Here at Westchester Health, we get a lot of questions from our pregnant moms and their partners asking what happens in labor and delivery so they can better prepare for it, both mentally and physically. How long will it last? How much will it hurt? How do we know when it’s starting? To keep expecting parents informed (and maybe a little calmer), we recommend this highly informative blog by Lauren Adler, MD, FAAP, a pediatrician with our Westchester Health Pediatrics group (excerpted below).
Preparing for childbirth: the 3 stages of labor
You won’t know exactly how your own labor and delivery will go until it happens, but you can prepare for it as best you can by understanding the typical sequence of events. There are three stages of labor:
- First stage: early labor and active labor
- Second stage: lasts through the birth, with the baby traveling down and out of the birth canal
- Third stage: after your baby is born, when the placenta is delivered
Stage 1: Early labor and active labor
The first stage of labor, the longest of the three stages, is divided into two phases: early labor and active labor.
How to know you’re entering early labor:
- You have contractions that become stronger at regular and increasingly shorter intervals.
- You have lower back pain and cramping that does not go away.
- Your water (amniotic fluid) breaks (can be a large gush or a continuous trickle).
- You have a bloody mucus discharge (brownish or red-tinged). This is probably the mucus plug that blocks the cervix. Losing your mucus plug usually means your cervix is dilating and becoming thinner and softer (effacing).
How long it lasts: Early labor is unpredictable. For first-time moms, early labor could progress to active labor right away (within hours) or it might take several days. The progression is often shorter for subsequent deliveries.
What you can do: For many women, early labor is not that uncomfortable until the contractions increase in frequency and intensity. Best advice:
- Try to stay relaxed
- Take a shower or bath
- Listen to relaxing music
- Try breathing or relaxation techniques taught in childbirth class
When to leave for the hospital or birth center: If your water breaks or you experience significant vaginal bleeding, contact your healthcare provider right away.
During active labor, your cervix will dilate from 6 cm (centimeter) to 10 cm. Your contractions will become stronger, regular and closer together. Your legs might cramp and you might feel nauseated. Your water will most likely break if it hasn’t already, and you might experience increasing pain and pressure in your back. If you have not yet headed to your labor and delivery facility, now is the time.
How long it lasts: Active labor generally lasts 4-8 hours or more. On average, your cervix will dilate at approximately one cm per hour.
What you can do: Try breathing and relaxation techniques you learned in childbirth class to counteract your growing discomfort. Unless you need to be in a specific position for close monitoring of you and your baby, consider these techniques during active labor:
- Change positions
- Roll on a large rubber ball (birthing ball)
- Take a warm shower or bath
- Walk, stopping to breathe through contractions
- Have a gentle massage between contractions
Stage 2: Birth/delivery of your baby
The last part of active labor (often referred to as transition) can be particularly intense and painful. Contractions will come close together and can last 60-90 seconds. You’ll experience pressure in your lower back and rectum.
If you want to begin to push but you’re not fully dilated, your healthcare provider might tell you not to. Pushing too soon could not only quickly tire you but also cause your cervix to swell, which might delay delivery. This transition stage usually lasts 15 minutes to an hour.
How long it lasts: It can take from a few minutes up to a few hours or more to push your baby into the world. It might take longer for first-time moms and those who have had an epidural.
What you can do: Push! Your healthcare provider will ask you to bear down during each contraction or tell you when to push. You can push while squatting, sitting, kneeling, or even on your hands and knees. At some point, you might be asked to push more gently or not at all. Slowing down gives your vaginal tissues time to stretch rather than tear.
After your baby’s head is delivered, the rest of the body will follow shortly. His or her airway will be cleared if necessary. Your healthcare provider or your partner will then cut the umbilical cord.
Stage 3: Delivery of the placenta
During the third stage of labor, after your baby is born, you will deliver the placenta.
How long it lasts: The placenta is typically delivered in 5-30 minutes, but the process can last as long as an hour.
What you can do: By now your focus has most likely shifted to your baby. You will want to hold him/her close to you on your chest, and you might even try breastfeeding.
Even though labor is over, you will continue to have mild contractions but they will be close together and less painful. You’ll be asked to push one more time to deliver the placenta, and your healthcare provider will examine it to make sure it’s intact. Any remaining placenta tissue must be removed from the uterus to prevent bleeding and infection. After you deliver the placenta, your uterus will continue to contract to help it return to its normal size. If you sustained tears in your vaginal region, you may need stitches.
How to tell false labor from real labor
Many women, especially if it’s their first baby, may think they are in labor when they’re actually not. This is called false labor. Your body sometimes carries out “practice” contractions” (called Braxton Hicks contractions) in the last weeks of pregnancy or even earlier. At Westchester Health, we advise our patients that the best way to tell if they’re in true labor is to time their contractions and how long each one lasts. With true labor, contractions become regular, more intense and more frequent. Braxton Hicks contractions are not in a regular pattern and they taper off and go away. Even with these guidelines, it can be hard to tell if labor is real. If you are unsure, contact your healthcare provider.
Helpful websites we recommend
- Mayo Clinic: Labor and Delivery
- American Pregnancy Association: Labor and Birth
- Office on Women’s Health: Labor and Birth
Questions about labor and delivery? Come see us.
If you’d like more information about childbirth or if you have questions related to any aspect of your pregnancy, please make an appointment with one of our Westchester Health pediatricians or a Westchester Health OB/GYN. Our #1 goal is for you to have a safe pregnancy and deliver a healthy baby. Whenever, wherever you need us, we’re here for you.
To read Dr. Adler’s blog in full, click here.