You are about to bring your baby into the world. This is a very special, and at the same time, a bit scary and exciting experience. So, how does this process of childbirth happen? Today, we will talk about the different stages of it. It is very important for you to be aware of these things, because then you can face this special experience well and confidently.
Simply put, childbirth is the process of your baby and placenta coming out of your uterus through your vagina. There are three main stages to this.
1. First stage: The onset of labor, meaning contractions of the uterus begin.
2. Second stage: Pushing and birth of the baby.
3. Third stage: Delivery of the placenta.
Doctors also call this a "normal labor." But remember, not everyone's labor is "normal." You may experience some of these stages, but your baby may be delivered by cesarean section (C-section). Or, if you had a planned C-section, you may not experience this first stage at all. And if you have an induced labor, it may be a little different. Everyone's labor experience is unique.
It's normal to feel scared when you don't know exactly what's going to happen with something this big. While the doctors taking care of you have a rough idea of what your delivery will be like, they can't tell you exactly how your delivery will go. But don't worry, they'll be there with you and help you through this journey. The only goal for both you and the doctors is a healthy delivery.
The first stage of labor: the onset of labor pains
This stage begins when your uterus starts to have regular contractions, which are painful contractions. This stage ends when your cervix is fully dilated and effaced.
Doctors often tell you to time the time between contractions. When you do this, it's easy to measure the time in seconds from the time one contraction starts to the time the next contraction starts.
Regular contractions are contractions that are very strong and come at regular intervals, about every three to five minutes. These are different from the occasional, less intense, and less frequent "training" contractions called Braxton Hicks. You can go into labor on your own, or you can have labor induced in a hospital (medical induction).
This first stage can last anywhere from 12 to 19 hours. If you have had babies before, this stage may end sooner.
There are two more sub-stages in this first stage:
- Early labor: This is when your cervix opens to about 6 centimeters. This usually takes about 6 to 12 hours.
- Active labor: This is when your cervix is fully dilated, to 10 centimeters. You may feel like pushing your baby. This usually lasts about 4 to 8 hours.
Your doctor will probably tell you that you can stay at home during this early stage of labor. However, you should be prepared to go to the hospital. Once you start going into active labor, you will definitely need to stay in the hospital.
What can you do to make the first phase easier?
In this first phase, you may find it helpful to do the following:
- Do gentle stretches slowly.
- Meditate.
- Walk back and forth, change positions.
- Practice deep breathing exercises.
- Take a bath or shower with lukewarm (not hot) water.
- Use a birthing ball to help with labor.
- Walk.
Also, it's very important to have someone to support you. It could be your husband, a family member, a friend, or even a `(doula)`.
If the pain is unbearable, talk to your medical team about pain relief options.
Can you sleep with early labor pains?
Everyone copes with pain differently. In general, it's best to sleep through the early labor pains and rest if you can. However, it can be a little difficult to sleep through the pain.
Second stage of labor: pushing and birth
This stage begins when your cervix is fully dilated (10 centimeters). It ends with the birth of your baby. This can take anywhere from half an hour to several hours.
Whether you push or not, the baby will gradually move down the vagina. This is the second stage of labor:
- The pain comes every two to five minutes, lasting about 60-90 seconds.
- You will need to push when the pain comes, but you can rest during the pain. The doctor will tell you when to push.
- Your baby's head is starting to appear (baby crowns).
- The doctor will help you remove the baby from the vagina.
- After the baby is born, the doctor cuts the umbilical cord.
You may have a planned or emergency C-section instead of having a vaginal birth.
Third stage of labor: Delivery of the placenta
This stage begins after the baby is born and ends with the expulsion of the placenta. This is the shortest stage, usually lasting no more than 30 minutes.
In the third stage of labor:
- The pains start to come back between 5 and 30 minutes after the baby is born. These pains help the placenta separate from the uterus.
- You may have to push. Or the doctor may press on your belly to help the placenta come out.
- There may be heavy bleeding for a while, either when the placenta comes out or afterward.
- Some mothers may feel cold or feverish. If you have these symptoms, be sure to tell your doctor.
If you had a C-section, the doctor will remove the placenta when the baby is removed from the uterus.
The doctor will check to make sure the placenta is completely delivered. This is because retained products of conception can cause complications. If you have had an episiotomy (an incision between the vagina and anus) or if your vagina has torn, the doctor will stitch the placenta after it has been delivered.
How does labor begin? What causes it?
Scientists aren't sure exactly how labor actually begins, but they think it's the result of a series of biochemical changes in your uterus and cervix. Both your body and your baby contribute to these changes.
Your cervix, which is tight and closed during pregnancy, should thin and open during labor. Your uterus should also start to contract (squeeze).
Experts believe that when your baby is ready to be born, your body releases a small substance that stimulates your hormones and starts the labor process. For most people, this happens naturally between 37 and 42 weeks of pregnancy. In some cases, a doctor will artificially induce labor.
There are two main factors that affect the onset and continuation of labor:
- Prostaglandins: These are substances that act like hormones. They are produced by cells in the uterus. They help the cervix open and the uterus contract.
