Childbirth Class Two Online

Definitions of Common Terms Used in Labor and Birth

Black doctor examining pregnant patient's belly
Ariel Skelley/Blend Images/Getty Images

Let's start by learning a bit about your body. This is going to mean some terms and definitions. These terms and definitions will come in handy throughout class.

Braxton Hicks contractions: Painless, irregular contractions of the pregnant uterus, beginning during the first trimester and increasing in frequency as the pregnancy advances.

Cervix: the neck of the uterus.

Contraction: rhythmic tightening of the uterus, usually causing the cervix to dilate and allow the passage of the baby. In labor contractions get stronger, closer together and longer.

Dilatation: the enlarging of the cervix to 10 centimeters.

Effacement: the thinning of the cervix. Your cervix starts out being two inches long, and 50% effaced would be a 1 inch cervix.

Labor: The period of contractions that change the cervix and ends with the birth of your baby.

Lightening: Your baby changing positions in the uterus before labor, usually described as the baby "dropping." First time moms can see this as soon as 4-6 before their due date, whole other moms will notice this not until labor begins.

Placenta: The organ within the pregnant uterus through which the fetus derives its nourishment; at term it averages one-sixth the weight of the fetus; is disk-shaped, about 2.5 cm thick, and 17.5 cm in diameter.

Station: How far the baby is "down" in the pelvis. Measured in negative and positive numbers. -5 is a floating baby, 0 station is said to be engaged in the pelvis, and +5 is crowning.

Uterus: Female reproductive organ that weighs about 2-3 ounces and is about the size of a small woman's fist prior to pregnancy. During pregnancy this organ becomes 10 by 14 inches and weighs in at about 2-3 pounds. This is where a normal pregnancy takes place.

The Cervix

Effacement of the Cervix
LifeART (and/or) MediClip image copyright 2008. Wolters Kluwer Health, Inc.- Lippincott Williams & Wilkins. All rights reserved.

Dilation of the Cervix

Complete dilation is 10 centimeters, this is when the cervix is fully open and the baby can further descend into the birth canal (vagina) during the pushing (second stage) of labor.

More information on what a vaginal exam measures.

In addition to how far your cervix is open will be the effacement or thinning of your cervix (measured in percentages) and the ripeness of your cervix. Effacement and dilation happen together rather than one before the other for the majority of women.

Try this!
If you feel the tip of your nose (no one can see you), this would be how an unripe cervix will feel, firm but fleshy. As it begins to soften or ripen, it will become more like the feeling of your ear lobe (touch it!). When it is really soft and buttery it will be more like the inside of your cheek, very flexible and soft.

What Matters

For first time moms effacement is actually more important than dilation at first, because the cervix will need to be soft to dilate. After you've had a baby previously the cervix seems to open more easily. It is said that the average first time mom will dilate just under a centimeter per hour once active labor has started and the mom having baby number two or more will dilate just over a centimeter per hour once active labor has begun.

However, there are no hard and fast rules about who will dilate how quickly that actually work. As you know babies can't read calendars and your cervix can't tell time. Some will dilate much more quickly and others more slowly.

Timing Contractions

Timing Labor Contractions

Contractions are what most people focus on during labor. They can be helpful in determining where you are in labor, in fact, sometimes more so than your cervical dilation. When you go to the hospital or birth center, when you call your practitioner, these decisions will usually be made based upon what your contractions are doing.P] Timing contractions isn't that difficult. However, many people don't understand the basics. Looking at the chart below you can figure out the three most important pieces of information gathered by timing contractions: how long the contractions last, how far apart they are, and what type of rest period you have in-between the contractions.

More information on timing contractions.

Photo © Robin Elise Weiss You can use a watch with a second hand, a timer or a stop watch to time the contractions. Some people choose to write them down, others do not. Do not chase her with the stop watch, unless you don't mind being yelled at. It's also handy to time a few contractions and get an idea of where they are and then stop until several hours have past or there is a definite change in contractions, either closer together, stronger, longer or further apart.

Red = Rest Period Between Contractions
Green = Duration of the Contraction (From beginning to end.)
Blue = How Far Apart The Contractions Are (From beginning of one to the beginning of next.)

