Labor

Having a baby is one of the most exciting experiences of your life. It can also be quite stressful if you do not know what to expect. One of the most important items on your list of things to do should be taking a childbirth education class. Childbirth education classes will help you prepare for the birth of your baby by providing an overview of what you can expect from your body, your health care service providers and from your baby during this time. You will learn about options to increase your comfort and reduce anxiety, such as using a labor doula. Knowing your options and being prepared will result in a birth that is more productive, more comfortable, and faster.

One of the first items addressed in childbirth education classes is what to expect during the different stages of labor. Labor occurs in three stages. The first stage of labor is divided into three separate phases: the early phase, active phase, and the transitional phase. The second stage is pushing and delivering the baby, and the third stage is the delivery of the placenta.

In the first stage of labor during the early phase, you may begin to experience back ache and mild labor pains that are irregular at first. You will lose your mucous plug, which will lead to an increase in vaginal discharge with bloody streaks; that is called "show" and results from small capillaries opening from the stretching and thinning out of the bottom of the uterus, the cervix. For most women, this stage is fifteen to twenty hours long with a first birth. The cervix will soften and efface (or thin out) and dilate (or open). The best way to imagine this process is to think of popping a lifesaver into your mouth. Feel with your tongue how thick the middle is and how small the center opening. If you felt that lifesaver ten minutes later, the middle would be very thin and the opening much wider. The same thinning and opening occurs at the cervix. You may also have loose stools and menstrual-like cramping.

However, very little intervention is needed at this time, just rest and hydration. You can stay at home or wherever you are most comfortable in the early phase, when you may feel excited and very sociable. Do remember to empty your bladder frequently though, because a full bladder makes it more difficult for your uterus to do its job, and an empty bladder gives more room for the baby’s passage out. If your contractions begin earlier than the thirty-seventh week of your pregnancy (or three weeks prior to your due date), it is important to call your health care service provider, rest, hydrate and keep your bladder empty. If you have an increase in your bleeding, if you have constant abdominal pain or if your membranes rupture, in each case, you should call your health care service provider and go to the hospital.

Gradually, the backache and cramping will become stronger and last longer. Generally, healthcare providers agree that when the contractions occur every five minutes and last sixty seconds, it is time for you to leave for the hospital. Be sure to ask your own doctor or healthcare provider when he or she believes the contractions are coming fast enough to warrant going to the hospital.

By this point, you will be in active labor. In active labor, there will be an increase in “show” and an increase in the strength and duration of the contractions. In the early phase, your cervix dilates from zero to three centimeters ("cm"). In the active phase, the effacement continues, and you progress from four to eight cm. The contractions are now closer together, about every two-and-one-half to four minutes, and stronger in intensity. They can last forty-five to sixty seconds or longer. When the contraction occurs, you become more inward and less talkative because you need to concentrate on the work at hand. Now you will begin to use the skills you have learned in classes, including position changes, slow deep breathing, concentration, and relaxation. Warm showers and the birth ball may offer comfort (providing you don't have any medical or obstetric complications), along with music and massage. Ice packs or cold packs, or a combination of both, can be soothing. It is important to stay as relaxed as possible both to conserve energy and to help your body do what it needs to do. Nausea and vomiting can occur at this time, and your nurse and caregiver can provide you with medication if you wish. This phase of labor can last as little as three hours and as long as eight hours.

The next phase of labor is transition, which is the most difficult but the shortest phase of labor. During transition, the cervix dilates to ten cm. Your contractions come one right after the other and are very strong; sometimes having two peaks. You may feel hot one minute and cold the next, and you may feel irritable and overwhelmed. The massage and touching that were so welcome in the last