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Stages of Labor |
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Once true labor contractions begin, you’ve entered the first stage of labor. While there is great variation in each woman’s experience, labor and delivery progress through three stages.
During stage one, your cervix dilates and effaces, preparing for the passage of the baby. By the end of this stage, the cervix is 100% effaced, or thinned, and 10 cm dilated so that the baby can pass into the birth canal (vagina). The first stage of labor is the longest, and fortunately the easiest. This stage is divided into three phases:
In this phase the cervix dilates from 0 to 3 cm. You may be uncomfortable, with a backache, feeling of fullness, or menstrual-like pain. You may have a slight bloody or pinkish show, and loose bowel movements. This phase lasts an average of around 8 hours, but this can vary wildly from woman to woman, and can also occur over days without noticeable discomfort. Some women don't recognize labor until they're well into the 2nd stage. Contractions in this phase may be irregular, coming every 5 to 20 minutes, or anywhere in between. As a result, it can be difficult to pinpoint the start of labor, and whether or not this is actually true labor. Generally, if the contractions follow an overall trend of getting longer, stronger and more frequent, then you're on your way!
During this stage, it is unnecessary to go to the hospital. It is recommended that you stay home and relaxed as long as you are comfortable -- if you have ANY doubt, call your care provider -- as labor has a tendency to progress better in comfortable and familiar surroundings, and you are more likely to rest and stay relaxed at home than in the hospital. If you are hungry, now is your chance! You likely won't be allowed to eat much -- if anything -- once you get to the hospital, so try to get some energy now, but avoid anything heavy, fatty, or difficult to digest. Think whole grains, fruit, and lots of fluids. Avoid anything too sugary, as this can serve to dehydrate you, which is the last thing you want. Try to move around - go for a walk, or at least walk around the house. Walking enlists gravity, and helps labor to progress. But keep things gentle. You don't want to tire yourself out now. Read, watch TV, finish preparing the baby's room, play a game, anything to entertain and distract you. You can time your contractions once they start getting more frequent. When they are 4-5 minutes apart, and are lasting for more than 45-60 seconds, now you can head to the hospital. Again, if EVER you're not sure, call your care provider, or the hospital.
Once your cervix is 3 or 4 cm dilated, you move into phase 2, called active labor. In this phase, the contractions are stronger, occur more often, and come closer together - every 4 or 5 minutes, and lasting about 40 - 60 seconds. If you're not already there, you should head to the hospital around now. Again, the thing to look for is contractions that get overall longer, stronger, and more frequent.
This phase is more intense than the first, and your cervix will dilate from 3 or 4 cm to 7 cm. The contractions are getting to be more work at this point, and you may have to concentrate more on each one, maybe not being able to talk through them. Again, continue walking around. Barring any complications, walking throughout your labor is strongly recommended. Try other positions also to ease the discomfort - in a tub, in the shower, kneeling, laying on your side, squatting -- whatever seems to help. Try to avoid laying on your back unless you have to -- it can slow down labor, and won't help the pain much. Try to stay hydrated if you're allowed to have water or ice chips. Also remember to go pee often, as a full bladder can impede labor. Coaches -- remind mom of this. You can use your breathing exercises now, if they help. Many women swear by them, claiming they couldn't get through labor without them, but some say they just feel unnatural, and create added stress. Whatever works for you, do it, just make sure that you ARE breathing. Holding your breath can increase the pain, and can also deprive baby of oxygen.
You may feel anxious, exhausted, and irritable. This stage lasts, on average 4 - 6 more hours. It's perfectly normal to feel fed up and tired, but just remember how close you're getting. Each contraction gets baby closer to you. Try to picture that. This is Pain with a purpose. Try to focus on what you've accomplished, and how far you've come.
This is the most difficult phase of labor. Fortunately, it is also the shortest. Your cervix will dilate from 7-10 centimeters. Transition lasts on average 30 minutes to an hour and a half. Again, this can vary depending on each woman. Every labor is different. Contractions are coming fast and furious now -- every 2 to 3 minutes, and lasting 60 - 90 seconds. That's not much time in between to rest, and it can feel like they are coming one on top of the other, with no break. Take heart -- you really are almost there. When this is over, you can start pushing your baby out. An encouraging thought -- transition is, on average, about 20 contractions. Maybe that'll help you get there. Many women report that just when they feel they can't take anymore -- they're through it.
