Stages of labor and birth: Baby, it’s time!

The labour and delivery process is separated into three stages: When you start having contractions, you are in the first stage of labour. It produces gradual cervical alterations and ceases when your cervix is fully dilated (open). When you’re fully dilated, the second stage of labour begins and finishes with the birth of your baby. This stage is also known as the “pushing” stage. The third stage, sometimes known as labour, begins shortly after your baby is born and finishes with the delivery of the placenta.

How long does it take to give birth?

Every pregnancy is different, and the length of labour varies greatly. Labor might take anywhere from ten to twenty hours for first-time mothers. However, for some women, it lasts much longer, while for others, it lasts much shorter.

Women who have previously given birth vaginally usually have a faster labour.

First stage of labor

There are three stages to the initial stage of labour:

• Early labour: By the end of this period, your cervix has effaced (thinned out) and dilate (opened) to around 6 centimetres (cm).

• Active labour: During active labour, your cervix dilates more quickly and opens up to 10 cm. Contractions are becoming longer, stronger, and more frequent.

• Transition: As active labour progresses, contractions get longer, stronger, and closer together — this might be the most challenging period of your labour.

The first stage of labour is the longest and can last anywhere from days to a few hours, especially if you are giving birth for the first time. Early labour is the most time-consuming, while transition is the quickest.

Phase 1: Early labor

What to expect

Contractions start. You’ll begin to experience contractions at regular intervals. Early labour contractions can be difficult to tell apart from irregular Braxton Hicks contractions, often known as false labour. True labour contractions are more regular than Braxton Hicks contractions and get closer together as time goes on. (If you’re not sure if you’re in actual labour, see if you and your labour partner or doula can have a full dialogue.) If you have to stop to breathe throughout contractions, especially in the middle of a sentence, you’re definitely in active labour).

Contractions become longer, stronger, and more closely spaced. They’ll eventually come every four to five minutes for 40 to 60 seconds apiece. (Some women will experience considerably more frequent contractions during this stage, but they will still be mild and last no more than a minute.) When your cervix is around 6 cm dilated and your progress begins to speed, early labour finishes.

You may experience some discomfort. Early labour contractions can be pretty painful at times. Early contractions will be light enough for you to chat through them and putter around the house, or even doze off between them, if your labour is usual.

A mucousy vaginal discharge is possible. The so-called bloody display may be tinted with blood. This is totally normal, but if you notice more than a speck of blood, contact your caregiver immediately.

Your water may break. If this happens, even if you aren’t having contractions yet, call your doctor.

Coping tips

Periodically time contractions. Don’t become a slave to your stopwatch just yet – recording every contraction over the many long hours of labour is unpleasant and taxing, and it isn’t required. Instead, timing them at regular intervals to get a feel of what’s going on. In most circumstances, your contractions will tell you when it’s time to pay attention to them more closely. You can also ask your labour partner to keep track of when you can no longer relax completely between contractions, or when you can’t finish a phrase or express a concept without stopping to cope with a contraction.

Rest. Because you may have a long day (or night) ahead of you, it’s critical to try to be as rested as possible. If you’re exhausted, attempt to fall asleep in between contractions.

Relax. If you’re feeling worried, try some relaxation techniques, take a warm bath, or do something to take your mind off things for a while, such as watching a movie or reading a book.

Keep yourself hydrated by drinking plenty of water. Also, even if you don’t feel like it, remember to urinate frequently. A full bladder can make it difficult for your uterus to contract properly, but an empty bladder allows your baby to descend more easily.

Phase 2: Active labor

What to expect

Contractions grow more severe. When you’re in active labour, things really start to move. You won’t be able to talk through your contractions as they become more powerful — more regular, longer, and stronger.

Contractions become more frequent. In most situations, contractions occur every 2 1/2 to 3 minutes, while some women never have more than 5 minutes between contractions, even during transition.

The cervix expands. Your cervix dilates at a faster rate. (Transition, which occurs when the cervix dilates entirely from 8 to 10 cm at the end of active labour, is detailed in the next section.)

Although your baby may have started to descend earlier or may not start until the next stage, he may begin to descend toward the end of active labour.

