Labor and delivery are an incredible time in a soon-to-be new mother’s life. Each experience is completely unique and special, and no two deliveries are the same, which makes it hard to predict exactly how your labor might go. Regardless, you should have a general idea of the different stages of labor to prepare yourself for what you might experience.
Labor is normally separated into three unique stages: first, second and third. Each of these stages will lead into the next, but have defining characteristics, and what you can do in order to make it through each will change as well.
- The First Stage is characterized by the beginning of contractions and the transition of your cervix from closed to fully dilated at 10 centimeters. It involves several stages for the dilation of your cervix, the evolution of contractions from mild to intense, as well as the final transition into the second stage.
- The Second Stage is also known as the “pushing stage”, as it is the period of labor that occurs after full dilation and ends with the birth of your baby.
- The Third Stage occurs after the birth of the baby, through the delivery of the placenta and other after birth.
Remember that there are wide variations in labor. Most labor for new mothers can take place between 10 to 20 hours, but may be shorter for more experienced mothers. Each labor will be unique, however, and this time can shorten or lengthen dramatically.
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The First Stage: Getting Ready for Baby
The first stage is often split into three separate mini phases of labor that start with Latent (Early) Labor, moves to Active Labor, and finishes with the Transitional Phase.
This phase of labor can be the most difficult to know when it is truly starting. The contractions that characterize early labor can resemble Braxton-Hicks Contractions and other signs of false labor. To be sure you are experiencing real labor and not false labor, track your contractions. If it is true labor, they should begin to lengthen, become stronger, and become more frequent. Eventually, they will be coming every five minutes and lasting 40 to 60 seconds each as you reach the end of early labor. The contractions felt during early labor can be painful for some women, but generally, they are the mildest of the entire birthing process. You should be able to continue functioning throughout this phase of labor, talking through the contractions, and there is no need yet to rush to the hospital, or wherever else you have chosen to have your baby. Another sign that early labor has begun is the bloody show. This is the expressing of a small amount of blood-tinged mucus from your vagina. This is completely normal, but if there is more than just a tinge of blood, you should call your doctor. In addition, if your water breaks during this stage, it is advised that you call your doctor, as most women will experience their water breaking during the active stage. (If you are less than 37 weeks pregnant and any of these symptoms of labor occur, please call your doctor right away as you might be in pre-term labor.) You might also experience back pain, indigestion, diarrhea, or abdominal warmth. Early labor lasts roughly 6 to 12 hours but varies a lot from person to person. It ends after your cervix dilates to about 4 to 6 centimeters.
What Can You Do
During this stage of labor, relaxation is the key to success. You should be drinking lots of water, in addition to urinating frequently. If at night, attempt to sleep in between contractions. If not, try to do relaxing activities such as read a book, take a warm bath, or watch a movie.
2. Active Labor
This is where the real work starts! Active labor is characterized by contractions that become increasingly intense. They are longer, stronger, more frequent, and more painful. The contractions will last for 40 to 60 seconds, and will begin to occur in a pattern, every few minutes. In this stage, your cervix quickly dilates to 7 or 8 centimeters. Additionally, the baby might begin its descent into your pelvis. Your contractions should become as frequent as every 2 ½ to 3 minutes, but could lengthen to every five minutes. Now is the time to head to the doctor. You may also feel an increase in your back pain, discomfort in your legs, an increase in bloody show, an inability to talk through your contractions, and finally, if it has not happened already, the breaking of your water. This stage can last anywhere from 4 to 8 hours but can be much faster or slower. Receiving Pitocin can speed it up as well as having delivered a baby before. On the other hand, having an epidural, or being a first-time mother might elongate this phase.
What Can You Do
This is the stage in which you might be offered pain medication or an epidural if it is in your birth plan. If you have chosen to go the natural route, now is the time to practice your breathing exercises, begin visualizing the labor, and have your partner or someone else give you a gentle massage. Also, it is recommended that you switch positions in order to find the position that feels the best and most natural for you. You do not have to lay on your back with feet in the stirrups as you see in the movies! Your labor is yours, and you can choose a variety of positions to better birth your child.
This is the final phase of the first stage. Your body will quickly dilate your cervix from 8 to the full 10 centimeters. This phrase is called transitional or advanced labor as it marks the transition from the first stage of labor to the second stage of labor. This is the most intense part of the first stage. Your contractions will become increasingly faster and may last for over a minute each. You may also begin experiencing shivering and shaking. At this point, the baby is sitting in your pelvis waiting to be delivered. Because of this, you might begin experiencing intense rectal pressure and you may need to relieve yourself, or experience gas. You might also feel the need to suddenly “push” or bear down in order to help relieve the pressure. At this point, you will also begin to experience much more bloody discharge as the capillaries in the cervix begin to rupture, in addition to bouts of nausea and vomiting. Between the painful contractions, some women also report feeling drowsy, on top of fatigue and general exhaustion. Your legs may begin to cramp and shake uncontrollably and you could feel tightness in your chest. These symptoms vary from woman to woman, labor to labor. These symptoms also depend on whether you have chosen an epidural. The epidural might help you relieve the pain, and change the type of pressure you are feeling. If you begin to feel as if you are not an active participant in this stage of your labor, you can ask your doctor to lower the amount of medication you are receiving. The transitional phase is the most intense, but luckily, it is also the shortest for most women. In new mothers or mother’s choosing an epidural, it might take a few hours. However, if you have had children before, or are choosing to experience labor naturally, it could last only a few minutes.