You may feel more pain in your back, and the contractions are definitely more intense now. You can feel nauseous, chilled, shaky -- some women also report hot flashes. It is not uncommon for women to feel a little crazy during transition. It is very tiring and demanding, and you're already tired. Don't worry about it. Things that helped before may only annoy you now -- don't be shy to communicate your feelings. You may find it very hard to concentrate on anything, let alone relax. But try -- you are so close! If you've made it this far without medication -- now is when you may lose faith. This is such a short phase in comparison -- only 20 contractions -- you can do it! Coaches -- now is the most important time to give her what she needs. Efficient encouragement now can make all the difference.
You might feel an urge to push during this phase -- don't (unless your care provider has told you to). Pushing before the cervix is fully dilated can cause it to swell, prolonging this phase, which you probably won't appreciate. At 10 centimeters the first stage of labor is over, and it's time to get your baby out!
Stage two can take a few minutes or a few hours. It tends to take longer for first-time moms and women who have epidurals for pain control. During this stage you will push; at times your doctor may ask you to stop pushing. First, the baby will crown. This means that the widest part of the baby’s head appears in the vaginal opening.
As the head is pushed through, the vagina and perineum are stretched, which may cause a burning sensation. Once the head is out, the baby’s mouth and nose may be suctioned with a syringe to clear out mucus. Shortly after, the rest of the baby’s body is delivered and you may hear your baby’s first cry. The umbilical cord, which connects the baby to the placenta, is clamped and cut.
Stage three usually takes only a few minutes, but can last up to half an hour. You may continue to have mild contractions. Your doctor or midwife may massage your lower abdomen to help push the placenta out, and you may need to push one more time. The placenta comes out with a small burst of blood.
While you are resting and greeting your baby, your doctor will examine your vagina. If there was tearing or you had an episiotomy, stitches may be put in. You may also be given medications to encourage uterine contractions and minimize bleeding.
You and your baby will be closely monitored while you are in the hospital. Now that you’ve made it through the delivery, take advantage of this time to get some rest, ask any questions, and prepare yourself for the next big challenge — motherhood.
Stage one: early and active labor
During stage one, your cervix dilates and effaces, preparing for the passage of the baby. By the end of this stage, the cervix is 100% effaced, or thinned, and 10 cm dilated so that the baby can pass into the birth canal (vagina). The first stage of labor is the longest, and fortunately the easiest. This stage is divided into three phases:
Phase 1 - Early Labor or Latent Phase
In this phase the cervix dilates from 0 to 3 cm. You may be uncomfortable, with a backache, feeling of fullness, or menstrual-like pain. You may have a slight bloody or pinkish show, and loose bowel movements. This phase lasts an average of around 8 hours, but this can vary wildly from woman to woman, and can also occur over days without noticeable discomfort. Some women don't recognize labor until they're well into the 2nd stage. Contractions in this phase may be irregular, coming every 5 to 20 minutes, or anywhere in between. As a result, it can be difficult to pinpoint the start of labor, and whether or not this is actually true labor. Generally, if the contractions follow an overall trend of getting longer, stronger and more frequent, then you're on your way!
During this stage, it is unnecessary to go to the hospital. It is recommended that you stay home and relaxed as long as you are comfortable -- if you have ANY doubt, call your care provider -- as labor has a tendency to progress better in comfortable and familiar surroundings, and you are more likely to rest and stay relaxed at home than in the hospital. If you are hungry, now is your chance! You likely won't be allowed to eat much -- if anything -- once you get to the hospital, so try to get some energy now, but avoid anything heavy, fatty, or difficult to digest. Think whole grains, fruit, and lots of fluids. Avoid anything too sugary, as this can serve to dehydrate you, which is the last thing you want. Try to move around - go for a walk, or at least walk around the house. Walking enlists gravity, and helps labor to progress. But keep things gentle. You don't want to tire yourself out now. Read, watch TV, finish preparing the baby's room, play a game, anything to entertain and distract you. You can time your contractions once they start getting more frequent. When they are 4-5 minutes apart, and are lasting for more than 45-60 seconds, now you can head to the hospital. Again, if EVER you're not sure, call your care provider, or the hospital.
