Beginning of labor

Stages of labor | March of Dimes

Every woman’s labor is different. And it may be different each time you have a baby.

Learning about stages of labor before your due date can help you know what to expect so you can feel ready for your baby’s birth.

Use a birth plan so your health care provider and hospital staff know what your plans are for labor and after birth.

Having a professional support person, like a doula, during labor can help you have a better experience with labor and birth.

Try to stay comfortable and relaxed through labor. Move around and try different positions to find what works best for you.

What are stages of labor?

Labor (also called childbirth) is the process of your baby leaving the uterus (womb). Labor is divided into three stages:

Labor
Pushing and birth
Delivery of the placenta

Every woman’s labor is different. And your labor may be different each time you have a baby. But there are patterns to labor that are true for most women. Learning about the stages of labor and what happens during each one can help you know what to expect once labor begins.

What is a birth plan?

A birth plan is a set of instructions you make about your baby’s birth. It includes things like:

Where you want to have your baby
Who you want to be with you during labor and birth
If you want medicine to help with labor pain
If there are cultural traditions you’d like to follow during labor and birth
If you plan to breastfeed

Before your due date, use the March of Dimes birth plan to help you think about how you want your labor to be. Share the completed plan with your partner, your health care provider and the staff at the hospital where you plan to give birth.

What is a doula?

You may want to have a professional support person help you through labor and childbirth. A doula is a professional labor assistant. This is someone who is trained to give physical and emotional care and support to women and their families before, during and after childbirth. For example, a doula can:

Help you stay comfortable
Explain what’s happening during labor and birth and any procedures you may have
Encourage you and give you confidence
Support your family and friends who are with you during labor
Let hospital staff know what you need
Help you get started breastfeeding

Having a support person like a doula can be good for you, your baby and your family. It can help you feel good about your birth experience. Having a doula can help:

Shorten your labor
Reduce your need for pain medicine during labor
Reduce your risk of needing a cesarean birth or the need for your provider to use forceps or suction with a vaginal birth
Your baby get a good Apgar score at birth. Your baby gets an Apgar test right after birth to check his overall health. The test checks his heart rate, breathing, muscle tone, reflexes and skin color.

To find a certified doula, ask your provider or go to DONA International.

You also may want to have your partner, a friend or a family member be a support person to help you through labor. They can go to childbirth education classes with you to learn ways to help, like timing your contractions, helping you relax and helping you move around to find a comfortable position. Ask your provider about childbirth education classes in your area.

If you decide to have a doula or another support person help you with labor and birth, put their names and contact information in your birth plan. Share your plan with your provider and with hospital staff.

What happens in the first stage of labor?

The first stage of labor is the longest stage. For first-time moms, it can last from 12 to 19 hours. It may be shorter (about 14 hours) for moms who’ve already had children. It’s when contractions become strong and regular enough to cause your cervix to dilate (open) and thin out (efface). This lets your baby move lower into your pelvis and into your birth canal (vagina). This stage of labor ends when you are 10 centimeters dilated. The first stage is divided into three parts: early labor, active labor and transition to stage 2 of labor.

Early labor

For most first-time moms, early labor lasts about 6 to 12 hours. You can spend this time at home or wherever you’re most comfortable. During early labor:

You may feel mild contractions that come every 5 to 15 minutes and last 60 to 90 seconds.
You may have a bloody show. This is a pink, red or bloody vaginal discharge. If you have heavy bleeding or bleeding like your period, call your provider right away.

What you can do in early labor:

This is a great time for you to rely on your doula or labor support person. Try the methods you learned about in childbirth education classes about how to relax and cope with pain. During early labor:

Rest and relax as much as you can.
Take a shower or bath.
Go for a walk.
Change positions often.
Make sure you’re ready to go to the hospital.
Take slow, relaxing breaths during contractions.