What Can You Do
This is a stage in which it is a good idea to reach out to your significant other or family member in the room with you for encouragement. You will begin to feel frustrated, impatient, and exhausted and so having someone there to tell you how amazing you are doing will surely help. Keep yourself breathing, either by doing breathing exercises or by panting to help resist the urge to push. A massage by a loved one might also help, though if you do not want to be touched, do not hesitate to speak up. You could also ask for either a cold or a warm compress as well, depending on what you would prefer. Most importantly, like in the previous phase of the first stage, change positions! You are not confined to one specific position for delivery. Move around and find what makes you as comfortable as you can be.
The Second Stage: Here Comes the Baby
Now that your cervix is fully dilated, your baby has almost reached the finish line! The baby is finally beginning its descent into the birth canal and the process of being delivered. You have not been able to really make the birthing process move any faster, but here is where that changes as you are entering what is commonly referred to as “the pushing stage”. This stage becomes a little easier as well, as your contractions should begin to space out again. The contractions also become easier to handle as the sensation of pushing can help relieve the pain and pressure caused by the contractions. This could be different for some women, though, as they may not like the sensation of pushing. Just as in everything else, this stage can either move quickly or more gradually, depending on how many children you have had and again, on whether you have chosen an epidural. Your body at this stage is working its hardest to push your baby out. As the uterus contracts, it pushes the baby’s head further into the birth canal, but as the contraction ends, the baby moves back slightly. This is Mother Nature’s version of “two steps forward, one step back.” Be aware of your own body in this stage, however, as doctors will often coach you into pushing on each contraction. Remember that this is your labor, your body, and your baby, and you can choose a slower, more gradual pace if you feel it is what you need. Variety in body position might also help you. Some women may choose to deliver on all fours, to squat, sit up more, etc.
Once the baby’s head begins to show, you will feel the need to push increase greatly due to both your body’s reaction and your natural excitement and impatience. As the baby’s head moves into your cervix, you might also begin to feel a pinching, burning, or even stinging sensation. At this point, your doctor may instruct you to begin to push more slowly, or gently. Pushing too fast or hard at this point in the labor might cause you to tear your vaginal wall. Pushing more gently can help your body stretch to accommodate the size of your baby’s head. When the widest part of your baby’s head pushes past your cervix, this is known as crowning. Slowly, you will begin to see its forehead, eyes, nose, mouth, and then finally its little chin as its head fully emerges from the birth canal. The excitement in the room will be palpable, and the doctors and nurses will move forward to suction mucus out of the nose and mouth of the child. At this point, the doctor will also feel around the child’s neck to ensure that the umbilical cord is not wrapped about its throat and endangering the child. If it is, the doctor will push it lower to make sure the delivery is safe.
After this, the baby’s head will be turned to the side to better position it for the shoulders to be delivered one at a time. After that, the baby’s body should slide out easily, with a wet sensation. If choosing a more traditional route of delivery, this will be the moment in which the doctor might choose to clamp or cut the umbilical cord. However, many mothers are now moving towards delayed cord clamping, allowing the child to receive as many nutrients from the placenta as possible. At this stage, the baby will also be wiped down, and either wrapped in a towel or placed on the chest of the mother to encourage skin-to-skin contact. At this moment, you will probably forget your exhaustion, and will probably experience the height of emotions. You may feel awe, bliss, euphoria, and a healthy dose of relief that your baby has arrived safely. This stage, much like the others, is also varied on how long it takes. It also can last from mere minutes for some, to hours for others.
What Can You Do
Just do your best! Breathe, focus on the goal, and if it helps you, keep a mirror positioned so you can see your baby crown and come out. This motivation will help you “push” through stage two, pun intended. After your bundle of joy has been delivered, revel in the moment. Cuddle your baby, bask in the awe of how amazing this little creature is that you made. You did it!
Stage Three: The Placenta and After Birth
The third and final stage of labor is characterized by the delivery of your placenta or afterbirth. Minutes after giving birth, you will begin to feel more contractions although they will often not be painful. These contractions are your uterus pushing to separate the placenta from the uterine walls and expel it. These pushes will be gentle and may not even be felt at all. Oftentimes it only requires one single push. This stage normally only takes 5 to 10 minutes from start to finish.
After your placenta has been expelled, you will continue to feel mild contractions, as your uterus becomes firm. This allows your body to stop bleeding, and you might be able to feel the edges of your uterus through your skin. At this point, you might begin to experience after birth pains that can last for a few days after delivery, but more often than not it will not last longer than a few hours and it is very mild. If you tore during delivery, now is the time that the doctor will suture you if needed, although many times they will allow your body to heal naturally, as long as there is not a risk to the mother. It is finally time to relax and enjoy your baby. Soon after, you can begin to breastfeed your baby. Not all babies will be eager to feed right after birth, but continue to hold your child nearby and most children will begin to nurse within an hour of birth. This triggers the release of oxytocin, which helps the mother keep her uterus firm. You might feel shaky due to the leftover adrenaline, but it is normal.
If you chose an epidural, the nurses will remove the medication at this point, and they might borrow your baby for a moment to assess its health, and make sure it has eye drops and other necessary medications. After that, it is time to cuddle. Spend quiet time with your baby and significant other or loved ones, and just enjoy that you are finally done and you have an amazing little baby to show for it.