There are three main stages of labor. The first stage, which includes early labor, active labor, and transition, is followed by the second stage, which includes pushing and delivery, and the third stage, which is the delivery of the placenta. Women going through their first delivery can expect a longer labor, usually around 15 hours. After the first delivery, a woman can expect labor averaging eight hours. Of course, since all women and deliveries are different, it can vary significantly in either direction.
First Stage:
- Early Labor begins with contractions that gain in intensity and regularity. They are not to be confused with Braxton Hicks contractions, which are “exercise” contractions the uterus performs throughout the pregnancy. These tend to last longer, are more painful, and are closer together. Their function is to efface and dilate the cervix, which means to thin out and to open, respectively.
Women may also experience a blood-tinged, mucous vaginal discharge known as the “bloody show.” This phase of the first stage of labor averages about eight hours, although it is hard to pinpoint an exact amount of time. Once you are in early labor, it might be a good idea to call your doctor.
- Active Labor begins when the cervix dilates from about three or four centimeters to about eight. By this time, contractions are very intense and usually painful. Women find that contractions during the active stage of labor are difficult or impossible to talk through. Contractions last approximately 60 seconds and occur every five minutes for at least an hour. The average woman dilates from a four to ten centimeters in approximately six hours, depending on whether pitocin or an epidural has been administered.
- Transistion is characterized by the cervix completing its dilation, from eight to ten centimeters. This is known as the most intense stage of labor, characterized by extremely strong, painful contractions every two to three minutes. The baby has descended into the pelvis, placing added pressure on the rectum.
The bag of waters has usually broken by this point, and there is some bloody discharge. Women may suffer from an intense urge to push at this point. This stage of labor can take only a couple of minutes up to several hours. If you’ve had other children, this stage of labor can go quite quickly.
Second Stage:
The second stage of labor, pushing, occurs after the cervix has fully dilated. This is considered to be a slightly easier stage to handle than transition, because pushing helps. Women may try different positions to find which one works best for pushing. As the baby travels through the birth canal, there is extreme pressure on the perineum, the area between the rectum and vagina. The doctor or midwife will stretch the vagina and perineum to avoid tearing.
Once the widest part of the baby’s head is out, an event called crowning, the doctor will maneuver the baby’s head to help the shoulders make it through. Some women are able to push the baby out with a few pushes, while others work for hours. Unfortunately for some, this is the point at which an emergency cesarean must be performed if the baby cannot make it through the birth canal.
Third Stage:
The third and final stage of labor is the delivery of the placenta. Continued, smaller contractions separate the placenta from the wall of the uterus. Just one or a few small pushes delivers the placenta, usually only taking five to 30 minutes.
After the placenta is examined to check if it is complete, the doctor and nurses monitor the uterus to make sure it is contracting properly and firming up. If there was a tear to the perineum or an episiotomy, the doctor or midwife will sew it up. Many women feel euphoric and relieved at this stage, because the pain of childbirth is behind them and they have their new baby in their arms.