Nausea and vomiting are common side effects. This is extremely typical at this stage, sometimes due to epidural anaesthesia producing a drop in blood pressure, and sometimes due to nerve stimulation inducing vomiting.

What to do

If you’re a first-time parent, it’s time to call your midwife or doctor and possibly go to the hospital or birth centre once you’ve had regular, uncomfortable contractions (each lasting approximately 60 seconds) every four to five minutes for at least an hour. Some caregivers prefer to be contacted sooner, so make sure to discuss this with them ahead of time. Some doctors will encourage you to stay at home as long as possible, especially if you want an unmedicated, low-intervention birth.

How long active labor lasts

If it’s your first child. On average, active labour lasts between five and seven hours, though every woman is different. It might be as long as a day or as short as an hour.

If you’ve already had a baby, the active period should last between two and four hours on average.

Labor may take longer if you have an epidural or a large baby.

Coping tips

If you’re in pain, get some relief. During the active phase, the majority of women opt for pain medication, such as an epidural.

Experiment with relaxing techniques. Whether or not you plan to use medication, many pain-management and relaxation strategies used in natural delivery, such as breathing exercises and visualisation, can aid you during labour.

Hire a labour coach or enlist the help of a birth partner (doula). A paid doula, a partner, a friend or family member, or a friend or family member can all be a big assistance right now. You’ll most likely benefit from a lot of mild encouragement.

Move. While walking may feel fantastic, you’ll most likely want to stop and rest against something (or someone) throughout each contraction. As long as there are no issues, you should be allowed to roam around the room freely after your caregiver evaluates you.

On your side, sit or lie down. If you’re fatigued, try rocking in a chair or sleeping on your left side in bed.

Get yourself a massage. This is a fantastic moment to request a massage from your birth partner or doula to help with labour pain.

If you have access to a tub and your water hasn’t burst, take a warm shower or bath. Even if your water has burst, you can probably take a shower because the risk of infection is minimal. If your water has broken, though, don’t take a bath.

Phase 3: Transition

Because it marks the change to the second stage of labour, the last section of active labour is referred to as the transition period.

What to expect

Cervix is fully dilated. Your cervix expands from 8 to 10 centimetres.

Contractions that are extremely powerful. This is the most difficult phase of the process. Contractions are often intense, occurring every two to three minutes and lasting a minute or more. You can start shivering and shaking.

Apply some pressure to your rectum. Your baby has normally dropped significantly into your pelvis by the time your cervix is fully dilated and transition is complete. This is when you may start to feel rectal pressure, as if you need to go to the bathroom.

A desire to push. Some women begin to bear down – to “push” – and may even make deep grunting sounds as a result. Some infants arrive earlier than others, and the mother feels compelled to push before she is fully dilated. Other infants arrive later, and the mother reaches full dilatation without experiencing any discomfort. (If you’ve had an epidural, the amount and type of medication you’re given, as well as how low the baby is in your pelvis, will determine how much pressure you feel.) Request that your epidural dose be reduced at the end of transition if you want to be a more active participant in the pushing stage. However, keep in mind that this will aggravate contractions).

Discharge. A lot of bloody discharge is common.

Nausea. You may feel sick to your stomach or vomit.

How long transition lasts

It can take anywhere from a few minutes to several hours to transition. If you’ve already had a vaginal delivery, it’s much more likely to be quick.

Coping tips

If you’re not using an epidural, this is the time when you could start to doubt your ability to cope with the pain, so you’ll need a lot of extra encouragement and support from people around you.

Think about getting a massage. Some women enjoy mild touch (effleurage), while others prefer a firmer touch, and yet others prefer not to be touched at all.

Shift your weight. If you’re experiencing a lot of pressure in your lower back, for example, getting down on all fours may help.

Compresses, either cold or warm. A cool compress on your forehead or a cold pack on your back may be soothing, or you may prefer a heated compress.

Remove all sources of distraction. On the other side, because transition requires complete concentration, you may wish to avoid any distractions, including music, talk, and even that cool cloth or your partner’s loving touch.

