Early Labor - How to know when to go to the hospitalCeridwen Morris
Labor is such a dynamic, changing process that it’s been divided into three stages. You don’t have to remember every number and label, but it’s important to understand that early labor is very different from active labor, which is different from pushing.
First-Stage Labor: Dilating and Effacing
The first stage of labor is when a women’s cervix dilates (opens) to 10 centimeters and effaces, or softens. The cervix is the opening to the uterus and is hard and sealed during pregnancy. As labor begins, it stretches, thins out and opens. When it’s open, you’ll move into the second stage where you will push the baby out.
The first stage is usually much longer than the second stage of labor – especially for first-time mothers. It can take anywhere from hours to days. Though that can sound very intimidating, for much of that time, you are in “early labor.”
This part of labor – though most often the longest – is not the hardcore labor you may have heard about. In fact, women in early labor can be walking, watching movies, going out to dinner, cooking, sleeping, etc. It’s actually good to ignore labor for as long as possible and save your energy for the harder parts to come. During early labor, the contractions are about 5-30 minutes apart and last 45-60 seconds. They can be mildly to increasingly difficult to handle. By the end of early labor, the contractions get quite close together (more around the 5-minute mark than the 30-minute mark), and the cervix opens to a full 3 centimeters.
During active labor, the cervix opens up an additional 7 centimeters. Contractions become closer together, moving from about 3-5 minutes apart to as close as 90 seconds apart. They can be 45-90 seconds long. The last part of active labor is called “transition,” and this is where the body is transitioning from the dilating phase to the pushing phase. It’s the shortest, most intense part of labor and requires incredible focus. Some women feel a strong urge to bear down and are soon able to do this as pushing isn’t far off. Active labor is shorter than early labor, but it can be several hours of very hard work.
During active labor, a woman goes into what’s known as her “internal self.” In other words, she is not up for socializing, conversation, jokes or logistical hassles. If a woman is not on pain medications, she will require focus and support in the room. This is the part of labor during which pain-coping strategies are necessary: getting into a tub of water, having a lower back massage, moving into positions, pacing or rocking. Women sometimes vocalize or focus their attention on something else to help cope.
When to Go in
Most women are better off laboring at home during early labor and then going to the birthing facility once active labor is underway. This could be around the point where contractions are 3-5 minutes apart and have been consistent for about an hour, but talk to your midwife or doctor.