Labor is more than just contractions! There are three different stages that you will move through from your first contraction to your baby and then the placenta being born! In this blog, I will be breaking down all three stages of labor (plus the mini phases within each stage) so you can understand what is going on when to head to your birth location and feel more confident as you navigate your birth experience.
When labor begins, it’s common to have many questions: How do you know you’re in active labor? When should you go to your birth location? This guide will break down the stages of labor, common clues to help you identify where you are in the labor timeline, and actions you can take during each phase to support your labor progress.
The Stages of Labor
Labor is divided into three main stages:
- Dilation Stage: This is the first stage, where the cervix dilates from 0 to 10 centimeters. This is what we commonly think of when we think of labor–the actual contractions!
- Expulsion Stage: The second stage involves pushing the baby out. This can initiate from you spontaneously pushing or from you being encouraged to begin pushing.
- Placental Stage: The third stage is the delivery of the placenta–a lot of people forget we also need to birth the placenta!
First Stage: Dilation
The first stage of labor is further divided into three phases: early labor, active labor, and transition.
Early Labor
- Duration: Early labor is typically the longest phase, often lasting several hours to over a day. You may actually sleep through this phase and not know you were in labor yet!
- Contractions: Contractions are usually more than 10 minutes apart during early labor. They are usually mild and can be slept through or managed easily. You know they are happening, but you are not bothered by them or need additional support. You can usually continue to walk and talk through your contractions.
- Actions: Focus on rest and nourishment. Eat a meal high in fat and protein to sustain you through labor. If you are feeling well-rested, get up and move! Go for a short walk. If you feel tired, rest! Take a nap!
Early Active Labor
- Contractions: Contractions become more frequent, around 4 to 10 minutes apart. You will need more support during contractions, but you can still engage in activities between them. You may no longer be able to walk or talk through your contractions, but you are still in early labor!
- It is common to think you are much further along because you need more support during contractions, and your contraction timer may be yelling at you to head to your birth location when contractions are 4-1-1 (4 minutes apart, lasting for one minute over the past hour). However, in this phase, you are usually around 2-3 centimeters dilated and still in early labor!
- How do you know you’re still in early active labor?? Pay attention to the IN BETWEEN of contractions. During contractions, you may need more support, but in between contractions, you can return to the space and mentally engage with your environment.
- Another key thing that I notice as a doula when my clients are shifting to active labor is that they no longer want to be on their phones to text or communicate with me! When staring at your phone becomes mentally taxing, it could be a good sign you are shifting to active labor!
- Actions: Continue to rest and eat. Depending on your proximity to your birth location and your pain preferences, you may consider heading to the hospital or birth center during this phase.
- If you want an epidural, heading to your birth location near the end of this phase can be a good idea, as it can take some time to get pain relief. If you want to go unmedicated, it can be helpful to wait until near the end of active labor.
Active Labor
- Contractions: Contractions are now 2 to 3 minutes apart and more intense. You will need significant support during contractions and may enter a mental state often referred to as “labor land.” You are no longer mentally present in between contractions! You may actually try to sleep, but trying to converse or interact with your environment is mentally taxing!
- Actions: If you plan to have an unmedicated birth, aim to arrive at your birth location towards the end of active labor. If you prefer an epidural, plan to arrive earlier in this phase. You will also need a lot of support from your partner and birth team during this phase!
Transition: Release of stress hormones to transition from active labor to pushing.
- Duration: Transition is the shortest but most intense phase of the first stage.
- Symptoms: Expect a release of stress hormones, which can cause shaking, nausea, or a feeling of needing to poop. You may feel overwhelmed or doubt your ability to continue without pain relief.
- This flood of stress hormones is important as it helps your baby get amped up for birth–we need them to do a lot of new things in a very short period, such as breathing!
- However, this flood of stress hormones can be overwhelming for you and generate a fight-or-flight response. This is helpful, as it activates your sympathetic nervous system to help you begin pushing which can be physically intensive!
- Actions: Recognize that these feelings are normal and a sign that you are nearing the pushing stage. Seek emotional and physical support from your birth team.
Second Stage: Expulsion
The second stage of labor is pushing the baby out. This stage varies in length, often lasting from a few minutes to a few hours.
- With Epidural: Pushing may take longer as you need to re-establish the mind-body connection.
- Without Epidural: Pushing can be quicker since you can feel the contractions more intensely.
Pushing Strategies
- Coached Pushing: Common in hospital settings, especially if you have an epidural. A medical professional will guide you through each push.
- Spontaneous Pushing: Let your body lead the way, pushing as you feel the urge.
Third Stage: Placental Delivery
After your baby is born, the placenta must also be delivered.
- Duration: Typically takes 2 to 5 minutes but can last up to 30 minutes.
- Management Styles:
- Active Management: Involves medications like Pitocin and gentle cord traction to encourage placenta delivery and reduce the risk of postpartum hemorrhage.
- Expectant Management: Waiting for the placenta to detach and deliver naturally without medical intervention.
Signs of Placental Detachment
- The uterus lifts up.
- A gush of blood.
- The umbilical cord lengthens as the placenta descends.
Conclusion
Understanding the stages of labor and their nuances can empower you during childbirth. Whether you opt for a natural birth or plan to use pain relief, knowing what to expect and when to seek help can make the process more manageable. Remember to communicate your preferences with your birth team and seek their support as needed. Every labor experience is unique, but being informed can help you navigate this transformative journey with confidence.
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