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Labor is generally broken down into the first, second and • Descent of presenting part of baby

third stages, each of which is further segmented into • Head is in fixed position between pains
phases. • Sedation, change of position, increased
hydration does not stop true labor
Many people, especially those pregnant for the first
time, may experience a long period of what is known as My personal experience suggests that prodromal labor
“prodromal labor” or was once called “false labor.” contractions may indeed seem to increase in intensity
Prodromal labor may begin as early as a month or even and get closer together, but these will eventually stop,
6 weeks before the due date and persist until true labor leaving you just as pregnant as you were before, and in
begins. Prodromal labor can be disruptive to activities of my own case frustrated and discouraged. What to do?
daily living, but may not be a sign that delivery is Try to rest, yoga or gentle stretching may help, sipping
imminent, however, prodromal labor can transition to herbal soothing herbal teas may help2; in my own
true labor very quickly. Prodromal labor may be experience I was not well hydrated, and I was stressed
identified as follows1: out. Drinking fluids, and resting on my left side was
usually the cure.
• Contractions come at irregular intervals
• No change in frequency or inconsistent
• Severity is irregular
The First Stage of Labor
• Discomfort mainly experienced in front The first stage of labor consists of the latent phase, the
• Walking does not promote regularity or active phase, and the transitional phase of labor.
increased severity The latent phase of labor comes first. This may last an
• No bloody show indefinite period of time, some say 6-8 hours in first-time
• No change in cervix parents, and is the period of time during which the cervix
• No descent of presenting part dilates from 0-4 cm, and the cervix effaces from 3 cm
• The baby’s head is not engaged long to about 0.5 cm long3. During the latent phase, it is
• Rest, change of position, increased fluid intake, best to try and rest, eat and drink normally, and don’t get
mild sedation stops contractions. too excited! Every labor is different, and you don’t want
to get worn out early on.
True labor may be identified as1:
During the active phase of the first stage of labor, the
• Contractions occur at regular intervals
pace and intensity of contractions will pick up a bit as the
• Intervals shorten cervix dilates from 4 cm to 10 cm, and becomes
• Contractions lengthen, increase in intensity completely effaced3. During this time, rest if you can, but
• Pain starts in the back and wraps around to front movement like walking, dancing, or squatting can help
• Walking increases intensity move the baby down the birth canal. You may not feel
• Degree of uterine hardening increases with like eating, but do keep up your fluids; using smoothies
intensity of contractions and electrolyte water may be really good choices during
• Bloody show often occurs this time. Also, don’t forget to go to the bathroom to void
• Cervix changes, effacing and dilating

1 Posner, Black, Jones, & Dy, 2013, p. 129 3 Marshall & Raynor, 2014, p. 329
2 Howland, 2019
or defecate about every hour4—you many not feel the baby’s head molds to fit in the parent’s pelvis. During this
usual sensations that would prompt you to go, and the time, many minute adjustments are made in both the
less things crowded around the birth canal, the better. baby’s body and the parent’s6. If the waters have not
already broken, it generally happens during the second
The transitional phase of labor is noted from the time the
stage. At the end of the active phase of the second stage,
cervix is dilated to 8 cm, until it is fully dilated and part of
the baby is fully born.
the lower uterine segment; the active and transitional
phases may overlap at this time frequently referred to as
“transition5.’ Once dilated to 8 cm, the intensity of
The Third Stage of Labor
contractions often increases. You may feel an urge to The third stage is from the birth of the baby until the
push at this point, but wait until your provider tells you complete expulsion of placenta, fluid and membranes.
it’s time. Pushing before you’re fully dilated and effaced Generally, during this time you will be holding your baby,
can cause swelling, that sets you back. However, getting to know them, and you may find it to be the right
sometimes your body will take over here, and you’ll find time to begin nursing, as many babies are born ready to
you’re pushing even if you didn’t mean to. This is normal, suckle for comfort and bonding. Encouraging suckling at
called “spontaneous pushing,” and you should work with this point is very good for the delivery of the placenta;
your body, letting your body do what is most natural6. the oxytocin hormone released in the birthing parent’s
body in response to suckling will cause the uterus to
continue to contract, and aid in expulsion of the
The Second Stage of Labor
placenta8. For some people this time without any urge to
The second stage of labor is also sometimes called the
push, and without contractions may last just a few
“pushing stage.” This is often when the parent is
minutes, or may extend for longer, even up to an hour9;
instructed to bear down, chin to chest during each
as stated above, every labor and delivery is different.
contraction—contractions that are usually much more
intense, but may be further apart to allow for parent and When you begin to feel crampy low in your abdomen, or
baby to have a chance to recover a bit between each you begin to have low back pain, or just an
push. But the second stage is more than just pushing, and uncomfortable “squishy” feeling, it’s probably time to
has its own latent, and active phases. push the placenta out. The contractions may not feel as
strong, but it’s important to work with your body to help
When you are in transition, your midwife may or may not
expel your placenta. It’s very good to be in a mostly
do a cervical check to confirm your complete dilation and
upright position at this time, to let gravity help with the
effacement. You can request this if you want
job of expelling the placenta. There will almost certainly
confirmation.
be a gush of fluids and blood as the placenta detaches
Not all people experience the latent phase of the second from the wall of your womb—your provider will be
stage of labor, which is sometimes noted as a time where noting the amount of blood and fluid to watch for
contractions change again and the laboring parent seems hemorrhage. From experience, it is not unusual to feel a
to get a rest from almost continuous contractions7. As little light headed or weak at this point. Your body has
mentioned above, some people experience a lull in the just done an enormous amount of work and is making
frequency of contractions, but they become quite a bit major adjustments from being pregnant to being
more intense7. postpartum. Don’t fret about this, but do tell your
provider if you think you’re experiencing something
The active phase of the second stage is begun when the outside of just normal adjustment: blurred or darkening
cervix is fully dilated and effaced, and contractions come vision, spots in your eyes, a feeling that you might faint
with a compulsive urge to push with each wave. These or blackout. These symptoms aren’t always caused by an
are “expulsive” contractions. During this time period, the emergency, but you do need attending to, and your care
baby descends through the birth canal, the presenting team needs to be aware of your experience to care for
part is moves progressively down the birth canal, and the you appropriately.

4 Posner, Black, Jones, & Dy, 2013, p. 139 7 Marshall & Raynor, 2014, p. 370
5 Marshall & Raynor, 2014, p. 330 8 Marshall & Raynor, 2014, p. 398
6 Lemay, 2018 9 Marshall & Raynor. 2014, p. 399
References

Howland, G. (2019, March 1). Prodromal labor symptoms & what you can do. Retrieved from

https://www.mamanatural.com/prodromal-labor/

Lemay, G. (2018, July 26). Pushing for first-time moms. Retrieved from https://midwiferytoday.com/mt-

articles/pushing-first-time-moms/

Marshall, J. E., & Raynor, M. D. (2014). Myles textbook for midwives (16th ed.). St. Louis, MO: Elsevier Health Sciences.

Posner, G., Black, A., Jones, G., & Dy, J. (2013). Oxorn Foote human labor and birth, sixth edition (6th ed.). New York,

NY: McGraw Hill Professional.