Visualize. It could be helpful to concentrate on the notion that those painful contractions are assisting your baby in making his or her way out into the world. With each contraction, try to visualise her movement.

Make sure you have an excellent birth partner or labour coach. The good news is that if you’ve gotten this far without medication, you can usually be guided through the transition – one contraction at a time – with frequent reminders that you’re doing a fantastic job and that your baby’s arrival is approaching.

Second stage: Pushing

When your cervix is fully dilated, the second stage of labour begins: your baby’s final descent and birth.

What it feels like

More evenly spaced contractions. Your contractions may be a little further apart at the start of the second stage, allowing you to get some much-needed rest in between.

As the pressing begins, the intensity decreases. Because bearing down provides some relief, many women find their contractions in the second stage easier to handle than those in active labour. Others dislike the sense of being pushed.

The need to push is strong. Your uterus contracts, putting pressure on your baby and pushing him through the delivery canal. You may feel compelled to push early in the second stage if your baby is very low in your pelvis (and sometimes even before). However, if your baby is still quite high, you won’t feel this sensation right away.

Pushing: What to expect

You might want to take things slowly at first. If everything is going well, take it slowly and let your uterus do the work until you feel the urge to push. Waiting a little longer may result in you being less weary and frustrated in the long run.

It’s possible that you’ll be told to shove. In many hospitals, encouraging women to push with each contraction in order to speed up the baby’s descent is still common practise. If you’d rather wait until you have a strong urge to bear down, tell your carer. This technique, known as “labouring down,” has been proved to be just as effective as directed pushing, but it takes a little longer to deliver.

Epidurals can help to alleviate the sense of being pushed. If you’ve had an epidural, the lack of sensation can make it difficult to feel the urge to push, so you might not notice it until your baby’s head has descended fairly far. Patience is a virtue that often pays off. However, in other circumstances, precise directions will be required to assist you press properly.

Your baby’s descent: What to expect

The force of your uterus, together with the force of your abdominal muscles if you’re actively pushing, exerts pressure on your baby to keep moving down the delivery canal with each contraction.

• It doesn’t matter if you go fast or slow. It’s possible that the plunge will be swift. The drop could be gradual, especially if this is your first child.

• The head of your baby moves down and then back. When a contraction ends and your uterus relaxes, your baby’s head recedes slightly in a “two steps forward, one step back” pattern.

The first glimpse of your baby: What to expect

The scalp of your baby will appear. Your perineum (the tissue between your vagina and anus) will begin to expand with each push after a while, and your baby’s scalp will eventually become visible – a thrilling moment and a sign that the end is near. You can ask for a mirror or simply reach down and touch the top of your baby’s head to receive your first view of him.

An increased desire to push. The desire to push becomes much stronger now. With each contraction, you can see more and more of your baby’s head. As your tissue begins to stretch, the pressure of his head on your perineum is very intense, and you may sense a severe burning or stinging sensation.

Slow down or pant if given instructions. Your caregiver may encourage you to push more gently or stop pushing altogether at some time so that your baby’s head can stretch out your vaginal opening and perineum gradually. Perineum tears can be avoided by using a slow, controlled delivery. The need to push may be so strong by this point that you’ll be told to blow or pant during contractions to assist you cope. Coughing lightly instead of pushing can cause the baby’s head to descend more slowly and easily.

Crowning: How the head emerges

The entire head is visible. With each push, your baby’s head advances until it “crowns,” or when the broadest part of her head is finally visible. As your baby’s face begins to emerge: her forehead, nose, lips, and finally, chin, the excitement in the room will build.

Any stumbling blocks are removed by the provider. Your doctor or midwife may suction your baby’s mouth and nose when her head emerges, and feel around her neck for the umbilical cord. (If your baby’s chord is around her neck, your caregiver will either slip it over her head or clamp and cut it if necessary.)

The body of the baby prepares to emerge. To prepare for their escape, your baby’s head shifts to the side as her shoulders twist inside your pelvis. You’ll be instructed to push when her shoulders emerge one at a time, followed by her torso, during the next contraction.

Finally, it’s out there! What to anticipate.