Phase 2 - Active Labor
Once your cervix is 3 or 4 cm dilated, you move into phase 2, called active labor. In this phase, the contractions are stronger, occur more often, and come closer together - every 4 or 5 minutes, and lasting about 40 - 60 seconds. If you're not already there, you should head to the hospital around now. Again, the thing to look for is contractions that get overall longer, stronger, and more frequent.
This phase is more intense than the first, and your cervix will dilate from 3 or 4 cm to 7 cm. The contractions are getting to be more work at this point, and you may have to concentrate more on each one, maybe not being able to talk through them. Again, continue walking around. Barring any complications, walking throughout your labor is strongly recommended. Try other positions also to ease the discomfort - in a tub, in the shower, kneeling, laying on your side, squatting -- whatever seems to help. Try to avoid laying on your back unless you have to -- it can slow down labor, and won't help the pain much. Try to stay hydrated if you're allowed to have water or ice chips. Also remember to go pee often, as a full bladder can impede labor. Coaches -- remind mom of this. You can use your breathing exercises now, if they help. Many women swear by them, claiming they couldn't get through labor without them, but some say they just feel unnatural, and create added stress. Whatever works for you, do it, just make sure that you ARE breathing. Holding your breath can increase the pain, and can also deprive baby of oxygen.
You may feel anxious, exhausted, and irritable. This stage lasts, on average 4 - 6 more hours. It's perfectly normal to feel fed up and tired, but just remember how close you're getting. Each contraction gets baby closer to you. Try to picture that. This is Pain with a purpose. Try to focus on what you've accomplished, and how far you've come.
Phase 3 - Transition
This is the most difficult phase of labor. Fortunately, it is also the shortest. Your cervix will dilate from 7-10 centimeters. Transition lasts on average 30 minutes to an hour and a half. Again, this can vary depending on each woman. Every labor is different. Contractions are coming fast and furious now -- every 2 to 3 minutes, and lasting 60 - 90 seconds. That's not much time in between to rest, and it can feel like they are coming one on top of the other, with no break. Take heart -- you really are almost there. When this is over, you can start pushing your baby out. An encouraging thought -- transition is, on average, about 20 contractions. Maybe that'll help you get there. Many women report that just when they feel they can't take anymore -- they're through it.
You may feel more pain in your back, and the contractions are definitely more intense now. You can feel nauseous, chilled, shaky -- some women also report hot flashes. It is not uncommon for women to feel a little crazy during transition. It is very tiring and demanding, and you're already tired. Don't worry about it. Things that helped before may only annoy you now -- don't be shy to communicate your feelings. You may find it very hard to concentrate on anything, let alone relax. But try -- you are so close! If you've made it this far without medication -- now is when you may lose faith. This is such a short phase in comparison -- only 20 contractions -- you can do it! Coaches -- now is the most important time to give her what she needs. Efficient encouragement now can make all the difference.
You might feel an urge to push during this phase -- don't (unless your care provider has told you to). Pushing before the cervix is fully dilated can cause it to swell, prolonging this phase, which you probably won't appreciate. At 10 centimeters the first stage of labor is over, and it's time to get your baby out!
Stage two: your baby’s birth
Stage two can take a few minutes or a few hours. It tends to take longer for first-time moms and women who have epidurals for pain control. During this stage you will push; at times your doctor may ask you to stop pushing. First, the baby will crown. This means that the widest part of the baby’s head appears in the vaginal opening.
As the head is pushed through, the vagina and perineum are stretched, which may cause a burning sensation. Once the head is out, the baby’s mouth and nose may be suctioned with a syringe to clear out mucus. Shortly after, the rest of the baby’s body is delivered and you may hear your baby’s first cry. The umbilical cord, which connects the baby to the placenta, is clamped and cut.
Stage three: delivery of the placenta
Stage three usually takes only a few minutes, but can last up to half an hour. You may continue to have mild contractions. Your doctor or midwife may massage your lower abdomen to help push the placenta out, and you may need to push one more time. The placenta comes out with a small burst of blood.
While you are resting and greeting your baby, your doctor will examine your vagina. If there was tearing or you had an episiotomy, stitches may be put in. You may also be given medications to encourage uterine contractions and minimize bleeding.
Postpartum care
You and your baby will be closely monitored while you are in the hospital. Now that you’ve made it through the delivery, take advantage of this time to get some rest, ask any questions, and prepare yourself for the next big challenge — motherhood.
