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The first stage of labor

The first stage of labor is the preparation phase. For months, your body has
been working to keep baby in. And now it’s time for your baby to come out.

Your body does this through contractions. Contractions help dilate (open) and
efface (thin) the cervix, which is what connects your uterus to your vagina
(birth canal).

What happens during the first stage of labor?

The first stage of labor is mainly distinguished by how dilated the cervix is and
the characteristics of the contractions. Within this first stage, there are three
phases: early, active and transition. If it’s your first time giving birth, the first
stage of labor may take several days to complete. Here’s about how long
each phase typically lasts:

 Early phase: Up to 24-48 hours

 Active phase: Up to about eight hours
 Transition phase: Up to about three hours

Early (latent) phase of labor

In the latent phase, contractions start out mild and irregular, typically lasting
for less than a minute. They’ll gradually become stronger and more frequent
as your cervix dilates. During this phase, you may notice thick pink or red
vaginal discharge – this is the mucus plug that helped keep bacteria from
passing through the cervix during pregnancy.

Active phase of labor

You may have reached active labor once your contractions last for around a
minute and have been occurring at least every 5 minutes for an hour (or ever
7 minutes if it’s not your first baby). This is when it’s time to call your provider
or hospital, as you have been instructed. Other signs that it’s time to go to the
hospital include:

 Your water breaks. This can feel like a sudden gush or a slow trickle
from your vagina. It’s possible for your water to break before you reach
active labor – call your care provider if it does.
  Intense contractions that you can’t walk or talk through.
 Bloody discharge that’s more watery than the mucus plug.

During active labor, you may also experience:

 Nausea or vomiting
 Leg cramps
 Pain and pressure in your lower back

Transition phase of labor

The end of active labor is sometimes referred to as the transition to the

second stage of labor. It’s when the cervix completely dilates to a full 10
centimeters, and is the shortest – but generally considered the hardest – part
of labor. If this is your first time giving birth, transition may take up to a few
hours, or it may progress quickly. Contractions will be the longest, strongest
and most frequent so far.

During the transition phase, you may also feel:

 Pressure in the lower back and rectum

 An urge to push (tell your care provider if you do, as they’ll want to
make sure you’re fully dilated first)

Inducing labor

There are some cases where labor has to be started manually (induced).
Labor induction may be recommended for reasons such as:

 Labor hasn’t started naturally around two weeks after the due date.
 Your water has broken but contractions haven’t started for several
hours.
 There’s not enough amniotic fluid.
 You have an infection or other pregnancy complication.
The second stage of labor
The second stage of labor begins once your cervix is fully dilated, and ends
when your baby is born. It may take anywhere from a few minutes to a few
hours. It’s possible that this stage could take longer if you find it harder to
push from the numbness of an epidural, or if it’s your first time giving birth.

What happens during the second stage of labor?

The second stage of labor is all about pushing. Your doctor or midwife will
guide you through how and when to push – you may be instructed to push
when you feel the urge, or when you’re having a contraction. Contractions
could remain as intense as they were at the end of stage one, but they may
be a little less frequent.

The third stage of labor

Once your baby has been born, you’re in the third stage of labor. This stage is
considered complete once the placenta has been delivered, which generally
happens within 30 minutes of childbirth.

What happens during the third stage of labor?

You’ll continue to have contractions, but they’ll be milder. These contractions

will move the placenta out of your uterus, and over the next few days, help
your uterus return to its normal size. If necessary, your care provider will
remove any remaining tissue from your uterus.

The first hours of recovery after labor

It’s finally time to meet, hold and celebrate your baby! Most babies are ready
to breastfeed shortly after birth. Breastfeeding releases the hormone oxytocin,
which encourages helpful, mild “post-birth” contractions and reduces bleeding.
If your baby’s ready and you’re having trouble getting started, you can ask for
help from a nurse or breastfeeding consultant. And if you or your baby don’t
want to breastfeed, you’ll still get to hold them skin-to-skin to begin bonding
unless your baby needs medical attention.

These first hours after birth mark the start of your recovery, and are
sometimes referred to as the fourth stage of labor. During the rest of your
hospital stay, your care team will monitor your blood pressure and other vital
signs, and make sure you aren’t bleeding too much. They may also give you a
shot of oxytocin and abdominal massages to promote contractions and control
bleeding. You may find that you get chills or shakes during this stage, so ask
for a blanket if you need one. If you had an epidural, the tube will be removed
from your back, and if you had any small tears during delivery, you’ll be given
local anesthetic and stitches.

And before you go home, you’ll receive plenty of tips for continuing your
postpartum recovery and information about what to expect now that you’ve
given birth.

What to know about the possibility of a C-section

Not every parent goes through all the stages of labor and delivery as they’re
described above. A cesarean delivery (C-section), which involves surgically
delivering a baby through the abdomen, isn’t something many people think
about as they approach their due date, unless it’s planned. However, C-
sections account for up to 20-35% of births in the United States.

The most important thing to know is that a C-section is only recommended

when it’s the best choice for you and your baby. One may be scheduled in
advance if there’s a clear medical reason for doing so, but often the need for a
C-section doesn’t arise until closer to, or during, labor. For example, one of
the most common reasons for an unplanned C-section is stalled labor, in
which the cervix stops opening despite continued contractions.

Start preparing for labor and delivery

Everybody’s big day is different. But if you’re reading this, you’re already
doing two of the best things you can to get ready: learning and planning. In
addition to becoming familiar with the process of giving birth, here are a few
other tips:

 Take a class: Childbirth classes can teach you everything from tools for
staying relaxed during labor to what to expect from different forms of
pain relief, and more.
 Prepare a birth plan: Writing a birth plan to give to your care team will
help them support your labor, delivery and postpartum care according to
your preferences.
 Strengthen your pelvic floor: Your pelvic floor muscles are going to go
through a lot during labor. Practicing Kegels (flexing the muscles that
stop urination) and other exercises can help reduce your risk of pelvic
floor dysfunction after birth.

Questions:

What are the three phases on the first stage of labor?

Signs of true labor?

 Regular and strong contractions.

 Pain in your belly and lower back.
 A bloody mucus discharge.
 Your water breaking.

False labor: contractions are often irregular and do not get closer together. True labor:
contractions come at regular intervals and get closer together as time goes on.
(Contractions last about 30 to 70 seconds.

false labor pains, are contractions of the uterus that typically are not felt until the second or third
trimester of the pregnancy. Braxton-Hicks contractions are the body's way of preparing for true
labor, but they do not indicate that labor has begun