Birth

Real labour shows as regular contractions that grow longer, stronger and closer together and do not ease with rest. With a first baby, you usually leave when they come about every 5 minutes for an hour. Waters breaking, bleeding, less movement or constant pain: call or go without waiting.

An epidural is a local anaesthetic placed in the lower back by an anaesthetist. It relieves contraction pain within 10 to 30 minutes, without putting you to sleep or harming the baby. It can slightly lengthen pushing, does not increase the risk of caesarean and does not cause lasting back pain.

A caesarean delivers the baby through an incision in the abdomen and uterus, most often under a spinal or epidural anaesthetic: the mother stays awake. The baby is born within 5 to 10 minutes, the operation lasts 40 to 50 minutes and skin-to-skin remains possible. Allow about six weeks before lifting heavy things or resuming sport.

A natural, or vaginal, birth has three stages: the cervix opens to 10 cm, you push until baby is born, then the placenta is delivered. With a first baby, dilation lasts about 8 hours on average and descent and pushing up to 3 hours. Two hours of monitoring follow, with baby skin to skin.

An episiotomy is a cut in the perineum made as baby is born; it is no longer routine. A tear happens by itself and affects up to 9 in 10 first vaginal births, most often without serious consequences. The stitches dissolve on their own and the skin heals in one to two weeks. Cold, gentle hygiene and pain relief help.

To choose where to give birth in Morocco, clinic or hospital, look at safety first: a neonatal unit on site, and an anaesthetist and operating theatre available day and night. Then come the room, your partner's presence, practices (skin-to-skin, breastfeeding help) and cost, to be confirmed in writing together with the share reimbursed by the AMO.

The first days in the maternity unit are for monitoring mother and newborn, and for getting baby's feeding started with the team. Baby is weighed, examined and screened, with tests that vary by establishment; for you, bleeding, the uterus and any scar are checked. The stay often lasts a few days: protect your rest and limit visitors.

A breech baby is bottom or feet down. It is common in the second trimester, but only 3 to 5% of babies are still breech at term. Around 36 weeks, an external cephalic version succeeds about once in two. If not, a planned caesarean or a vaginal birth is discussed against precise criteria.

Induction of labour means starting labour when it does not begin by itself or when waiting becomes riskier. With no particular problem, the pregnancy is monitored from 41 weeks and induction is offered between 41 and 42 weeks. Depending on the cervix, hormones, a balloon, breaking the waters and oxytocin are used.

Giving birth without an epidural is a possible choice, and a reversible one: you can ask for it midway. The best-supported ways to cope with contractions are freedom to move and change position, continuous support from a companion, warm water, breathing and massage. Find out beforehand what your maternity unit allows.

A baby is premature when born before 37 weeks of pregnancy. Depending on gestation, they may spend days or weeks in the neonatal unit. Skin-to-skin care, which the WHO recommends from birth, and breast milk help them grow. Their development is then judged by corrected age, during the first two years.

From birth, a newborn receives an Apgar score at 1 and 5 minutes, then a full examination by the paediatrician. In the first days, several screenings are possible: the Guthrie test, a drop of blood taken from the heel, looks for rare conditions best treated early, and a painless hearing test. In Morocco, what is offered varies by maternity unit: ask.

Being afraid of giving birth is very common, especially with a first baby or after a difficult birth. Getting informed, preparing, choosing your companion and telling the team your wishes all help. When fear invades your sleep or leads you to avoid pregnancy, it is called tokophobia: it can be treated, with a psychologist's help.

A birth plan is a page where you write down your wishes for labour: who accompanies you, how to manage pain, positions, medical procedures, skin-to-skin and breastfeeding. It is discussed with your gynaecologist and the maternity unit in the third trimester, and stays flexible: your safety and baby's come before the paper.