What to Expect During the Stages of Labor

Here's what happens during the stages of labor:

Pre-Labor

  • What happens: Uterine contractions cause the cervix to relax, thin out and dilate 1 to 2 cm. The baby drops into the pelvis.
  • Duration: A few hours to a few weeks.
  • What you feel: Painless, non-rhythmic contractions called Braxton-Hicks; frequent urination; loose bowel movements; vaginal discharge; bloody show.
  • What to do: Continue a level of activity you are comfortable with and you have discussed with your prenatal care provider. Finish preparation and/or packing for the trip to the hospital or birth center. Rest up!

First Stage - Early

  • What happens: The cervix relaxes, thins out nearly completely and dilates halfway or more. The baby's head descends farther into the pelvis.
  • Duration: A few hours to a few weeks.
  • What you feel: Slow, steady contractions; eventual leaking or rupture of membranes.
  • What to do: Continue a level of activity you are comfortable with and you have discussed with your prenatal care provider. Try to sleep or rest often. Empty bladder. Call your doctor or midwife.

First Stage - Late

  • What happens: Cervix completely thins out. The baby's head descends lower. The amniotic membrane bulges and breaks.
  • Duration: 3 to 4 hours.
  • What you feel: Contractions are 3 to 5 minutes apart, last around 60 seconds and are intense; membranes usually break and gush fluid; backache; deep pelvic pressure.
  • What to do: Continue a level of activity you are comfortable with and you have discussed with your prenatal care provider. Try kneeling or squatting. Rest, using pillows for comfort. Drink and snack. Empty bladder.

Transition

  • What happens: Cervix dilates completely. The baby's head squeezes through the cervix into the birth canal. The baby begins to stretch the vaginal canal and puts pressure on rectal, pelvic and back structures. The cervix is being pulled up over the baby's head.
  • Duration: 15 to 90 minutes. This is the shortest, but most intense, phase.
  • What you feel: Backache, bowel pressure, hot and cold flashes, shaking, nausea, vomiting and aching thighs. Contractions are 1 to 3 minutes apart, last 60 to 90 seconds and are intense, overwhelming and relentless.
  • What to do: Change positions for comfort. Squat, kneel or sit leaning forward. Between contractions, suck on ice chips, sip juice and rest. Relax pelvic muscles.

Second Stage

  • What happens: Perineal tissues, tissues of the urinary passage and the rectum stretch, preparing to accommodate the baby and triggering the urge to push. Baby twists and turns through the birth canal. The baby's head and then body eases out. The baby is delivered.
  • Duration: 30 minutes to 3 hours.
  • What you feel: Irresistible urge to push. Contractions often less intense and further apart (3 to 5 minutes).
  • What to do: Short, frequent pushes when you have the urge. Rest between pushes. Relax pelvic muscles during pushing. Change positions. Resist pushing during crowning of the baby's head by panting or blowing.

Third Stage

  • What happens: The uterus contracts or expels the placenta and clamps uterine blood vessels to stop bleeding. Hormones are released to help contract the uterus and stimulate milk production.
  • Duration: 5 to 30 minutes.
  • What you feel: Cramping contractions; gush of blood as the placenta separates.
  • What to do: Relax and stay warm. Place your baby on your abdomen and, if you are breastfeeding, encourage the baby to suck.

© Parenthood.com, used with permission.

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