix: During the weeks leading up to delivery, the cervix may begin to dilate (open) and efface (thin), preparing for the passage of the baby.
• Membrane rupture: commonly known as "water breaking", is when the amniotic sac ruptures, releasing the amniotic fluid. This can happen before or during labour.

It is important to maintain regular communication with your health care provider during the last weeks of pregnancy to monitor these and other signs of readiness for birth.

Each woman and each pregnancy is unique, so these signs may vary in intensity and sequence.

The birth process is generally divided into four main stages, each with specific characteristics and durations.

Understanding these stages can help you better prepare for what lies ahead and know what to expect.

• First stage: dilatation

Latent phase: the onset of labour is characterised by irregular contractions that begin to dilate and efface the cervix. This phase can last for several days, especially in first timers.
Active phase: dilatation progresses from 3 to 4 cm to approximately 7 cm. Contractions become more regular, intense and frequent. It is common for the amniotic sac to rupture during this phase.
Transition: is the final part of the first stage, where dilatation progresses from 7 to 10 cm. Contractions are intense and very frequent, marking the preparation to start pushing.

• Second stage: expulsion

Beginning of pushing: Once the cervix is fully dilated, the pushing phase begins, where the mother is encouraged to push with each contraction to help the baby move down the birth canal.
Birth of the baby: this stage culminates with the birth of the baby. The length of this phase can vary widely, especially among first-time women and those who have given birth before.

• Third stage: birth

After the baby is born, the stage of labour begins, where the placenta is delivered. This stage can last from a few minutes to half an hour and is usually less painful, although contractions may continue until the placenta is completely expelled.

• Stage four: immediate postpartum recovery

Although not always mentioned as a stage of labour, the first hours after birth are crucial for the mother's recovery and early bonding with the baby. During this time, the mother's physical recovery, the initiation of breastfeeding and the newborn's well-being are monitored.

Each of these stages is vital to the birth process and can vary significantly from woman to woman. Being informed about what happens at each stage will help you face labour with greater knowledge and peace of mind.

Dilation of 7 to 10 cm, which occurs during the transitional phase of the first stage of labour, is known to be one of the most intense and challenging phases of the birth process.

The duration of this phase can vary significantly from one woman to another and can also differ between different births of the same woman.

Factors influencing duration

• First pregnancy: in women giving birth for the first time, this phase can last 2 to 3 hours on average, although there is wide variability.
• Subsequent pregnancies: In women who have given birth before, this phase tends to be shorter, lasting 1-2 hours or even less.

Characteristics of this phase

• Contractions: are particularly intense and frequent, occurring every 2 to 3 minutes and lasting about 60 to 90 seconds each.
• Intensity: It is common to experience intense sensations of pressure and the urge to push, although it is recommended to wait until you are fully dilated to begin effective pushing.

Tips for managing this phase

• Relaxation and breathing techniques: use techniques learned in childbirth preparation courses to manage pain and remain calm.
• Continuous support: the presence of a doula, partner, midwife or loved one to provide emotional and physical support can be invaluable.
• Comfortable positions: changing position to relieve pain and facilitate dilation, such as walking, rocking, taking a hot shower or soaking in a bathtub.

It is important to remember that each birth is unique and that these durations are averages, not fixed rules.

Open communication with your health care team and trusting your body are key to navigating this stage of labour with confidence.

Being close to giving birth is accompanied by a number of signs and symptoms that indicate that labour is near or has already begun.

Recognising these signs can help you prepare for the moment you head to the hospital or birthing centre.

