Stages of Labor - What to Expect

Stages of Labor
What to Expect

Preparing for labor is one of the most important jobs for an expectant mother. It can be incredibly exciting and at the same time very frightening. The best thing you can do to prepare yourself is to learn about the labor process.

STAGE 1
The first part of labor is subdivided into 3 sections: the latent, active, and the transition phases.

PHASE 1 — Latent
The latent phase is the longest part of labor; it can last up to 12 hours, during which the cervix dilates (opens) from 0-3 cm. Effacement (thinning of the cervix) also occurs. At this phase, you may experience a bloody show (mucous mixed with blood) and menstrual-like cramping (confined to the back and radiating to the front) or rupture of membranes (broken bag of water). During this time, you must call your health care provider. If your water breaks, remember to notice the color of the fluid (usually clear or cloudy) and tell your health care provider. If you have not already, now is the time to gather the personal items needed for your hospital stay. At this point, you may feel relief that your pregnancy is going to end. Usually, there is not much physical discomfort. You might even be able to watch TV, play cards, or even sleep. However, many women have an underlying anxiety to get started.

PHASE 2—Active
The active labor phase can be determined by cervical dilatation from 4-7 cm. The labor pains are usually stronger, and the contractions are closer together. By this time, you should be in your chosen birthing facility. This is the time when focused breathing and relaxation techniques are needed. You may find yourself restless, desiring frequent position changes, ambulation, massage therapy, and hot or cold compresses. If these prove ineffective, talk to your healthcare provider about stronger pain relief methods. You may become fearful that you will not be able to continue. You might get tired, discouraged, and even feel overwhelmed. But hang in there! Let your coach help you focus.

PHASE 3—Transition
The transition phase lasts from 7 cm to fully dilated (10 cm). By this point you may be experiencing increasing rectal pressure, and having the feeling of bearing down. Emotionally, you are likely to be very irritable. Nevertheless, you must stay focused. Remember, the end is near.

STAGE 2
Pushing begins when you are fully dilated (10 cm). At this stage, your contractions might be further apart, so may rest between your pushes. The urge to push becomes stronger as the baby moves down the birth canal. You might even feel a burning sensation. You might feel very determined to finish the labor process and even get a burst of energy. You may experience a sense of relief, seeing the end in sight. You want this to be over, and you cannot wait to see your baby.

Learn as much as you can during your hospital stay. Ask a lot of questions. The nurses are the experts and are there to help you. Once discharged, expect to see your obstetrician and pediatrician in approximately 2 weeks. You can expect your first period about 6 weeks after delivery, or longer, if you are breastfeeding.

STAGE 3
This part is characterized by the delivery of the placenta shortly after your baby emerges and the umbilical cord is cut. You might feel mild contractions, which are necessary for the delivery of the placenta and for the uterus to go back to pre-pregnancy size. It is also the time an episiotomy (vaginal or cervical tear) will be repaired. You’ll want to hold your baby, and focus almost all of your questions and concerns on the baby’s well being.

STAGE 4
Shortly after delivery, you will begin a vaginal discharge, dark red in color, called lochia. It usually lasts 2-4 weeks and will change in color and amount. Most women feel a generalized shivering, and may continue to have mild cramps. This will pass, but ask the nurse to give you a blanket and possibly a mild analgesic until it does. You’ll be tired but will likely feel overwhelming joy and disbelief. About this time, you’ll become aware that you’re thirsty and hungry. This is the perfect time to eat something light, and then sleep. You won’t realize it at the time, but this could be your last good sleep for a while.

Provided by Cathy Sheedy, RN, MSN, Director of Women’s and Children’s Services, Holy Name Hospital.