This is a common question I get when my patients walk onto the unit. My usually response, not getting into details, is “It really depends on your body. Everyone is different. No labor is the same. Labor generally lasts from 12-30+ hours.” The 30+ hours usually scares people, but hey, where would I be if I lied to you? I say 30+ because hey, sometimes it happens. I will sum up each labor stage and explain what goes on in each stage.
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The first stage is the onset of true labor until the cervix is 10cm. The first stage is the longest of them all and is broken down into three categories.
- Early Labor: From onset of labor till 3cm dilated
- Active Labor: continues from 3cm until the cervix is 7cm
- Transition Phase: Continues from 7cm to 10cm.
What does cervical dilation look like? Check out this nifty visual guide here.
Let’s talk more about Early Labor.
- It can last 8-12 hours
- During this time your cervix is working towards effacing and dilating to 3cm
- Contractions are usually mild and somewhat irregular, but as labor progress they will become more frequent and stronger
- Contractions can feel like lower back pain, menstrual cramps, or pressure/tightening in the pelvic area.
- Contractions usually last around 30-45 seconds and are every 5-30 minutes. This gives you plenty of time to rest
- You water may or may not break. Pay attention to the color. We want to know if it is clear or meconium stained. Meconium stained means your baby had their first poop in utero. If you are overdue, this is fairly common. Sometimes meconium can indicate stress, but this isn’t always true. Just let your provider know time and color if it breaks at home.
What can I do in Early Labor?
Hold up don’t pick up the phone and ring your doc or midwife yet (I know the excitement or nerves are building now, I know it is easier said than done, but really try and relax). Take a deep breath and relax. Enjoy the comfort of your own home before you rush to the hospital.
Conserve your energy, you are going to need it once labor really starts to kick in. Stay hydrated and fuel up. It will be one heck of a roller coaster ride, but so worth it at the end.
Try and rest. You won’t be getting much of it once you kick in. If you can’t sleep try and play a game or watch a movie to keep your mind busy.
If your water breaks or you are really starting to work through contractions, or they are closer together give your doc or midwife a shout.
*please note if you are higher risk, your water breaks, you become dizzy, have a headache you can’t shake, seeing floaters, have pain under your right breast, have increased swelling of your feet, hands, or face, or you are bleeding bright red call your doc/midwife right away!*
Let’s chat about active labor
This is when things really start to pick up. This is the time you’d give your doc or midwife a ring!
- It can last from 3-5 hours.
- During this stage your cervix will dilate from 4cm to 7cm
- Contractions will be closer together about 3-5 minutes apart and lasting 45-60 seconds.
- Contractions are going to feel much stronger and longer
What can I do in Active Labor?
This stage is all about pain management and positions. Move, move, move. Try side lying, standing, rocking, hands and knees, or even the shower. If you hospital has a tub even try that.
Back rubs and even pressure on your lower back may help some. Just know going in what you want and communicate it to everyone. Not everyone likes back rubs or being touched.
Even though hard, try and stay hydrated and eat a little bit here and there. I found that fruit, popsicles, or even honey sticks helped keep me/my patients well fueled. Of course as things really progress you may not want to eat and you may become nauseous and vomit.
The transition phase: things really start to get intense.
This is the phase many women say “I can’t do it,” but honey let me tell you, YOU CAN DO IT! You’re stronger than you think you are, trust me.
This is the hardest phase, but also the shortest (that may help some).
At this point you may get the labor shakes, chills, become nauseous and vomit.
- This phase can last from 30 minutes to two hours
- The cervix will finish dilating to 10cm
- Contractions are much stronger and last 60-90 seconds and come every two minutes
What can I do during this phase?
As mentioned above try different positions. You may not even want to move, but sometimes moving helps. You can use the shower or bath. During this phase you may not want to eat, drink, or even talk. Just prepare your significant other, you may appear angry, but know it is a normal part of transition.
Breath through your contractions and keep telling yourself, “One at a time,” or “One closer to meeting my baby.” It may give you some relief.
The period after the cervix is 10cm to the delivery of baby
What happens during this stage?
- This stage can last anywhere from 15 minutes to 2+ hours
- Contractions may slow or stay consistent at 2 minutes, everyone’s body is different. They last about 45-90 seconds and come every 2-5 minutes.
- At this point you will have an urge to push, lots of rectal pressure. Make sure to tell your nurse/provider once you feel this! We all get pretty excited
- Okay – let’s talk poop. You are going to do it, get over it. Really. It isn’t a big deal, in fact it is pretty natural. After all you are using the same muscles.
- At this stage your baby will crown, you will feel a burning sensation. This is known as the “ring of fire”. While you crown you may hear your provider say small pushes, or grunt your baby out. This is so you don’t tear too much
How should I push? What should I expect?
There are many different positions you can deliver in. Hands and knees, side lying, on your back (not all the way flat), and you can even using a birthing stool. As mentioned there are many positions, you don’t have to be confined to one spot! Of course if you have an epidural, you may not be able to get into some positions.
Only push when you have a contraction or feel the urge. Use the same muscles as you would during a bowel movement. Just remember you will poop, it is inevitable. Don’t worry about it, it isn’t like the provider or nurse will announce it! We are pretty discrete, you may not even notice.
Rest as much as you can in between. You’re going to need all the energy
If you want ask you provider or nurse for a mirror to watch your progress. It may give you a little extra umpf!
Oh! I want to mention, don’t be discouraged if you see baby’s head move back in. Baby rocks back and forth, this is so they can get under that bone. Eventually he/she will crown, just keep pushing.
The delivery of the placenta. It lasts about 5-30 minutes. During this time the provider may be expecting your perineum to see if you tore, while waiting for the placenta.
Remember no bones for this one! Phew!
Your provider will massage your uterus. This may be uncomfortable, or painful, you did just push a baby out of it. And like any muscle after a long workout, it will be sore and tired.
After the delivery of the placenta you will be monitored for a few hours to make sure you don’t bleed. This means extra fundal checks (yay!) and frequent vitals. The upside? You get to snuggle your cute little bundle of squish!
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