Stages of labor
Labor occurs in three stages. When regular contractions begin, the baby moves down into the pelvis as the cervix both effaces (thins) and dilates (opens). How labor progresses and how long it lasts are different for every woman. But each stage features some milestones that are true for every woman.
Stage 1 – Contractions and cervix dilation
The first stage begins with the onset of labor and ends when the cervix is fully opened. It is the longest stage of labor, usually lasting about 12 to 19 hours. Many women spend the early part of this first stage at home. You might want to rest, watch TV, hang out with family, or even go for a walk. Most women can drink and eat during labor, which can provide needed energy later. Yet some doctors advise laboring women to avoid solid food as a precaution should a cesarean delivery be needed. Ask your doctor about eating during labor. While at home, time your contractions and keep your doctor up to date on your progress. Your doctor will tell you when to go to the hospital or birthing center.
At the hospital, your doctor will monitor the progress of your labor by periodically checking your cervix, as well as the baby’s position and station (location in the birth canal). Most babies’ heads enter the pelvis facing to one side and then rotate to face down. Sometimes, a baby will be facing up towards the mother’s abdomen. Intense back labor often goes along with this position. Your doctor might try to rotate the baby, or the baby might turn on its own.
As you near the end of the first stage of labor, contractions become longer, stronger, and closer together. Many of the positioning and relaxation tips you learned in childbirth class can help now. Try to find the most comfortable position during contractions and to let your muscles go limp between contractions. Let your support person know how he or she can be helpful, such as by rubbing your lower back, giving you ice chips to suck, or putting a cold washcloth on your forehead.
Sometimes, medicines and other methods are used to help speed up labor that is progressing slowly. Many doctors will rupture the membranes. Although this practice is widely used, studies show that doing so during labor does not help shorten the length of labor.
Your doctor might want to use an electronic fetal monitor to see if the blood supply to your baby is okay. For most women, this involves putting two straps around the mother’s abdomen. One strap measures the strength and frequency of your contractions. The other strap records how the baby’s heartbeat reacts to the contraction.
The most difficult phase of this first stage is the transition. Contractions are very powerful, with very little time to relax in between, as the cervix stretches the last few centimeters. Many women feel shaky or nauseated. The cervix is fully dilated when it reaches 10 centimeters.
Stage 2 – Pushing and delivery
The second stage involves pushing and delivery of your baby. It usually lasts 20 minutes to two hours. You will push hard during contractions and rest between contractions. Pushing is hard work, and a support person can really help keep you focused. A woman can give birth in many positions, such as squatting, sitting, kneeling, or lying back. Giving birth in an upright position, such as squatting, appears to have some benefits, including shortening this stage of labor and helping to keep the tissue near the birth canal intact. You might find pushing to be easier or more comfortable one way, and you should be allowed to choose the birth position that feels best to you.
When the top of your baby’s head fully appears (crowning), your doctor will tell you when to push and deliver your baby. Your doctor may make a small cut, called an episiotomy, to enlarge the vaginal opening. Most women in childbirth do not need an episiotomy. Sometimes, forceps (tool shaped like salad tongs) or suction is used to help guide the baby through the birth canal. This is called assisted vaginal delivery. After your baby is born, the umbilical cord is cut. Make sure to tell your doctor if you or your partner would like to cut the umbilical cord.
Stage 3 – Delivery of the placenta
The third stage involves the delivery of the placenta (afterbirth). It is the shortest stage, lasting five to 30 minutes. Contractions will begin five to 30 minutes after birth, signaling that it’s time to deliver the placenta. You might have chills or shakiness. Labor is over once the placenta is delivered. Your doctor will repair the episiotomy and any tears you might have. Now, you can rest and enjoy your newborn!
Stage 4 – Post-delivery
Following labor and delivery, care continues for both mom and baby.
- Stitching of tears or episiotomy and massaging of the uterus happens to help it return to the pre-pregnancy size (called involution)
Within 12 hours (of birth):
- Hearing screening checks for hearing loss in the range where speech is heard. Identifying hearing loss early helps babies stay on track with speech, language, and communication skills. Learn more.
Within 24 hours (of birth):
- Heart screening
- Bilirubin test
- Spot test for several rare disorders
Learn more about newborn screenings from the Minnesota Department of Health.
We respect the special private time for parents and their new baby for the first hours after birth. This uninterrupted time is enormously beneficial to the child’s growth and development. Mothers and fathers maximize the bonding experience before introducing the little one to family and friends.
Read more in this issue of Minnesota Parent.
If you choose to breastfeed your baby, our OB staff will help initiate breastfeeding within an hour of birthing your baby. We will encourage breastfeeding on demand and practice rooming-in, allowing mothers and babies to remain together 24 hours a day.
Welia Health has certified lactation consultants to help new moms achieve their breastfeeding goals.