Stages of Labor

As you draw closer to the end of your pregnancy there are likely two things on your mind, first might be the question of “when will this all be over?” (because lets face it pregnancy is not the easiest task in the world and most of us stopped beliving that storkes delivered babies a while ago). And second, “what the heck is labor going to be like?”.

There may be a bunch of questions floating around in your head about labor, and it’s possible you’ve heard some total horror stories and may be freaking out (I’ve been there and totally get it).

No matter how you are feeling or what kind of birth you are planning or hoping for, understanding the physiological stages of labor is sound birth preparation. Setting aside time during pregnancy to become familiar with the progression and common indicators in labor can reassure you and build your confidence while in the middle of your own labor.

I know it helped me that my doulas shared this awesome information beforehand so I understood what would happen. It also helped that they reinforced what was going on verbally for me while I was in labor, talk about an empowering and uplifting experience!

Now before we go any further, a disclaimer here. One, I’m not a Doctor, or any other type of Medical professional. Two, this post is NOT adivce in any way shape or form, but me sharing my experience in a way that I think can help others take fear out of motherhood.

Also this post discusses the process of labor and childbirth from the perspective of a vaginal delivery, but is based on the information I have from having an uncomplicated pregnancy and uncomplicated delivery. Every situation is different and unique and I highly recomend that you listen to the medical proffesionals that are taking care of you. By all means ask questions and get clarification but if they are giving you advice there is a reason for it!

What are the stages of labor?

Labor (also known as childbirth) is the process of a baby leaving the uterus (or womb). Most of the time labor is focused on three physiological stages & recovery:

• Labor
  • Pre-Labor
  • Early Labor
  • Active Labor
  • Transition
• Pushing & Delivery
• Delivering the Placenta
• Recovery

Before we dive in, it is important to note that each delivery is uniqe. You may or may not notice all the signs or signals that labor is happening (I know I didn’t). And in some of us specific stages may pass more quickly or slowly then others. That’s OK! Labor isn’t a race to the finish, it’s a process, one that our bodies instictively know how to handle (at least that’s my belife). And while it may not go exactly the way you hope there is a chance you will experience these stages of labor in some way shape or form.

If you are having a c-section and go into labor first you will experience these stages in some way. As I haven’t experienced that myself I’m going to be writing from a perspective of someone who has had a non-medicated vaginal delivery. I don’t want you feeling left out, you are giving birth! I just don’t have that perspective on it you are going to. I would, however, LOVE to hear your story about how everything went and what you experienced. So feel free to share your birth story with me!

Stage 1: Pre-Labor, Early Labor, Active Labor and Transition

The American Pregnancy Association counts this as “The time from onset of true labor until the cervix is completely dilated

1A) Pre-Labor

Did you know this is actually considered part of labor? And I’m not just talking about the whole being pregnant part. There is a recognized time frame before all the contractions and cervix dialating where you are seen as “pre-labor”. This is sometimes also refered to as “about to labor”, or “tiered of being pregnant.

What you might be feeling:

You know how some women make comments about being “tottaly done with pregnancy?” yeah, in the later stages we often are exhausted and ready to have our bodies back. But that urge to just be done with pregnancy is normal and a part of the process.

You may have a burst of energy, if you have been exhausted and suddenly have a huge surge in energy it’s a likely sign you are close to labor. Often this energy will be accompanied by an urge to nest (prepping baby’s room, folding and refolding their clothes, are just some of the examples I’ve heard about), and it likely will have some restlessness.

If you’ve ready my painless birth story, you’ll note that I reference being restless the night before. Even waking up a couple times during the night before we had our son. It’s common to hear women talking about the restlessness, the nesting and being done with pregnancy at various stages of pregnancy, but it will be strongest at this point and usually is accompanied by a good burst of energy.

Possible Physical Signals

These don’t always happen to all women, but you could loose your mucous plug, increase the experience of braxton hicks (the practice contractions for labor), see some dialation, and apparently you could loose a bit of weight.

