For most birthing people, labor looks a lot different from what you see on the big screen, with much subtler signs. (Case in point: only about 10% of expectant parents have their water break.)
While it’s impossible to predict exactly how your labor experience will go, you may feel calmer heading into the last stretch of your pregnancy if you have a general sense of what to expect. Here’s an overview of the stages of labor.
Labor, which typically happens between weeks 38 and 41 of pregnancy, can be separated into three different stages: 1) early and active labor; 2) delivery of your baby; and 3) delivery of the placenta.
As you approach the first stage of labor, your body may give some signs that it’s preparing for delivery, including the following:
You may experience contractions — the tightening and relaxing of your uterus — before labor begins, during the final months of your pregnancy. These are called Braxton Hicks contractions and may feel similar to labor contractions.
Braxton Hicks contractions are irregular in timing, maintain or even decrease in intensity, and often last for 15-30 seconds. They may stop when you stand or walk.
True labor contractions typically occur 2-5 minutes apart, last 60-90 seconds, and grow more intense with time. In contrast to Braxton Hicks contractions, they don’t stop if you get up and move or change your position.
If you’re unsure whether you’re experiencing Braxton Hicks or true labor contractions, contact your doctor.
The first stage of labor is the longest of the three stages. It is typically divided into two distinct phases — early labor and active labor. Early labor often begins with mild contractions as your cervix both opens and thins. The opening of the cervix is referred to as dilation and its softening and thinning is referred to as effacement.
Early labor may last anywhere from hours to days. It is often longer for those giving birth for the first time and shorter for those who’ve already delivered a baby. Many pregnant individuals remain at home during this phase.
For some, this stage may not feel very uncomfortable, but others may experience more intense contractions. There are some things you can do to stay as comfortable as possible, like walking, taking a shower or bath, changing positions, and practicing breathing techniques.
Next comes active labor, which typically lasts 4-8 hours or more. You will likely experience contractions that grow stronger over time and your water may break. (Water may also break earlier, or not at all — each individual’s experience is different.) Your cervix will dilate from 6-10 centimeters at about one centimeter per hour. This is the time to head to your desired birthing location if you haven’t already.
You can ask your healthcare team for pain medication or anesthesia during this stage of labor if you are comfortable doing so. Creating a birth plan can help you decide in advance how you want to approach pain management.
For many, the final part of active labor can be an intense experience, with 60-90 second contractions and less time between each. If you feel the need to push, be sure to consult with your doctor before doing so — pushing before your cervix is fully dilated can lead to swelling and delayed delivery. This part of active labor is often referred to as transition and may last from 15-60 minutes.
Delivering your baby — the second stage of labor — varies from one individual to another and can take anywhere from a few minutes to a few hours. It often lasts longer for first-time parents or those who have received an epidural.
During this stage, you will actively push as your baby moves from the uterus to the birth canal. You can try different positions to push from — squatting, sitting, kneeling, or on your hands and knees — and choose one that works best. Your care team may ask you to push more slowly or stop pushing at some point in this stage. This is intended to allow your vaginal tissues to stretch.
Once your baby is delivered, your care team may wait a couple of minutes before cutting the umbilical cord so that more nutrient-rich blood flows to your baby. This can help prevent iron deficiency.
Your healthcare team will closely monitor your blood pressure during delivery, to keep you and your baby healthy. A healthy range for blood pressure during labor is typically less than 120/80.
You’re almost done with labor after the birth of your baby, but there’s one last stage: delivery of the placenta, which typically takes about 30 minutes to an hour. Your contractions should feel less intense as your placenta moves to the birth canal.
Your doctor will perform a check-up to ensure that the entire placenta has been delivered. Any pieces left inside of the uterus will need to be removed to avoid infection. From this point on, your uterus will contract back to its normal size. Your care team will also decide whether you need to repair tears in your vaginal region with stitches. If you haven’t already received anesthesia, a local anesthetic will likely be administered by the area in need of stitching.
It’s okay to feel uneasy or nervous as you prepare for labor. Many parents-to-be experience these feelings. In addition to leaning on your loved ones for support, consult trusted providers including your doctor and the Ruth Health team.
Have additional questions about pregnancy, the stages of labor, or postpartum life? Send us an email at firstname.lastname@example.org and we’ll make sure you get the information you need.
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