How Does Labor Progress?
How does labor work? What can you and your support person expect? We did our best to lay it all out for you here. Be sure to leave any questions in the comments!
To start off, there are 3 stages of labor, and the first stage is broken down into 3 phases.
First stage of labor: This is the longest stage of labor and involves three phases - early, active, and transition. During this stage, the cervix dilates and effaces, and contractions become stronger and more regular. This stage can last anywhere from a few hours to several days, depending on the woman and the circumstances of the labor.
Second stage of labor: This is the stage when the baby is born. During this stage, the cervix is fully dilated, and the woman pushes the baby out. This stage can last anywhere from a few minutes to a few hours.
Third stage of labor: This is the stage after the baby is born, and the placenta is delivered. This stage typically lasts a few minutes to an hour.
Labor progresses differently for every person and can be affected by factors such as the position of the baby, the birthing person's physical health, and the psychological state of the birthing person (are they feeling nervous, scared, or hesitant, or are they feeling safe, held, and loved?). Some birthing people may have a very quick labor, while others may have a longer labor. Each labor is unique and both rewarding and challenging in its own way. While short labors get your baby to you faster, they are often more intense as dilation of the cervix is happening in a much shorter time. This can result in increased intensity of contractions, or shorter breaks in between the contractions. The opposite can be true for longer labors. While the contractions may be less intense or with longer breaks in between, fatigue can begin to set in after a long period of time without sleep and meals. This is just one example of how labors can differ.
First Stage of Labor
Early Labor. Also known as the first phase of labor, early labor is the initial phase of the labor process when the cervix begins to dilate and efface (thin out) in preparation for the baby's delivery. This phase of labor can last anywhere from a few hours to a few days, depending on the birthing person and the circumstances of the labor.
At the beginning of early labor, the birthing person may experience mild contractions, which feel like cramping or tightening in the lower abdomen or back. These contractions are often irregular and may not be very painful. Other signs of early labor can include:
Changes in vaginal discharge: You may notice an increase in vaginal discharge or a change in its consistency or color.
Back pain: Some people experience back pain or discomfort during early labor.
Bloody show: This is when you pass a small amount of blood and mucus as your cervix begins to dilate.
Diarrhea or nausea: Some people experience diarrhea or nausea during early labor.
Difficulty sleeping: It can be difficult to sleep during early labor because of the discomfort or anticipation of the labor process.
As early labor progresses, a clear contraction pattern will begin to emerge and contractions become longer, stronger, and closer together.
Active labor is the second phase of the first stage of labor, and it typically begins when the cervix is around 6 centimeters dilated. During active labor, the contractions become stronger, longer in duration, and more frequent as the cervix continues to dilate until it is 8 cm dilated. This phase of labor typically lasts anywhere from a few hours to several hours.
Some signs that you may have entered active labor include:
Contractions that are getting stronger and more frequent: You may notice that the contractions are lasting longer and occurring more frequently, often every 3 to 5 minutes.
Increased discomfort: The contractions may become more intense, and you may need to use breathing techniques or other comfort measures to manage the intensity.
Difficulty speaking during contractions: As the contractions become more intense, it may become more difficult to talk or concentrate during them.
Water may break: If your water (amniotic sac) hasn’t broken yet, it may break in active labor, which can intensify the contractions further.
A change in behavior: You may become more focused or serious as the contractions become stronger.
During active labor, it's important to stay hydrated, keep your bladder empty, and rest between contractions. Continue to use comfort measures such as movement and positioning, breathing techniques, hydrotherapy, and massage to manage the intensity. It's also a good idea to contact your provider or head to your birthing location, so they can monitor your progress and provide support and guidance throughout the birthing process. The typical rule for heading to your birthing location is the 4-5/1/1 rule - contractions coming every 4-5 minutes, lasting a minute, for 1 hour or more. See the image below to learn how to time contractions.
Transitional labor is the final phase of the first stage of labor, and it occurs when the cervix dilates from 8-10cm. This phase of labor is known for being the most intense and difficult, as the body prepares for the baby's delivery.
During transitional labor, the contractions become very strong and close together, and the mother may feel a lot of pressure and discomfort in the lower back and pelvis. A change in hormones can also trigger the fight or flight response, causing the laboring person to feel like they want to be done, or can’t do it anymore. If you have been coping with the contractions pretty well, and start to say things like “I can’t do this anymore”, you are getting very close to meeting your baby! Other signs of transitional labor can include:
Intense contractions: The contractions may last up to 90 seconds and occur every 2 to 3 minutes.
Pressure in the pelvis and/or rectum: You may feel a lot of pressure in the pelvis, as the baby moves down the birth canal. You also may feel like you need to poop, as the baby descends low enough to put pressure on the rectum.
Nausea or vomiting: Some women experience nausea or vomiting during transitional labor.
Hot flashes or chills: You may experience hot flashes or chills as the body responds to the intense contractions.
Shaking or trembling: Some women experience shaking or trembling during transitional labor.
Difficulty concentrating or communicating: As the contractions become more intense, it may become more difficult to focus or communicate.
Transitional labor can be very challenging, but it typically only lasts for a short period of time (30 minutes to 2 hours). It's important to stay focused, stay hydrated, keep your bladder empty, and continue to use comfort measures such as movement, position changes, hydrotherapy, and breath work. During transitional labor, your focus should be on making it to the break in between the contractions, and not the contractions themselves.
Second Stage of Labor
Once the second stage of labor arrives, and it is time to push your baby out, many people find relief to push with the contractions. The transition from coping with contractions to working with them is often a welcome one. Be sure to keep changing positions, stay hydrated, and keep your bladder empty during pushing. Why do we keep mentioning keeping your bladder empty? The bladder also lives inside the pelvis. The more full the bladder is, the more space it takes up, leaving less space for your baby to descend. A good rule is to empty your bladder every hour or so. This is the best stage of labor - at the end, you get to meet your baby!!
Third Stage of Labor
The third stage of labor is the birth of the placenta. After pushing a baby out of your vagina, the last thing you are going to want to do is push more things out of your vagina. Luckily, the placenta has no bones, and usually only requires on small push to expel. Ask your provider to give you a tour of the placenta if you are interested! If you plan to keep your placenta, make sure your provider knows this ahead of time, and be prepared to bring it home in your own cooler.
How did your labor progress? What questions do you have? Share in the comments!
