Every woman who gives birth has a unique experience. General speaking though, there are three distinct parts to the birth process: labor (which is divided into early labor, active labor, and transition), the birth itself, and the delivery of the placenta.
Complications can occur during any phase of labor, so it’s smart to be proactive and have a birthing plan in place that spells out exactly what you would like to have done during each stage of your labor and delivery. You should also have plans for what you’d like to have done if something out of the ordinary develops. Discuss your birthing plan with your obstetrician if possible or with another physician who specializes in obstetrics and gynecology.
Labor consists of three phases: early labor, active labor and transition. Your body can also help you learn what contractions are like by triggering false labor or Braxton Hicks contractions.
Early labor begins with irregular uterine contractions whose purpose is to prepare the cervix for the impending birth. By the end of the latent phase of labor, your cervix will be dilated to three or four centimeters.
Early labor can last anywhere from a few hours to a few days. Contractions may last between 30 and 45 seconds and often feel like strong menstrual cramps. At the beginning of early labor, you may only experience a contraction every half hour or so, but by the end, contractions will be coming five minutes apart. Sometimes, though, after regular contractions for hours, contractions will stop altogether. In most instances, this is entirely normal. This is your body is giving you an opportunity to rest.
If your amniotic membrane ruptures during this phase, your contractions will start to get much stronger. Note the color and odor of the fluid, and write down the time the rupture occurred. Many women won’t experience their water breaking until the active phase of labor.
When contractions are about five minutes apart, it’s time to head to the hospital or to summon your midwife to your home. During the next five hours or so, if all goes well, your cervix will dilate to approximately eight centimeters.
Contractions will be between three and five minutes apart and last between 45 and 60 seconds. Emotional extremes are natural during this phase. Contractions hurt, and you will likely feel vulnerable. In addition to pressure and discomfort in your uterus and pelvis, you may also feel pain in your lower back.
During the transition phase, the cervix dilates to a full 10 centimeters. This can take anywhere from half an hour to two hours. Contractions are extremely intense, and there’s not much time to rest between them. Your body may react violently to your labor in other ways as well. Chills, nausea, vomiting and diarrhea are common responses in this phase of labor.
When your cervix is 10 centimeters dilated, you are ready to give birth. If you’re like most women, you won’t give birth immediately, however. This phase typically lasts two hours or longer as your baby passes through the birth canal and vagina, and out into the world.
You may notice that the quality of your contractions is changing. They may last longer than they did during active labor and transition, but they’re spaced two to five minutes apart, and when they occur, you’ll feel a strong urge to push. Your baby’s head should be engaged in the birth canal before you begin pushing, however.
There’s no need to lie flat on your back while you’re pushing. If you feel the need to squat or rest on your hands and knees, do so, and let gravity help the birth process.
The Delivery of the Placenta
After your baby is born, you’ll continue to feel contractions as the placenta separates itself from the walls of your uterus and is expelled through your vagina. These contractions will be much milder, though. This phase typically lasts only half an hour at most. In some cases, your nurse, physician or midwife may apply pressure to your uterus through massage to facilitate the expulsion of the placenta.
After your child is born, your health care providers will continue to monitor you for another few hours to make sure there are no signs of unusual bleeding, which could be a sign that your uterus is not contracting normally.
When it comes to giving birth, it’s important to remember that no two births are exactly alike—this is even true of women who have multiple births. Likewise, having an idea of what is normal to expect can help take some of the anxiety out of bringing a child into the world.