Labor Stages & Vaginal Birth

Introduction

Most babies are born between the 38th and 42nd week of pregnancy.  Remember that a due date is just an estimate of your baby’s delivery date.  Your doctor will give you specific instructions on what to do if you begin labor.  However, regular contractions, leaking or a sudden gushing of amniotic fluid, or bloody discharge or bleeding are signs that labor is beginning and that you should go to the hospital.

Signs and Symptoms of Labor

Signs and symptoms of labor include cramps, similar to menstrual cramps, or labor contractions.  You may experience nausea, diarrhea, or indigestion.  You may have lower back pain or a dull lower backache.  Your pelvic floor, thighs, and groin area may ache or feel pressure or tightening. T here may be a change in your vaginal discharge.  Your vaginal discharge may be thin, watery, pinkish, brownish, or contain blood.  You may or may not pass a mucus plug.  A trickle or rush of fluid from your vagina can indicate that “your water has broken,” meaning that the membrane surrounding your baby has ruptured and the amniotic fluid is leaking out.

You should contact your doctor if you suspect you are experiencing labor.  Call your doctor or go to the hospital immediately if you have bleeding with cramps and pain, watery vaginal discharge, or regular contractions that are 10 minutes apart or less.  You will be admitted to the hospital and examined to see how far along in labor you are.

Stages of Labor

The first stage of labor is the longest.  It may last up to 15 or 20 hours for first time mothers.  Women who have given birth before may proceed through the first stage much quicker.  During this time, regular contractions dilate and shorten your cervix.  You may feel brief pain during each contraction.  You may be encouraged to stand up and walk between resting.  The cervix will open to 10 centimeters (3.9 inches) when it is fully dilated, and your baby is ready to move through the birth canal to be born.

You may or may not choose to receive pain medication during your labor.  It is a personal choice.  You will discuss pain relief with your doctor during your prenatal visits.  You may also change your mind during labor and receive pain relief if you did not originally plan to have it.  There are many different types of pain relief to choose from.  Common methods of pain relief include epidural anesthesia, cervical anesthesia, nitrous oxide, pelvic anesthesia, and pain medication.  It may help to have your partner, a loved one, or a labor coach in the delivery room to help you feel calm and safe.

The second part of labor is the expulsion phase.  It begins when the baby presses down on the pelvic floor and lasts until your baby is born.  The expulsion phase usually takes less than a few hours, although it may be longer for new mothers.

You may feel pressure on your rectum and the urge to bear down or push.  Your doctor will give you specific instructions on when to push and when to relax.  Your doctor may make a small incision, an episiotomy, between your vaginal opening and your anus to reduce tearing or accelerate birth.

You will hear your baby’s first cries when the umbilical cord is cut and clamped.  Phlegm and mucus will be removed from your baby’s airways.  Your baby will be carefully examined and may be placed on your chest. 

The final stage of labor, the afterbirth stage, may take place minutes to an hour after your baby is born.  During this stage the placenta is discharged from your uterus.  Your vaginal opening area will be checked for tears and may require some stitches.  You will be cleaned and brought to the recovery room.  Your baby will be brought to the nursery and undergo some additional protective measures.  You will be reunited in your hospital room as soon as possible.  You and your baby will be sent home with specific instructions, typically after spending a day or two in the hospital.