Here’s what happens when your baby flies through the air:

1. He should be towelled off and kept warm.
2. If your baby appears to have a lot of mucus, your doctor or midwife may swiftly suction his mouth and nasal passages.
3. He’ll be lifted onto your bare belly if there are no issues, and you’ll be able to touch, kiss, and simply wonder at him. Your baby will be kept warm by skin-to-skin contact, and he’ll be wrapped in a warm blanket – and possibly given his first cap – to avoid heat loss.
4. Your caregiver – or your partner – will clamp the umbilical cord in two places and then cut between the two clamps.

You may be experiencing a wide range of emotions right now, including happiness, astonishment, pride, disbelief, excitement, and, of course, overwhelming relief that it’s all over. Even if you’re exhausted, you’ll likely experience a burst of energy, and all thoughts of sleep will fade away for the time being.

How long the second stage lasts

The duration of the second stage varies from a few minutes to many hours.

• The typical time without an epidural for a first-timer is close to an hour, and about 20 minutes if you’ve had a previous vaginal delivery.
• The second stage may last longer if you’ve had an epidural.

Coping tips

When pushing, experiment with different postures until you discover one that feels comfortable and effective. During the second stage, it’s not uncommon to switch positions.

Third stage: Delivering the placenta

What to expect

Your uterus begins to contract again minutes after delivering delivery. The placenta normally separates from the uterine wall during the first few contractions.

Your caregiver may advise you to gently push to help evacuate the placenta if she notices symptoms of separation. This is usually a single, quick thrust that is neither difficult nor painful.

How long the third stage lasts

On average, the third stage of labor takes about five to ten minutes.

What happens after you give birth

Your uterus tightens. Your uterus should contract and become very rigid after you deliver the placenta. You’ll be able to feel the top of it around the level of your navel in your stomach. Your caregiver, and later your nurse, will check to see if your uterus is still firm, and if it isn’t, they will massage it. This is significant because the uterus’ contractions assist in cutting off and collapsing the open blood arteries at the placenta’s attachment point. You’ll continue to bleed excessively from those veins if your uterus doesn’t contract properly.

Breastfeeding is an option. If you plan to breastfeed, start now if both you and your baby are ready. Although not all babies want to nurse right after birth, try holding your baby’s lips close to your breast for a few minutes. If given the opportunity, most newborns will begin to suckle within the first hour or so after birth. Early breastfeeding is beneficial to your kid and can be extremely enjoyable for you. Nursing also stimulates the production of oxytocin, the same hormone that produces contractions, which keeps your uterus firm and constricted.

Other therapies, such as oxytocin, may be used. You’ll be given oxytocin to assist your uterus contract if you’re not planning to nurse or if your uterus isn’t firm. (At this stage, many providers provide it to all women.) You will also be treated if you are bleeding heavily.

The contractions will stop. At this point, your contractions are relatively light. Your attention has moved to your kid, and you may be completely unaware of what is happening on around you. If this is your first child, you may only experience a few contractions after the placenta has been delivered. If you’ve already had a baby, you may experience some contractions over the next day or two. These “afterbirth aches” often resemble severe menstruation cramps. If they trouble you, ask for pain relievers such Ibuprofen, which is highly useful for cramping.

You can also feel unsteady or have the chills. This is very normal and will pass quickly. If you require a warm blanket, do not hesitate to request one.

Your caregiver will check the placenta to make sure everything is in place. She’ll then thoroughly examine you to see if there are any tears in your perineum that need to be patched.

Before being sutured, you’ll be given a local anaesthetic injection if you tore or had an episiotomy. While you’re getting sutures, you might want to hold your newborn as a distraction. Ask your partner to sit by your side and hold your new arrival as you look at him if you’re feeling unsteady.

An anesthesiologist or nurse anaesthetist will come by and remove the catheter from your back if you had an epidural. It only takes a second and is completely painless.

Coping tips

Insist on some quiet time with your infant unless he or she requires particular attention. Eyedrops and vitamin K might be put off for a while. As you get to know your new baby and marvel at the wonder of birth, you and your partner will want to spend this unique time together.

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