The Stages of Labor 


 

The Stages of Labor

1. The First Stage            Early Labor                              Prodromal labor                      ActiveLabor                         Transition       

2. The Second Stage     Pushing

3. The Third Stage        Delivering the placenta

Most labors occur in three stages.  How long these stages last and specifics about each stage will be different for everybody just as everybody had different pregnancies.  However, reading more about this may help you navigate through your labor and feel empowered with information.                             

1.The First Stage: (Early labor to Transition)

               
                                                  

       

       

       

       

       

      • This stage lasts through the cervix opening (called dilating) and thinning(effacement). This has to happen so that the baby can move through into the birth canal and prepare to make an entrance into the world!
      • This will be the longest stage of your labor, the marathon of contractions! The first stage of labor occurs when the cervix    opens (dilates) and thins out (effaces) to allow the baby to move into the birth canal. It's actually divided into three phases of it's own: Early Labor, active labor, and transition.

      Early Labor

       

       

       

      • Early labor consists of the period from where you cervix goes from completely closed (0 centimeters) to 3 cm.
      • Contractions are mild to moderate during this phase, but everyone senses pain differently, and this stage can be quite painful for some women.
      • When labor is beginning you will likely pass your mucous plug (although this can happen a week or so before hand!) and you will see bloody show when your cervix starts to open. This is like stringy bloody discharge and is nothing to worry about if labor is expected at this time.
      • Other symptoms you might feel are intense pains in your back, nausea and even diarrhea (your body‘s natural way of “cleansing itself for delivery). This stage won’t be over until the cervix continues to dilate and this can actually take DAYS… which is really disappointing to some moms who head into the hospital only to be sent home until more progress is made. This is referred to as “prodromal labor”.

      Prodromal labor can be exhausting, and frustrating. You may be having irregular yet painful contractions and feel like you are making absolutely no progress… but you are! Every contraction stimulates the release of Oxytocin. This is a good time to relax, practice breathing techniques, soak in a warm tub, and even do some walking. It is imperative that you stay well hydrated and force yourself to rest! Many women experience a “surge” of energyduring this stage, and it is easy to wear yourself out! This may be a good time to take a look at the link Natural Induction Methods to help the process along.

      Active Labor

      When the contractions get more regular and start following a pattern, you will be in active labor.

       

       

      • The cervix will dilate to seven centimeters during this part of labor!
      • Contractions can last 60-90 seconds, and be as close as 3 minutes apart. You may find that the contractions are becoming quite intense, and are difficult to walk and talk through.
      • This is a good time to grab the baby bag and head to the hospital! Active labor averages about three to eight hours but this greatly varies for different women, especially if you have had a delivery before (might be a lot less or might follow the old pattern). The first stage comes to a close withtransition.

      Transition: (This is when the cervix dilates from seven to ten centimeters).

      This is usually the fastest and hardest phase of labor. Many women describe this as the most difficult part of labor; however, if you have decided to have an epidural, you may quite comfortable and "chatting away", waiting to hear that you are complete.  Even when an epidural is in place, some women may experience pressure, and sometimes "intense pain" once the baby descends below the point of the epidural. 

       

      • Depending on your dilitation, your labor nurse may call anesthesia in to give you a "bolus" of medication into your epidural catheter.  Many women are surprised when this occurs, and it may be too late for the "bolus" of medication and time to push!  Even women who are perfectly comfortable with an epidural can experience the "shakes", chattering teeth, hot and cold flashes, and nausia/vomiting when transition occurs. 
      • Contractions can last up to 90 seconds long and only leave you time to take a breath between them! Those who have chose to go without the epidural may feel an intense urge to push, shaky, hot/cold, and experience nausia and vomiting.  The urge to push is very powerful,  but you’ll want to try to hold off until you’re fully dilated and your doctor tells you that its time to push. If you push too soon, this can cause swelling or tearing of the cervix, which in turn can make it difficult or impossible to deliver vaginally and may require a c-section or dangerous bleeding for mom.

      2. The second stage:  Time to push!

      • The second stage begins when you are fully dilated and it is time to push! Contractions may spread out a little and you are able to bear down, which can relieve some of the discomfort.
      • The baby starts its decent down the vaginal canal. Your perineum will eventually start to bulge and then the baby’s head will appear at the vaginal opening, which is referred to as ‘crowning’. It is very normal to expell feces at this time, and for some women this can be quite embarrassing!  I can tell you, this happens in approx. 85% of deliveries, so there is no need to feel embarrassed! 
      • When the baby’s head is out, they will suction the nose and mouth, and then the baby’s shoulders get in position for exit. A few more pushes and the baby is out! This stage may last a few minutes to an hour, again, depending on mom. Also, if you’ve had an epidural, the urge to push may be numbed and it may take you longer.

      Happy Birthday!

       

       

      3. Third Stage:   (Delivering the placenta)

      • After your baby is born, your uterus will begin contracting again soon to separate the placenta from the wall of your uterus. Your doctor may encourage you to push gently to help get this out. It usually takes one small push and may be slightly uncomfortable, with instant relief once the placenta is delivered.
      • This part only takes about ten to twenty minutes. When the placenta is out, youruterus will draw itself up and begin to firm; the nurse who is taking care of you will occasionally check to see that it is still firm and if it gets soft, she will massage it to make sure that it remains firm. You may also be instructed to do this on your own, as this encourages the uterus to “clamp down” and avoid bleeding. It is important to report any sudden “gushes” to your nurse.
      • Afterwards: What now? If you’re planning on breastfeeding, this is when your infant is most alert and a great time to initiate this. You may feel ‘afterbirth pains’ when your baby nurses,which are really more like strong menstrual cramps; this is natures way of assisting your uterus to "clamp down" as this releases oxytocin, which causes your uterus to contract.  Your doctor will inspect  you to repair up an episiotomy or any tears that my have occurred during birth.

       "The stages of Labor" written by: Erin B., RN