Honestly I didn’t loose my mucous plug until much later in labor, but I do know I had some early light contractions that were inconsistent in timing, intensity etc. For me it mostly felt like kiddo was just moving around and making himself more comfortable. Or like he wanted to stretch and was being confined too much.

Things to do

Rest where you can, no I’m not talking about sleeping cause you won’t sleep later. I’m talking about resting your body, you have a marathon coming up and you will need the energy your body can squirl away now to handle it. Rested muscles tend to react better when they are called on then exhausted ones. If you can get some sleep though, your body will thank you.

So keep your nesting to the small stuff, and that burst of energy use it to do things that will help you recover or prep for the labor. Like packing or organizing your hospital bag, or cooking extra food and freezing it for your postpartum recovery.

Important

If you are feeling contractions and are not sure if you are in labor or not try doing something like having a drink of water and moving around a bit. Braxton Hicks will stop/lighten if you do something, labor contractions will continually get stronger.

Oh and listen to the people around you with this stage, if they tell you that you are having contractions you probably are.

1B) Early Labor

Dilation: 0 – 4 cms
Contractions: 5 – 25 min appart lasting 30 – 45 seconds each

What you might be feeling

Excitement, Fear, Nesting continues and you may want to be a hostess….

Ok, you are probably expecting the Excitement (I mean new baby coming soon and all), and Fear of the “coming” labor or delivery. You may already be expecting to feel like nesting, but did you know some women also get the urge to “host”? Yes I’m talking about having people over and throwing some kind of event, even if only a small one.

In my case it turned into the determination to NOT MISS my nephews birthday party…. which, (spoiler alert) we ended up doing anyway… baby is going to come when baby is going to come. But you may go into a “hostess planning mode” for say a “Welcome Home Baby Shower” like one of my friends did. Within like an hour there were lists of all the games to play and food to be organized and… let’s just say it was a fun party later we were all just a tad concerned because none of us knew this was actually a sign of labor at the time.

Possible Physical Signs

You could see any of the signs from pre-labor (loss of mucous plug, practice labor, some dilation etc), plus there is an increased chance of more vaginal discharge. AND your practice labor could get stronger and move into a “light contraction or tightening” phase. While I didn’t notice mine a couple friends have since told me that these ones feel kinda like doing sit ups. To them at least it just felt like their lower abdomen was engaging.

You could also experience shivering or shaking. I personally was facinated by this, my husband and I have trained in some martial arts work (him a lot more then me), and the focus of some of that work was the “fight or flight” response. When the shivering and shaking started for me it felt a lot like an adrenalin rush.

I’ve since confirmed that essentially that is what this symptom means, it’s your body releasing a really cool hormone cocktail that helps relax the muscles that need relaxing AND conserve energy for the work you have a head of you. Our bodies are truely AWESOME!

You could also have your waters break here.

What you can do

Ok, if you are facing the fear of childbirth I suggest you go pop on over to this page where I have a bunch of positive birth stories. Or grab your copy of Ina May’s Guide to Childbirth and read the first half of the book all over again! Or heck you can even go read My Painless Birth Story.

Outside of that the biggest recommendation I got here (mostly from my doula) was to keep drinking liquids. The cheat sheet they gave me recommends enough to use the washroom every half hour or so, but I couldn’t handle that. Remember the shivering and shaking possible symptom? Yeah, when that hormone cocktail is released one of the things it does is pull the blood away from your digestive system, that means you could lose the desire to eat or drink.

I compromised by drinking blue poweraide as much as I could handle, but I know it was not a lot and both my husband and doula were consistently trying to get me to have more.

It is also recomended here that if you can eat light meals do so. Just pick foods that if they come back up later (it happens) they won’t be sour.

If possible you could also alternate rest with light activity, I did a lot of pacing and talking during this stage until my doula made me rest.

If you are working with a doula or doula team you should definately let them know what is happening at this point. I’m so lucky that my doula was with me for this stage, and while the whole “ass in the air” part was not fun, this was the point that we needed to get kiddo pointing in the right direction and without my doula’s help I likely would have been in labor longer then I was!

