Pregnancy

The Three Stages Of Labour: A Step-By-Step Journey

stages of labourAt first, you might think that labour is just one hard long slog but it is in actual fact divided into different stages. This article aims to help you identify the different stages and what happens to your body during each stage.

 

The First Stage

The first stage begins with the onset of contractions, which cause progressive changes in your cervix, and ends when your cervix is fully dilated. The first stage is divided into three phases: early labour,  active labour and transition. During early labour the cervix gradually thins out (effaces) and opens (dilates). During active labour your cervix begins to dilate rapidly and contractions are stronger, longer and closer together.

Early Labour

You are officially in labour when regular contractions cause your cervix to efface and dilate. It can be tricky trying to determine exactly when true labour starts because early labour contractions are difficult to distinguish from the inefficient Braxton Hicks contractions that may precede true labour contractions.

While labours vary greatly, it may start with contractions coming every 10 minutes and lasting 30 seconds each. Eventually they will be coming every five minutes, and lasting 40 to 60 seconds each as your get closer to the end of early labour. The contractions during this phase tend to be mild and generally last less than a minute. In some cases the contractions in this phase can be quite painful – however you will most likely walk through these without them taking too much of your attention.

It is not unusual to get your show at this stage of labour. The show is a blood-tinged mucous discharge which serves as a -plug for your cervix. As your cervix dilates, the mucous plug dislodges and this is almost always a sure sign that active labour is imminent. Early labour will end when your cervix is about 4 centimetres dilated and your progress starts to speed up.

It is difficult to say exactly how long early labour lasts as it is difficult to identify exactly when early labour starts. The length of labour is variable, however should you be having your first baby and your cervix isn’t effaced or dilated, this phase could take between 6 and 12 hours. If this is not your first baby or you have a cervix that is effaced and dilating, it is likely to go much quicker.

Active Labour

This is the phase in which things really start moving. Your contractions will become longer, stronger and more frequent and you will no longer be able to talk through them. Your cervix will dilate more quickly and go from 4 to 10 centimetres. In active labour, the last 2 centimetres in dilation is called transition which will be discussed later in this article.

Your baby might start to descent towards the end of active labour. In some cases the baby has already started to descent or won’t until the next stage. The rule of thumb is that once you have regular, painful contractions every five minutes it is time to call your midwife or doctor and head to the hospital.

On average active labour for a first time mommy will last for between 4 and 8 hours. This is if you have not been induced, or have been given an epidural. An induction speeds up labour whilst an epidural slows it down. If you have already had a vaginal birth, active labour will most likely go more quickly.

Transition

This is the last part of active labour at which time your cervix dilates from 8 to 10 centimetres. Transition of the most intense part of labour and contractions will be very strong and will be coming every two to three minutes lasting a minute or more. By the time your cervix is completely dilated and transition is over, your baby would have descended into your pelvis and this is when you will feel rectal pressure.  This makes you feel as if you want to have a bowel movement and you will most likely spontaneously want to bear down or push.

Some babies descend earlier than this and women get the urge to push before they are fully dilated. It is important to remember that every woman is different as is every labour.

In some cases, at this stage of labour, women might feel nauseated and start making grunting noises.

Transition can last anywhere from a few minutes to a few hours but is most likely to be fast if you have already had a vaginal delivery.

 

The Second Stage

The second stage of labour is once you have fully dilated and you deliver your baby. This is sometimes referred to as the -pushing stage .

You may find that the contractions during the second stage of labour are easier to cope with because bearing down (pushing) provides some relief. As the uterus contracts it exerts pressure on the baby. This pressure moves the baby down the birth canal.  Providing there are no problems it is advisable to take this stage slowly and let your uterus do the work for you until you feel the urge to push. Taking it easy will leave you less exhausted after the delivery of your baby.

Each contraction during the second stage pushes your baby further and further down the birth canal. It is difficult to say beforehand what position you will find pushing most comfortable as it differs from woman to woman. Trying out different positions once you are in the second stage will help you identify what is most comfortable, effective and right for you.

After pushing for a while, you will begin to bulge at the tissue between your vagina and rectum or mostly commonly known as your perineum. Before long the top of your baby’s head will become visible. This is a very exciting part as you can be reassured that the end is very near!

The urge to push becomes more intense and with your baby’s head pressurising your perineum you may feel a burning or stinging sensation as the tissue there begins to stretch. This is when listening to your caregiver is vitally important as they will advise you on when to push, how strong or gently to push or to not even push at all. The reason for this is that this gives the baby’s head a chance to gradually stretch out your vaginal opening and perineum. A slow, controlled delivery can very successfully prevent a torn perineum. Because the urge to push at this stage is so overwhelming your caregiver might advise you to blow or pant during contractions to help prevent you from pushing.

You will be coached to push until your baby’s head emerges or -crowns . Your baby’s head will finally appear showing first his forehead, nose, mouth and chin. Once your baby’s head is out, your caregiver will wipe or suction mucous from your baby’s nose and mouth and check whether the umbilical cord is around the baby’s neck. If the cord is around the baby’s neck, there is no need to worry as they can simply slip it over their head or if need be, clamp and cut it.

The baby’s head then turns to the side and his shoulders will rotate inside your pelvis to get into the correct position for final delivery. With your next contraction you will push your baby at which time the shoulders will emerge, one at a time, followed by the rest of the body.

Your little one is now out at last and will immediately be put onto your chest for warmth. A towel will also be put onto him to keep him warm as well as to dry him off. While you are marvelling at the miracle you have just given birth to, your caregiver will be clamping the cord and once the cord has stopped pulsating it will be cut.

 

The Third Stage

This is the stage where your placenta is delivered. Minutes after you deliver your baby your uterus will begin to contract again and this is to separate the placenta from the uterine wall. You may need to push gently to help expel the placenta and it is usually one very small push which is not difficult or painful. The delivery of your placenta will roughly take five to ten minutes.

This is the time to congratulate yourself on a job well done! You will feel a range of emotions from exhaustion to excitement to being completely overwhelmed. Luckily your body is amazing and will know exactly what to do after you have delivered your baby.

Your uterus will now contract and become very firm. The firming up of your uterus subsequent to the delivery of your placenta helps cut off and collapse the open blood vessels where the placenta was attached to the uterine wall. If your uterus does not firm up you will continue to bleed from these vessels. Early breastfeeding will help trigger oxytocin, the same hormone that causes contractions to help keep your uterus firm to cut off the blood vessels as mentioned above.

Your uterus will continue to contract for a few days after the birth of your baby and feel like strong menstrual cramps. You will notice that the contractions are particularly strong when you are breastfeeding. If they are too painful, do not be afraid to ask your caregiver for pain medication.

 

 – Candice Shelley

 

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