Different Stages of Labor – Complete Guide to Birthby Elizabeth MacDonald
Did you know that most couples spend more time working on their baby registry than they do preparing for labor? They spend more time dreaming and setting up a nursery than educating themselves on birthing. Do not fall into this category! Do not just walk into the two hour hospital class that covers a medicated birth, bathing/swaddling, and breastfeeding basics all in one breath. You only have one shot at this pregnancy, this birth, and this baby’s infancy. You will make plenty of mistakes (DUH – no one is perfect), but you want to have no regrets. Whether this is your first birth or your fifth, take the time to educate yourself.
I am a birth (and baby) junkie. I can spot a pregnant or new mom two stores away and have no fear approaching her and chatting! I have been teaching natural childbirth classes to couples for years and have had five wonderful births. While this doesn’t make me an expert, is does make me educated and very well researched. If you know me in real life, you are probably chuckling at this while thinking, “Holy crap. That girl does more research than anyone I know.” I told you, I like to be educated. I feel as though being a parent is my absolute greatest adventure in life, and I’ve got one chance at it. Damn right, I’m giving it my all. I will make sure that my husband and I make the best, informed decisions for our family. I hope that you will do the same!
*Instead of pulling random images, I decided to use the photos from my third birth. We had the honor of working with an amazing birth photographer (www.dustilynnphotography.com)
*Yes, it was a homebirth. Yes, I am badass – just as you are for delivering my baby in the manner that I chose.*
Labor is not a wham-bam-thank-you-mam contraction and push-fest. I’m going to start by saying that your partner should be prepared too. This will not only help YOU through labor, but it will bring the two of you closer than you thought you could be. There are wonderful books out there on birthing, and I highly recommend that you read as many as you can. Even if you don’t plan a natural, unmedicated birth, read like you are because you will learn more about the body and its capabilities.
There is no “normal” when it comes to labor. Doctors like to tell you that the average woman dilates at a centimeter an hour and then pushes for two hours. This is based on the curve of all women, meaning that very few are actually in this category and most fall on either side. I have watched couples labor for 70 hours (HEROES) and couples wake up with contractions 2 minutes apart and hold a baby within 2 hours (EQUALLY HEROES – hello downhill part of a rollercoaster!!). The truth is that your labor is designed to birth your baby. No one can predict how fast or slow it will go.
I prepare all of my couples for the crazy, intensity of either side of the bell curve and love hearing their birth stories afterward. For the sake of time, I am going to write about spontaneous labor today. Spontaneous labor is when labor occurs all on its own, without any type of medical intervention.
Contractions may start, your water may break, or back pain may occur. These are the most common starts to labor. Wait, let me back up. You may also have a day of diarrhea, bloody show, a lost mucus plug, or a general sick feeling right before labor begins, BUT these could also not mean labor is starting (confusing, right?). So don’t read too far into any of these symptoms.
No matter how labor begins for you, you will be hit with a wave of emotions. Hopefully you are in the safety window of 37/38 -42 weeks and baby is in a great birthing position. (Remember true full term is now labeled 39 weeks.) Typically excitement hits you first. You want to call your partner home, tell your family, maybe even make your contractions “facebook official.” I urge you to slow down. Birth is a marathon, not a sprint. Let’s not get overworked just yet.
1st Stage of Labor: Early Labor
Contractions: 10 minutes apart and consistent, lasting 45-60 seconds Do not leave for place of birth yet.
I call this the putsy-putsy stage. You should continue going about your daily routine and let the contractions come and go. You can call your partner, but let’s leave everyone else out of it for now. I wouldn’t really call it labor until contractions are 10 minutes apart and consistent. You may be anxiously cleaning, repacking your bag, prepping things for a homebirth, or just baking cookies, remember to give in to each contraction and let it do its job. Some women can still talk and move through the contraction waves at this point, while others may be silent. Make sure to eat something during this stage; you will need energy throughout the marathon ahead. During early labor, you may see blood in the toilet or in your underwear. This is known as the bloody show. There is absolutely no cause for alarm unless the bleeding is heavy and continuing, bloody show is normal (and also normal for it to NOT happen). Contractions will typically last 45-60 seconds in length and progressively become more intense as labor advances. It may feel better to stay moving between contractions. The body is going through many changes at this point: the brain is noting antibodies needed in breastmilk to allow baby the exact right nutrients needed for this immediate environment, baby’s nervous system and lungs are being prepped with each contraction, the body is moving baby down into ideal positioning. If you are feeling tired at all, nap or rest. You are going to need all of your energy. If you are well rested, walk. Walking opens the inlet of the pelvis.
