Signs and Stages of Labor
Signs of Labor
First-time moms always want to know when they should go to the hospital or birthing center. There are two positive signs of true labor to look out for. The first sign is that labor contractions become more intense, last longer, come closer together in a regular pattern and discomfort does not stop with walking or activity. The second sign is that your water breaks (amniotic sac ruptures). If your water breaks, you should pay attention to four things. Use the acronym COAT to help you remember:
- Color of fluid
- Odor of fluid
- Amount of fluid
- Time your water broke
Call your doctor or healthcare provider if you think your water has broken or if you are having regular contractions. Most healthcare providers advise going to the hospital when your contractions are five minutes apart, lasting one minute for at least one hour (remember 5-1-1).
Stages of Labor
Labor and delivery are divided into three stages. During each stage, many changes are occurring within your body. The first stage of labor starts from the time true labor begins until the cervix is completely dilated to 10 centimeters. The second stage of labor starts at complete cervical dilation until the delivery of your baby. The third stage of labor starts after the delivery of the baby until the placenta detaches from the uterine wall and is expelled through the vagina. Labor and delivery times vary by woman and by pregnancy, and no two are exactly alike.
There are several factors that can affect your progress in labor and delivery:
- Position of the baby's head
- Size of the baby
- Whether the baby is facing mom’s front or back
- Size and shape of mother's pelvis
- Mother's physical and emotional state
- Effectiveness of the contractions in dilating the cervix
- Medications or anesthesia administered
First Stage of Labor
During the first stage of labor, contractions help your cervix thin and begin to open. This is called effacement and dilation. As your cervix dilates, your healthcare provider will measure the opening in centimeters. During this stage, your cervix will widen from one or two centimeters to about 10 centimeters. The first stage of labor is usually the longest because there are three phases within the first stage. It begins with the onset of true labor and ends when the cervix is completely dilated or 10 centimeters. The average duration for this stage for women having their first child is 12-16 hours, and for women having their second or third baby this stage is around 6-10 hours.
The first phase of the first stage of labor is called the early phase.
The early phase lasts from the start of labor until the cervix dilates to three centimeters. The duration of this phase averages eight hours for first-time mothers and is usually the longest phase of labor. Women are usually feeling eager and excited in this phase of labor. It is not necessary to go to the hospital at this point. You will probably spend most of early labor at home. Try to rest, drink fluids, eat light meals if you want to, and keep track of your contractions. These contractions are mild, somewhat irregular, but over time will grow stronger and closer together. When you notice a clear change in how frequent, how strong, and how long your contractions are, and when you can no longer talk during a contraction, you are probably moving into active labor.
The second phase of the first stage of labor is called the active phase.
The active phase of labor dilates your cervix from three centimeters to seven centimeters and averages around 4-5 hours. This is the time when most women will go to the hospital or birthing center. For most mothers, as your labor progresses, your water may break during this phase, causing a gush of fluid. After your water breaks, you can expect your contractions to speed up and to feel more pressure as the baby’s head moves further down into the pelvis. Slow, easy breathing is usually helpful at this time. Walking, standing, sitting upright and changing positions will help labor progress. The contractions during this phase grow stronger, more uncomfortable and are progressively longer.
The third phase of the first stage of labor is the transition phase.
The transition phase is the hardest phase within the first stage of labor, but remember that it is also the shortest. It can be as short as 30 minutes and as long as 2 hours. This phase will dilate the cervix from 7 centimeters to 10 centimeters or complete dilation. These contractions are very intense and they may sometimes seem as if they are one right after another. When you feel an urge to push, tell your healthcare provider.
Second Stage of Labor
The second stage of labor starts when the cervix is fully dilated and ends with the delivery of the baby. Now it is time to push. This stage is shorter than the first stage, lasting anywhere from 30 minutes to three or more hours. Your nurse will tell you when it is time to push and will instruct you on pushing effectively.
Third Stage of Labor
The third stage of labor begins after the baby is born and ends with the delivery of the placenta. It is the shortest stage and lasts anywhere from five to 20 minutes. After a few early labor-like contractions and massage of your uterus, the placenta is expelled.