- Seek immediate medical care if there is heavy bleeding, severe pain, or signs that something does not feel right during labor.
- Contact a doctor or midwife if the water breaks and contractions do not start or progress normally.
- Get urgent help if the placenta does not come out as expected after birth or if there are signs of heavy postpartum bleeding.
Normal labor happens in a series of stages. These stages include cervical dilation, the pushing stage when the baby is born, and the delivery of the placenta.
In most cases, labor starts on its own at term. Most women give birth between 38 and 41 weeks of pregnancy.
Common signs that labor may be starting include loss of the mucus plug, rupture of the amniotic sac, and contractions that become stronger over time. At first, contractions may be irregular. As labor progresses, they usually become stronger, more regular, and closer together.
Stage 1 of labor: Dilation
The first stage of labor begins with the start of cervical dilation and ends when the cervix is fully dilated to 10 cm.
This stage is divided into two phases, according to the degree of cervical dilation:
1. Latent phase
The latent phase is a preparatory phase of labor in which the cervix dilates slowly until it reaches about 6 cm.
This phase is marked by a gradual increase in uterine activity, irregular uterine contractions, and increased cervical secretions, including loss of the mucus plug.
The latent phase of labor may last an average of up to 20 hours for women who have never given birth and up to 14 hours for women who have given birth before. It may also last longer in women who had a cesarean delivery in a previous pregnancy.
What you can do during this phase:It is important for the birthing person to feel physically and emotionally comfortable. Helpful measures may include massage, emotional support, dancing, listening to music, resting, sleeping, walking, or getting into a pool to relax.
Also recommended: 12 Signs of Labor: What to Expect & When to Go to the Hospital tuasaude.com/en/signs-of-labour2. Active phase
The active phase is the second part of the 1st stage of labor. According to the American College of Obstetricians and Gynecologists (ACOG), the active phase of labor begins at 6 cm of cervical dilation and continues until full dilation is reached at 10 cm. During this phase, dilation happens more quickly.
In general, the cervix dilates about 1.2 to 1.5 centimeters per hour, and this phase may last 4 to 8 hours. Women who have given birth before usually have a faster active phase.
During this period, it is common to feel pain from contractions. As the cervix continues to dilate, contractions usually become more regular and closer together.
In addition, the amniotic sac (bag of waters) may rupture during this phase if it has not already happened.
What you can do during this phase: You can try easing contraction pain by changing positions to find what feels most comfortable, taking a warm shower, or sitting on a birthing ball. You can also breathe in slowly and deeply and exhale slowly with an open mouth during contractions, which may help relax the perineum.
In addition, walking slowly or climbing stairs may help the baby move into a better position for birth.
Stage 2 of labor: Pushing and birth
The pushing stage begins when the cervix is fully dilated at 10 cm and ends with the birth of the baby.
The length of this stage varies and depends on factors such as whether a person has given birth before and whether epidural anesthesia is used.
During this stage, contractions continue, and you may feel a strong urge to push.
What you can do during this phase: It is recommended to push according to your body’s signals and choose the position that feels most comfortable, such as squatting, sitting, or kneeling.
Stage 3 of labor: Placental delivery
The placental delivery stage is the third stage of labor and occurs after the baby is born. It is defined by the delivery of the placenta, which may come out on its own within about 30 minutes or be removed by the doctor if necessary.
During this phase, the woman may continue to feel contractions, although they are usually less intense, until the placenta has been completely expelled.
The doctor or midwife may give an injection of oxytocin, which helps the placenta come out and helps prevent heavy bleeding. According to the American College of Nurse-Midwives (ACNM), oxytocin is the preferred first-line medication for active management of the third stage of labor to help prevent postpartum hemorrhage.
What you can do during this phase: It is important to relax and hold your baby in your arms, which helps stimulate breast milk production.
During this stage, after the baby is born, the obstetric and nursing team will also perform a general assessment and use controlled traction on the umbilical cord to help the placenta separate from the wall of the uterus.