Fadi Kimbley

The length of labour​ varies for different women. The average active phase of labour lasts for 8–12 hours in your first pregnancy. Labour is often shorter for subsequent pregnancies.

This is often the least painful stage of the labour. During this phase, you may experience very non-specific symptoms such as a mild backache, abdominal cramps, bloody show or passing of the mucous plug. Ambulation can help by distracting you from these symptoms and hasten this phase. You may start to prepare to head for the hospital once the contractions increase or if your water bag bursts. ​

During this phase, the contractions increase in intensity and frequency, lasting for up to 45 seconds at times. By this time, you should have been in the hospital for an internal vaginal examination to assess the extent of cervical dilatation. You would have been admitted into the delivery suite for the management of this phase of labour.

It is a common practice to manage your labour actively. This entails artificially rupturing your membranes and getting you started on an intravenous medication known as oxytocin to maximize your contractions. Studies have shown that this shortens the labouring process and thus avoids the problems associated with a prolonged labour, such as infections and post-delivery bleeding.

Furthermore, the rupture of the membranes enables your doctor to assess the colou​r of the liquor to see if meconium (motion) has been passed out by your baby, which may indicate that your baby is under stress. Be assured that there is nothing unnatural about this as it merely serves to assist your natural delivery process. Furthermore, it does not increase your chance of having a cesarean section.

You will also be offered a variety of pain relief options (readthe article on Labour Pain Relief​).

This is the stage where you are required to work the hardest to help push your baby out. Your doctor and/or the midwives will be beside you to help guide you​ through this. You may notice an urge to bear down owing to the pressure of the baby’s head on your perineum and back passage. This may be accompanied by the passage of faeces but do not be embarrassed. To aid the delivery, your legs may be raised up to allow more room within your birth canal. It is also here that an episiotomy may be made for the delivery (read the article on Pushing and delivery: Is an episiotomy needed?)

At times, your obstetrician may even need to assist you by using either a vacuum, forceps device or even fundal pressure to help deliver the baby’s head (read the article on Vacuum and Forceps delivery​).

Once the baby is delivered, your uterus will continue to squeeze out the placenta so that it separates from the wall of the uterus (Figure 35.2). ​

This separation process is usually accompanied by a sudden gush of blood from your vagina. Prior to this, the baby’s cord blood will be collected​. You can help at this stage by remaining patient while your episiotomy or vaginal tear is being repaired.

In almost all the cases, we do actively manage your third stage of labour. This includes administering an intramuscular injection of an oxytocic after the delivery of your baby, followed by the delivery of the placenta through a controlled cord traction technique. Again, this has been found to reduce the incidence of post-delivery bleeding.

Rarely, separation does not occur and this results in a retained placenta. In addition to causing discomfort, it can also give rise to increased bleeding. Under these circumstances, it may be wise to have your doctor remove it manually by inserting his hand into your womb through the vagina under a general or regional anesthesia (manual removal of placenta).

Some patients may opt to claim back the placenta for personal or religious reasons. For others, the hospital would dispose of it in an appropriate manner.

Immediately after a seemingly uneventful vaginal delivery, some common problems may arise in the immediate postnatal period. These include: ​

Unfortunately, there have not been conclusive studies to look into the advantages and risks of the different birthing positions. Thus, it is important to discuss your birth plan and communicate your desired birthing position with your obstetrician so that preparation can be made when you are admitted to the delivery suite. This discussion should commence before you reach term (i.e. 37 weeks of pregnancy).

This concept of delivery involves the labouring mother sitting in a warm tub of water in an attempt to reduce the pain and discomforts of labour in a more “natural” way. Some women who had opted for this have found it a more satisfying method of delivery.

However, there are certain disadvantages associated with it. Some of the hospitals are not equipped with the facilities to support such a birth. Monitoring of the baby’s condition becomes difficult with the mum submerged in the water. Infections may also occur as the water is contaminated with urine and faeces. Owing to the warmth of the water, blood loss may be greater after the delivery of the placenta. Great care must be practised to remove the baby from the water immediately after the delivery to reduce other complications.​

​You should speak to your obstetrician in greater detail if you have any queries over this. ​

Engagement is the movement of your baby’s head into the pelvis. It occurs at the end of your pregnancy. Your baby is considered engaged when the head has descended below the pelvic bone. In primips (first time mothers), engagement typically occurs before labour. In multips (those who have delivered before), the baby may not engage until the start of labour. During engagement, your abdomen may seem smaller as the baby enters your birth canal. You may also feel some aches or heaviness in your pelvic joints and perineum as well.

In most pregnancies, babies are born head first. This means that most would have turned to a head down position by 37 weeks. In only 3% to 4% of cases, the babies are found to be breech at time of delivery. After 37 weeks, if the baby is still not in a head down position, it is very unlikely that the baby would turn spontaneously.

In some cases, there may be frequent changing of fetal lie and presentation after 36 weeks. This is termed as an unstable lie.

In such situations, your obstetrician will need to assess you properly and decide on the best mode of delivery.

Source: Dr TAN Thiam Chye, Dr TAN Kim Teng, Dr TAN Heng Hao, Dr TEE Chee Seng John, The New Art and Science of Pregnancy and Childbirth, World Scientific 2008.

Visit Parent Hub, for more useful tips and guides for a healthy pregnancy.

• Driver = 230 yards.
• 3-wood = 210 yards.
• 2-iron/4-wood = 190 yards.
• 3-iron/5-wood = 180 yards.
• 4-iron = 170 yards.
• 5-iron = 160 yards.
• 6-iron = 150 yards.
• 7-iron = 140 yards.

NEW DELHI: The Karnataka Examination Authority (KEA) will announce the revised Karnataka Common Entrance Test (KCET 2022) results tomorrow, October 1, 2022. KCET 2022 new rank list 2022 will be released on the official website, kea.kar.nic.in as per the Karnataka High Court order.Also Check: KCET 2022 Revised Result Live Updates

The examination authority announced the KCET revised results 2022 date on September 28, 2022 and informed candidates that the revised UGCET 2022 results will be based on the high court order that suggested to follow the formula recommended by a technical committee to redo Common Entrance Test rankings for this year.

The committee headed by B Thimme Gowda, vice chairman of the Karnataka State Higher Education Council suggested an average deduction of six marks in each subject from pre-university PU-II marks of COVID-19 year 2020-21 students so that their KCET rankings for this year will be 'normalised' with 2021-22 batch PU-II students.

Over 2 lakh candidates appeared in this year’s KCET 2022 exam held for admission into various undergraduate courses in Government, University, Private Aided, Private un-aided institutions in Karnataka. The KEA declared the KCET result 2022 on July 30. Along with the declaration, the officials announced that the 2021 batch students will be ranked based on the 50:50 ratio of PU-II marks and the entrance exam marks.

Following the announcement, students approached the Karnataka High Court challenging the KEA decision to not consider the 2020-21 PU marks for entrance to professional courses in KCET 2022 on August first week.

Also read | MBBS doctors move Supreme Court over cancellation of INI CET open round counselling 2022

The petitioners had argued that excluding the marks of the qualifying examination will completely disturb the merit matrix as the KCET marks are usually lower. Further, due to COVID-19 pandemic situation, the KEA had declared the Karnataka PU results based on internal marks from colleges.

A single-judge bench on September 3 quashed a note by the Karnataka Examination Authority issued on July 30. The division bench disposed of the appeal of the KEA against the single-bench order and constituted a committee on September 20.

Candidates can follow the steps given below the view the KCET revised results 2022 on the official website.

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