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After around 40 weeks of growing and carrying a new life, a pregnant woman's hardest work begins -- the process of labor. Labor has been compared to pushing a grand piano across a warehouse floor. It is strenuous, exhausting work.
The contractions of labor are the result of the tightening and releasing of the uterus. Effacement is the thinning or shortening of the cervix to prepare it to dilate and let the baby through. The cervix gradually disappears as it is being pulled up by the contractions. Dilation is the opening of the cervix from its closed state to a diameter of 10 centimeters. These terms are used to gauge the progress of labor, signaling the changing of phases and stages.
There are four labor stages: The first labor stage, called cervical dilation, has three phases. Second stage is the actual pushing phase. Third stage comes after the birth of the baby and continues through the delivery of the placenta. And the fourth stage is the initial recovery period for the mother.
There is no way to predict how long a labor will last. Though the typical "textbook" labor lasts 12 to 14 hours, every labor and birth is unique to the individual. Contractions may continue for several days, but in prolonged early labor, the contractions are usually mild and there is plenty of time to rest between them.
First Stage of Labor
The first stage of labor begins with the onset of regular contractions and ends when the cervix is completely dilated.
The latent phase of first stage labor is the longest of the three phases, helping the cervix dilate up to three or four centimeters as it effaces. This can take five hours or more and dilation may move along slowly for many hours.
In this phase, contractions last about 30 to 40 seconds, with the interval between contractions shortening to about five minutes apart. Typically, these contractions are mild and easy to manage. Women have described contractions in this phase as similar to menstrual cramps. Contractions are felt in the lower back and towards the front of the lower abdomen.
Many women have mixed emotions during this phase. They can be excited and happy, knowing that the end of pregnancy is near. They also may feel some apprehension—especially first-time mothers.
Although a woman may have a lot of energy, she should eat lightly, drink to thirst and rest. Conserving energy is the name of the game, especially because labor may continue longer than anticipated. This would be the time to alert those that make up your support team.
During the middle or active phase of first stage labor, the cervix dilates at an accelerated rate to about seven centimeters. Active phase usually lasts around three hours. Effacement remains constant throughout the active phase of labor.
Contractions become more intense and regular, shortening to three to five minutes apart, lasting about 60 seconds. At this time in labor, the mother needs to increase her concentration during contractions, which may be feeling more painful. Some women may request drugs at this time.
The bloody show can occur during the active phase. This mucus is bloodier than the pinkish-tinged mucus seen in early labor. This is not a cause for alarm. However, as this phase progresses, the mother may become less talkative and outgoing; her focus will be more inward.
If a woman is not tired, she may sit up or walk during labor and should be encouraged to change positions frequently -- at least every 30 minutes. Some facilities allow women to shower or relax in a warm tub. Supportive coaching and relaxation are essential at this time.
The transition phase ends the first stage. This is the final stretching of the cervix before the baby moves down into the birth canal. This is a short but increasingly intense phase, usually lasting about two hours, when the cervix dilates from eight to 10 centimeters. Contractions become very powerful, two to three minutes apart, lasting 60 to 90 seconds. This allows little rest between contractions.
At this point, the mother must concentrate to work with her breathing and her body's natural rhythm, and often requires direct coaching. She'll likely become irritable and sensitive to her environment, experiencing some trembling, hot and cold flashes, nausea, vomiting and mercurial emotions. If the bag of waters has not already broken, it probably will during transition. And the mother may experience the urge to push as the baby is traveling downward into the birth canal.
Read on for more stages of labor