Stages of Labor

Once your labor has begun, you will begin to experience "contractions". The contractions you feel are the tightening and relaxing of the uterine muscles as it prepares to send your baby into the world. The contractions will cause your cervix to become thinned and stretchy. It will be 100% thinned (or effaced) and 10 cm open (dilated) when it is time for the baby to be born.

STAGE I (Contractions & Dilating)
The process of labor is broken down into three stages. The first stage when all the contractions and dilating and stretching take place is split up into three parts: Early, Active, and Transition.

Early Labor — In Early labor you may experience mild contractions that are anywhere from five minutes to thirty minutes apart. Pain is a subjective thing, so everyone will feel differently about their contractions and their pain. Work with your coach, nurse and physician to help you deal with your pain management throughout your labor. You should be aware of all options available to you today to help you work through your labor. These include both medical and non-medical methods. The important thing is that you as the patient are comfortable with your labor experience. During this early labor stage you may experience backache, mild diarrhea, anxiety, and or excitement. During this stage in labor, 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 should try to rate their intensity on a scale of 1-10 to help guide you with your progression of labor.

Active Labor — As you progress to Active labor, you will notice an increase in the length and intensity of your contractions. The cervix is really beginning to open up now, and you may hear the medical team say you are 4-7 cm along. Remember that the goal is 10 cm. The baby is actively trying to get in position to be born. Women say that during this time 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 lips and mouth wet, and provide comfort measures such as massage or music.

Transition Phase — As you enter the Transition phase, the contractions are more intense, and your cervix should become fully dilated to 10 cm. The baby is applying pressure to the mothers 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 neccessary 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. It is not uncommon to have mood swings, hot flashes, and a desire to give up and go home. It then becomes the important role of the support person to talk them through this and give the mom the encouragement she needs to finish the job and deliver the baby.

STAGE II (Delivery of the Baby)
As you move from Stage I Transition to Stage II, you probably will 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. It may be hard, but try and rest between contractions saving your strength for pushing the baby out during 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 (Delivery of the Placenta)
The last stage of labor is Stage III or delivery of the placenta. The contractions will help your uterus expel the placental contents. You may have some bleeding, feelings of chills or exhaustion. The baby's medical team will clean your baby and do a physical assessment to confirm everything is okay. If you have some peritoneal tears, your physician will use this time to do your episiotomy repair. Your nurse will massage your uterus and will be checking it frequently over the next several hours to make sure it is hard and that you are not experiencing any excessive bleeding.

Baby, Oh Baby! 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. The new job of being a parent lasts even longer than 40 weeks, and you will need all your strength to help you love and care for your new baby.