Stages of Labor
What to Expect During Childbirth
If you are reading this, it is likely that you already know that having a baby is hard work.
The labor process occurs after a prolonged time of being pregnant. Your baby has been in the uterus (in utero) for almost 40 weeks. By the time your labor actually begins, you will probably be totally ready to welcome your baby into the world.
When it is time for the baby to be born, your body will go through some physical changes designed to bring that baby out of your uterus. In fact, many women will not even realize that they have started their true labor, which can be as simple as a backache, slight cramping, or abdominal pain. Some will only know that their labor has started when their water breaks, which can actually be anything from a trickle of fluid to a big puddle.
If you experience these symptoms during your pregnancy, call your obstetrician for instructions. If you are at the end of your pregnancy, the obstetrician may have you go to the hospital where you are set to deliver to enable the medical team to determine if you are in true labor. Never be embarrassed to call and ask questions or go to the hospital for false alarms.
Once your labor has begun, you will begin to experience "contractions." These are the tightening and relaxing of the uterine muscles as they prepare to send your baby into the world. The contractions will cause your cervix to efface and dilate. (Effacement means a shortening of the cervical canal; dilation involves a gradual widening of the cervical opening.) The cervix will be completely thinned (or effaced) and 10 centimeters open (dilated) when it is time for the baby to be born.
STAGE I (Contractions and Dilating)
The process of labor is broken down into three stages. The first stage
is from the start of true labor to complete dilation of the cervix. This
stage is divided into three parts: Latent, Active and Transition.
Latent Labor — In Latent labor you may experience mild contractions that are anywhere from five to 30 minutes apart. During this Latent labor stage you may also experience backache, mild diarrhea, anxiety and/or excitement. During this initial stage, most women can walk around, take a warm shower or bath, or engage in breathing patterns to relax. Your support person can participate by keeping you company, giving you a back massage, offering words of encouragement, or keeping a log for you of your contractions (how far apart they are and how long they last). You can rate their intensity on a scale of 1 to 10 to help guide you with your progression of labor. You should be aware of all the options--both medical and non-medical--available to you to help you work through your labor and pain.
Active Labor — As you progress to Active labor, more rapid dilation occurs. The cervix is really beginning to open up and you may hear the medical team say you are 4 to 7 centimeters along. Remember that the goal is 10 centimeters. It is during this time that the baby is actively trying to get in position to be born. Women say that during this stage of labor they may feel stronger and longer contractions, more back pain, and may feel the need to concentrate on the process at hand. The support person can continue to provide encouragement, use a moist towel to help keep your lips and mouth wet, and provide comfort measures such as massage or music.
Transition Phrase — As you enter the Transition phase, the contractions are more intense, and your cervix will become fully dilated to 10 centimeters. The baby is applying pressure to the mother's bottom area and you may have an overwhelming desire to push against that pressure. Do not push until the medical team instructs you to do so. If it is necessary for you to stop pushing, use breathing patterns and your support person to help you through the feelings of pressure and discomfort. Women go through many emotional moments during the Transition phase of labor including even a desire to go home. It then becomes the important role of the support person to talk the woman through this period and give her the encouragement she needs to finish the job and deliver the baby.
STAGE II (Delivery of the Baby)
As you move to Stage II, you may experience a lot of pressure in your bottom area. The urges to push are strong and it actually feels helpful to many women to begin pushing as they are now active participants in the process. Although it may be difficult to do, try to rest between contractions and save your strength for pushing the baby out during the contractions. Many women get a "second wind" prior to delivery to help them get through this second stage of labor. Your support person can help you find the most comfortable position, continue to offer encouragement, and help you focus on your breathing. Your medical team will help guide you through the process of pushing and successfully delivering your baby. Once your baby is born, savor the moment, for you will only get that once in a lifetime with each child you deliver.
STAGE III (The Placenta)
The last stage of labor is Stage III or the time between the delivery of the baby and the delivery of the placenta. Uterine contractions will help expel the placenta, usually within 20 minutes of the delivery of the baby. You may have some bleeding, chills or exhaustion.
Your physician will examine your vagina and perineum. If you have some tears, your physician will do the repair. Your nurse will massage your uterus and will be checking it frequently over the next several hours to make sure your uterus is firm and that you are not experiencing any excessive bleeding.
At the same time, your baby's medical team will clean your baby, suction the nose and mouth, and keep the baby warm. They will also assign the baby scores called APGAR scores which assess the baby's overall status after birth.
You did it! Congratulations! The work was hard, but in the end so rewarding. Give yourself a big hug for a job well done, and get some rest as you will need all your strength to help you love and care for your new baby. The joy of being a parent is exhilarating and exhausting. Enjoy every minute of your new beginning together.