- Oxytocin: When your baby pushes against your cervix, it stimulates your pituitary gland to release a hormone called oxytocin. This oxytocin travels to your uterus and causes contractions.
There may be several early signs that indicate that labor is about to begin. These are:
- Back pain
- Bloody mucus discharge (`bloody show` - passing of the `mucus plug`)
- Diarrhea
- Preoccupation with things like cleaning the house and organizing things (`Nesting`)
Has labor really begun? What are the early signs?
It can be hard to know for sure if you're actually in labor. If this is your first baby, it's easy to mistake other symptoms, like irregular Braxton Hicks contractions, for true labor. There is a pattern to true labor, and it gradually increases over time.
If you are in real labor, pay attention to these three things:
- Frequency: How often do you have contractions? Keep a record of them in a book or on a labor app on your phone to see if they come at regular intervals.
- Duration: How long does each contraction last? As labor progresses, the duration of the contractions will increase. Keep a watch or a timer on your phone nearby and record the duration of each contraction.
- Intensity: Does the pain you feel gradually increase? You may feel pain more intense as you go through the stages of labor. Keep track of how your pain feels over time.
What is "abnormal labor"?
To protect the health of both you and your baby, doctors follow guidelines that define what constitutes a "normal labor." They do this so they know when to intervene to prevent complications. Before any medical intervention is performed, your medical team will explain their concerns and the options available to you.
Abnormalities in the first stage
Doctors consider early labor to be prolonged if :
- If you are having a baby for the first time, it will take more than 20 hours.
- If you've had babies before, it's more than 14 hours.
Doctors consider active labor to be prolonged if :
- If your membranes have ruptured and you have been in labor for four hours, your cervix is not dilated more than 6 centimeters.
- If your water broke, you were given oxytocin (Pitocin®), and your cervix is still not dilated more than 6 centimeters after six hours of labor.
Abnormalities in the second stage
Doctors consider the second stage of labor to be prolonged if:
- If you are having a baby for the first time, this stage lasts more than three hours without an epidural, or more than four hours with an epidural.
- If you have had babies before, this stage lasts more than two hours without an epidural, or more than three hours with an epidural.
Abnormalities in the third stage
Doctors consider the third stage abnormal if the placenta remains in your uterus more than 30 minutes after the baby is born.
When do you need to go to the hospital?
The best thing to do is to stay in the hospital while you are in active labor. This is the second stage of the first stage of labor.
If you have contractions that last for at least an hour, call your doctor or the hospital maternity ward. If your water breaks, call your doctor or the hospital, whether you feel any pain or not. If you think you are still in the early stages of labor, or if you think these are Braxton Hicks contractions, let your healthcare team know what is happening.
Seek medical advice immediately if you have these symptoms:
- Chest pain
- Dizziness or fainting (syncope)
- Severe nausea and vomiting
- Difficulty breathing (dyspnea)
- Swelling of the legs, arms, or face (edema)
- Heavy bleeding
- Significant decrease in baby's movements
What happens when you go to the hospital?
When you arrive at the hospital, you will need to check in at the registration counter in the maternity unit. You will most likely be sent to a `triage` room first. This is part of the admission process. Hospitals usually ask that you only bring one person with you to the `triage` room.
After the `Triage` room, you will be taken to the labor, delivery, and recovery room (`LDR` room):
- You will be given a hospital gown to wear.
- A doctor will check your pulse, blood pressure, and fever.
- An external fetal monitor is placed around your abdomen to measure uterine contractions and the baby's heart rate.
- A doctor will perform a cervical exam to see how far along the labor has progressed.
- You may have an IV line (a type of intravenous line) placed in a vein in your arm to give you fluids and medicine.
How long will I have to stay in the hospital?
The length of time you stay in the hospital depends on the hospital and the type of delivery you have. Generally, you will have to stay in the hospital longer if you have a ``C-section'', because it is a surgical procedure. Also, if you have any complications or health problems during delivery, you may have to stay in the hospital longer.
Is there a fourth stage of labor?
Some experts consider the first two to three hours after the placenta is delivered to be the fourth stage of labor. This is when you begin to bond with your newborn. Your uterus also begins to relax, and doctors will watch for any unusual bleeding.
How long does it usually take to give birth?
For a first-time mother, labor usually takes between 12 and 24 hours. Subsequent pregnancies usually take less time (around 8 to 10 hours). The first stage of labor usually takes the longest.
It's normal to experience a range of emotions as you prepare for labor. It's also normal to feel a little scared, as well as happy. Talking to your doctor about these and your symptoms can help you understand what to expect.
Finally, remember this (Take-Home Message)
Childbirth is an unforgettable and unique experience in a mother's life. Being aware of these stages will help you prepare mentally and physically for this journey. Remember, every birth is different. Your medical team, your family, and your partner are your greatest strength during this time. They will help you face this experience as comfortably and confidently as possible. Don't be afraid of anything, and if you have any questions or doubts, ask your doctor. We wish you and your baby a healthy, happy birth!
` Childbirth, stages of childbirth, pregnancy, postpartum, having a baby, health tips, mother and child
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