Comfort Measures for Labor

Using a rebozo in labor
Photo © Wendy Scharp

Heat Therapy

Heat is for mild to moderate pain. It helps expand blood vessels, increases blood flow to the area, and provides relaxation for the tissues. You can get heat therapy from heating pads, rice socks, warm water, etc. This is also beneficial for labor.

Cold Therapy

Cold is used for more severe pain, and penetrates more deeply than heat. It can reduce the blood flow to the area and help reduce swelling. Cool to cold compresses can be used as can special cold packs. These are used many times in labor for back pain, and for cooling down a mom who is working hard.

No matter which therapy you use, remember that alternating between the two will ensure the best results for most people. You will also want to watch the temperature of the products. Never place heat or cold packs on numbed skin.

Massage Therapy

Relaxation and tension are often relieved by pressure and massage. You don't have to be a professional to be able to give a great massage. The most important thing is to listen to your partner about how they want to be massaged and what techniques feel the best to them. A light (usually on the belly) is called effleurage. A firm, solid pressure on the sacrum (low back, just above the bottom) is called counter pressure.

Massage oils and lotions can add to the relaxation effect. The scents that you choose should be pleasing to both people and should be chosen based on the goal of the massage. For example, mint is more invigorating but lavender is more soothing. The lotion or oil can also reduce friction during the massage. Some recommendations might be: grape seed oil, prepackaged lotions, etc.


This Mexican shawl can be used in a variety of ways to help alleviate the pain of labor and increase your ability to relax.

How Labor Begins

Couple Walking in Early Labor at the Hospital
Couple Walking in Early Labor at the Hospital. Photo © Andersen Ross / Getty Images

Scene: A darken room, with only the glow of the clock radio. The numbers read some unearthly hour of the morning. A woman bolts upright in bed, clutches her stomach and begins to violently shake her husband, "It's time!" They rush off to the hospital, she promptly has her clean 3 month old looking baby born and is sitting in a white gown, all before the span of 15 minutes is up.

We often think of labor as beginning with your typical television show type of labor, however, for most of us labor will be something much more difficult to predict.

While everyone tells a mom she'll know when she's in labor, you don't know what that means and you might wonder if you really will know when it's time.

My best advice is to tell you that many women spend very early labor or prelabor wondering if this is the real thing, labor.

Labor: The period of contractions that change the cervix and ends with the birth of your baby.

The definition seems clear enough, but what does that mean for you?

Most women will have a series of events that tell them that their body is preparing for labor. Labor may still be days or weeks away, but it's nice to know that your body is heading the right direction.

Mucous Plug

The mucous plug is really nothing more than glorified snot. Basically it has held the position of the inside of your cervix for many moths protecting your body and baby from infection. As the cervix begins to efface and dilate little pieces of mucous can be seen in chunks or strings when wiping. Sometimes you will loose a large chunk at once, called the plug. Because the cervix is so sensitive and the blood vessels are all right on the surface you can sometimes find that the plug has pink or bloody tinge to it. Labor will usually begin possibly within days but also up to several weeks after the plug has been dislodged.

See also: True or False Labor Quiz

Beginnings of Labor

Labor - Station Pelvis
LifeART (and/or) MediClip image copyright 2008. Wolters Kluwer Health, Inc.- Lippincott Williams & Wilkins. All rights reserved.


In first time moms this can happen up to 6 weeks prior to the birth, though not always and frequently not until well into labor. Usually moms will notice that they can breathe a bit more easily, heartburn may temporarily abate, though the trade off is more frequent trips to the bathroom. This is simply the baby settling into the pelvis in preparation for its birthday!


This is where you get a burst of energy and feel like cleaning your house or washing all of the baby's clothes. I can't say it's not a sign of impending labor, but it's not a reliable sign. It's also one you can trick yourself into. Just ask me about that part, I actually hung 14 windows of plastic wrap and did the heat application to seal the windows for winter in my ninth month, hoping it would put me into labor!


