Labor and delivery, postpartum care

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Stages of labor: Baby, it's time!

By Mayo Clinic staff

Every labor is unique, even from one pregnancy to the next. How will you know when to go to your delivery facility? Go when contractions are five minutes apart or closer, or if you have fluid leakage.

If everything goes smoothly, you can expect to go through three distinct stages of labor.

Stage 1: Early labor, active labor and transition

Labor begins when your cervix opens (dilates) and thins (effaces) to allow your baby to move into the birth canal. This stage is divided into three phases.

Early labor
Your cervix will dilate to about 3 centimeters. Contractions may feel mild to moderately strong, last 30 to 60 seconds and come every five to 20 minutes.

You may notice a thick, stringy, blood-tinged discharge from your vagina, known as a bloody show. You may experience a backache, upset stomach and, possibly, diarrhea.

Length. Early labor is unpredictable, lasting hours or days.

What you can do. Until your contractions intensify, follow your daily routine, take walks or relax with a movie or book. You'll probably still be wondering if this is the real thing.

It may help to:

  • Shower or bathe
  • Listen to music
  • Have a gentle massage
  • Drink water, juice or other clear liquids
  • Eat light, healthy snacks
  • Apply ice or heat to your lower back

Active labor
Your cervix will dilate to nearly 7 centimeters. Contractions will intensify, lasting at least 45 seconds and often a minute or longer, coming every two to four minutes. You may feel increasing pressure in your back. It's time to go to your labor and delivery facility.

As your labor progresses and pain intensifies, you may want pain relief. Your health care team will help you make the best choice for you and your baby.

Length. On average, active labor lasts three to eight hours. It may be shorter — especially if you've had a previous vaginal delivery.

What you can do. Try breathing and relaxation techniques.

It may help to:

  • Use a rocking chair
  • Roll on a birthing ball
  • Change positions
  • Walk, stopping to breathe through contractions

Test new positions or activities for at least three contractions. It might take that long to have any effect.

Transition
Your cervix will dilate from 7 to 10 centimeters. Your contractions will increase and strengthen, often reaching peak intensity almost immediately and lasting up to 90 seconds, with little time before the next one begins. You may feel pressure in your lower back and rectum.

Length. On average, transition lasts between 15 minutes and three hours. It's likely to be quicker if you've already had a vaginal delivery. But this is often the most difficult stage of labor.

What you can do. Concentrate on getting through each contraction.

It may help to:

  • Change positions
  • Have a cool, damp cloth on your forehead
  • Get massages between contractions

Try not to push until you're told it's time. It may help to pant or blow. Pushing too soon may cause your cervix to tear or swell, which can delay delivery or cause bleeding.

Stage 2: Birth

Time to deliver your baby.

Length. It can take from a few minutes to several hours or more. It often takes longer for first-time moms.

What you can do. Push! You may be encouraged to push with each contraction to speed the process. Or you might push only when you feel the urge.

It may help to:

  • Lie in a birthing bed
  • Squat or sit
  • Get on your hands and knees or kneel while your labor coach supports your upper body
  • Try different positions

At some point, you may be asked to push more gently or to stop to give your vaginal area time to stretch rather than tear. Feeling your baby's head between your legs or seeing it in a mirror can spur you on.

After your baby's head is delivered, his or her airway will be cleared, and your health care provider will make sure the umbilical cord is free.

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MS00037

Sept. 12, 2008

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