Active labor

This is when you head to the hospital! Active labor usually lasts about 4 to 8 hours. It starts when your contractions are regular and your cervix has dilated to 6 centimeters. In active labor:

Your contractions get stronger, longer and more painful. Each lasts about 45 seconds and they can be as close as 3 minutes apart.
You may feel pressure in your lower back, and your legs may cramp.
You may feel the urge to push.
Your cervix will dilate up to 10 centimeters.
If your water hasn’t broken, it may break now.
You may feel sick to your stomach.

What you can do in active labor:

Make sure the hospital staff has a copy of your birth plan.
Try to stay relaxed and not think too hard about the next contraction.
Move around or change positions. Walk the hallways in the hospital.
Drink water or other liquids. But don’t eat solid foods.
If you’re going to take medicine to help relieve labor pain, you can start taking it now. Your choice about pain relief is part of your birth plan.
Go to the bathroom often to empty your bladder. An empty bladder gives more room for your baby’s head to move down.
If you feel like you want to push, tell your provider. You don’t want to start pushing until your provider checks your cervix to see how dilated it is.

Transition to the second stage of labor

This can be the toughest and most painful part of labor. It can last 15 minutes to an hour. During the transition:

Contractions come closer together and can last 60 to 90 seconds. You may feel like you want to bear down.
You may feel a lot of pressure in your lower back and rectum. If you feel like you want to push, tell your provider.

What happens in the second stage of labor?

In the second stage of labor, your cervix is fully dilated and ready for childbirth. This stage is the most work for you because your provider wants you to start pushing your baby out. This stage can be as short as 20 minutes or as long as a few hours. It may be longer for first-time moms or if you’ve had an epidural. An epidural is pain medicine you get through a tube in your lower back that helps numb your lower body during labor. It's the most common kind of pain relief used during labor. The second stage ends when your baby is born.

During the second stage of labor:

Your contractions may slow down to come every 2 to 5 minutes apart. They last about 60 to 90 seconds.
You may get an episiotomy. This is a small cut made at the opening of the vagina to help let the baby out. Most women don't need an episiotomy.
Your baby’s head begins to show. This is called crowning.
Your provider guides your baby out of the birth canal. She may use special tools, like forceps or suction, to help your baby out.
Your baby is born, and the umbilical cord is cut. Instructions about who’s cutting the umbilical cord are in your birth plan.

What you can do:

Find a position that is comfortable for you. You can squat, sit, kneel or lie back.
Push during contractions and rest between them. Push when you feel the urge or when your provider tells you.
If you’re uncomfortable or pushing has stopped, try a new position.

What happens in the third stage of labor?

In the third stage of labor, the placenta is delivered. The placenta grows in your uterus and supplies your baby with food and oxygen through the umbilical cord. This stage is the shortest and usually doesn’t take more than 20 minutes.

During the third stage of labor:

You have contractions that are closer together and not as painful as earlier. These contractions help the placenta separate from the uterus and move into the birth canal. They begin 5 to 30 minutes after birth.
You continue to have contractions even after the placenta is delivered. You may get medicine to help with contractions and to prevent heavy bleeding.
Your provider squeezes and presses on your belly to make sure the uterus feels right.
If you had an episiotomy, your provider repairs it now.
If you’re storing your umbilical cord blood, your provider collects it now. Umbilical cord blood is blood left in the umbilical cord and placenta after your baby is born and the cord is cut. Some moms and families want to store or donate umbilical cord blood so it can be used later to treat certain diseases, like cancer. Your instructions about umbilical cord blood can be part of your birth plan.
You may have chills or feel shaky. Tell your provider if these are making you uncomfortable.

What happens after your baby is born?

Congratulations! It’s time to hold your baby! Right after birth your provider places your baby skin-to-skin on your chest and covers him with a blanket. Holding your baby skin-to-skin helps your baby stay warm as he gets used to being outside the womb. It’s also a great way to get started breastfeeding. You can start breastfeeding even within an hour of your baby’s birth. Even if you don’t plan to breastfeed, hold your baby skin-to-skin so you get to know each other right away. Your baby will welcome your gentle touch, and this closeness can help you and your baby bond.

After birth, your body starts to change to help you heal. Your provider takes your temperature and checks your heart and blood pressure to make sure you’re doing well. If you had anesthesia during labor, your provider makes sure you’re recovering without any complications.

