3 Vital Stages Of Labor: What Happens In Them And What To Do

In This Article

As is common knowledge, labor pain during vaginal birth is characterized by strong uterine contractions. Women who have undergone labor may have told you about their experiences of the pain involved and the associated difficulties. Knowing the details of the vital stages of labor may prove useful in making you better prepared for what is to come.

Labor pain is divided into three stages: early labor, active labor, and transition. Read this article to learn more about what happens during these stages and what you can do to make your labor easier and more comfortable.

Stages Of Labor

Labor progresses in three stages. Let’s see what they are (1):

The first stage: This is the longest part of labor and the latent phase may last up to 20 hours. It begins with the onset of the true contractions and lasts until the cervix is dilated to 10cm.

The second stage: It lasts from cervical dilation until the delivery of the baby.

The third stage: The process of childbirth ends with the delivery of the placenta.

Image: Shutterstock

Quick tip

If your labor begins at night, remember that there is no need to rush to the hospital, instead, try to get some sleep. If you are unable to sleep, engage yourself in light activities around the house, such as cleaning your closet (3).

Stage 1 Of Labor

This stage marks the onset of the labor contractions that cause the cervix to soften and dilate. It involves three phases, namely early labor, active labor, and transition phase.

Image courtesy: National Women’s Health, Auckland District Health Board

Phases in stage 1 of labor	What’s happening	What you can do
Early labor When you think you are in true labor, start timing your contraction. You can write down the time when each contraction starts and stops. Mild contractions begin 15-20 minutes apart and last 30-40 seconds.	Several hormonal and physical changes might indicate the start of your labor. The cervix starts to efface and dilate to 4cm (1). The mucus plug, which has been blocking the cervical passage and protecting the uterus from any infection throughout the pregnancy, is now discharged. The contractions will start in an irregular pattern and last for 30-60 seconds coming every 5-20 minutes (2). Once the gap between two consecutive contractions reaches five minutes, it means the labor is established. As the cervix begins to dilate, you will notice a slight pink or bloody discharge from the vagina. Lower back pain, loose bowel movements, and pressure in the pelvic area are other symptoms during this phase. The amniotic sac can rupture at any time during the first stage. This phase can last for hours or even days.	Call the doctor to know what to do. Distract yourself by watching television or playing games. Try to sleep by changing positions. Take a bath or shower if the water has not broken. Have snacks to build your energy reserve. Empty your bowel as often as you can. Get a massage of neck and shoulder done to relieve the tension. Drink enough fluids – a few glasses of water or juice. You may take pain killers such as paracetamol if needed.
Active labor	The cervix continues to dilate from 4-7cm (3). The contractions get closer, regular and stronger. They occur every 3-5 minutes and last for about 60 seconds. The water will break with a gush of fluid, and this speeds up contractions. This phase will last for 3-5 hours. It is the time to proceed to the hospital.	Seek help from your partner and mother. Get a massage done on the lower back. Practice breathing techniques. Change positions while sleeping. Sit comfortably using pillows. Keep drinking water to hydrate yourself. Walking, standing, and sitting upright can help progress the labor.
Transition	The cervix now dilates from 7-10cm. The contractions get longer, stronger, and intense and last for 60-90 seconds, coming in every 2-3 minutes. This is the shortest yet the most challenging phase. You are likely to have hot flashes, chills, vomiting, nausea, and gas during this phase.	Continue with breathing exercises. Have your partner by your side to support you during the contractions.

When to call the doctor?

Call your doctor right away if:

The water breaks.

Abdominal pain gets severe and constant.

The baby’s movement slows down or stops.

You have bright red vaginal bleeding, which is not normal.

Stage 2 Of Labor

The second stage involves pushing the baby into the birthing canal and eventually delivering. This stage progresses as follows:

The cervix is fully dilated (10cm) by this time.

This stage lasts for 30 minutes to two hours in the first-time mothers (4). Epidural can also prolong the length of the second stage of labor.

