What to Expect Throughout the Three Labor Stages

Here is a guide on what to expect throughout the three labor stages, from the initial contractions through the delivery of the placenta, ensuring you’re prepared for each phase.

Every pregnancy reaches a point where all that is left to do is wait. The books have been read, the nursery has been decorated, and the child safety seat has been placed. Susan Cooter, director of Prepared Childbirth Educators, a Hatboro, Pennsylvania-based group, states, “After you reach 37 weeks of pregnancy, your baby could be born at any time.”

Despite the fact that most women give birth between 37 and 42 weeks, it is impossible to predict exactly when labor will begin. “Not knowing makes some women quite apprehensive,” says Cooter, a licensed doula trained to provide emotional and physical support during labor.

If you’re a first-time parent, it’s possible that you won’t recognize when you’re in labor. “Many women visit the hospital just to be instructed to return home,” observes Cooter. Braxton-Hicks contractions, also called “practice contractions,” can be challenging to distinguish from actual labor contractions. However, if your contractions gradually get more intense, last longer, and become closer together, you are likely in labor.

When you will be more comfortable in the early stages of labor, it may take some time to determine if you are indeed in labor; therefore, it is best to stay at home. In fact, a first-time mother or father can expect to be in labor for 12 to 19 hours, although some labor can last longer. “Labor with subsequent pregnancies is typically shorter,” adds Cooter.

When it’s time to check into the hospital or birthing facility, remember that things don’t always (or, more properly, seldom) go according to plan. You may not be able to receive the epidural you desire, or you may require a cesarean section. “It’s okay to have a concept of how you’d like the birth to unfold, but you must be adaptable,” adds Cooter. In fact, many physicians and midwives prefer the phrase “birth preference” over “birth plan” because it is practically impossible to control certain parts of the delivery process.

Bearing in mind that the stages of labor vary for each individual and their pregnancies, here is what you can anticipate.

First Stage of Labor: Cervical Dilation and Effacement

When contractions occur at regular intervals, such as every 8 or 10 minutes, and become closer together, it is often time to contact your doctor or go to the hospital. Additional signs of labor include “rupture of membranes” (when your water bursts) and passing bloody discharge, sometimes known as “bloody show.”

However, while some women will lose their mucus plug during labor once they are a few centimeters dilated, others will have lost it weeks before, rendering it an unreliable sign of labor. Note that only some experience the same labor symptoms, so if you are unsure, contact your doctor. They may not be able to diagnose you with labor over the phone, but they can guide you through the subsequent steps.

This first phase of labor is further subdivided into the early (or latent) phase, the active phase, and the transition phase.

1. Early (or Latent) Labor Period

For first-time parents, the early stages of labor are the longest and are sometimes jokingly referred to as the “entertainment phase” since it is frequently beneficial to divert attention to other things to pass the time without stressing about what is to come. As long as contractions are still relatively moderate and further apart than approximately five minutes, most women remain at home and in close communication with their practitioner.

Typically, contractions are weak and irregular, occurring 5 to 30 minutes apart and lasting 30 to 45 seconds. You may observe a reddish discharge and have some abdominal discomfort. The water may break (membrane rupture) early in this phase or later in labor, either on its own or with the assistance of your practitioner.

Duration of this phase:

This initial phase of labor lasts an average of 6 to 10 hours for first-time parents but only 2 to 5 hours for repeat parents. Nonetheless, it can sometimes continue longer than 24 hours. Variations in labor duration rely on numerous factors, including the intensity of contractions, the shape of the uterus and pelvis, and the baby’s position.

How do contractions appear during this phase?

During this period, contractions typically last between 30 and 60 seconds, and they begin approximately 20 minutes apart and decrease to approximately 5 minutes apart. Watch for contractions that remain even when you move, that increase in intensity and begin in your back, and travel to your front.

Things to do:

According to Cooter, anything that helps you relax would suffice. “Relax, take a shower, have a modest meal, go for a walk, and practice slow breathing,” she advises.

Active Phase of Pregnancy

The active phase of labor is still technically stage one, however, it is when significant preparations for childbirth commence, and most women begin to labor more strongly. During the active period, contractions typically occur three to five minutes apart and steadily increase in intensity and frequency.

Pains may be concentrated in the lower back, abdomen, or thighs and may be powerful enough to impede speech. You may also have an increase in the quantity of reddish or brownish discharge, sometimes known as a “bloody show.”

Duration of this stage:

This phase of labor lasts between 3 and 6 hours for first-time mothers and between 1 and 3 hours for subsequent mothers. If you’ve taken Pitocin, a medicine that causes contractions, this phase may go more swiftly; but, if you’ve received an epidural, things may progress more slowly (although data shows that the epidural does not slow down labor in a statistically significant way). But, depending on the intensity of the contractions and the baby’s position, labor can frequently last significantly longer.

How do contractions appear during this phase?

Contractions become more powerful, last 45 to 60 seconds, and occur every 3 to 5 minutes.

