As the third trimester rolls around your door, the trepidation of meeting your baby can slowly mix with the dread of facing labor. If this is your first time giving birth, the unknown, stories from your friends, and Hollywood’s dramatic labor demonstrations can quickly mix to create the perfect cocktail of anxiety. And if this isn’t your first birth, well… you’ve been there before, and that can sometimes make the anxiety worse, especially if it didn’t go the way you wanted.
One of the main causes of anxiety about labor is the unknown and the feeling that nothing is under your control. But that's not entirely true! The first step to taking ownership of your birth experience is to educate yourself! When you know the steps to come, you can regain control over your emotions and worries. Like reading a driver's manual before getting behind the wheel for the first time. Understanding the stages of labor, its progression, and its challenges also gives you the ability to make informed decisions about the type of labor and interventions you want.
In this article, we will discuss the stages of labor to help you better prepare. There are three stages of labor: early labor, active labor, and transition. Each stage is different from the one before and the one(s) to come. Being able to identify which stage you are in helps you determine how much time you have left, what to do, and what to expect.
LATENCY PHASE
The latent phase can begin either with your water breaking or with contractions. Only 10% of women have their water break in a dramatic splash in the middle of a mall like in the movies. For most women, this occurs as a slow to medium flow of water that doesn't seem to stop for an hour or more.
For others, labor begins with contractions that can be quite difficult to differentiate from false contractions (Braxton Hicks)! Since latent labor usually involves mildly painful contractions, every 5 to 30 minutes, you can easily mistake it for prodromal labor and wonder if you are actually in labor or not.
What differentiates latent labor from prodromal labor is that the contractions in latent labor actually dilate your cervix to about 3 or 4 cm. These contractions can be in your lower back or like painful, low menstrual cramps and can even cause a stretching sensation in your cervix.
The good news is that even if you are in early labor but aren't sure, it's okay! You don't need to go to the hospital just yet, but make sure you have your plan and driver ready.
Typically the latent phase lasts 8 to 12 hours but can be much longer.
ACTIVE PHASE
Active labor begins around 4 cm, but some sources agree that it doesn't really start until 6 cm dilated. Your contractions will become more painful, more regular, and closer together every 3 to 5 minutes. Most hospitals will ask you to come in when your contractions are:
-1 min duration
-Every 5 minutes
-For at least 1 hour
This applies to first babies, but if you are on your second or third and are known for having quick deliveries, your doctor will probably ask you to go home earlier.
During the active phase, you will begin to feel the need to concentrate to overcome the pain. Changing positions often and taking a long bath to relax will help you dilate more quickly. When your cervix is about 7 cm dilated, you will feel a strong pull in your vagina, especially during “normal labor” or “frontal labor.” Many women will have their water break during this phase and experience light bleeding. The red and pink blood seen during the active phase is a sign that your dilation is progressing and blood vessels are breaking as a result, a very normal and healthy progression of labor.
Many women will be offered an epidural during the active phase of labor which can last on average 5-7 hours. It is recommended to wait until you are 6 cm dilated before having an epidural if possible as it can slow down labor that is not yet well established. Some cases will warrant an epidural earlier, for example a mother who is too tense, does not dilate after several hours of active labor, and is now too tired to progress healthily without rest.
TRANSITION PHASE
The transition usually lasts from 30 min to 2 hours but can extend beyond that. You will dilate between 8 and 10 cm.
If you had an epidural, the transition won't be much different than the active phase after you got one. If you didn't have an epidural, you might start roaring like a lioness!!! They say keeping your mouth open and your jaw loose helps with dilation, so go ahead and roar!
You may feel nauseous and vomit. This is normal. You may feel chills and a little light-headed and confused. This is normal.
Your mantra during the transition should be “one contraction at a time”
Some women may even feel like they are falling asleep or losing consciousness between contractions. This is normal!
Transitioning is the hardest phase but it also means you're going to have a baby soon and is often the shortest phase!
Once When you are 10 cm dilated, your body will naturally start pushing if you have not had an epidural. If you have had an epidural, your doctor will tell you when to push so that it happens during a contraction. They will also tell you how long to push for. When you push, it will not feel like you are pushing a baby, but more like you are pushing everything below your waist. If you have had an epidural, it may be a little difficult to push hard enough because you will not feel. To help, take a deep breath and while holding your breath, bring your chin to your chest, and as you exhale slowly, push.
Your baby will descend into your birth canal until his head is close to being born. This is when you will be able to feel the ring of fire. The ring of fire is basically a time when a woman who has not had an epidural may feel like her vagina is on fire, or burning, from being too tight and may feel like it might tear. If you can, relax and don't push too hard if the baby is doing well. Slowing down the head and allowing the skin to relax more can help prevent tearing. However, sometimes it is impossible to slow down your body's pushing. You should not try to hold a contraction or force against a contraction, just relax as much as possible.
After your baby's head, shoulders and body will come out quite easily!
And then ladies… you’re done. You’ve given birth. Your placenta will follow soon, but don’t worry about it, because you’ll be holding your newborn in your arms, marveling at what you’ve just accomplished.
Labor is hard but our bodies were designed to handle it! In most cases, labor goes well and no intervention is needed. There is no need to be afraid or nervous, but instead use this time to decide what pain management you do and do not want and write a birth plan to share with your doctor and nurses.
This is YOUR birth. You have choices and options.
And if everything doesn't go "perfectly," your doctor or midwife will be there, ready to intervene.