Labour and delivery

Signs of labour include lower back or abdominal pain, painful contractions, waters breaking, and bloody or mucous discharge. If these appear before full term or if there is heavy bleeding, contact your maternity clinic during office hours, or Oulu University Hospital Emergency Department for Pregnant Women after office hours.

Contractions

Preparatory contractions can occur days or weeks before labour and help the body get ready. Painless contractions are normal during pregnancy. When contractions become regular, strong, and less than 10 minutes apart, it’s time to go to the hospital. If you have been monitored for high blood pressure, slow fetal growth, or other conditions, follow the instructions provided by your healthcare professional.

Premature contractions (before 37 weeks) should be reported to your maternity clinic during office hours, or Oulu University Hospital Emergency Department for Pregnant Women after office hours.

Amniotic Fluid (Waters Breaking)

Amniotic fluid is clear and produced continuously until birth. It may leak slowly or gush out. If it is green, greenish, or bloody, or if you are not full term, go to the hospital immediately. If your baby is in breech position and your waters break at home, call 112 immediately and lie on your side while waiting for the ambulance.

If full term, the fluid is clear, there are no contractions, and your baby is moving well, you can prepare calmly at home before going to the hospital. If you are unsure whether your waters have broken, use a sanitary pad: continuous wetting usually indicates amniotic fluid.

Bloody Discharge

Small amounts may occur after sex or an internal exam and can be monitored at home if the pregnancy is full term. Early or heavy bright red bleeding, or painful, persistent contractions, require calling 112 and going to the hospital by ambulance. Wait lying on your side.

You can come to the labour ward at any time of the day, and you do not need to call in advance. Remember to bring your maternity card with you.

Mothers arriving at the labour ward are seen in order of urgency. At the reception, the midwife will review your health during pregnancy, any underlying conditions, and medications. You will be asked about the start, frequency, and regularity of your contractions, as well as any leaking of amniotic fluid or bloody discharge.

External and internal examinations are performed to assess the baby’s position and size, the opening of the cervix, and how the baby is positioned in the pelvis. If necessary, an ultrasound and a CTG (fetal heart monitoring) may also be done.

Depending on your situation, you may be:

• advised to go home and wait
• transferred to the women’s ward to await labour, or
• taken directly to the delivery room.

You will be cared for by a midwife in cooperation with an obstetrician. If needed, a paediatrician and an anaesthetist will also participate. A midwife student or a medical student may be present during your care.

Labour may be induced if your doctor assesses that the risks of continuing the pregnancy are greater than the risks associated with starting labour. Induction can be considered, for example, if your pregnancy has gone past the due date, if your waters have broken but contractions have not started, or for psychosocial or logistical reasons.

Before induction, the reasons, options, and possible risks will be discussed with you. Labour can be started mechanically, with medication, or by artificially breaking the amniotic sac to release the amniotic fluid. The method chosen always takes into account your and your baby’s wellbeing, the duration of your pregnancy, and any potential risk factors.

Labour may not begin immediately after induction. The baby may take its time, and actual labour can start several hours or even days after induction.

Opening phase

Labour begins when your cervix starts to open. This stage can last many hours, for first-time mothers usually 10–20 hours, and often shorter for mothers who have given birth before. Your contractions and the baby’s heartbeat are closely monitored. Pain relief options are discussed with you based on your needs and the progress of labour.

Pushing phase

Once your cervix is fully open and the baby has moved down the birth canal, you enter the pushing phase. You can push in positions that feel most comfortable, such as lying on your side, standing, or sitting. The midwife supports you throughout, helping your baby to be born safely. If needed, the perineum may be numbed or a small incision made to support a safe delivery.

The pushing phase ends with the birth of your baby. After the birth, you will receive medication to help the uterus contract and deliver the placenta. At this stage, the team usually includes the primary midwife, an assisting midwife, and, if needed, an obstetrician and a paediatrician.

Afterbirth

After your baby is born, the placenta and membranes are delivered. The midwife will check for any tearing and provide stitches if necessary. The uterus and bleeding are monitored to ensure everything is progressing safely.

After giving birth, your baby’s condition is checked and skin-to-skin contact with the mother is encouraged immediately. Early bonding and breastfeeding begin right away, and the baby stays on your chest or a support person’s chest. Mother and baby are monitored in the delivery room for about two hours. If your condition allows, you can shower. Birthday refreshments are provided for your family.

You will then be transferred to the Women’s Ward, where mother and baby stay together around the clock. Family rooms are available if a partner or support person can stay overnight (meal fee applies). Our staff is here to help you recover and to support you with caring for your baby and breastfeeding.

If the newborn needs intensive care, they will be transferred to the Neonatal Intensive Care Unit. Your partner or support person can accompany the baby while the mother is monitored. Once stable, the mother may join the baby in the neonatal unit.

Skin-to-skin contact

Skin-to-skin contact is a natural and safe way to start bonding with your baby right after birth. The baby is placed on the mother’s bare chest, wearing only a diaper, while the mother sits partially upright. Both mother and baby are covered with a blanket or nightgown, leaving the baby’s head uncovered.

Other family members can also have skin-to-skin contact. This close contact reminds the baby of the womb, letting them hear familiar heartbeats and stay warm. It creates a calm and safe moment for both the baby and the parent. Skin-to-skin contact also helps with breastfeeding. The baby instinctively moves toward the breast, which supports successful full breastfeeding. Close contact boosts parental confidence and helps parents recognize their baby’s cues.

Discharge is planned individually, based on the health of both mother and baby. Low-risk mothers may choose to go home directly from the delivery room after a six-hour observation period. For short-stay births, discharge usually occurs the following day.

If less than 36 hours have passed since birth, an appointment will be scheduled at the Children’s Day Hospital for both mother and newborn as part of the discharge process.