It is also completely normal for your adrenaline to stop labor at this point. Your emotions are a huge part of this experience. Do not become discouraged if contractions taper off; your body will start working toward labor again within the next few days (or sooner). Breathe, you will meet your baby soon.
Contractions: 5 minutes apart, lasting around 60 seconds and intensifying
Call your birth team once active labor has been consistent for an hour or so. No need to rush anywhere yet, but let them know you are progressing “This is it,” becomes your thought process. You know you are in labor and that baby will be here (relatively) soon. You will be working harder through the contractions at this point and may find one or two positions that work really well to handle the waves of tightness. Walking is still important, and you should be able to move and interact with others normally in between the contractions. Continue snacking and drinking fluids, and make sure to urinate often, as your full bladder can prolong labor. You will feel increasing pressure and fullness in your pelvis, your back may ache, and a general crampy feeling may occur. I recommend sitting on a yoga/birth ball and rocking it on out! The pelvis will be stretching and pulling, rocking will help. Stay distracted in between contractions, there may be quite a journey ahead of you.
Contractions will become more intense and come closer together. As you enter late first stage of labor, you will become very serious and start losing your modesty. Your movements will become slower and more deliberate. A lot of women feel the need to lie down and build a “nest” – a quiet, cool, dark, comfortable place and ride out the intensity of the waves. Close your eyes and mimic sleep. Breathe and use your relaxation techniques (that you have been practicing throughout your pregnancy). Your partner should be supporting you in any way possible: back rub, music, etc. Head to your place of birth. Late into this stage, you no longer will want to eat or even talk much. If asked to take a picture, you will most likely shake your head and moan. This is the best time to head to your birth place, especially if you are aiming for an unmedicated birth. Right about now is when most women’s water breaks. But have no fear, it is normal for it to break at ANY time of labor – or not to break at all and have a lucky baby born in the caul!
Contractions: Irregular, double peaking, intense, all encompassing
Inevitably, you will doubt your capability. Welcome to transition. This is the point of labor when contractions become so intense that unprepared women beg for drugs. But if you are prepared and know what to expect, and know that transition is typically the shortest part of labor, you will give in to the contractions and allow your body to bring baby into his final descent before birth. The toilet is a glorious place to transition. The cool porcelain and open seat just work so well during this stage. Most midwives will work to get you to the bathroom for transition (you probably won’t even realize this). Transition is animalistic and raw, real and emotional, painful and all encompassing. For some women though, transition is as simple as having cold feet (those are the women I’d like to slap, but you know – I’m super peaceful and would never do that). You can and will make it through.
2nd Stage of Labor: Pushing
Contractions: Spread out, pressure to push, the pain and intensity is gone.
You have done it. You have labored. Now it’s time to meet your baby. They key? Wait until your body pushes ON ITS OWN before you help baby out. It doesn’t matter that the doctor says, “It’s time to push.” Pushing before your body is pushing is a huge waste of time. This is why most women push for hours. After transition, the body will naturally give you a break. The contractions spread back out and become less intense. The waves become less of a painful tightening and more of a downward pressure. You’ll feel pressure on your rectum and think pushing will help, but I beg you wait. Relax, sleep, and celebrate how far you have come. You will know when your body pushes. You can talk freely again and will be more alert and “with it.” Once the body pushes, you may feel a burning sensation; this is the baby’s head passing through the cervix. You can push in any position that feels right. Lying flat on your back is strongly discouraged, as it works against gravity. Do not be afraid to change positions during this stage. If baby’s shoulders are “stuck” or heart rate is falling, change positions! By the end of 2nd stage labor, you are holding your baby!
3rd Stage of Labor: Placenta Delivery
You will be so high on after-birth hormones, that you probably won’t remember delivering your placenta. And after just delivering a baby, it is pretty easy to push out this incredible organ. It is important though that your birth team makes sure the entire placenta has passed and not even a shred was left attached to the uterus. If you feel feverish, your milk does not come in, or you start to feel ill within a few days, call your OB immediately. Take a minute to look at the placenta. This organ GREW A BABY inside of you. It is incredible! Perhaps even consider encapsulating it into pill form to rebalance your hormones after the birth! (I’ll leave that for another blog.)
- Lying on your back works against gravity and causes contractions to last longer and be more intense.
- Squatting shortens the birth canal by 10%.
- Relaxation is the key to a successful birth.
- You are in charge of your birth; education and knowledge will give you the power to make informed decisions.
- Knowing how far dilated and effaced you are will do nothing but terrify or aggravate you. You can go from 1 to 6cm in 5 minutes and one contraction or if can take you three days to dilate 5cm. It means absolutely nothing. As long as you are contracting, your labor is progressing. Your body will naturally begin pushing once you are dilated enough. Every “check” increases risk of infection to you and baby. Let your body do its job, mama. You’ve got this.