Step by Step Guide to the Stages of Labor and Birth

Signs of Labor

Pregnant Woman on the Phone with practitioner
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Your baby has been getting ready for the birth for quite a while, but the signs of labor are your first clue that the pregnancy is about to come to an end. The trick with the signs of labor is to remember that they are not always all seen, nor are they signs that labor will begin at any minute. These signs of labor are rather like subtle hints to finish getting ready as opposed to an alarm clock announcing the end.

This pre-labor phase can last for weeks. You might notice an increase in vaginal discharge. This may include losing your mucous plug. This might even be tinged with pink. This is a sign that can mean labor will begin anytime in the next few weeks. You may notice a brown tinged discharge after having sex or a vaginal exam. This is completely normal.

Contractions are another sign of impending labor. Some of these are the Braxton-Hicks contractions. They happen but don't really go anywhere. You can also have real contractions that are working on changing your cervix slightly or getting your baby to get into a better position but don't last long or get stronger.


Early Labor

A pregnant woman packing a suitcase for the hospital
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Early labor is the longest part of most labors. Here your body will continue to open and thin your cervix in a process called dilation and effacement. This is done with contractions. Though the contractions you experience in early labor may be very spaced out, even to the point of you only having a few contractions an hour.

During this part of labor, you are typically most comfortable at home. You can alternate periods of rest with activity. You may continue to see parts of or your whole mucous plug and perhaps even a bit of bloody show.

Your contractions probably last 45 seconds or fewer at this point in labor. They can range in time from 20 minutes apart to about 5 minutes apart. Don't forget that when timing contractions, the time apart is from the beginning of one contraction to the beginning of the next contraction. Most mothers do not need a lot of relaxation or comfort measures in this stage of labor. You may find that you spend a few seconds at the peak of each contraction stopping what you're doing but generally you are able to talk through them.

Consider using this time in early labor to make your final preparations for the birth of your baby. Some women finishing packing their labor bag or throw last minutes snacks into a bag for their partner. You might arrange any child or pet care as needed. Some moms even make brownies or bake a cake for the impending birthday celebration.

Active Labor

Squatting in Labor
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Active labor is when things start to pick up. You may notice that your contractions are lasting longer and becoming stronger. They are also coming closer together.

Most likely you will need to focus during your contractions. This is when you can use your relaxation skills, your comfort skills, and your coping skills. Some labor positions might feel better than others. You may also consider the use of water as a comfort measure. Your partner and/or doula can also be of help, even in the home setting before going to the birth center or hospital.

Many doctors and midwives advise that at some point during this stage of labor is when the majority of women should think about moving to a hospital or birth center if you are not planning a home birth. Some practitioners use the 4-1-1 rule. That is contractions that are 4 minutes apart, 1 minute in length and continuing for over an hour. Obviously there are some women who know that they need to go to the hospital or birth center sooner, sometimes because they can just tell, sometimes because they have a history of faster labors or because they require certain treatments or medications, like antibiotics.


Mom in Labor, Dad Helping
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As your cervix continues to open and thin, your baby is dropping lower and lower into your pelvis in this intricate dance of labor. As you make your way towards the end of labor, your contractions become closer together and you have less of a break in between contractions. These contractions may last 60-90 seconds long and happen about every three minutes.

You may be using all of your labor skills at this point from relaxation, water, massage, heat and cold to hypnosis based skills for coping with labor pain. Some women will also choose to use medicinal relief either towards the end of the active stage of labor or during transition. This is the hardest but shortest phase of labor, typically lasting from 30-90 minutes.

You may notice that you feel hot and cold. You might even feel nauseated or even vomit. You might even experience shaking. This is not unheard of for transition. You may also feel your baby moving down as your cervix nears complete dilation.

Some women also experience a small break towards the end of transition called the "rest and be thankful" phase by Sheila Kitzinger, an anthropologist who studies birth. This is a time when contractions can space out or even stop. It is thought to be a time when you can have a small break before the work of pushing your baby out comes. Some women have even been known to nap!


Mom Giving Birth
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This is the phase where you actively start to help push your baby out. Your cervix is now completely dilated and your baby is moving down even more until it is born. You will still have contractions during this stage of labor, but they are frequently different in feel and length.

You can choose different positions for pushing. These include: squatting, sitting up, hands and knees or laying back slightly. Your body will guide you to push, but if you need help your doula, midwife, doctor or nurses might also be of assistance.

Pushing can last anywhere from a few minutes to a few hours. This depends on if you have previously had a baby, your position while pushing and your baby's position.

Third Stage - Placenta

Fetal Side of the Placenta
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Once your baby is born, he or she will be handed to you to love on. After this point you may not even notice anything else in the room. Your uterus will continue to contract and within a few minutes your placenta is usually ready to be born. Your doctor or midwife may ask you to push once or twice, but this is nothing like having a baby!

If the cord has not yet been cut, now would be when you would cut the cord or allow someone else, including your partner to do the honors.

Now, sit back, relax and snuggle with your baby as you enjoy your first moments alone. Baby is ready to try to nurse most of the time, offer a breast and snuggle up. Your medical team will also do a placental exam.

Read more: 6 Things to Do With Your Placenta

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