Last reviewed: March, 2019

Contractions and signs of labor

Learning the signs of labor before your due date can help you feel ready for your baby’s birth.

Signs of labor include strong and regular contractions, pain in your belly and lower back, a bloody mucus discharge and your water breaking.

If you think you’re in labor, call your health care provider.

Not all contractions mean you're in true labor. Learning the difference between true and false labor can help you know when it’s the real thing.

What is labor?

Labor (also called childbirth) is the process of your baby leaving the uterus (womb). You’re in labor when you have regular contractions that cause your cervix to change. Contractions are when the muscles of your uterus get tight and then relax. Contractions help push your baby out of your uterus. Your cervix is the opening to the uterus that sits at the top of the vagina. When labor starts, your cervix dilates (opens up).

As you get closer to your due date, learning the signs of labor can help you feel ready for labor and birth. If you have any signs of labor, call your health care provider.

What are the signs of labor?

You know you’re in true labor when:

You have strong and regular contractions. A contraction is when the muscles of your uterus tighten up like a fist and then relax. Contractions help push your baby out. When you’re in true labor, your contractions last about 30 to 70 seconds and come about 5 to 10 minutes apart. They’re so strong that you can’t walk or talk during them. They get stronger and closer together over time.
You feel pain in your belly and lower back. This pain doesn't go away when you move or change positions.
You have an increase in vaginal discharge that can be clear, pink or slightly bloody (brownish or reddish). This is called bloody show. It can happen a few days before labor or at the beginning of labor. If you have bright red bleeding or if the bleeding is heavy, tell your provider right away.
Your water breaks. Your baby has been growing in amniotic fluid (the bag of waters) in your uterus. When the bag of waters breaks, you may feel a big rush of water. Or you may feel just a trickle.

If you think you’re in labor, call your health care provider, no matter what time of day or night. Your provider can tell you if it’s time to head for the hospital. To see for sure that you’re in labor, your health care provider measures your cervix.

What are signs that you may be close to starting labor?

You may be close to starting labor if:

Your baby drops or moves lower into your pelvis. This is called lightening. It means that your baby is getting ready to move into position for birth. It can happen a few weeks or even just a few hours before your labor begins.
You have an increase in vaginal discharge that’s clear, pink or slightly bloody. This is called show or bloody show. It can happen a few days before labor starts or at the beginning of labor.
At a prenatal checkup, your health care provider tells you that your cervix has begun to efface (thin) and dilate (open). Before labor, your cervix is about 3.5 to 4 centimeters long. When it’s fully dilated (open) for labor, it’s 10 centimeters. Once labor starts, contractions help open your cervix.
You have the nesting instinct. This is when you want to get things organized in your home to get ready for your baby. You may want to do things like cook meals or get the baby’s clothes and room ready. Doing these things is fine as long as you’re careful not to overdo it. You need your energy for labor and birth.

If you have any of these signs, you may start labor soon. Learn the signs of labor so you know when to call your provider.

What are false labor and Braxton-Hicks contractions?

Not all contractions mean you’re in labor. You may have contractions on and off before true labor starts. These contractions are called false labor or Braxton-Hicks contractions. They soften and thin the cervix to help your body get ready for labor and birth. You may feel them in the weeks right before your due date. Learning the differences between true labor contractions and false labor contractions can help you know when you’re really in labor.

It can be hard to tell the difference between true labor and false labor. When you first feel contractions, time them. Write down how much time it takes from the start of one contraction to the start of the next. Make a note of how strong the contractions feel. Keep a record of your contractions for 1 hour. Walk or move around to see if the contractions stop when you change positions.

What is preterm labor?

Preterm labor is labor that begins too early, before 37 weeks of pregnancy. Premature babies (born before 37 weeks of pregnancy) can have health problems at birth and later in life. If you’re not to 37 weeks of pregnancy and you have signs or symptoms of preterm labor, call your provider. Getting help quickly is the best thing you can do. Learn about risk factors for preterm labor and what you can do to help reduce your risk.

