As you get closer to becoming a mother, you have a lot of questions. It's normal to be a little scared and curious about what you'll face, especially when you have a baby. Today, let's talk about the process of having a baby, or simply the `Stages of Labor` as doctors call it. Knowing this will give you a lot of peace of mind.
What are the Stages of Labor?
Simply put, labor is the entire process of your baby, placenta, and baby coming out of your uterus and through your vagina. This doesn't happen all at once, but rather gradually, in several stages.
We usually divide this into three main stages:
1. First stage: The onset of labor pains (contractions)
2. Second stage: Pushing and birth of the baby
3. Third stage: Delivery of the placenta
Sometimes doctors call this a "normal labor." But remember, not everyone's experience is the same . You may not experience all of these stages the same way. For example, you may start some stages early, but end up having a C-section. Or, if you had a planned C-section, you may not experience the first stage at all. If you have an induced labor, your experience may be different. So, don't compare your experience to others .
It's normal to feel scared when you don't know exactly what's going to happen with something this big. But your doctors and nurses are all there to help you. Both you and they have the same goal of having a healthy baby .
First stage: The onset of labor (Labor - Contractions)
This is the first and usually longest stage of labor. It begins when you start having regular contractions at regular intervals . This stage ends when your cervix is fully dilated and effaced.
Doctors often tell you to keep track of when your pain starts. The time you need to look at is the time from the start of one pain to the start of the next pain. This is easy to measure in seconds.
Regular contractions are contractions that come at regular intervals, about every three to five minutes. They are not like Braxton Hicks contractions, which don't come all at once. Some people can have these contractions on their own, or they can be induced in the hospital through medical induction.
This first stage can last anywhere from 12 to 19 hours. However, if you have had a baby before, this time is likely to be much shorter.
This first stage also has two parts:
- 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 the cervix is fully dilated, to 10 centimeters. At this point, you may feel the urge to push the baby out. This usually takes about 4 to 8 hours.
Doctors usually say that you can stay at home during early labor. But you need to be ready to go to the hospital where you will have your baby. Once active labor begins, it is definitely best to stay at the hospital.
How to manage the pain in the first stage?
This initial stage may be a little difficult to bear. Try these things during this time:
- Do gentle stretches slowly.
- Meditate.
- Don't stay in the same place, move around, change your posture.
- Practice deep breathing.
- Take a bath or shower with lukewarm (not hot) water.
- You can use a birthing ball to help with labor.
- Take a walk.
It is also very important to have someone to help you at this time, a ``labor support person``. This could be your husband, a family member, a friend, or a ``doula``.
If the pain is unbearable, talk to your medical team about pain relief options.
Can you sleep during early labor contractions?
Everyone tolerates pain and discomfort differently. In general, it's best to sleep and rest during the initial pain if you can. But sometimes it can be a little difficult to sleep through the pain.
Second stage: Pushing and birth
This stage begins when your cervix is fully dilated (10 centimeters). It ends when your baby is born . This can take anywhere from half an hour to several hours.
Whether you push or not, the baby will gradually move down the vagina. Here's what happens during this second stage:
- Contractions occur every two to five minutes. Each contraction can last between 60 and 90 seconds.
- You should push when the pain comes. You can rest when the pain is gone. Your doctor will tell you when to push.
- The baby's head begins to appear (baby crowns).
- The doctor very carefully helps to remove the baby from the vagina.
- As soon as the baby is born, the doctor cuts the umbilical cord.
Sometimes, instead of having a vaginal birth, a baby may be delivered by cesarean section (C-section), either planned or emergency.
Third stage: Placenta delivery
This stage begins when your baby is born. It ends when the placenta is delivered. This is the shortest stage of labor . It usually lasts no more than 30 minutes.
This is what happens in this third stage:
- Between 5 and 30 minutes after the baby is born, contractions begin to come back. These are the pains that help the placenta separate from the uterus.
- You may need to push a little more. Or the doctor may apply pressure on your abdomen to help the placenta come out.
- Heavy vaginal bleeding may occur for a short time, either when the placenta comes out or after it has arrived.
- Some people may feel cold or have a fever. If you experience these symptoms, you should definitely tell your doctor.
If you have a cesarean section (C-section), the doctor will remove the placenta as soon as the baby is taken out of the uterus.
The doctor will definitely check to see if the placenta has come out completely. This is because retained products of conception can cause a variety of problems if parts of the placenta remain in the uterus. If you have had an episiotomy (a small cut in the vagina) or if you have a vaginal tear, the doctor will stitch it up after the placenta comes out.
How does labor begin? (What triggers labor?)
Scientists still don't know exactly how labor actually begins, but they think it's the result of a series of biochemical changes in the uterus and cervix. Both your body and your baby contribute to these changes.
The cervix, which is tight and closed during pregnancy, should thin and open during labor. The uterus should also start contracting.
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. In some cases, a doctor will artificially induce labor.
