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Three Stages of Labor - for Moms

Rachel O'Reilly

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By Aaryn Leineke

There is no “one-size-fits-all” labor. It can take days, even weeks from when your first contractions or early labor signs start to when you have your baby in your arms. That said, there are a few stages of labor that everyone will go through, and knowing what to expect during each stage can help you see the light at the end of the tunnel.

The below stages of labor refer to the ideal situations. At any moment of a pregnancy, need for medical intervention can arise. Make sure you’ve discussed with your doctor what to do when labor starts, and have your healthcare provider nearby or on-call for any questions or for alerting at any time during labor if things don’t feel right.

1.     First Stages, 0 hours - 2 weeks

       a.     Early labor: 0 - 3 centimeters

            i.     Anywhere from hours to a couple of weeks before birth, your cervix will dilate up to 3 centimeters. This stage of labor can happen over a lengthy period of time when you’re close to full term, without bothersome or painful contractions. It can also happen after contractions (also known as surges) start, and it could take a number of hours to days, and can be fairly uncomfortable.

            ii.     As much as possible, you should continue your day/night routine as normally as you can. It can take hours, and often the contractions are anywhere between 5-10 minutes apart and very sporadic. Therefore, if early labor begins at night, make sure to rest and close your eyes between surges. If you enter your first stages during the day, prep meals, go on walks near your home and handle any last-minute prep around the house, since you know now the baby will be there any day. You’ll notice you will have softer stool and you may feel the need to use the restroom more frequently than normal.

            iii.     When you think labor has started, you can call your doula, who can help if you’re feeling anxious or have some discomfort. If you and your baby are healthy, it’s best to stay home during early labor or as long as possible. If you plan to have a hospital birth and you and your baby are healthy, the nurses will most likely have you go back home if you are not in active labor yet, so keep that in mind if you feel eager to get to the hospital as soon as your first contraction comes, or if your water breaks. If you have a birth doula with you at home, she can help time your contractions and give you and your partner insight on when the labor is becoming more active.

       b.     Active labor: 3 - 6/7 centimeters

            i.     Contractions will be stronger, longer, and closer together (lasting 45 - 60 seconds/3-5 minutes apart). This is usually the time to either call your midwife to assist you at home, or have your partner take you to the hospital. Active labor is when you put all the classes and reading you did during pregnancy to work. Practice breathing techniques during each surge, and practice relaxing and letting go of the tension between surges.

            ii.     Switching positions often, gently walking, and going into the shower or bath are great ways to cope with active labor, and can help with the progression. Staying hydrated and making sure to urinate frequently is very important as well.

            iii.     Rely on your birth supporters to help keep you comfortable, calm and hydrated, and to keep a log tracking your contractions.

       c.     Transition: 7 - 10 centimeters

            i.     Transition is a very transformative stage. It’s when all the hard work from the many hours and possibly days of labor really kicks into gear and when (as a doula) I can see the light at the end of the tunnel for the mothers. But, that does not mean the mother always sees the same light. More than anything, this is when you will need the support of your birth team members. It can be considered the shortest stage of labor, but is typically the most intense. Contractions at this stage can be anywhere from 1-2 minutes apart, and lasting at least a minute, with little-to-no fluctuation on that pattern.

            ii.     During the transition stage, the baby can sometimes be low enough to activate the mother’s urge to push, yet in many cases, the cervix isn’t completely dilated, so you will need to resist. When there are urges to push, it is always good to make sure your doctor or midwife are nearby and aware. Nausea, hot flashes, vomiting, gas and the need to defecate are all normal.

            iii.     During active labor, breathe through one surge at a time. You may feel ready to “give up” or become impatient, but just know that each surge is what is bringing your baby closer to being in your arms.

2.     Second Stage, 0 - 4 hours (more or less)

       a.     Pushing

            i.     As a doula, this may be my favorite part of labor. This is when I see the energy of the mother come back to life. This is when your hard work reaches the point of finally being able to have some control again. Does that mean pushing isn’t hard, and labor is over? No. But, it brings a sense of accomplishment to know that your body made it to 10 cm. and has finally opened enough for you to push your baby out.

            ii.     In candid terms, birthing a baby will feel like taking the biggest bowel movement of your life. It can be difficult to comprehend, until you’re in that moment, the intense rectal pressure that you will feel, and will need to continue to push toward. There are many techniques of pushing: spontaneous pushing, or bearing down for counts of 10 seconds, squatting or getting on all fours -- all are wonderful ways to bring your baby earth-side.

            iii.     When you’ve found your preferred technique, it’s time to push with everything you have. The more efficiently you push, the more energy you are able to pack into each push, and the further you are able to bring your baby through the birth canal. The feeling of frustration or embarrassment can arise during this stage when you feel like it’s taking longer than you had anticipated. But, your birth support team will continue to remind you that it is normal, it is HARD work, the progress is there, and you’re doing all the right things to have your baby.

       b.     Delivery

            i.     Rest between surges/pushes and catch up on your breathing and oxygen intake.

            ii.     Use a mirror as guidance. Someone can hold or at hospitals and birth centers they have standing mirrors just for this. When you can see your body opening and the head of your baby emerge from your body, it will bring focus and encouragement back into your efforts.

            iii.     An increase of bloody show is normal. The feeling of tingling, stretching, burning or intense pressure on the vagina or rectum is normal when the baby’s head is passing through the birth canal. The crowning of your baby’s head can be very intense, and your healthcare provider may ask you to slow down and grunt your way through this time to avoid tearing of the perineum. Once the baby’s head is out, it often will take only one additional push to get the shoulders and remainder of his/her body out. Then, let the floodgates open with tears, joy, laughter, relief and love for your baby and appreciation for all of your hard work, and the support of your birth team.

3.     Third Stage, 0 - 30 minutes

       a.     Delivery of placenta

            i.     By the final stage of labor, if all goes well and you and your baby are healthy, your baby is in your arms. The doctor will give you time to connect with your baby by having skin to skin contact while they check on you. If your baby shows interest in your nipples or is bobbing her head up and down, you can allow her to latch onto your nipple to nurse.

            ii.     Mild contractions will eventually start up again. The placenta will release from your body you will have the urge to push again, with guidance from your healthcare provider. Many moms can experience some discomfort during this final stage, especially if you have tears along the opening of your vagina or on your vaginal wall from intense stretching.

            iii.     Your body’s hormones have gone through so much, so it is very normal for your legs and body to shiver and shake during this time.

After labor, your body may not feel like your own. You will feel like you just ran a marathon, and in many cases I've been told "I feel like I've been hit by a truck." Your body has just done the most powerful, amazing thing: it birthed a baby. You will need time to recover, and you will need more support in the weeks to come. But, know this: once you have your baby in your arms, and both of you are healthy, it will all be worth it.

Stay tuned for a follow-up post on the best ways to support a mom during these three stages of labor!