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. 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.
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 contractions during early labor. They will typically last 30 to 90 seconds and come at regular intervals. Near the end of early labor, your contractions will likely be less than five minutes apart.
As your cervix begins to open, you might notice a brown or blood-tinged discharge from your vagina. This is likely the mucus plug that blocks the cervical opening, also known as bloody show.
How long it lasts: Early labor is unpredictable. For first-time moms, the average length of early labor is six to 12 hours. 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 or relaxation techniques taught in childbirth class
- Change positions
- Drink fluids
- 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 (cm). Your contractions will become stronger, longer, closer together and regular. Your legs might cramp, and you might feel nauseous. You might feel your water break — if it hasn't already. 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 partner with you to 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
- Roll on a large rubber ball (birthing ball)
- Take a warm shower or bath
- Take a walk, stopping to breathe through contractions
- Have a gentle massage between contractions
The lst 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 swell, which might delay delivery. Pant or blow your way through the contractions.
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 a few 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.
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 minutes. In some cases, it might 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. You might also experience chills or shakiness. 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.
July 18, 2013
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