What are stages of labor?

Stages of labor include the whole process of labor, from your first contractions (stage 1) to pushing (stage 2) to delivery of the placenta (stage 3) after your baby is born. Learning about the stages of labor can help you know what to expect during labor and birth.

Last reviewed: December, 2018

Fears during pregnancy | Nutriclub

Most women experience fear and anxiety during pregnancy. What most often worries expectant mothers and how to relieve excessive anxiety - we analyze the points

During pregnancy, serious changes occur in the body of the expectant mother. The feeling of anxiety and fear during this period is experienced by 90% of women - this is a natural psychological reaction to changes in hormonal levels and adaptation of the body to new conditions. nine0004

Is there something wrong with my child?

It is important to know that nature has done everything to protect your baby in the womb. And modern medicine is able to detect and prevent many diseases and deviations. Do your best - see your doctor regularly and stay active and healthy - and you'll be fine. Timely diagnosis will help to identify diseases and infections at the initial stage that can threaten the baby, and cure them in a timely manner. The expectant mother is tested, she is given an ultrasound scan and screenings to detect fetal pathologies. All this will help you relieve anxiety and fear for the health of the baby. In order to stop worrying, it is worth thinking about the positive experience of your acquaintances and girlfriends, remember that most children are born healthy and that many developmental disorders are successfully corrected after birth. Read less horror forums, attend yoga and pregnancy fitness classes, and walk more. nine0004

I am afraid of childbirth

Fear of childbirth is a natural fear of physical pain. In order to get rid of it, you can be like childbirth preparation courses, where you will be taught how to breathe and push properly. Such courses are also good because you will see how many women are in the same position as you. You can discuss your concerns with the obstetrician-gynecologist in advance, decide how you will give birth: alone or with a partner, which type of anesthesia is preferable for you, if such a need arises. Remember that today doctors have a lot of opportunities to make the process of childbirth painless. In addition, you can prepare your body for childbirth by walking more, moving more and attending classes for pregnant women. nine0004

What if I'm a bad mom?

What if I take care of the child incorrectly and this will harm him? I will not have time to do everything that is necessary, because the child requires increased attention? I will not be able to properly feed and educate him? These are common fears that almost all women who give birth for the first time visit. It is important to know that there is nothing more natural than motherhood. You will cope with any number of children that will be born thanks to you. As a rule, as soon as the baby is born, everything comes by itself, and no one but you will understand your child better. And all your fears will dissipate in the first days of the baby's life. Not a single woman has a ready-made program for care and upbringing - instincts and daily practice help. nine0004

What if I can't breastfeed?

Only 5% of women cannot breastfeed for medical or psychological reasons. As a rule, these are such serious diseases as kidney pathology, heart defects, blood diseases, tumors, HIV infections, etc. There are acute psycho-emotional disorders that also prevent breastfeeding. If you do not have such diseases, then there is nothing to worry about. After childbirth, milk appears in all women without exception, and feeding on demand will provide the right amount of milk for the baby. Today, in many maternity hospitals, you can consult a nurse or even a breastfeeding specialist who will show you how to properly latch on to your baby. If you are concerned about cracks, then there are various products that are applied to the nipples before and after feeding, a breastfeeding specialist can also talk about this. And of course, a positive attitude is needed for successful feeding: remember that with mother's breast milk, the child receives absolutely all the trace elements he needs. nine0004

Will my life change?

Life will change, but definitely for the better. If before pregnancy your days were full of interesting people and things, then this will not disappear anywhere. Rather, on the contrary - after the birth of a child, new ideas and interests will appear. As many women note, a decree is a chance to learn new skills and abilities, and possibly change the field of activity if you have been thinking about it for a long time. The fact is that caring for a child can be combined with other activities, the main thing is to set yourself up correctly. Today there are great opportunities for distance learning and professional development. These are books, online courses, webinars, remote work. nine0003

There is a common myth that a child chains his mother to the house. It all depends on the desire of the woman: with the baby it is quite possible to go on a visit, to meet with friends or colleagues, to travel. Also, most babies sleep very soundly and won't be distracted if you invite guests.

