Your Pregnancy After 35 : Labor and Delivery (part 5) - Stages of Labor

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Labor

Nearly every woman wants to know if labor will be painful. Every labor is different, in great part because of the level of pain you experience. Be aware that contractions do hurt. The only thing we can tell you, which is true for every labor, is that no two labors are alike, not even for the same woman. Because labor is different for every woman, no one can predict what your labor will be like before it begins.

Labor is defined as the dilatation (stretching and expanding) of your cervix. The cervix opens while your uterus, a muscle, contracts to push out your baby. It is believed both mom and baby release the hormone oxytocin, which triggers labor to begin.

Some women experience long, intense labors; others have short, relatively pain-free labors. We have found if a woman understands the labor process and what causes childbirth pain, she has a better chance of reducing it. When you hear about a long labor, most of the time is spent in early labor. During this time, you experience contractions that may start and stop or be weaker or farther apart than they will be in active labor. In active labor, the cervix dilates and contractions are stronger and more regular. The average length of active labor is between 6 and 12 hours.

When you are afraid of the pain you expect to experience during labor and delivery, you tense up. This can make pain worse.

Your uterus is a muscular sac shaped like an upside-down pear. This muscle tightens and relaxes during labor (contractions) to expel the baby. During labor, your bladder, rectum, spine and pubic bone receive strong pressure from the uterus as it tightens and hardens with each contraction. The weight of the baby’s head as it moves down the birth canal also causes pressure.

Signs Labor May Begin Soon

You may bleed a little following a vaginal exam late in pregnancy or at the beginning of labor. Called a bloody show, it occurs as the cervix stretches and dilates. If it causes you concern or appears to be a large amount of blood, call your healthcare provider immediately.

Along with light bleeding, you may pass some mucus, sometimes called a mucus plug. Passing mucus doesn’t always mean you’ll have your baby soon or that labor is beginning.

Dilation of the cervix from 4 to 10cm (shown actual size)

Stages of Labor

Labor is divided into three stages. Each stage feels distinctly different and has a specific purpose. The information below explains what you might expect during labor and delivery.

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; they last about 1 minute.

Contractions become closer together and more regular.

What mother and labor coach can do

Food and drink may be restricted once labor begins.

Mother may be able to stay at home for a while, 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 healthcare provider immediately!

Stage 1—Active Phase
What’s happening

Cervix dilates from about 2 to 10cm.

Cervix continues to thin out.

This phase can last 20 minutes to 2 hours.

Mother is experiencing

Contractions become more intense and closer together.

Contractions are about 3 minutes apart and last about 45 seconds to 1 minute.

What mother and labor coach can do

Keep practicing relaxation and breathing techniques.

An epidural can be administered during this phase.

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.

What mother and labor coach can do

Relaxation and breathing techniques help counteract the mother’s urge to push.

Stage 2
What’s happening

Cervix is completely dilated.

Baby continues to descend into the birth canal.

As mother pushes, baby is delivered.

Baby’s nose and mouth are suctioned, and umbilical cord is clamped.

This stage can last a few minutes to a few hours (pushing the baby can take a long time).

Mother is experiencing

Contractions occur at 2- to 5-minute intervals and last from 60 to 90 seconds.

With an epidural, mother may find it harder to push.

An episiotomy may be done to prevent vaginal tearing as baby is born.

What mother and labor coach can do

Mother will begin to push with each contraction after cervix dilates completely.

Mother may be given analgesic or local anesthetic.

Mother must listen to healthcare provider or nurse when baby is being delivered; he or she will tell mother when to push.

As mother pushes, she may be able to watch baby being born, if mirror is available.

Stage 3
What’s happening

Placenta is delivered. Placenta is examined to make sure all of it has been delivered.

Episiotomy is repaired.

This stage can last a few minutes to an hour.

Mother is experiencing

Contractions may occur closer together but be less painful.

What mother and labor coach can do

Meet and hold the baby.

Mother may need to push to expel the placenta.

Mother may be able to hold baby while episiotomy is repaired.

Nurse will rub or massage the uterus through the abdomen to help it contract and to control bleeding (during the next few days, the uterus will continue to contract to control bleeding).

 
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