First stage: Early labor
Once your contractions are coming at relatively regular intervals and your cervix begins to progressively dilate and efface, you're officially in early labor. But unless your labor starts suddenly and you go from no contractions to fairly regular contractions right away, it can be tricky to determine exactly when true labor starts. That's because early labor contractions are sometimes hard to distinguish from the inefficient Braxton Hicks contractions that may immediately precede them and contribute to so-called false labor.
If you're not yet at 37 weeks and you're noticing contractions or other signs of labor, call your caregiver immediately so she can determine whether you're inpreterm labor.
During early labor, your contractions will gradually become longer, stronger, and closer together. While the experience of labor varies widely, it might start with contractions coming every ten minutes and lasting 30 seconds each.
Eventually they'll be coming every five minutes and lasting 40 to 60 seconds each as you reach the end of early labor. Some women have much more frequent contractions during this phase, but the contractions will still tend to be mild and last less than a minute.
Sometimes early labor contractions are quite painful, even though they may be dilating your cervix much more slowly than you'd like. If your labor is typical, however, your early contractions won't require the same attention that later ones will.
You'll probably be able to talk through them and putter around the house. You may even feel like taking a short walk. If you feel like relaxing instead, take a warm bath, watch a video, or doze off between contractions if you can.
You may notice an increase in mucusy vaginal discharge, which may be tinged with blood -- the so-called bloody show. This is perfectly normal, but if you see more than a tinge of blood, be sure to call your caregiver. Also call if your water breaks, even if you're not having contractions yet.
Otherwise, if you're at least 37 weeks along and your caregiver hasn't advised you differently, expect to sit out early labor at home. (When to call your midwife or doctor and when she's likely to have you go to the hospital or birth center are things to discuss ahead of time at your prenatal visits.)
Early labor ends when your cervix is about 4 centimeters dilated and your progress starts to accelerate.
Active labor
Once your cervix has dilated to four or more centimeters, and you are having strong, regular contractions, you are in active labor.
Your baby begins to move deeper into the pelvis; this movement is called “descent”. The distance your baby has traveled down into the pelvis is measured in stations, and each station equals one centimeter.
The baby also begins to turn or rotate, so that she can better fit through the shape of your pelvis.
What to do:
It is about time for you to head to the hospital or birth center. Your contractions will be stronger, longer and closer together. It is very important that you have all the support you can get. Now is also a good time for you to start your breathing techniques and try some relaxation exercises for you to use in between contractions. You should switch positions often during this time. You may want to try walking or taking a nice bath. Continue to drink water and remember to urinate periodically.
What to expect:
- Duration will last about 3-5 hours
- Your cervix will dilate from 4cm to 7cm
- Contractions during this phase will last about 45-60 seconds with 3-5 minutes rest in between.
- Contractions will feel stronger and longer
This is usually the time that you head to the hospital or birth center
Tips for the support person:
Give your undivided attention
- Offer verbal reassurance and encouragement
- Massage her abdomen and lower back
- Keep track of contractions (if she is being monitored, ask how the machine works)
- Go through the breathing techniques with her.
- Help make her comfortable (prop pillows, get her water, apply touch)
- Remind her to change positions frequently (take her for a walk or offer her a bath)
- Continue with distractions (music, reading a book, playing a simple card game)
- Don't feel badly if she is not responding to you.
Transition
The period during which your cervix dilates from seven centimeters to full dilation (around 10 centimeters) is called “transition". This phase ends the first stage of labor and usually lasts about 12 contractions, or about one hour. Although transition can be a very intense time for many women, it helps to remember that it usually doesn't last very long and that your contractions will not get any stronger. You may experience the following during transition:
Your contractions will be spaced much closer, may begin at a “peak”, or you may have double “peaks”.
- You will feel more irritable.
- You will not have an accurate sense of time.
- You may feel that you “can't go on”.
- You may feel nauseated, and even vomit.
- Your legs may shake.
- You may sweat and feel hot during a contraction, and then cold in between contractions.
- Your amniotic sac may rupture (if it hasn't done so already).
You may have the urge to have a bowel movement or bear down; this occurs as the baby's head presses on your rectum.
What to expect:
- Duration will last about 30 min-2 hrs
- Your cervix will dilate from 8cm to 10cm
- Contractions during this phase will last about 60-90 seconds with a 30 second-2 minute rest in between
- Contractions are long, strong, intense, and may overlap
- This is the hardest phase but thankfully the shortest
- You may experience hot flashes, chills, nausea, vomiting, or gas.
Tips for the support person:
- Offer lots of encouragement and praise
- Avoid small talk
- Continue breathing with her
- Help guide her through her contractions with encouragement
- Encourage her to relax in between contractions
- Don't feel hurt if she seems to be angry, it's just part of transition!