Key signals

• Regular and progressive contractions: Unlike Braxton Hicks contractions, which are irregular and usually disappear with movement or change of position, labour contractions are regular, become more intense and frequent over time, and do not diminish with change of activity.
• Membrane rupture: commonly known as "water breaking", is when the amniotic sac ruptures, releasing the amniotic fluid. This can happen in one big gush or in a steady trickle. Not all women experience rupture of membranes before the onset of contractions.
• Expulsion of the mucus plug: you may notice the expulsion of the mucus plug, which can be a thick, jelly-like discharge, sometimes mixed with blood, known as "implantation bleeding".
• Increased pelvic pressure: As the baby moves down into the pelvis, you may feel increasing pressure in the pelvic area and perhaps a feeling that the baby is "pushing down".
• Changes in energy: Some women experience increased energy, while others may feel more tired or anxious.
• Dilatation of the cervix: although this sign is usually checked by a health professional during examinations, dilation and effacement of the cervix are clear indicators that the body is preparing for labour.
  Recommendations

If you think you are about to give birth, especially if you are experiencing regular, strong contractions or if you have noticed your membranes rupturing, it is important to contact your doctor or midwife. They will be able to give you guidance on when to go to the birthing centre or hospital and provide you with the support you need at this stage.

Remember that every birth experience is unique, and not all women experience all of these signs. Keeping open communication with your health care team and trusting your intuition are key during this exciting time.

Dilation is the process by which the cervix opens and thins to allow the baby to pass through during labour.

This is a key indicator of labour progress. However, it is not always evident to the woman without an examination by a health professional.

Here are some signs and situations that may indicate that dilatation is occurring:

Associated signs and symptoms

• Intensification of contractions: As the cervix dilates, contractions tend to become more intense, regular and frequent. An effective labour contraction usually lasts about 30 to 70 seconds and occurs every 5 to 10 minutes.
• Changes in vaginal discharge: expulsion of the mucus plug or an increase in vaginal discharge may indicate changes in the cervix, including dilatation.
• Feeling of pressure: As the baby descends and the cervix dilates, you may feel increasing pressure in the pelvic and rectal area.
• Light bleeding: known as "implantation bleeding", can occur as the cervix dilates and prepares for delivery.

Assessment by a professional

• Vaginal examination: The most accurate way to determine dilatation is through a vaginal examination by a health professional. During the examination, the opening of the cervix will be assessed in centimetres.
• Monitoring signs of progress: health professionals will also observe other signs of progress in labour, such as the effacement (thinning) of the cervix and the baby's descent through the birth canal.

It is important to remember that dilatation is only one part of the labour process and that the speed of dilatation can vary widely between women and between different births of the same woman.

Some women may dilate slowly for days before active labour, while others may experience rapid dilation within a few hours.

If you think you are in labour or have concerns about dilation, it is crucial to communicate with your medical team for appropriate guidance and support.

In the days leading up to labour, a number of symptoms may occur that indicate that the body is preparing for birth. These include:

1. ContractionsThese may become more regular and stronger as you get closer to labour.
2. Expulsion of the mucus plugVaginal discharge: An increase in vaginal discharge may be noted, sometimes including a plug of mucus that has sealed the cervix during pregnancy.
3. Water breakageAmniotic fluid release may occur in a large gush or a steady trickle.
4. InsetThe baby descends into the pelvis, which may make breathing easier but increases pressure on the pelvis and bladder.
5. Changes in energySome women experience an increase in energy, while others may feel more tired and anxious.

These signs are indications that labour may be near, but the exact timing can vary widely. It is always advisable to contact your doctor or midwife to confirm whether you are going into labour.

In the childbirth preparation course, it is essential to ask questions that will help you better understand what to expect during labour and how to handle various situations. Some key questions might include:

1. Breathing and relaxation techniquesWhat are the most effective techniques for pain management during childbirth?
2. Stage of labourHow can I distinguish the different stages of labour and know when to go to the hospital?
3. Medical interventionsWhat types of medical interventions might be necessary and how can I prepare for them?
4. Delivery planHow can I make sure that my preferences are taken into account during childbirth?
5. Postpartum careWhat care will I need after birth and how can I plan for support at home?

Asking these questions can provide clarity and confidence as you approach the birth experience, ensuring that you feel prepared and supported.

The duration of childbirth classes may vary depending on the specific programme and the institution offering it. Generally, courses can last from a few weeks to several months. Each session usually lasts 1-2 hours and may be offered once a week. It is important to ask about the intensity and timing of the classes so that you can organise your schedule accordingly and ensure that you can attend all the important sessions.