By Jenilee Matz, MPH
“No two labors are alike,” says Robin Elise Weiss, PhD, MPH, a certified childbirth educator and doula in Louisville, KY. Each woman progresses at her own pace. Yet while your labor will definitely be unique, childbirth has several common stages you’ll likely go through. Knowing what may happen can help relieve some of the anxiety as you get closer to your due date.
Also known as: Early labor
How long it lasts: 8 to 12 hours on average (up to 18 hours is possible, says Weiss), until your cervix (the opening to the uterus) opens up, or dilates, to 4 centimeters
How it feels: Your cervix is just beginning to dilate and soften to allow delivery of your baby. The contractions in this phase may not feel like what you’d expect from contractions at all. At first, they won’t be regular or painful. Instead, early labor may feel like menstrual or stomach cramps, pelvic pressure or low back pain. In fact, “many women don’t realize they’re in early labor until after the fact,” Weiss explains. Contractions may come every 5 to 30 minutes and last 30 to 60 seconds. You may also experience some nausea or diarrhea.
What you should do: Call your provider to let them know that you think labor has started. “This is a must if your water has broken, even if you’re not having contractions,” says Linda Burke-Galloway, MD, a board-certified OB/GYN in Orlando, FL, and author of The Smart Mother’s Guide to a Better Pregnancy. Once your water has broken, “your baby is no longer protected and is more susceptible to infections,” she explains. Most of the time, your provider will recommend going to the hospital if your water has broken.
If your water hasn’t broken, try to go about your day. “If you’re normally asleep at 2 a.m., sleep even if you’re awakened by contractions,” Weiss suggests. You’ll need as much rest as you can before delivery. You can also eat lightly now so you’ll have plenty of energy.
Also known as: Active labor, including what midwives call “transition”
How long it lasts: From 3.5 to 7 hours; on average, your cervix will dilate 1 centimeter or more per hour until you are fully dilated (10 centimeters)
How it feels: Your contractions will be more regular, longer, stronger and closer together. They are working to further dilate your cervix, and are typically painful. “Women will know they’re in active labor when they have contractions that require their attention,” Weiss notes. Contractions last 45 to 60 seconds and come every 3 to 5 minutes.
Eventually, contractions will lengthen, with briefer breaks in between. You may feel nauseated and vomit, have chills, and experience pain or pressure in your back and rectum (bottom) that shoots down your legs.
What you should do: Head to the hospital. “If you’ve been having consistent contractions or back pain every 5 minutes for an hour, you need to be checked,” recommends Burke-Galloway. You should be timing each contraction from start to finish to see how long they last, and from the start of one to the start of the next to see how frequently they occur.
This is the time most women will get an epidural if it’s part of their birth plan. If you’re planning an unmedicated delivery, you may want to get in the tub or shower to help with the pain — you’re getting closer!
The final, and most intense, part of this phase — what midwives call transition — is when you’ll rely on your support team the most. They should be trying to make you as comfortable as possible.
“Don’t push until you feel the urge or until your healthcare provider tells you to,” Burke-Galloway advises. Pushing before you’re fully dilated could cause your cervix to swell and may prolong labor.
Also known as: Pushing and delivery of the baby
How long it lasts: A few minutes to a couple of hours
How it feels: Your contractions may spread out. You may even get a brief break where they stop completely. Weiss calls this the “rest and be thankful” phase.
You’ll feel pressure in your rectum when it’s time to push. As your baby’s head starts to come out, which is called “crowning”, you’ll feel stinging or burning around the opening of your vagina.
What you should do: Listen to the suggestions of the providers coaching you as they can help you find positions to push effectively. You might think you’ll be embarrassed about the sounds you might make or the fluids that may release at this point, but in the actual moment, no one minds. The hospital staff has seen it all before, and you’re too busy focusing on the task at hand.
Eventually, you’ll push baby’s head free. Once the shoulders are out with the guidance of your provider, the rest of the baby's body should follow easily.
Also known as: Delivery of the placenta
How long it lasts: 5 to 30 minutes
How it feels: You’ll still have contractions when you’re delivering the placenta, but you may be so exhilarated that you don’t feel them.
What you should do: Thankfully, not much (you’ll likely have your baby in your arms and be fairly distracted at this point). Delivering the placenta isn’t hard work, and should begin to happen automatically after baby is born.
Your provider may ask you to push, or they may just massage your abdomen, which will encourage the placenta to release. You may be given synthetic oxytocin (Pitocin) after you deliver, to encourage your uterus to contract. This helps to reduce bleeding.
Now, at the true end of your labor and delivery, you can fully indulge in the emotional exhilaration of finally welcoming your new little one. Let the tears of joy flow!
Published on December 30, 2015.
Jenilee Matz is a freelance medical writer living in the suburbs of Charlotte, NC. She earned her Master of Public Health degree from the University of South Carolina, and previously worked for the Centers of Disease Control and Prevention.
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