Important

Sleep and/or rest is the most important thing at this point. If you are awake you can change position and use the washroom every half hour or so. If you are up for it every couple of hours you can do something a bit more like stairs or go for a walk.

In all stages of labor you should listen to your body about what it wants, if it wants to move then move, if it wants to sleep then sleep. This stage can be very long so distract yourself with things that won’t over tire you.

1C) Active Labor

Dilation: 4 – 7 cms
Contractions: 1 – 5 minutes apart, lasting 45 – 60 seconds each

What you might be feeling

The biggest thing I noticed in this stage was more focus and concentration, granted it wasn’t on the birth but on my nephew’s party for some reason. But yes I was almost hyper focused at the time.

There could also be a strong urge or need for Routine, repition, or rythm.

You will likely want/need support of some kind as the contractions will be longer and stronger as well as closer together. I found this was a great time to have my doula pushing on my low back during a contraction. With her experience she got a great rhythm down that meant I really didn’t feel any discomfort from the actual contractions.

Personally this is the stage where I started turning inward more, I almost entierly stopped talking and I started humming (yes humming). I’d say I “Ohmed” my way through birth because of this but it was more of a chest resonation that happened to also make sound out of my mouth.

Possible Physical Signs

Here is where the neausea is possibly going to start up… not all women get it but you could notice some or you may not be able to keep anything down and the stuff you ate in the previous phase may come back to haunt you.

A higher sensitivity to touch, I’ve always been sensitive to touch so this was inevitable for me. And it is one of the many reasons I recommend having a doula with you! Someone you know who is looking out for YOUR comfort, will already know how to read your body and what it wants AND know how you handle touch.

It can feel like you are climbing a mountain here, mostly due to how the contractions are shifting into a new gear and there is a whole new round of hormones being dumped into your system.

What you can do

Change it up, focus on your breathing and change the pattern of it, if nausea doesn’t prevent it continue eating and drinking. Go to the washroom frequently, take a bath or shower, change positions, use pillows for support, and go on your hands and knees to help with back labor.

Make the deep throaty sounds… yup, my “ohming”/humming is a good thing to do in this stage. Reason being is that it triggers a relaxation response in your body. When you are relaxed you are less likely to feel pain from the contractions them selves (note I said less likely not guaranteed).

The humming also helps keep you in the present, one of the biggest problems we have as humans is anticipating the future. Anticipating the future while in the middle of childbirth can bring back “all the fears”. So if you can, keep that mind focused on the moment. If you have to think about the future focus on how awesome it will be to hold your baby soon.

Important

The biggest things I heard from my doula at this point was that I needed to stay relaxed, in the present and to let her help me stay comfortable. We knew kiddo was now in the correct position so all we had to do was wait and let my body handle the heavy lifting.

If you can continue alternating between rest and activity, let your doula or partner massage you (so long as it feels good). Keep your breathing slow and relaxed, and use a low deep sounding voice when being vocal.

1D) Transition

Dilation: 7 – 10 cms
100% effacement
Usually lasts for 5 – 20 contractions

What you might be feeling

I’m going to be upfront, this is the stage that freaked me out the most before I went through it. Now I might make a few jokes about it occasionally but the intensity is what caught me off guard.

Emotionally speaking most women experience fear, panic, doubt, loss of control, overwhelmed and a whole host of other less-than-fun stuff hitting them all in one go.

I have a theory about this, it’s a personal opinion not something I’ve done a tone of research on so take it with that in mind. At this point your body is ready to deliver the baby, and it does this I-gotta-get-the-kid-out hormone dump with a truck load of adrenalin. The point of the adrenalin is to kick your body into a specific part of the fight or flight mode where your body can do these absolutely amazing things you would never think it could do normally. Like how your cervix and vagina can expand around baby as it comes out. And how all the ligaments and joints in your pelvis shift and adapt to make sure there is enough room for baby to move. That is a LOT for a body to take, and this adrenalin dump gives your body the resources it needs to do just that.

If you are NOT used to facing this hormone regularly all the above emotions are NORMAL responses to huge amounts of this hormone.

