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Stages of labor: Baby, it's time!By Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/stages-of-labor/PR00106
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Stages of labor: Baby, it's time!
Labor is a natural process. Here's what to expect during the three stages of labor — and how to promote comfort as labor progresses.By Mayo Clinic staff
Every woman's labor is unique, even from one pregnancy to the next. In some cases, labor is over in a matter of hours — or less. In other cases, labor tests a mother's physical and emotional stamina. You won't know how your labor will unfold until it happens. You can prepare, however, by understanding the typical sequence of events.
Stage 1: Early labor and active labor
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|Cervical effacement and dilation|
The first stage of labor occurs when the cervix opens (dilates) and thins out (effaces) to allow the baby to move into the birth canal. This is the longest of the three stages of labor. It's actually divided into two phases of its own — early labor and active labor.
During early labor, your cervix will begin to dilate. You'll feel mild to moderately strong contractions during early labor. They may last 30 to 90 seconds and come at regular intervals. As your cervix begins to open, you might notice a thick, stringy, blood-tinged discharge from your vagina. This is known as bloody show.
How long it lasts: Early labor is unpredictable. It can last for hours or even days, especially for first-time moms. It's often much shorter for subsequent deliveries.
What you can do: Until your contractions increase in frequency and intensity, it's up to you. For many women, early labor isn't particularly uncomfortable. You might feel like doing household chores, taking a walk or watching a movie — or you might simply continue your daily activities.
To promote comfort during early labor:
- Take a shower or bath
- Listen to relaxing music
- Have a gentle massage
- Try slow, deep breathing
- Change positions
- Drink water, juice or other clear liquids
- Eat light, healthy snacks
- Apply ice packs or heat to your lower back
Now it's time for the real work to begin. During active labor, your cervix will dilate to 10 centimeters. Your contractions will get stronger, last longer and come closer together. Near the end of active labor, it might feel as though the contractions never completely disappear. You might feel increasing pressure in your back as well. If you haven't headed to your labor and delivery facility yet, now's the time.
Don't be surprised if your initial excitement wanes as your labor progresses and the pain intensifies. Don't feel that you're giving up if you ask for pain medication or anesthesia. Your health care team will help you make the best choice for you and your baby. Remember, you're the only one who can judge your need for pain relief.
How long it lasts: Active labor often lasts up to eight hours. For some women, active labor lasts hours longer. For others — especially those who've had a previous vaginal delivery — active labor is much shorter.
What you can do: Look to your labor coach and health care team for encouragement and support. Try breathing and relaxation techniques to combat your growing discomfort. Use what you learned in childbirth class or ask your health care team for suggestions.
To promote comfort during active labor:
- Change positions
- Rock in a rocking chair
- Roll on a birthing ball
- Take a warm shower or bath
- Place a cool, damp cloth on your forehead
- Take a walk, stopping to breathe through contractions
- Have a gentle massage between contractions
The last part of active labor — often referred to as transition — can be particularly intense. If you feel the urge to push but you're not fully dilated, your health care provider might ask you to hold back. Pushing too soon could cause your cervix to tear or swell, which might delay delivery or cause troublesome bleeding. Pant or blow your way through the contractions.
Stage 2: The birth of your baby
It's time! You'll deliver your baby during the second stage of labor.
How long it lasts: It can take from a few minutes up to several hours or more to push your baby into the world. It often takes longer for first-time moms and women who've had an epidural.
What you can do: Push! You might be encouraged to push with each contraction to speed the process. Or you might take it more slowly, letting nature do the work until you feel the urge to push.
When you push, don't hold tension in your face. Bear down and concentrate on pushing where it counts. Experiment with different positions until you find one that feels best. You can push while squatting, sitting, kneeling — even on your hands and knees.
At some point, you might be asked to push more gently — or not at all. Slowing down gives your vaginal tissues time to stretch rather than tear. To stay motivated, you might ask to feel the baby's head between your legs or see it in a mirror.
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. The rest of your baby's body will follow shortly.
Stage 3: Delivery of the placenta
After your baby is born, you'll likely feel a great sense of relief. You might hold the baby in your arms or on your abdomen. Cherish the moment. But a lot is still happening. During the third stage of labor, your health care provider will deliver the placenta and make sure your bleeding is under control.
How long it lasts: The placenta is typically delivered in about five to 10 minutes. In some cases, it may take up to 30 minutes.
What you can do: Relax! By now your focus has likely shifted to your baby. You might be oblivious to what's going on around you. If you'd like, try breast-feeding your baby.
You'll continue to have mild contractions. Your health care provider might massage your lower abdomen to encourage your uterus to contract and expel the placenta. You might be asked to push one more time to deliver the placenta, which usually comes out with a small gush of blood.
Your health care provider will examine the placenta to make sure it's intact. Any remaining fragments must be removed from the uterus to prevent bleeding and infection. If you're interested, ask to see the placenta.
Your health care provider will also determine whether you need stitches or other repair work. If you do, you'll receive an injection of local anesthetic in the area to be stitched if it's not numb already. You might also be given medication to encourage uterine contractions and minimize bleeding.
Savor this special time with your baby. Your preparation, pain and effort have paid off. Revel in the miracle of birth.
- Funai EF, et al. Management of normal labor and delivery. http://www.uptodate.com/home/index.html. Accessed Jan. 4, 2011.
- Simkin P, et al. Nonpharmacological approaches to management of labor pain. http://www.uptodate.com/home/index.html. Accessed Jan. 4, 2011.
- Satin AJ. Latent phase of labor. http://www.uptodate.com/home/index.html. Accessed Jan. 4, 2011.
- Funai EF, et al. Mechanism of normal labor and delivery. http://www.uptodate.com/home/index.html. Accessed Jan. 4, 2011.
- Normal progress of labor. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingston Elsevier; 2007. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-443-06930-7..50014-1--cesec14&isbn=978-0-443-06930-7&sid=1097726136&type=bookPage§ionEid=4-u1.0-B978-0-443-06930-7..50014-1--cesec14&uniqId=230414861-3#4-u1.0-B978-0-443-06930-7..50014-1--cesec14. Accessed Jan. 4, 2011.
- You and your baby: Prenatal care, labor and delivery, and postpartum care. The American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/ab005.cfm. Accessed Jan. 4, 2011.