Labor and Delivery

Normal Labor

When it is time for your baby to be born, your body will go through a series of changes to prepare for and complete the birthing process. Like pregnancy, your labor and delivery will be different from any other women's. In fact, each time you give birth, your labor and delivery will probably be different.

Early Labor

Labor is divided into two phases: early, or latent, labor and active labor. Early labor may last as many as twenty hours, especially during your first pregnancy. There are several hormonal and physical changes that indicate you are in early labor.

  • Lightening
  • Passing of the mucus plug
  • Irregular contractions
  • Breaking of water
  • Effacement and dilation of the cervix.

Lightening

The process of your baby settling or lowering into your pelvis is called lightening. Lightening can occur a few weeks or a few hours before labor begins.

The changes that indicate early labor may occur in the days or weeks leading up to the birth of your baby.

Passing of The Mucus Plug

During your pregnancy, a mucus plug accumulates at the cervix to seal off the cervix and protect your baby from infection. When your cervix begins to open wider to prepare for the birth of your baby, the mucus is discharged into your vagina. The mucus will be clear, pink, or slightly bloody.

Irregular Contractions

During early labor, you will most likely experience irregular contractions that are mild enough that they do not interfere with your normal activities. These early, unpredictable contractions begin the process of opening (dilating) your cervix so that your baby can be born.

No one knows what causes labor to start or can predict when labor will start or how long it will last.

Breaking of Water

As your body prepares for childbirth, the amniotic sac that has surrounded your baby during pregnancy usually breaks, releasing the amniotic fluid it contains. When this happens, you may feel either a sudden gush or a trickle of fluid that leaks steadily. The fluid is usually odorless and may look clear or straw-colored.

If your "water breaks," write down the time, approximately how much fluid is released, and what the fluid looks like. Call you doctor with this information.

Not all women have their water break during labor. Many times, your doctor will rupture the amniotic membrane in the hospital.

Effacement and Dilation of The Cervix

During early labor, your cervix will gradually thin and stretch (called effacement) and open (called dilation) to prepare for the passage of your baby through the birth canal. How fast your cervix opens and thins varies from woman to woman and cannot be predicted with any certainty until active labor begins. In some women, this process may occur over a period of weeks.

Cervical effacement is described as a percentage, with 100% being completely thinned. Dilation is expressed in centimeters from 0 to 10, with 10 being completely dilated or open.

How Do I Know When I'm In Labor?

Many women experience what is known as "false" labor pains or Braxton Hicks contractions. These irregular uterine contractions are perfectly normal and generally start during your third trimester of pregnancy.

To determine if you are in true labor, ask yourself the following questions:

Question
True LaborFalse Labor
How often do the contactions occur?Contractions come at regular intervals and last about 30-70 seconds. As time goes on, they get closer together.Contractions are often irregular and do not get closer together.
Do the contractions change with movement?Contractions continue even when you move or change positions.Contractions may stop when you walk, rest, or change positions.
How strong are the contractions?Contractions generally increase in strength as time goes by.Contractions are usually weak and do not get much stronger. Or they may be strong at first and then get weaker.
Where do you feel the pain?Contractions usually start in the lower back and move to the front of the abdomen.Contractions are usually only felt in the front of the abdomen or pelvic region.

When Do I Go To The Hospital?

If you think you are in true labor, you should begin timing your contractions. Write down the time each contraction starts and stops. The time between contractions, called the interval, includes the length or duration of the contraction and the minutes in between the contractions.

Mild contractions generally begin 15 to 20 minutes apart and last 60 to 90 seconds. You should go to the hospital once you reach active labor. For most women, active labor is characterized by strong contractions that last 45 to 60 seconds and occur 3 to 4 minutes apart. Talk with your doctor about the best time for you to go to the hospital.

Call your doctor if:

  • You think your water has broken
  • You are bleeding
  • Your contractions are very uncomfortable and have been coming every five minutes for an hour.

Staying Comfortable During Early Labor

For most women, the early stages of labor -- before active labor begins - are best experienced in the comfort of their own home. While you are at home, there are several things you can do to help cope with any discomfort you feel:

  • Try to distract yourself; take a walk, read a book, watch a movie.
  • Soak in a warm tub or take a hot shower.
  • Try to sleep if it is in the evening.

Labor

Labor has three stages:

  • 1st: Strong, frequent, and regular contractions (latent phase until 4cm, active phase to 10 cm)
  • 2nd: The birth of your baby
  • 3rd: The delivery of the placenta.

Strong, Frequent Contractions

Compared with early labor, the contractions that occur once you enter active labor are more intense and more frequent (every 2 to 3 minutes) and longer lasting (50 to 70 seconds). As your contractions intensify, you may:

  • Feel restless and excited
  • Find it difficult to stand
  • Have food and fluid restrictions
  • Want to start using any breathing techniques or other calming measures you've chosen to manage pain and anxiety
  • Feel the need to shift positions
  • Want pain medication, such as epidural anesthesia
  • Be given intravenous (IV) fluids.
Contractions feel different for each woman and may feel different from one pregnancy to the next. They move in a wave-like motion from the top of the uterus to the bottom.

The Birth of Your Baby

The strong contractions you experience during active labor are your body's way of pushing your baby through the birth canal. During the birth process, your contractions may slow down to every 2 to 5 minutes, lasting 60 to 90 seconds.

Other things you may feel as your baby passes through the birth canal include:

  • You may have a strong urge to push or bear down with each contraction.
  • The baby's head is likely to create great pressure on your rectum.
  • You may need to change positions several times to find the position in which you feel most comfortable.
  • When you baby's head passes through your vagina (crowns), you may feel a burning pain. The head is the largest part of the baby and the hardest part to deliver.

The pushing stage of your labor can be as short as a few minutes or can last for several hours, especially for your first birth. The doctors and nurses will be there to make you feel as comfortable as possible and to offer support, guidance, and pain relief.

The Delivery of the Placenta

After you deliver your baby, your mind and your body may have different agendas. You will want to be getting to know your baby; however, your uterus will be busy contracting as the placenta detaches and passes through the birth canal. Your contractions will continue until after the placenta is delivered. Your doctor will make sure the entire placenta has been detached and delivered.