The main way to get rid of fears during pregnancy is to fill your life with events and people that make you happy. The condition of the mother is passed on to her child, and to please and take care of yourself is the most important thing you can do for the baby during this period. nine0004

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Harbingers - childbirth is coming soon! nine0001

Wrestler Maria Vladimirovna

Obstetrician-gynecologist

MD GROUP Clinical Hospital, Mother and Child Clinic Savelovskaya

False contractions

They may appear after the 38th week of pregnancy. False contractions are similar to Braxton-Hicks contractions, which a woman could already feel starting from the second trimester of pregnancy (the uterus seems to stiffen for a few seconds - a couple of minutes, then the tension in it subsides). False contractions train the uterus before childbirth, they are irregular and painless, the intervals between them are not reduced. Real labor pains, on the contrary, are regular, their strength gradually increases, they become longer and more painful, and the intervals between them are reduced. That's when you can already say that the birth began for real. In the meantime, false contractions are going on, it is not necessary to go to the maternity hospital - you can easily survive them at home. nine0004

Abdominal prolapse

Approximately two to three weeks before birth, the baby, in preparation for birth, presses the presenting part (usually the head) against the lower part of the uterus and pulls it down. As a result, the uterus moves lower into the pelvic region, its upper part ceases to put pressure on the internal organs of the chest and abdominal cavity. In the people it is called - the stomach dropped. As soon as the stomach drops, the expectant mother notices that it has become easier for her to breathe, but, on the contrary, it becomes more difficult to sit and walk. Heartburn and belching also disappear (after all, the uterus no longer presses on the diaphragm and stomach). But, having dropped down, the uterus begins to put pressure on the bladder - naturally, urination becomes more frequent. nine0004

For some, uterine prolapse causes a feeling of heaviness in the lower abdomen and even slight pain in the inguinal ligaments. These sensations arise due to the fact that the child's head, moving down, irritates the nerve endings of the pelvic organs.

During the second and subsequent births, the belly drops later - right before the birth. It happens that this harbinger of childbirth is not at all.

Removal of the mucous plug

This is one of the main and obvious harbingers of childbirth. During pregnancy, the glands in the cervix produce a secret (it looks like a thick jelly and forms the so-called cork), which prevents various microorganisms from entering the uterine cavity. Before childbirth, under the influence of estrogens, the cervix softens, the cervical canal opens slightly and the cork can come out - the woman will see that there are mucus clots on the linen that look like jelly. Cork can be of different colors - white, transparent, yellowish-brown or pink-red. Often it is stained with blood - this is completely normal and may indicate that childbirth will occur within the next day. The mucus plug can come out all at once (at once) or come out piecemeal throughout the day. nine0004

Weight loss

Approximately two weeks before delivery, weight loss may occur, usually by 0.5–2 kg. This happens because excess fluid is removed from the body and swelling decreases. If earlier during pregnancy, under the influence of the hormone progesterone, fluid in the body of a pregnant woman accumulated, now, before childbirth, the effect of progesterone decreases, but other female sex hormones - estrogens - begin to work hard, they remove excess fluid from the body of the expectant mother. nine0004

In addition, the expectant mother often notices that at the end of pregnancy it became easier for her to put on rings, gloves, shoes - this means that swelling on the hands and feet has decreased.

Change of stool

Right before childbirth, hormones often act on the intestines - they relax its muscles, as a result, stool disorder begins. Sometimes such frequent (up to 2-3 times a day) and even loose stools are mistaken for an intestinal infection. But if there is no nausea, vomiting, discoloration and smell of feces, or any other symptoms of intoxication, you should not worry: this is one of the harbingers of the upcoming birth. nine0004

And on the eve of childbirth, you often don't want to eat at all. All this is also the preparation of the body for natural childbirth.

Mood changes

Many women experience mood changes a few days before giving birth. The expectant mother gets tired quickly, she wants to have more rest, sleep, even some kind of apathy appears.

The Masterpiece Mom