The Stages of Labor
The question I get most often is “how can I manage the pain of labor?” Truthfully, the most important thing you can do to cope with the sensations of labor is to understand what to expect. Once you know what is going to happen, it is easier to give yourself positive affirmations that what you are experiencing is normal and bringing you closer to your baby. Here is a quick guide to the stages of labor.
Pre-labor
While pre-labor is sometimes unfortunately called “false labor”, this is a misnomer because it implies that pre-labor is not preparing the body for birth. This could not be further from the truth. Pre-labor can last for hours, days, or even weeks before the onset of early labor. It is a time for the uterus to begin to prime and prepare itself for birth, getting familiar with the movements it will have to make to help your baby into the world. During this time, you may experience Braxton-Hick’s contractions. These are contractions that feel tight and maybe uncomfortable but are not generally considered painful. They should show no pattern and may come and go. During this time, the cervix may begin to soften and thin. Usually, no action is recommended during this time. Just relax and prepare for baby!
First Stage: Dilation
This stage is what people usually think of when they hear “labor”. It encompasses all the three phases that come before pushing and can last anywhere from 2-24+ hours.
1. Latent (0-6cm)
This is early labor. Most of the time of labor is usually spent here. During this time, the cervix begins to dilate with each contraction. They may feel painful or not but are usually manageable. It is recommended to rest, eat, and distract yourself during this time. Focusing too much on labor can cause undue stress or anxiety. Once contractions become 4 to 5 minutes apart for an hour, you should consider heading to the birth location.
2. Active (6-8cm)
During active labor, intensity begins to kick up a notch. You will no longer be able to distract yourself during contractions by talking or moving, and instead should be focusing on your established coping techniques. At this time, you should be at the birth location, or getting there if you are not. This phase sometimes happens very quickly, especially if you have given birth before.
3. Transition (8-10cm)
This may be the most intense part of labor. It can sometimes be characterized by vomiting or shaking. Luckily, it passes very quickly and then it is time to push! The baby is beginning to enter the birth canal.
Second Stage: Delivery
At this point, your cervix is fully dilated, and the baby is entering the birth canal. This is the pushing stage and can last 15 minutes to a few hours. It can be on the longer side if it is your first birth or if you have an epidural, though do not count on this because each birth is different and may be unpredictable. You will usually feel an instinctive urge to push if unmedicated. Follow this urge and push when you want to, your body knows what it is doing. If you have had an epidural and have reduced or complete loss of feeling in your abdomen and lower body, your provider can instruct you on when and how to push. You can also try various positions during the pushing stage. Crowning (when the widest part of the baby’s head is exiting the vagina) is sometimes characterized by a burning or intense stretching sensation called the “ring of fire”. Welcome this feeling because baby will be in your arms very soon! Once the baby is born, the second stage of labor is complete. Congratulations!
Third Stage: Placenta
The final stage of childbirth takes place after the baby has arrived. This is when the placenta is pushed out. Usually, this is takes 20 minutes or less and is relatively not painful. The placenta has no bones and thus comes out easily. Some providers may offer interventions during this time to speed along the placenta, but this is usually not necessary. Alternatively, skin to skin contact and breastfeeding your baby can contract the uterus and help the placenta move along. Use this time to bond with baby and try not to worry about anything else.
