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Stages of Labor

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The stages of labor are divided differently depending on the text you read. Here I have laid it out for you as I was taught in medical school. 
The process of giving birth takes place in several stages over many hours or even a few days-from early labor through delivering the baby and the placenta. During labor, contractions in  your uterus and a complex array of hormones open your cervix and move the baby into position to be born.

Stage 1: 

The time from of the onset of true labor until the cervix is completely dilated to 10 cm.  Phase one of labor consists of 3 stages: Early Labor, Active Labor, and Transition. 
Early Labor Early labor is often the longest part of the birthing process, sometimes lasting 2 to 3 days. Uterine contractions:
  • Are mild to moderate (you can talk while they are happening) and last about 30 to 45 seconds. You may feel only uncomfortable and not realize that you are having contractions.
  • May be irregular (5 to 20 minutes apart) and may even stop for a while.
  • Open (dilate) the cervix to about 3 cm (1 in.). First-time mothers can have many hours of early labor without the cervix dilating.
Women frequently go to the hospital during early labor and be sent home again until they are in active labor or until their "water" breaks (rupture of the membranes). This phase of labor can be long and uncomfortable.
Active Labor 
The active stage of labor starts when the cervix is about 3 cm (1.2 in.) to4 cm (1.6 in.) dilated. This stage is complete when the cervix is fully effaced (thinned) and dilated (opened)  and the baby is ready to be pushed out.
Compared with early labor, the contractions during active labor are more intense and more frequent (every 2 to 3 minutes) and longer-lasting (50 to 70 seconds). Now is the time to be at or go to the hospital or birthing center. If your water hasn't broken before this, it may now.
As your contractions get stronger, you may:
  • Feel restless or excited.
  • Find it hard to stand up.
  • Want to start using breathing techniques or other ways to control pain and anxiety. (This is where your doula comes in.)
  • Feel the need to shift positions often. This is good for you, because it improves your circulation.
  • Want pain medicine.

TransitionThis is the  end of active labor. As the baby moves down, your contractions become more intense and longer and come even closer together.When you reach transition, your delivery isn't far off. During transition, you will be self-aware and will concentrate more on what your body is doing. You may be annoyed or distracted by others' attempts to help you but still feel you need them nearby as a support. You may feel increasingly anxious, nauseated, exhausted, irritable, or frightened.
If it is your first labor transition can take up to 3 hours. A mother who has vaginally delivered before will usually take no more than an hour. Some women have a very short, if intense, transition phase.


Stage 2:

The period after the cervix is dilated to 10 cm until the baby is delivered.
Hello Baby! The second stage is the actual birth, when the baby is pushed out by the contractions. This pushing stage can be as short as a few minutes or as long as several hours. You are more likely to have a fast labor if you have given birth before. During the second stage:
  • Uterine contractions will feel different. Though they are usually regular, they may slow down to every 2 to 5 minutes, lasting 60 to 90 seconds.
  • You may have a strong urge to push or bear down with each contraction.
  • You may need to change position several times to find the right birthing position for you.
  • You can have a mirror positioned so you can watch your baby as the head comes through the vagina (crowns).
  • When the baby's head crowns, you will feel a burning pain. This is the perineum stretching.  If this is happening quickly, your doctor may advise you not to push every time, this may give the perineum a chance to stretch without tearing.

Stage 3:

Delivery of the placenta.After your baby is born, your body still has some work to do. This is the third stage of labor, when the placenta is delivered. You will still have contractions. These contractions make the placenta separate from the inside of the uterus, and they push the placenta out. 
You may be given some medicine to help the uterus contract firmly. Oxytocin (such as Pitocin) may be given as a shot or in a vein (intravenously) after the placenta is delivered. You can say no to this.  Oxytocin is given to make your uterus contract quickly and bleed less. Breast feeding right away can also help the uterus shrink and bleed less.
The third stage can be as quick as 5 minutes. With a preterm birth, it tends to take longer. But in most cases, the placenta is delivered within 30 minutes. If the placenta doesn't fully detach, your doctor or nurse-midwife will probably reach inside the uterus to remove by hand what is left inside. Your contractions will continue until after the placenta is delivered, so you may have to concentrate and breathe until this uncomfortable process is complete.

  • Home
  • Your Doula
  • Doula Practice
    • Natural Labor
    • Fee Schedule
    • Facilities
  • The Birthing Process
    • Your Body
    • Stages of Labor
    • Common Medical Interventions
  • Contact Me
  • Lait Haven
  • The Endeavor