The Stages of Labor
Claudia was ecstatic for her prenatal appointment with her doulas. This appointment had been scheduled for weeks, and was finally here. While they had all been in communication consistently, there was something about being in the same space as her doulas that pumped her up a bit. Claudia was now 34 weeks pregnant and was preparing for her final 6 weeks before motherhood. She was looking forward to discussing what to expect in the stages of labor that her body would endure.
The doulas explained, demonstrated, and listened. Claudia asked, deliberated, decided, and felt at ease. As the conversation turned to when to call her provider, her doulas, and the stages of labor, Claudia perked up. “Wait, so I don’t have to rush to the hospital at the moment my contractions are trackable? Or the moment my water breaks? I can be comfortable and labor at home?” She questioned. The doulas smiled confidently.
The Three Stages of Labor
Did you know that there are three…THREE stages of labor that the body goes through for a birth? The three stages of labor are: first stage, second stage, and third stage. Pretty creative, huh? Well, within the first stage alone, there are actually THREE stages. Followed by a second and third stage cycle. So you see, birth IS pretty creative. Let’s discuss what to expect in each of these labor stages.
What to Expect in Each Stage of Labor
Within each stage, there are some distinct characteristics that can help to decipher the differences. Uterine contractions, cervical change, engagement of the baby in the pelvis, and the birthing person’s temperament can come into play in identifying the stage that one may be experiencing. All of these facets are occurring at once during the stages of labor; and all work together to bring baby down and into the birthing canal for delivery.
Stages of Labor-The First Stage
The first stage of labor contains three stages: early, active, and transitional. Taking notice of the physical and emotional changes that occur as labor is progressing. Your doulas are versed in these stages, and able to support you through affirmations, comfort measures, and confidence.
In early labor, the body is quietly working behind the scenes. This stage of labor can last days, with the average stage lasting 12-24 hours. The cervix has begun to dilate; opening from 0-4 centimeters. Dilation is not physically felt. In fact, only a vaginal exam can determine dilation. Uterine contractions are occurring sporadically, and can come in surges. These contractions are lasting 30 seconds to 60 seconds, and are mild-to-moderate, feeling like menstrual cramps. These contractions are not measurable in the sense of pattern.
During this stage of early labor, ways to provide comfort comes in the form of emotional support. Going about one’s day is a great way to keep one’s mind preoccupied. Have plans? Great! Keep them, and keep notice of any changes you feel within the body. Have any last minute baby “to-dos”, wonderful! Complete that nursery, send out the baby shower ‘thank yous’, give that birth facility bag one more look over. Keep keen on the pattern of contractions, as they become rhythmic, you are entering the next stage of labor.
Active labor is the second stage of labor in the first stage of labor. In this stage of labor, the body has begun to find its groove in the laboring process. The cervix is dilated between 4-7 centimeters. Contractions have formed a pattern, coming 3-7 minutes apart and lasting 60 seconds. The contraction surges are longer, stronger, and closer together. These contractions may make you take notice more than in early labor. In the active labor stage, this is where your support team rallies up. Give your provider a ring, and have your doula by your side. One may choose to remain in their most safe and comfortable space for as long as labor is progressing safely for them and the baby.
Oxytocin is flowing through the body, and it’s a welcomed hormone. When contractions are consistently in a pattern of 5-1-1, head to the birthing facility (if not already). This is contractions coming 5-minutes apart, lasting 1-minute, coming in 1-hour.
The temperament of the birthing person will have noticeably shifted. The conversational demeanor is now labored and sparse. The laboring may become vocal and focused. Physical comfort measures, rest, emotional validation, words of affirmation, hot and/or cold compresses and more provide comfort during this stage of labor.
The final stage of labor in the first stage of labor is transitional labor. Transitional labor welcomes a 7-10 centimeter dilated cervix. In this stage of labor, the mucus plug may make its appearance, noting that a mucus plug can present at any time in the third trimester and regenerate itself. Concentrations are surging 2-3 minutes apart and lasting on average 90 seconds. Which can bring intensity during labor, with feelings of not catching a breath or a break in-between the contractions. These contractions are bringing the baby down and engaging the baby into the birth canal.
This stage of labor can last 30 minutes to 4 or more hours. The birthing person may show signs of exhaustion, defeat, determination, anxiety about pushing, and more. In this stage, a member of the birth team may step in to help lead through the doubts and fears. Instilling faith and confidence that the baby will soon be here.
Stage of Labor-The Second Stage
The pushing phase defines the second stage of labor. In this stage, the cervix is completely dilated to 10 centimeters, has completely ripened, and is 100% effaced. In other words, the cervix has opened to 10 centimeters, it’s soft (like an earlobe), and is completely thinned out (like the webbing between the thumb and index finger).
This stage of labor can last 30 minutes to 3-hours, and in instances can be determined by the baby’s management of the birth process and/or the provider’s call. In the pushing stage focus, affirmations, and encouragements are present. One can choose to have directed pushing, passive descent, or a combination of both.
Directed, or coached pushing, is when one is given the cues when to push and is counted through the pushing in a series of 3 pushes holding for 10 seconds each.This form of pushing is beneficial for medicated births. Passive descent is allowing the baby and the body to maneuver together. Allowing the birthing person to “push” when they feel the urge to do so. This form of pushing is beneficial for no-to-low intervention births. A combination of both is allowing the body to come into the surge of pushing, and gaining the assistance of your birth team to coach through the series. This form of pushing is helpful for birthing individuals that enjoy the support of knowing “when and how to push”, and is permitted the space to birth in their prefered calm manner.
Stages of Labor-The Third Stage
The third stage of labor, we welcome the delivery of the placenta. With the delivery of the placenta, this stage can last typically 6-30 minutes. There are both medical and psychological ways for a placenta to be delivered. Medically, Pitocin may be administered to help contractions to expel the placenta more rapidly. Additionally, a nurse or the provider may apply pressure to the uterus to assist with its descendants. In some instances, a provider may “tug” on the umbilical cord to have the placenta delivered more quickly. This is not an ideal occurrence, and can be a contributor to placental retention.
Physiologically, allowing the placenta to deliver naturally is one way for no intervention birth experience. This allows the placenta to self-descend. In many cases of delayed cord clamping in the golden hour, this is also a participated part of the process.
Patting her belly as she laid on the living room chaise, Claudia was feeling grateful for the prenatal appointment interaction with her doula team. Her heart was full of gratitude for the companionship and compassion from her doulas. The knowledge she gained during their meeting allowed Claudia the space to share her fears and frustrations. She felt confident and empowered going into the next six weeks, and navigating what her body will begin to do. Understanding the stages of labor was a sense of control that Claudia needed to calm her laboring fears.