The first stage of labor:
So those intermittent mild twinges have turned into regular contractions and they are also starting to not feel so mild? Congratulations! It sounds like you might be going into proper labor. This can come as a welcome relief if you have been having irregular contractions for days, if you are finding the last few weeks of pregnancy rather uncomfortable, or if you simply want to meet your baby.
The first stage of labor consists of two phases – the latent phase, in which the cervix starts to open and you may feel irregular contractions for hours or sometimes days, and established labor, when your cervix has dilated to more than 3cm and the contractions are regular. During the latent phase, it may be a good idea to have something to eat and drink, as you will need the energy later on and you might not feel like eating once labor is established.
If your labor starts in the daytime, stay upright and try to remain gently active as this will help move the baby down into the pelvis and this in turn will help the cervix to dilate. If your labor starts at night, try to stay relaxed and sleep if you can.
It is probably time to go to the hospital or a midwife-led unit if:
- Your waters break
- Your contractions are regular and occurring approximately every 5 minutes
- Your contractions are strong and you want pain relief
In a first pregnancy, the time from the start of established labor to being fully dilated (cervix diameter of 10cm) generally lasts from 6 to 12 hours and is often shorter in subsequent pregnancies. However, sometimes labor can be slower than expected and you may be offered ways to speed it up. The main methods are:
- Breaking your waters – this is often enough to make your contractions stronger and more regular.
- Oxytocin drip – if breaking your waters doesn’t work, your midwife or doctor may suggest using a drug called Syntocin or Pitcoin, which are synthetic versions of oxytocin, the chemical your body releases to start labor. This can make your contractions pretty intense pretty quickly so it might be worth discussing pain relief options beforehand.
In both the first and second stage of labor, you will be encouraged to specific patterned breathing exercises, particularly if you are not receiving any pain relief medications. You can read more about these exercises here.
The second stage of labor:
The second stage of labor is the time from when your cervix is fully dilated through to when your baby is born. If you are not being monitored, there are several positions you might want to try in order to make the pushing easier. At this point you can push during contractions whenever you feel the urge. Often you will get an urge to push that feels like you want to defecate and sometimes you even do! But don’t be embarrassed, this is very common and is something the midwives, nurses, and doctors are used to dealing with.
This stage should last no longer than 3 hours if this is your first baby and if this is a subsequent pregnancy, this stage should last no longer than 2 hours.
When your baby’s head is ready to come out, you will be asked to stop pushing in order to allow the head to be born slowly and gently, giving the skin and muscles of your perineum (the area between your vagina and anus) time to stretch. Once the head is out, most of the hard work is finished and the rest of the body is normally born in one or two contractions. Congratulations – you have successfully birthed another human being!
The third stage of labor:
The third stage of labor is when your womb contracts and you birth the placenta. You can either do this without any interventions or you will undergo what is called ‘active management’. In active management you will be given an injection of Pitcoin or Syntocinin and this will help your womb contract. Once the placenta has come away from the womb, your midwife will pull placenta out of the vagina with the umbilical cord.