All About Labor and Delivery

 

The stages of Labor and Delivery

Labor

It's only natural to wonder what labor and delivery will be like, even if this isn't your first baby. Every pregnancy is different and so is every labor and delivery. Childbirth classes can be a very good way for a couple to answer many of the questions that they are sure to have. In these classes they will also learn breathing and relaxation techniques that will help ease labor along. You will also want to discuss your concerns with your physician. Don't be afraid to ask questions, even if they seem silly to you. Be assured that your doctor will have heard them before.

How will I know I'm in labor?

It can be tricky to determine when real labor has started. Many women assume that the first contractions they feel signal labor, but usually this is not the case. If the contractions are irregular and do not dilate the cervix, you are in false labor. In real labor, the contractions will be regular and get closer together over time. Check with your doctor if there is any question as to whether or not you are in labor. You should also call your doctor if your membranes rupture (your water breaks).

Is it time to go to the hospital?

Your physician will probably give you fairly specific instructions as to when to go to the hospital. If he doesn't, make sure you ask. This can be very reassuring to you when labor is approaching and you begin to feel the first contractions.

 STAGE WHAT IS HAPPENING WHAT YOU MAY EXPERIENCE WHAT YOU CAN DO
STAGE 1 (early Phase)

Uterine contractions cause the cervix to dilate (open) and to efface (thin out).

The cervix dilates to 4 to 5 cm.

You may have pinkish discharge ("show" or "bloody show").

Your membranes may rupture, causing a gush or trickle of amniotic fluid from the vagina.

Mild contractions occur at 15- to 20- minute intervals in the beginning and last about 60 seconds. Gradually they will become more regular and closer together.

Once labor starts, do not eat solid foods; broth gelatin and fruit juices are good choices.

You may be able to remain at home for a while if you are at term (ask your doctor when you should go to the hospital). If you are in premature labor, have intense, constant pain or you have bright red bleeding, call your doctor immediately.

Use relaxation and breathing techniques learned from childbirth class.
Active Phase
Cervix dilates from 4 to 8 cm and continues to efface.

Contractions become more intense and frequent.

Eventually contractions will be about 3 minutes apart and last about 45 seconds.

Continue using relaxation and breathing techniques.

If Labor is very painful, you may be able to receive an epidural block after your cervix is 4 to 5 cm dilated. (When an epidural is given to soon, it can slow and thus lengthen delivery.)
Transition Phase

Stage 1 is changing over to Stage 2.

Cervix dilates from 8 to 10 cm and continues to efface.

contractions are 2 to 3 minutes apart and last about 1 minute.

You may be very uncomfortable, feeling nauseous, chilly, sweaty and drowsy.

You may feel strong pressure, causing to urge to push; do not push until your doctor , nurse or midwife says your cervix is completely dilated.

the hospital staff may move you to the delivery room if you will be delivering there.
Continue relaxation and breathing techniques to counteract the urge to push.
STAGE 2

Cervix is completely dilated.

The baby continues to descend.

As you push with your contractions, your baby will be born. the doctor will immediately suction the baby's nose and mouth and clamp the umbilical cord.

Contractions occur at 2- to 5-minute intervals and last 60 to 90 seconds.

If you have received an epidural, you may find it difficult to push effectively. You may receive an episiotomy to prevent tearing of vaginal tissues as your baby's head emerges.

After the cervix is completely dilated, you will begin to push with your contractions.

You may be able to receive an intravenous injection of an analgesic (e.g., Demoral) or a tranquilizer, or you may get a low spinal or "saddle block" if you have not has a regional anesthetic.
STAGE 3

After your baby is born, the placenta separates from the wall of the uterus and is expelled.

The doctor will examine the placenta to make sure that it is intact and that all of it has been delivered.

Contractions may be closer together and less painful than previously.

The doctor will repair your episiotomy.

When your baby is being delivered, you will need to listen to your doctor to know when and when not to push; this will prevent the baby from being born to quickly.

As your push with your contractions, you may be able to watch the birth of your baby via an overhead mirror.

You'll meet and hold your baby, and may need to push to help expel the placenta.

You may get to hold your baby while the doctor repairs the epziotomy.