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What stages will I go through
during labor and childbirth?
(Part 1)
The process you'll go through during labor and childbirth can be
divided into three stages:
The first stage begins with the onset of contractions and the
gradual effacement (thinning out) and dilation (opening) of the
cervix. That's followed by active labor, when your cervix begins
to dilate more rapidly and contractions are longer, stronger,
and closer together. In the last part of active labor (and the
end of the first stage), called transition, your cervix dilates
fully to 10 centimeters.
The second stage of labor begins once you're fully dilated and
ends with the birth of your baby. This is often referred to as
the pushing stage.
The third and final stage begins right after the birth of your
baby and involves the separation and delivery of the placenta.
For first-time moms who are at least 37 weeks along, labor and
delivery takes an average of 15 hours, although for plenty of
women it lasts more than 20 hours, and for a lucky few it's over
much sooner. For women who've been through labor before,
deliveries average around eight hours.
First stage: Early labor
Once your contractions are coming at relatively regular
intervals and your cervix begins to progressively dilate and
efface, you're officially in early labor. But unless your labor
starts very suddenly and you go from no contractions to fairly
regular contractions right away, it can be tricky to determine
exactly when true labor starts. That's because these early labor
contractions are sometimes hard to distinguish from the
inefficient Braxton Hicks contractions that may immediately
precede them and contribute to so-called "false labor." (If
you're not yet 37 weeks and you're noticing contractions or
other signs of labor, call your caregiver immediately so she can
determine whether you're in preterm labor.)
During early labor, your contractions will gradually become
longer, stronger, and closer together. While the experience of
labor varies widely, typically it might start with contractions
coming every ten minutes and lasting 30 seconds each. Eventually
they'll be coming every five minutes and lasting 40 to 60
seconds each as you reach the end of early labor. Some women
have much more frequent contractions during this phase, though
the contractions will still tend to be mild and last less than a
minute.
Sometimes early labor contractions are quite painful (though
they may be dilating your cervix much more slowly than you'd
like!). If your labor is typical, though, your contractions now
won't require the same attention that later ones will. You'll
probably find that you can still talk through them and putter
around the house. You may even feel like taking a short walk. If
you feel inclined to relax instead, take a warm bath, watch a
video, or doze off between contractions if you can.
You may also notice increasing mucousy vaginal discharge, which
may be tinged with blood — the so-called "bloody show." This is
perfectly normal, but if you see more than a tinge of blood, be
sure to call your caregiver. Also call if your water breaks,
even if you're not having contractions yet.
Otherwise, if you're at least 37 weeks along, and unless your
caregiver has advised you differently, expect to sit out early
labor at home. (When to call your midwife or doctor and when
she's likely to have you go to the hospital or birth center are
things to discuss ahead of time at your prenatal visits.) Early
labor ends when your cervix is 3 to 4 centimeters dilated and
your progress starts to accelerate.
How long it lasts?
It's not easy to say how long this phase typically lasts or even
(after the fact) how long it lasted for a particular woman. The
length of early labor depends in large part on how ripe your
cervix is at the beginning of labor and how frequent and strong
your contractions are. With a first baby, if your cervix isn't
effaced or dilated to begin with, this phase may take about
eight hours, though it can be longer or significantly shorter.
If your cervix is already very ripe or if this isn't your first
baby, it's likely to go much more quickly.
Coping tips
Don't become a slave to your stopwatch just yet — it's stressful
and exhausting to record every contraction over the many long
hours of labor, and it isn't necessary. Instead you may want to
time them periodically to get a sense of what's going on. In
most cases, your contractions will let you know in no uncertain
terms when it's time to take them more seriously.
Meanwhile, it's important to do your best to stay rested, since
you may have a long day (or night) ahead of you. Be sure to
drink plenty of fluids so you stay well hydrated. And don't
forget to go to the bathroom often even if you don't feel the
urge. A full bladder may make it more difficult for your uterus
to contract efficiently, and an empty bladder leaves more room
for your baby to descend.
First stage: Active labor
Active labor is when things really get rolling. Your
contractions become more frequent, longer, and stronger, and
your cervix begins dilating faster — going from 3 to 4
centimeters to 10 centimeters. In contrast to early labor,
you'll no longer be able to talk through the contractions.
Toward the end of active labor your baby may begin to descend,
though he might have started to descend earlier or he might not
start until the next stage.
As a general rule, once you've had regular, painful contractions
(each lasting about 60 seconds) every five minutes for an hour,
it's time to call your midwife or doctor and head to the
hospital or birth center. (Some prefer a call sooner, so clarify
this with your caregiver ahead of time.) In most cases, the
frequency of contractions eventually increases to every
two-and-a-half to three minutes, although some women may never
have them more often than every five minutes, even during
transition.
How long it lasts
Labor varies widely, but on average it takes about six hours for
a woman having her first baby to go from 4 centimeters to full
dilation. That's if she's not being given oxytocin (Pitocin) or
using an epidural, though. Pitocin generally speeds up the
active phase, while epidurals tend to make it last longer. If
you've already had a vaginal birth, active labor is likely to go
much more quickly.
Coping tips
Breathing exercises, relaxation techniques, and a good labor
coach can be a huge help now. Massage and lots of gentle
encouragement are lifesavers, too. When you get to the hospital
or birth center, you should be able to move freely around the
room after your caregiver evaluates you, as long as you don't
have any medical or obstetric complications.
You may find that it feels good to walk, but you'll probably
want to stop and lean against something (or someone) during each
contraction. If you're tired, try sitting in a rocking chair or
lying in bed on your left side. This might be a good time to
take a warm shower or bath, if you have access to a tub, or to
ask your partner for a massage. If you've already decided you
want pain medication or you're having a hard time coping with
contractions and nothing else seems to help, now's the time to
talk to your provider about getting an epidural or systemic
medication. |
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