Stage One: Labor
The first stage of labor starts when you have regular contractions and your cervix begins to change—and ends when it is time to push out your baby. The first stage is divided into three phases, latent phase or early labor, active phase, and transition. Note: Rupture of the amniotic sac, or breaking your water, usually occurs during the first stage of labor, but in about 10 percent of moms will occur before labor begins. If you break your water while you are still home you should call your healthcare team and let them know.
What to Expect: During early labor (latent phase) you will dilate about 3 centimeters. Your contractions may last up to a minute and may come three to 20 minutes apart. These contractions may be mild, comparable to strong menstrual cramps. You may have a backache and mild diarrhea.
Timeline: This early phase of labor is the most unpredictable. Sometimes it can even stop and start over days before “real labor” begins. You are usually better off being home during this part of labor, unless your pregnancy is unusually complicated and constant monitoring of you and the baby is needed. While some moms-to-be find it hard to relax during latent phase, other women may not even realize they have begun labor until active labor begins.
What to Expect: In active labor your cervix will open up to near complete dilation. Contractions will lengthen, lasting from 45 to 60 seconds and should come at two- to three-minute intervals. Your contractions will be stronger, and your membranes may rupture if they have not already done so. Your contractions will become more intense, and you will need to take action to manage your discomfort. In active phase, you won’t be able to hide your contractions from those around you—you will need to change your breathing, or activity, or your facial expression will change as you manage the increasingly intense sensations.
Timeline: During active phase the cervix usually dilates about a centimeter an hour, sometimes faster, sometimes slower.
What to Expect: This is the most challenging stage of labor! You will dilate to 10 centimeters (also called “complete” dilation) and your contractions will last 60 to 90 seconds. Your rest periods between contractions will shorten, lasting just 30 to 90 seconds. Your contractions will now be very intense. Often in transition if you have chosen natural childbirth you start feeling like you can’t do it. But that feeling is a sign that the end is in sight. Some women experience nausea and vomiting during the transition phase. You may feel very sleepy and doze between contractions. Your mood might even be irritable as you experience hot flashes, chills, and feel a little shaky. You may also feel a lot of pressure in the rectal area. You will soon start feeling like you want to push!
Timeline: This part of your labor lasts on average between 10 and 60 minutes.
Stage Two: Birth
What to Expect: Your contractions will shorten and you’ll have more time in between contractions to rest. You may feel a “second wind” of strength. The urge to push may be uncontrollable now. If you choose to have an epidural, however, you may not feel this urge to push. If this is the case, your healthcare provider will help you know when the time is right to push by watching your contractions on a monitor. Sometimes it is better to “labor down” and let the baby descend from contractions rather than pushing without an urge.
The contractions during this phase last approximately 50 to 90 seconds and come every two to three minutes. You may feel extreme back and rectal pressure. If you are having natural childbirth or if you use mild medication such as Stadol® or Nubain®, you will feel a pins-and-needles or burning sensation in your vaginal area from the baby’s head crowning.
Timeline: This part of your birth will last between just a few minutes and three or more hours.
Stage Three: Afterbirth
What to Expect: After the baby is born you will probably feel a great sense of relief. You may have mild contractions during the delivery of the placenta as it detaches from the uterus and is pushed out. This is also called afterbirth.
Timeline: Delivery of the afterbirth takes between five and 20 minutes.