Contractions get longer and stronger.

The pushing phase:

During this phase, the natural urge to push gets stronger. Along with that, you may also experience (5):

Increased pressure in the perineum, rectum, and lower back.

A strong bowel pressure.

A burning or stretching feeling in the vagina due to crowning (the baby’s head moving down). At this stage, the woman is asked to stop pushing so that the perineum stretches gradually.
Usually, there is a wait for the next contraction, then the baby is born.

The baby comes out, usually with the head first.

What you can do:

Image: Shutterstock

Try different positions — squatting, lying on your side with your leg up or resting on your hands and knees.

Take deep breaths before and after each contraction.

Curl into push as much as possible, this allows all of your muscles to work.

Concentrate on the contractions and take a break in between.

Try different positions while sitting, standing, or walking.

If you get hot flashes, use a cold face washer.

Keep yourself hydrated by taking fluids.

Stage 3 Of Labor

After the baby is born, the placenta is delivered in the third stage.

The average time of the third stage of labor is six minutes (6).

Labor stimulation, analgesia during labor, and cord drainage could prolong the phase.

The contractions begin 5-10 minutes after childbirth and are mild and less painful.

The vagina feels fuller as the placenta passes through.

Chills and shivering are common while you are delivering the placenta.

Things to know

During the third stage of labor, your doctor may massage your uterus through the abdomen to help it contract and reduce bleeding (1).

What you can do:

Stay relaxed.

Image: Shutterstock

Ask the doctor, if you wish to see the placenta.

Begin breastfeeding your baby after the delivery.

What Happens After Labor?

After the delivery of the baby, the placenta is expelled from the uterus. If the placenta fails to come out after 30 minutes of childbirth, the condition is known as retained placenta and may be harmful for the mother. The medical personnel may assist you by injecting drugs such as Syntocinon (7).

In case of any tears in the vaginal area, the doctor will place the stitches by giving local anesthesia. This anesthesia will be given only if you did not get one during labor (1).

Quick fact

Novocain is the usual choice of anesthesia before placing the stitches. These stitches are absorbed by the skin and need not be removed later (1).

Frequently Asked Questions

1. At what stage of labor is epidural given?

Epidural is given when you are 4-5cm dilated and have regular contractions. However, an epidural can slow down the contractions. In this case, Picotin will be given to speed up the labor.

2. What does it feel like when I start to dilate?

As the cervix dilates, it becomes softer. You can insert a finger into the vaginal opening that feels like soft lips. While doing this, you may probably feel the head of your baby.

3. Which Stage Of Labor Is The Longest And How Long Does It Last For?

The duration of labor varies from woman to woman. The first stage of labor is usually the longest and for the first time moms, it may last from 6-20 hours. However, in those who have had babies earlier, this stage could be quite shorter lasting for 2-10 hours. Moreover, if the cervix is not dilated properly or the fetus is not in the optimal position, then it is certain that the labor will get prolonged.

4. Do I have to get a cut or episiotomy?

You may experience a perineal tear, which could be sutured by your midwife or doctor. You might also have an episiotomy, if necessary, while pushing. An episiotomy is a procedure in which a small incision is made in the second stage of labor to quickly enlarge the opening for the baby to pass through. It should only done in an urgent situation to make the opening wider for the baby. The incision begins at the posterior fourchette and travels laterally, right or left, at a 45 to 60-degree angle to avoid injure to the anal spincture muscles. This will help in the delivery of your baby and prevent large irregular tears of vaginal walls (8).

The three stages of labor are vital. Call your doctor promptly if you experience abdominal pain or vaginal bleeding during the first stage. The second stage is the pushing phase, where the baby starts coming out through the birthing canal. In the third stage, the childbirth ends, and the placenta is delivered. After labor, the doctor injects medications to stop the blood loss and stitches the vaginal area if there are any tears. Labor is associated with certain discomforts; however, staying calm, distracting yourself, and drinking fluids may ease the process.

References:

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