Two main things affect the onset and continuation of labor:
- Prostaglandins: These hormone-like substances called prostaglandins are produced by cells in the uterus. These help the cervix open and the uterus contract.
- Oxytocin: When your baby pushes against your cervix, your pituitary gland releases a hormone called oxytocin. This oxytocin travels to your uterus and causes contractions.
Before labor begins, you may experience several signs, such as:
- Backaches
- Bloody show - losing your mucus plug
- Diarrhea
- The interest in cleaning the house and arranging things (Nesting)
What are the signs of early labor?
It can sometimes be difficult to know for sure if you're in labor. If this is your first time, it's easy to mistake other symptoms, such as irregular Braxton Hicks contractions, for real labor pains. Real labor pains have a pattern, and they gradually increase over time.
If you are actually in labor, pay attention to these three things:
- Frequency: How often do you get contractions? Keep track of this in a book or in a labor app on your phone. This will help you track whether they come at regular intervals.
- Duration: How long does each contraction last? As labor progresses, the duration of each contraction will increase. Use a stopwatch, a regular watch, or the timer on your phone to record how long each contraction lasts.
- Intensity: Are the contractions getting more intense? You will feel the pain more intense as you progress through the stages of labor. Pay attention to how the pain feels over time.
What is an abnormal labor?
To protect the health of both you and your baby, doctors follow guidelines that define what constitutes an abnormal labor. They do this so they know when to intervene, and to try to prevent complications. Before any medical intervention is performed, your medical team will explain their concerns and the options available to you.
Unusual first stage
Doctors consider early labor to be prolonged:
- If you are having a baby for the first time, it will take more than 20 hours.
- If you have had a baby before, if it lasted more than 14 hours.
Active labor is considered prolonged when:
- Your membranes have ruptured (or "water breaks") if your cervix has not dilated past 6 centimeters despite four hours of labor.
- If the cervix has not dilated past 6 centimeters after the bag of waters has broken, oxytocin (Pitocin®) has been given, and labor has lasted for six hours.
Extraordinary second stage
Doctors consider the second stage of labor to be prolonged if:
- If you are having a baby for the first time, the spinal tap will last more than three hours without an epidural, or more than four hours with an epidural.
- If you have had a baby before, if it lasts more than two hours without an epidural, or more than three hours with an epidural.
Extraordinary third stage
If the placenta is still in the uterus 30 minutes after the baby is born, doctors consider the third stage to be abnormal.
When should I go to the hospital?
It is best to stay in a birthing center, that is, a hospital, during active labor. This is the second part of the first stage.
If you have contractions every five minutes for at least an hour, call your doctor or the hospital labor floor. If your water breaks, call your doctor or the hospital labor floor, whether you feel any pain or not. Even if you are in the early stages of labor, if you think you are having Braxton Hicks contractions, let your healthcare team know what is happening.
If something like this happens, get help immediately:
- Chest pain
- Dizziness or fainting (syncope)
- Severe nausea and vomiting
- Shortness of breath (dyspnea)
- Swelling of the legs, arms or face (Swelling - edema)
- Heavy bleeding
- Significant decrease in fetal movement
What happens when you go to the hospital?
When you arrive at the hospital, you will need to register at the labor and delivery desk. You will likely be taken to a triage room first. This is part of the admission process. Hospitals usually ask that you bring only one person with you to the triage room.
After the triage room, you will be taken to an LDR room (Labor, Delivery, and Recovery room):
- You will have to wear a hospital gown.
- A doctor will check your pulse, blood pressure, and fever.
- An external fetal monitor is placed around your abdomen to monitor uterine contractions and the baby's heart rate.
- Your doctor will do a cervical exam to see how far along your labor is.
- You may have an IV line put 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 how you delivered your baby. Typically, if you had a cesarean section (C-section), you will have to stay in the hospital longer, 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 relaxes during this time, and doctors will monitor you for any abnormal bleeding.
How long does childbirth usually take?
The average first birth lasts between 12 and 24 hours. Subsequent births usually last less (between 8 and 10 hours). The first stage of labor is usually the longest.
It's normal to feel a range of emotions as you prepare for labor. It's natural to feel happy and a little scared. Talking to your doctor about these signs and symptoms will give you a better idea of what to expect. Your partner and medical team are there to support you. They will help you navigate this labor as comfortably and confidently as possible.
Finally, things to remember (Take-Home Message)
Having a baby is a big experience in life. Being aware of this in advance will give you great strength to face that moment.
- There are three stages of labor: the onset of labor, the birth of the baby, and the expulsion of the placenta.
- Everyone's experience is different: Don't compare your experience with others.
- There are ways to manage pain: breathing exercises, changing positions, etc. can help. If the pain is unbearable, seek medical advice.
- Know exactly when to go to the hospital: Call the doctor when the pain comes at regular intervals, when the bag of water breaks.
- You are not alone: your medical team, family, and partner are all there to help you.
We hope this information is helpful to you. We wish you a healthy baby!
` Labor, childbirth, pregnancy, pain, having a baby, stages of labor, placenta
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