I’m a bit more familiar with how it feels to have a lot of hormone dumped into my system then most. And I’ll tell you this, I tried to make a joke about not being able to handle it. Then WHAM adrenalin rush and not only was I able to handle it but it was the coolest moment ever (like time froze and I could see what was coming and I was actually happy in the middle of it all YEAH for adrenalin).

Possible Physical Signs

Ok, in support of my theory above, suprise suprise most of these are also signs and symptoms of an adrenalin rush.

You could experience, shaking, nausea, hot or cold temperature changes, hear more of the sounds around you, the pressue in your abdomen will increase, there could be more blood, and you could get leg cramps.

At this point if your water hasn’t broken yet you will most likely notice a forceful spray pushing out. (Ask me how I know 😉 )

What you can do

Use your positive affirmations or just repeate something that feels good to you. I kept humming, keep your breathing light and let it flow with the contractions.

If you have someone with you you can use eye contact to help focus and stay in the present. I’m not huge on eye contact myself, but at this point I had hubbys hand in the water with me, I started twisting his wrist to see if he would ask me to stop or not.

Important

The big thing here is that YOU ARE ALMOST DONE! Often this stage is really short, and the exciting greet the baby is almost at hand.

This is also the stage where a lot of women feel like they can’t continue. It’s normal, and you can and will.

The contractions at this stage will feel pretty strong, that means they are working!

Right after this you will likely get a short pause to rest, both you and baby deserve it after all your hard work.

Stage 2: Pushing & Delivery

Usually when I used to think about childbirth this was the part that I would focus on. After all the movies and TV shows would normaly start with a woman screaming in pain and I figured this was that point… at least until I had a painless natural birth.

2A) Pushing

Dialation: 10 cms
Contractions: 2 – 5 minutes apart lasting for 60 – 90 seconds

What you might be feeling

In this stage you are most likely to feel powerful, in control, excitement, fear, and a desire for guidance.

It can be a confusing mix of positive and scary emotions. Many women feel the need to be coached on how to push, and scared about pushing at the same time.

At the same time you may be looking back at everything you’ve done so far and managed to handle and you could very well be feeling on top of the world with amazement over how much your body can and has handled.

I fell squarely in the “powerful, in control, excited” emotions when my Midwife told me I could push if I wanted to. My brain registered the words and I was so happy that baby was about to be here.

Possible Physical Signs

Pressure, you will have a lot of pressure and your body may be pushing with out you telling it to. There could be some grunting involved and you could feel rather hot all of a sudden (think I’m in the middle of a very intense workout type hot).

The pressure it’s self is likely the thing that you will feel the most, there will be pressure on the rectal area, perineum and lower as baby moves down. Some women say they could feel baby move down through the canal, I personally didn’t but I only had one push so it was over so quickly I didn’t get much sensation of pushing.

This is also the stage where women feel baby’s head “crowning” sometimes described as a stretching or burning sensation. I did feel stretched but for me it was like having a good poop type stretch.

What you can do

Relax, specifically your perenium, keep that low throaty sound going if it helps.

Change position if your body feels like it wants to.

Push gently, let your body do the work. Your body knows what it needs to do and how to make that happen so if you can let your body take care of business.

Important

Squatting can encourage rotation of the baby’s head and helps your pelvis to open. However if you are not usually a squatter this can be one of those positions that can be harder to be in. Listen to your body and what it wants to do.

A cool cloth on your face and neck can help both with the heat and with pulling your attention away from what your body is doing.

2B) Delivery

What you might be feeling

You could be feeling a whole host of things, from fear and a desire to stop to elation over what is happening. THERE IS NO WRONG WAY TO FEEL AT THIS POINT. Lean on your support team to get you through it.

Possible Physical Signs

In this stage you are more likely to make higher pitched sounds, the stretching sensations will be stronger and for some will feel like burning. You are also most likely to tense up at this point more then any other.

What you can do

Relax as much as you can, I know, I know easier said then done. But that is especially important for your perineum to reduce tearing.

I was also advised that when baby’s head comes it is good to pant your way through that.

