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You are here: Home -> Labor and Delivery -> Labor Today: Friday, June 23
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Labor and Delivery
Water Breaking
Inducing Labor
Childbirth-Education Classes
Premature Labor
What Should I Bring to the Hospital?
Labor
Tests During Labor
Dealing with Pain in Childbirth
Cesarean Delivery
Will I Need an Episiotomy?
Baby's Birth Position
Delivery of Your Baby
After Your Baby Is Born
If Your Baby Is Late
Emergency Childbirth
Hospital Births: Losing the Fear Factor
After Your Baby's Birth
Your New Baby
Feeding Your Baby

Labor

Labor is defined as the dilation (stretching and expanding) of your cervix. This occurs when your uterus, which is a muscle, tightens (contracts) to squeeze out its contents (your baby). Tightening of the uterus can cause pain.
Labor is different for every woman; that's the reason we can't predict what your labor will be like before it begins. You may also find your labor is different from one delivery to the next.
There are differences between true labor and false labor.

The Stages of Labor

Labor is divided into three stages-each stage is distinctly different and serves a specific purpose.
Stage 1. Stage 1 of labor is the longest and consists of three phases-early, active and transition. This first stage of labor usually lasts 6 to 8 hours but can be longer for a first birth.
In the early phase, labor is just getting started and dilation of the cervix has just begun. In the active phase, the cervix dilates at a fairly constant rate. Transition includes complete dilation. Contractions help the cervix dilate and thin out. They also help move the baby down the birth canal for delivery.
At the transition phase, the pace and intensity of labor increases, signaling that labor is moving into the second stage.

True Labor or False Labor?

ConsiderationsTrue LaborFalse Labor
ContractionsRegularIrregular
Time between contractionsCome closer togetherDo not get closer together
Contraction intensityIncreasesDoesn't change
Location of contractionsEntire abdomenVarious locations
Effect of anesthetic or pain relieversWill not stop laborSedation may alter or stop frequency
Cervical changeProgressive cervical changeNone
Stage 2. In stage 2 of labor, you are fully dilated and begin to push. Contractions change and become much harder, longer and more frequent. Along with your pushing, these contractions help deliver the baby. This stage can take 2 hours or longer. Anesthesia at this point, especially an epidural block, may prolong this stage of labor because your urge to push is decreased. At the end of the second stage, your baby is born.
Stage 3. Stage 3 of labor doesn't usually take too long. During stage 3, the uterus contracts and expels the placenta (afterbirth). You will be given oxytocin to help contract the uterus.
Some doctors describe a fourth stage of labor, referring to the time period after delivery of the placenta, while the uterus continues to contract. Uterine contractions are important in controlling bleeding after the birth of your baby.
It's a good idea to ask your doctor certain questions about preparing to go to the hospital. He or she may have specific instructions for you. You might want to ask the following questions:
When should I go to the hospital once I am in labor?
Should I call you before I leave for the hospital?
How can I reach you after regular office hours?
Are there any particular instructions to follow during early labor?

The Three Stages of Labor

Stage of Labor

Stage 1-Early Phase

What's happening

 Cervix opens and thins out due to uterine

 

contractions

 

 Cervix dilates to about 2cm

 

 This phase can last 1 to 10 hours

Mother is experiencing

 Membranes may rupture, accompanied by gush or

 

trickle of amniotic fluid from vagina

 

 Pinkish discharge may appear (bloody show)

 

 Mild contractions begin at 15- to 20-minute

 

intervals and last about 1 minute; contractions

 

become closer together and more regular

Mother and/or partner

 Mother should not eat or drink once labor begins

can do

 Mother may be able to stay at home, if she is at term

 

 Begin using relaxation and breathing techniques

 

learned in childbirth class

 

 If water has broken, if labor is preterm, if there is

 

intense pain, if pain is constant or there is bright red

 

blood, contact doctor immediately!

Stage of Labor

Stage 1-Active Phase

What's happening

 Cervix dilates from about 2cm to 10cm

 

 Cervix continues to thin out

 

 This phase can last 20 minutes to 2 hours

Mother is experiencing

 Contractions become more intense

 

 Contractions, come closer together

 

 Contractions are about 3 minutes apart and last

 

about 45 seconds to 1 minute

Mother and/or partner

 Keep practicing relaxation and breathing

can do

techniques

 

 An epidural can be administered during this phase

 

The Three Stages of Labor, continued

Stage of Labor

Stage 1-Transition Phase

What's happening

 Stage 1 begins to change to Stage 2

 

 Cervix is dilated to 10cm

 

 Cervix continues to thin out

 

 This phase can last a few minutes to 2 hours

Mother is experiencing

 Contractions are 2 to 3 minutes apart and last about

 

1 minute

 

 Mother may feel strong urge to push; she shouldn't

 

push until cervix is completely dilated

 

 Mother may be moved to delivery room, if she is not

 

in a birthing room

Mother and/or partner

 Relaxation and breathing techniques help

can do

counteract mother's urge to push

Stage of Labor

Stage 2

What's happening

 Cervix is completely dilated

 

 Baby continues to descend into the birth canal

 

 As mother pushes, baby is delivered

 

 Doctor or nurse suctions baby's nose and mouth

 

and clamps umbilical cord

 