You may also encounter:

At this point, many individuals want an epidural because they are experiencing pain in their back, hips, feet, and legs. Yet, even with pain medication, active labor might irritate some individuals. “I believe this was when I began to yell at my spouse,” Kearney adds. “It hurt so bad that I wanted to vent on someone.”

How to proceed:

You have been admitted to a hospital or birthing center by this point in labor. If you have an epidural, you may not be able to get out of bed, but it’s still a good idea to change positions approximately every half hour. Nowadays, the majority of nursing personnel are highly skilled at repositioning patients, frequently using balls of various shapes strategically positioned between the thighs or ankles to allow the pelvis to open. If you do not have an epidural and are mobile, consider walking up and down stairs for a few minutes or marching in place (if hospital policy permits).

According to Cooter, “this movement encourages the cervix to open and facilitates the baby’s rotation into the birth position.” Use the relaxation techniques you learned in childbirth education classes and solicit your partner’s emotional support at this time. Your hospital may also use a stethoscope, handheld Doppler equipment, or an electronic monitoring gadget to measure the baby’s heartbeat.

Transitional Period

At this period, contractions are typically severe and occur every two to three minutes. This phase is characterized by increasing exhaustion, trembling, and nausea as the body exerts itself to achieve complete dilatation and effacement.

As the baby’s head progresses into the vaginal opening, you may feel a strong need to push or bear down, accompanied by pressure in the rectal area and stinging in the vaginal area. But, you should NOT push until your practitioner gives you permission, which will occur after the cervix is completely dilated.

Duration of this stage:

This is the shortest but a most intensive phase, lasting between 10 minutes to 2 hours on average.

How do contractions appear during this phase?

Contractions are becoming increasingly severe, lasting 60 to 90 seconds and occurring every 1 1/2 to 2 minutes.

You may also encounter:

You may experience pelvic and rectal pressure, hot flashes and/or chills, cold feet, nausea, and/or vomiting. It is typical to feel overwhelmed and despondent throughout labor as if it will never end.

How to proceed:

Picture yourself in a place where you feel safe and at ease, such as on the beach, against a tree, or in a rocking chair in your child’s nursery. Deepen your breath and flesh out the scenario with details. What is visible? What do you smell? What do you perceive? If you’re in more pain than you anticipated, it’s usually not too late to request pain assistance. But whether you receive any will depend on the availability of an anesthesiologist.

2. Second Phase of Labor: Pushing and Delivery

Once the cervix has fully dilated, labor enters its second stage. Your infant is descending the birth canal. Contractions continue to be intense, lasting approximately 60 seconds and occurring every 3 to 5 minutes. You may experience a strong impulse to push.

As soon as your cervix is completely dilated, your practitioner will most likely give you the green light to push. Now, contractions continue, although they are often more apart. Some individuals suffer from nausea and vomiting. Once you begin to exert yourself, you may become increasingly out of breath and exhausted; you are likely experiencing the most difficult workout of your life.

Duration of this stage:

With your first child, pushing can last up to two to three hours, and possibly even longer, but with your second child, pushing is typically much shorter. If your baby is in distress or does not appear to be progressing through the delivery canal, your doctor may need to perform a C-section and use forceps or a suction device to assist them.

How do contractions appear during this phase?

As the baby’s head crowns or protrudes at its largest point outside the vaginal opening, you may experience acute pain in your vaginal and perineal areas. In certain cases, a doctor may conduct an episiotomy (an incision made between the vaginal entrance and the rectum, also known as the perineum, to give the baby more room to exit) to give the baby more room to exit. Even though episiotomy is no longer commonly performed, it is not uncommon to experience some ripping, particularly during the first birth. If you do not have an epidural for pain relief, your physician or midwife may use a local anesthetic to alleviate the agony. When the rest of your baby’s head and body emerge, you may be asked to push more gently or slowly. Finally, your child is born into the world with one final push.

How to proceed:

Take comfort in the fact that you’re nearly there! Focus on pushing your child down and out. Your companion can assist by urging you to push and allowing you to rest between each push. Try out various postures, such as getting on your hands and knees or kneeling while your spouse supports your upper body.

3. Third Stage of Labor: Delivery of Placenta

Your child’s birth is immediately followed by the delivery of the placenta (sometimes called “the afterbirth”). You’ll likely be so preoccupied with getting to know your infant that you won’t notice much of this stage!

Duration of this stage:

The placenta is typically delivered between 1 to 20 minutes for first and subsequent pregnancies.

Things you might encounter:

Minutes after the birth of your child, you experience contractions again. Typically, this results in placenta separation from the uterine wall. When your physician observes symptoms of separation, they may request that you push again to release the placenta. In certain instances, they may need to reach inside and assist in removing the placenta.

How to proceed:

Be patient. According to Davis, “I had a newborn, so it was quite simple to endure this last, relatively brief period of agony.”

Remember that a collaborative connection with your doctor or midwife will help promote a healthy delivery regardless of the mode of delivery.

Meaningful articles you might like: Higher Covid-19 Cases Linked to Heavy Breathing During Labor, 5 Strategies For Inducing Labor At Home, What is More Painful Labor Contractions or Pushing