Important

If you want you can reach down and touch baby’s head at this point, or take a look with a mirror. I personally didn’t, nor had I wanted to before or after the birth, but at this point, you would be able to see kiddo’s head coming out.

You’ll know when this stage is done because baby will no longer be inside you. CONGRATULATIONS you’ve done awesome!

Stage 3: Delivering the Placenta

To be honest, I didn’t pay attention to this stage, not everyone talks about it but getting the placenta out is just as important as getting the baby out.

Usually there is a delay between baby’s arrival and the placenta being delivered as well so take a moment to breathe and congratulate yourself on all your hard work.

What you might be feeling

Like every other stage you will feel a whole host of emotions. You’ll likely be involved with the baby, could feel elated, might be shocked, somewhat relieved, and more then a little overwhelmed.

Some women say that the first time they held their baby they were so struck by this overwhelming sensation of love that they will never forget it. Other women don’t feel even remotely bonded to their baby at this point. Both are right!

No matter what you are feeling you are likely not crazy focused on getting the placenta out but more on baby or even taking a well deserved rest.

Possible Physical Signs

Contractions will continue through this stage though typically they are not as intense as when pushing out baby. The placenta after all is softer and squishes more easily.

Your body will still be dealing with some adrenalin, so there could be some shaking, a touch of feeling cold, and some minor pain. There may also be a soothing feeling.

What you can do

This is another stage of “let your body do it’s thing“. As I had been in the water for the birth of Little G my Midwife asked me to get out and on to the bed that was near by. She prefers to deliver the placenta out of the water for easier monitoring of Mom. What no one expected was that my body was ready to kick out the placenta almost as soon as I laid down.

In a chat I had with her after she said it was almost comical, I litterally laid down looked over at my husband and new son, lifted my top leg (was on my side) and out gushed the placenta… intact and about 5 minutes earlier then she was expecting.

I don’t really remember that part, I just remember looking at my husband and son and thinking “give me the kid”. I was almost a little bit agressive about it actually.

Important

Big thing here is to enjoy your new baby, and congratulate yourself on all the hard work you have done. You are an AWESOME MAMMA!

Stage 4: Recovery

What you might be feeling

Everything, anything or nothing. If this is your first delivery you have joined the ranks of mothers before you, and each and everyone of them has had their own unique experience to becoming a mother. You will too! So please do yourself a favor and set aside your expecation on how you “should” feel.

You may or may not bond with baby right away, you may be extreamly happy one moment and really iritable the next. This is all normal! Take a breathe and be easy with yourself.

Possible Physical Signs

You may still have some cramping, your uterus has after all stretched from the size of a pear to the size needed to protect your baby. It will take some time for your body to return that aspect close to it’s original size.

Your tummy may be slightly smaller then it was when pregnant. You just delivered a baby, but that doesn’t mean your whole body will go back to exactly the way it was before right away. Muscles, tendons, ligaments and all the other parts of your body that changed to support this new life don’t work like elastics snapping back into place as soon as kiddo is born.

Bleeding, there is a 6 to 8 week period women have after delivering a baby called lochia. This is the process that your body uses to help heal the wound created by the placenta when you delivered it.

What you can do

There is a whole host of things you can do to take care of your body Postparum.

Rest, take the time you need to heal and take it easy. Don’t lift anything other then baby.

Drink lots of water, this is especially important if you are breastfeeding! But no matter what water will help you heal, and keep things “flushed out”

Do NOT USE TAMPONS or put anything inside you, it’s best to use pads and let your body do it’s thing. You litterally have an open wound inside and introducing objects (like tampons or your spouse) puts you at a risk of infection.

Once you are cleared for it try a PostPartum Sitz Bath, this will help heal any cuts or tears and make it easier to pee.

Important

Listen to your care provider! If they tell you something there is a reason for it, by all means ask questions and clarify stuff but heed their advice!

Go easy on yourself, babies don’t come with manuals, and your body needs to recover, plus your system is handling the after effects of some pretty powerful hormones. Give yourself time.