What to Expect During Labor
What Is Labor?
Labor, which has three stages, is the process leading to birth. The first stage begins when pregnant woman's uterus contracts and her cervix dilates. The uterine contractions that occur with labor are caused by hormones known as oxytocin and prostaglandin. During the second stage of labor, the baby is pushed through the vagina. The third stage of labor is the delivery of the placenta and fetal membranes, which happens just a few minutes after the baby is born. A typical labor lasts 12 to 14 hours, but the length and experience of labor varies considerably among women.
Your healthcare provider uses guidelines to determine if your labor is progressing normally. Occasionally, labor does not progress normally, and a pregnant woman may need medical assistance or a cesarean section. If labor begins before the 37th week of pregnancy, it is considered preterm. If you have any symptoms of labor before the 37th week, you should call your doctor immediately.
How Will I Know When I'm About to Go Into Labor?
Your "due date" is only an estimate of when labor will begin. It's normal for labor to begin anytime within two weeks before or after your due date. Labor will begin with the opening and thinning of your cervix, when your uterus begins regular contractions. When your body is preparing for labor, you will experience the following signs:
It may feel as if your baby has dropped lower in your abdomen. This happens when your baby's head settles deeper into your pelvis. This occurs a few weeks to a few hours before labor begins.
Mucus Plug or "Show"
You will pass a thick plug of cervical mucus or have an increase of vaginal discharge that may look clear, slightly bloody, or pink. The mucus plug is pushed into the vagina when the cervix begins to open. This may occur several days before labor begins or during the onset of labor.
You will feel a continuous trickle or a gush of fluid from your vagina. This is caused when the amniotic sac breaks, releasing the fluid that surrounded your baby during pregnancy.
When regular contractions occur, you may actually be going into labor. The contractions may feel like menstrual cramps or a backache.
When you actually go into labor, you will experience the following signs:
- Contractions will come at regular intervals, will last about 30-40 seconds, and will get closer and closer together.
- The contractions will not go away when you move around.
- Pain from the contractions will probably be felt in the back and the front of your abdomen.
What Is False Labor?
False labor pains, also known as Braxton-Hicks contractions, often occur in the last few weeks of pregnancy. They may be uncomfortable or painful and can lead you to think that you're going into actual labor. It can be difficult to tell the difference between false and true labor. In fact, sometimes the difference can only be determined by a vaginal and cervical exam. False labor may be characterized by:
- Irregular cramps that do not get consistently closer.
- Contractions that stop when you walk, rest, or change position.
- Contractions that are felt only in the abdomen (not in the lower back).
What Happens During Labor?
First Stage of Labor
During the first stage of labor, regular contractions begin, and your cervix will be completely dilated. The first stage of labor consists of a latent phase in which your cervix slowly dilates up to three or four centimeters—a process that can take five or more hours. It is marked by fairly mild contractions that last about 30-40 seconds and shorten to about five minutes apart.
The middle phase of the first stage of labor lasts about three hours. During this phase, your cervix will dilate to about seven centimeters and contractions become more intense and closer together. The contractions may be painful at this time, and some women request painkilling drugs. During this phase, you may want to change positions frequently, sit up, begin controlled breathing, or even get up and walk around. A warm bath or shower may help you relax. You will also benefit from coaching and support, which will help to increase relaxation.
The transition phase is the end of the first stage, which lasts about two hours. During this phase, the cervix dilates from eight to 10 centimeters. Contractions become very intense, about two to three minutes apart, and last from 60 to 90 seconds each. You will need to concentrate on your breathing and will benefit from a lot of coaching. During the transition phase, you may experience the following signs:
- Hot and cold flashes
- Sensitivity to the environment
- Nausea or vomiting
- Leg cramps
- The urge to push
Second Stage of Labor
During the second stage of labor, your cervix will be fully dilated to 10 centimeters. Contractions will be very strong and painful, will last about 60 seconds, and will come at intervals of about two to three minutes. You will have an intense urge to push. This stage lasts about two hours in a first-time mother. You may feel a stretching or burning sensation as the baby's head is pushed out of your vagina. At the end of the second stage of labor, after your baby is born, you will feel greatly relieved and excited.
Third Stage of Labor
The third stage of labor takes place within 30 minutes of the birth. It is the shortest stage, lasting about 20 to 30 minutes. During this stage, your uterus will contract and expel the placenta and membranes that have surrounded the fetus in your uterus. You will feel mild contractions that are very different from labor contractions. During these contractions you will be encouraged to push.
What If I Have Problems During Labor?
Your labor will be carefully monitored by your healthcare provider. Throughout labor, your vital signs, uterine contractions, and your baby's heart rate will be checked. These can be checked manually or with an electronic monitor. If any problems are detected, your healthcare provider can take the necessary action.
American Academy of Family Physicians
American College of Obstetricians and Gynecologists
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Last reviewed July 2007 by Ganson Purcell Jr., MD, FACOG, FACPE
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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