I teach childbirth classes and one of the biggest parts of the class is really helping students understand the timeline of labor. They all want to know: When will I really know labor is starting? When do I call? When do I go to the hospital?
Now of course all labors are different. Some are slower and some are faster. Some are fast then slow. Some are slow then fast. Some require checking into a hospital sooner than later, etc. etc.
But for the purposes of familiarizing first-time parents with the overall map of labor, I like to describe a roughly 24 hour + period during which mom will go from being pregnant to having a baby in her arms. I do this in great detail in class but here are the cliffs notes if you want to read them and maybe print out to have on hand when you go into labor.
Dilation: 0–3 centimeters
Contractions: 30–5 minutes apart
Contractions: 45–60 seconds long
Total Duration: 6–18 hours (roughly/average for first births*)
Mood might include: excitement, enthusiasm, frustration (discomfort), anxiety, burst of energy, nervous, relief, joy, giddiness.
At Night: Take a bath and have a glass of wine to see if that helps slow things down so you can have a night’s sleep.
During Day: Walk, eat well and often and drink fluids. Distract, distract, distract. Read, see movies, stretch, bath, shower, walk some more, try to stay busy or have fun or zone out (depending on how you feel); try to ignore the labor or at least prepare for the chance that you may have many hours (a whole day) before active labor kicks in. Massage can be nice and nipple stimulation if you want to get labor moving faster.
Either way, stay home during early labor, if possible. The contractions are usually painless for the first half, uncomfortable midway through and by the end of early labor can feel intense. You may not even know you’re in labor until about half way through early labor.
ACTIVE LABOR (go into the hospital at some point during active labor)
Dilation: 4–7 centimeters
Contractions: 5–3 minutes apart
Contractions: 60 seconds long
Total Duration: 4–6 hours (roughly/average for first births)
Mood might include: internal, focused on labor, suggestible (harder to make decisions), excited, nervous, tired, worried, confident, agitated, very perceptive about surroundings, annoyed, happy.
At night: Try positions that allow you maximum rest between contractions. Make use of pillows, leaning forward, closing eyes, bending knees.
In general: Allow yourself to be very focused through the contractions. Minimize distractions and dealing with other people. Turn down lights, find something useful to help you focus (rhythmic back, foot or head massage from a partner, rocking or swaying, moaning or breathing rhythmically through contractions, music, counting). Sit on a birthing/exercise ball and rock/roll during contractions. Get in the bath, get in the shower, drink water, eat a snack, make noise, pace, laugh, use something warm/hot on your lower back or belly, and avoid lying on your back (if you need to be monitored be creative about changing position or lie on your side). Follow your body’s instincts; remember the contractions are productive and bringing you closer to your baby.
Check with your care-provider but in the absence of other concerns, first time moms can wait to go to the hospital until contractions are between 3-4 minutes apart, one minute long and have been that way for a full hour. They will be intense at this point—too intense to talk through, and strong enough that you require incredible focus and pain coping to get through them.
Contractions: 3–2 minutes apart
Contractions: 60–90 seconds long
Total Duration: a few minutes–a few hours (roughly/average for first time moms)
Mood might include: Very focused or losing focus, overwhelmed, frustrated or relieved to be nearly done, wiped out, excited, calm, very sleepy between contractions.
This is typically the most intense (but shortest!) part of labor. It’s important to realize during this very challenging time that you’re so so so close.
Coping Strategies: Extra support can be really necessary here—sometimes a doula or partner will say “breathe with me” and mom will follow his or her lead through each contraction. This helps give mom focus when she is starting to loose it. Partners can remind mom she is doing it (if she says she can’t do it), she is so good at it (if she feels she’s not doing a good job) and that you love her. If a woman wants an epidural it’s usually in place now.
PUSHING PHASE Can last minutes or several hours with contractions roughly a couple minutes apart and about 90 seconds long.
Coping: Turn off the epidural if you have one in place (you’ll still have residual pain meds but by turning it off you may get some sense of the pressure and gain a bit more control over the pushing). Use gravity if possible: lean forward on hands and knees if pressure is on lower back, use a squatting bar or get into a supported squat. If lying down, try lying on your side or pulling the bed back up so you’re in more of a squat. Remember you don’t have to push in one position, you can change positions.
When a contraction begins take a deep breath in, hold your breath to bear down (like you do when you have a bowel movement) and then exhale when you need to. During each contraction you can push two times, sometimes three times. Try not to push so hard your face turns purple. Do what you can do.
Trust that you can do it and you’re working with the contractions to help push the baby out. Women can push with an epidural and feel it more or less, depending.
Any questions? Happy to answer them!
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