 This stage can last a few minutes to a few hours

 

(pushing the baby can last a long time)

Mother is experiencing

 Contractions occur at 2- to 5-minute intervals and

 

last from 60 to 90 seconds

 

 With an epidural, the mother may find it hard

 

to push

 

 An episiotomy may be done to prevent tearing

 

vaginal tissues as baby is born

Mother and/or partner

 Mother will begin to push with each contraction

can do

after cervix dilates completely

 

 Mother may be given analgesic or local anesthetic

 

 Mother listens to doctor or nurse when baby is

 

being delivered; doctor or nurse will tell mother

 

when to push

 

 As mother pushes, she may be able to watch baby

 

being born, if mirror is available

 

The Three Stages of Labor, continued

Stage of Labor

Stage 3

What's happening

 Placenta is delivered

 

 Doctor examines placenta to make sure all of it has

 

been delivered

 

 This stage can last a few minutes to an hour

Mother is experiencing

 Contractions may occur closer together but be less

 

painful

 

 Doctor repairs episiotomy

Mother and/or partner

 You'll meet and hold your baby

can do

 You may need to push to expel the placenta

 

 You may be able to hold your baby while the doctor

 

repairs your episiotomy

 

 Nurse will rub or massage the uterus through the

 

abdomen to help it contract to control bleeding

Stage of Labor

Stage 4

What's happening

 Placenta has been delivered

 

 Uterus continues to contract, which is important to

 

control bleeding

 

 This stage usually lasts a couple of days

The Bloody Show

You may bleed a small amount following a vaginal exam or at the beginning of labor. This "bloody show" occurs as the cervix stretches and dilates. If it causes you concern or appears to be a large amount of blood, contact your healthcare provider immediately.
Along with a bloody show, you may pass some mucus, sometimes called a mucus plug. Passing this mucus doesn't always mean you'll have your baby soon or that you are beginning labor.

Timing Contractions

It helps to time contractions correctly once they begin. There are two goals in timing contractions:
to find out how long a contraction lasts
to find out how often contractions occur
It helps for your doctor or the nurses to have this information so they can decide if it's time for you to go to the hospital.
Be sure to ask your doctor which method he or she prefers, because there are two ways to time contractions.
Start timing when the contraction starts and time it until the next contraction starts. This is the most common method.
Start timing when the contraction ends and note how long it is until the next contraction starts.

Labor and Your Partner

Well before your delivery date, sit down and talk with your partner about how you will stay in touch as your due date approaches. Some of my patients'partners rent personal pagers for the last month or so. (Some hospitals or HMOs supply pagers for expectant couples the last few weeks.) Line up a backup support person, in case your partner cannot be with you or if you need someone to take you to the hospital.
Your partner may be your labor coach, or you may have chosen another person for this important job. A labor coach can do a lot to help you through labor. He or she can:
time your contractions so you are aware of the progress of your labor
encourage and reassure you during labor
help you deal with your physical discomfort
help create a mood in the labor room
report symptoms or pain to the nurse and/or doctor
keep a watch on the door and protect your privacy
control traffic into your room

Eating and Drinking during Labor

Women often get nauseated as they labor, which may cause vomiting. For that reason your stomach should be empty during labor. You are not allowed to eat or drink anything during labor for your own safety.
You will not be allowed to drink anything, even if your labor is long. You may be allowed sips of water or ice chips to suck on. If labor is long, you may be given fluids through an I. V.

Enemas

You may not be required to have an enema-it is usually a choice. Discuss this with your healthcare provider at one of your prenatal appointments. There are benefits to having an enema early in labor. It decreases the amount of contamination by bowel movement or feces during labor and at the time of delivery. It may also help you after delivery if you have an episiotomy because having a bowel movement very soon after delivery can be painful.

Bowel Movement

Your first bowel movement usually occurs a day or two after delivery. If you had an enema, it could take a few days longer. It could be painful, especially if you have an episiotomy.
Most doctors prescribe stool softeners after delivery to help with your bowel movements. They are safe to take, even if you are nursing.

Back Labor

Back labor occurs when the baby comes out through the birth canal looking straight up. This type of presentation often causes lower-back pain.
Back labor may make delivery last longer. It may require rotation of the baby's head so it comes out looking down at the ground rather than looking up at the sky.

Who Will Be Present at the Birth?

You may want lots of family or no one except your partner present when you have your baby. Whomever you want present at the birth should be OK with your partner. As long as it's acceptable to your
doctor, you may make some of the decisions like this about the birth. My advice is to keep it small; don't let friends or family make you feel they have a "right" to be there.
Too many people in the delivery room can be a problem. Delivery is a very personal experience for you and your partner; it is not a spectator sport. Don't feel pressured to invite others to be with you at this time if you'd rather have privacy. For every additional person in the room, there is an increased risk of infection for you and the baby.
Labor and Delivery Articles:
Water Breaking | Inducing Labor | Childbirth-Education Classes | Premature Labor | What Should I Bring to the Hospital? | Labor | Tests During Labor | Dealing with Pain in Childbirth | Cesarean Delivery | Will I Need an Episiotomy? | Baby's Birth Position | Delivery of Your Baby | After Your Baby Is Born | If Your Baby Is Late | Emergency Childbirth | Hospital Births: Losing the Fear Factor
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