Unlike the Braxton Hicks Contractions you've had previously you may have periods of contractions that do change your cervical dilation and effacement, but stop without warning. This is why we tell women to use these practice bouts for just that purpose. What can you do to make life more comfortable during contractions? What happens when you change position? Which relaxation techniques work best at this point?

Other Prelabor Signs

  • Loose Stools
  • An upset stomach
  • Diarrhea
  • Weight loss
  • Slight increase in blood pressure

Real Labor or False Labor?

Pregnant Woman Packing her Hospital Bag
Pregnant Woman Packing her Hospital Bag. Photo © Monkey Business -

Many women will tell you that they made several trips to the hospital or spent hours on the hone with their practitioner or doula trying to determine if this was real labor or false labor.

First of all. let me say that there is no such thing as false labor. Certainly there are periods of contractions that do not end with the birth of the baby, but they are beneficial for reasons that we may not be able to measure like dilation. Perhaps they are helping the baby rotate to a better position or other benefit.

Here is a handy chart to tell if this is the real thing or not:

False Labor

  • Contractions don't get closer together.
  • Contractions don't get stronger.
  • Contractions tend to be felt only in the front.
  • Contractions don't get longer.
  • Walking has no effect on the contractions.
  • Cervix doesn’t change with contractions.

True Labor

  • Contractions do get closer together.
  • Contractions do get stronger.
  • Contractions tend to be felt all over.
  • Contractions do last longer.
  • Walking makes the contractions stronger.
  • Cervix opens and thins with contractions.

Don't worry if you wind up calling your doctor or midwife a few times. Even the most experienced mothers can be fooled by contractions.

More information on real versus false labor.

Water Breaking

Another common belief is that your water will break nearly as soon as labor begins or as a sure sign that labor is under way. The fact is that only 12% of women will start labor with the breaking of their water and that 75% of women, if left alone, will have their membranes intact until after 9 centimeters dilation.

Did my water break?

Late Pregnancy Discomforts and Relaxation for Childbirth

Fear Tension Pain Cycle
Photo © REW

Late pregnancy discomforts vary from woman to woman, and pregnancy to pregnancy. Having a comfortable pregnancy means learning to listen and respond to your body, a very handy tool for labor.

More information on complaints of pregnancy.

Relaxation is key in making for a more satisfying birth experience. The ability to release unwanted tension is a necessary fact for this event and for life. Learning the keys to relaxation will help you relieve stress throughout life and bring a sense of well-being.

Three Types of Relaxation

  • Physical
  • Mental
  • Emotional

It does take practice. We talked early about the Fear-Tension-Pain cycle and how you need to be able to break into parts of the cycle to relive unnecessary pain and frustration. Relaxation is one thing that can help you do this. Relaxation doesn't take fancy equipment. It comes in a variety of shapes and sizes, not one size fits all. Another benefit to relaxation is that it can fit into anyone's box of tricks, whether you definitely want pain medication, whether you don't want any pain medication or whether you're undecided.

Practice in a variety of setting and using a variety of techniques. In the next few weeks you'll have several different techniques introduces. Try all of them and figure out which work for you now. Remember, flexibility is important because what works now might not work in labor and vice versa.

More Relaxation for Labor

Couple Relaxing
Photo © Eriko Koga/Getty Images

Tense/Release Relaxation

This is simply an exercise to allow you and your partner to see and feel the difference between relaxed muscles and tense muscles. The body observation is very important and will become second nature the more you practice, even doing other techniques.

Start by getting in a comfortable position, where your partner can see the majority of your body. Use pillows to get comfortable and prevent unwanted tension. Start by having your partner tell you to tense a particular part of the body and then feel that part of the body for the feeling of tension.

Then the partner will say, "Relax." Try to say this in a very soothing voice. Now feel the difference in the relaxed muscle.

Go through each muscle group at least once, and preferably in order from head to toe or toe to head. Once you've finished spot check for areas that you know are prone to tension, the shoulders, the neck, the brow, the jaw, whatever is the place your partner hides tension the most.

Once you've worked through this exercise just lie still and focus on the in and out of your breath and make note of how your body feels when it is completely relaxed.

Now that you're relaxed, I'll see you next week in class three!

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