The Stages of Pregnancy Labor

The healthiest labor is the natural pregnancy labor. When everything is normal between the mother and child, then the natural way is the way to use. Below is a detailed look at the process of the baby as it passes through the birthing canal during pregnancy labor.

How to Define Natural Birth?

labor

In 1933, an English doctor named Grantly published a book called ‘Natural Childbirth’ and this title continued to be used from that time on. Because the baby has to pass through the birthing canal, it is also called ‘vaginal delivery’. For this type of labor, the midwife can assist the birth from within your home but it’s typically done in a hospital. During the labor process, if painkillers are used, then it is named ‘Medicated Birth’. Using the Lamaze breathing method to endure the pain is called ‘Lamaze labor’. Sitting on a swing to deal with the pain is called a ‘swing labor’. All are different types of natural birth.

Preparations Before Pregnancy Labor

These are the informations doctors and delivery nurses are expecting before you go to hospital so make sure you fill out the hospital application for laboring with the followings in mind.

1) Monthly Checkup

Every week during the last month of pregnancy, you must go for a checkup.

2) Basic Checkup

This includes checking on the weight, temperature, blood pressure, lipid level, abdominal circumference and an ultrasound to check on the baby, the baby’s heartbeat and the status of contractions.

3) Enema

During labor, there could be some discharge from the rectum which could dirty the body and the birthing table. An enema can prevent this and also stimulate movement in the intestines which in turn will help the womb contract. Not only this, it can help to clear out the intestines beforehand and prevent damage to the intestines.

4) Gynecological Check

This will check on the condition of the cervix, the position and posture of the baby, its progress down the birthing canal, the size of the pelvis, and the condition of the amniotic sac. At this stage, it is also possible to assess if natural childbirth is indeed feasible or if an induced labor or a Cesarean section is needed.

5) Fetal Monitoring

When placed on the abdomen, this device can monitor the baby’s heartbeat and the womb’s contractions. It is useful in identifying any fetal abnormalities in the labor process.

Other Checks

This involves an ultrasound to check the placenta and baby, and an x-ray to check the size of the baby’s pelvis.

1st Stage of Labor: Dilation

  • Rhythmic contractions begin and cervix dilates to 10cm
  • Time until birth: 13-14 hours
  • Stage Duration: 6-7 hours

Signs of Labor: Contractions

Approaching the birth, the mothers’ body will automatically adjust to match the birthing needs. Firstly, the birthing canal will become soft, follicular hormones will become active which in turn makes the combination of pelvic muscle, pubic bone and the mouth of the womb will be loosened. As birth approaches and the cervix opens wider, some blood and mucus will flow out.

The real sign of labor are when the rhythmic contractions have an interval of around 10 minutes. At this point, you must go to the hospital.

When contractions start, this is the first stage of pregnancy labor. The first stages of contractions will last 30-60 seconds with an interval of 5-20 minutes. This will gradually get more severe until contractions last 60-90 seconds with an interval of 2-4 minutes. At this point, you are at the half way stage of labor and there will be wave after wave of severe pain. The pain will eventually reach a summit and then will slowly fade.

Cervix Dilated to 10cm

This stage, especially for first time mothers, is the most painful. The cervix takes 8-10 hours to dilate to 2-3cm. So when the contractions start, you must be calm, avoid being tense, relax, and you will be able to overcome the worst of the contractions. Don’t cry out at the first sign of pain, think of the next wave and patiently endure. Deep breathing and massages will help. For first time mothers, from the start of contractions until the cervix is 10cm dilated requires around 14 hours, which covers nearly the whole period of labor. The first stage of labor itself consists of three stages: first stage is preparing to dilate to 3-4cm, second stage is to dilate to 7-8cm, and the last and most difficult stage is to dilate to 10cm.

First Stage of Labor

Early Stage

  • From the start of contractions until the cervix is 3-4cm dilated.
  • Requires around 8-9 hours.
  • The contractions are periodic; they will appear for 30-45 seconds every 5 minutes.

When the contractions start, you must maintain your composure and use the rest period in between to prepare for the next wave. Initially, there will be a 20 minute interval between contractions. It is good to use this time to take a bath and wash your hair. After birth, it will be around 2-3 days before you are able to take shower, but will be 4-6 weeks before you are able to have a bath, so it is best to relax and soothe your body with a bath before the next stage of labor begins. If the amniotic sac has already ruptured, there is a danger of the womb becoming infected with bacteria. If this is the case, then you must not bath or shower. When there is a 10 minute interval between contractions, then you must go to a hospital and be patient in enduring the pain of contractions. When the contractions start, remember to breathe deeply and slowly breathe out. The deeper the breath, the lighter the pain experienced. When the cervix is dilated to 3-4 cm, the active stage will begin.

Active labor

  • The cervix is dilated to 7-8 cm.
  • Requires around 3-4 hours.
  • Contractions will last for 1 minute with an interval of 3 minutes.

At this stage, the interval between contractions is much shorter and the pain will last longer. It is very important to remember to breathe deeply and give the baby as much oxygen as possible. As you bear down during the contractions, the baby will move towards the pelvis, but remember to reserve your energy for when the baby needs to be pushed out of the body.

Transitional Stage

  • The cervix is dilated to 9-10cm.
  • Time required around 1-2 hours.
  • Contractions will last for 90 seconds with an interval of 1-2 minutes.

At this stage you will feel a very strong contraction pushing outwards and the duration of this will exceed the period of rest between successive contractions. Excessive pain can cause weakness in the hands and feet after the severe contractions labor will begin, and you must call the nursing staff to attendance.

General Guidance: First Stage of Labor

Through gynecological examination, the doctor will know the exact stage you are in. Using fetal monitoring, we can determine the child’s heartbeat and the exact interval between contractions. If the womb’s contractions are not strong enough, then the doctor may choose to manually burst the amniotic sac.

2nd Stage of Labor: Fully Dilated

  • From the cervix being fully dilated to the birth of the baby
  • Stage Beginning: 2-3 hours
  • Stage Duration: 1-2 hours

Contractions Continually Push Outwards

During the second stage of labor, the cervix is fully dilated to 10cm and the baby is now able to pass through. The contractions will last 60-90 seconds with an interval of 1-2 minutes.

The Turning and Pulling of the Baby’s Head

During the first stage of labor, the baby’s head has been held firmly by the pelvis, and now the baby is getting ready to continue down the birthing canal and out of the mothers’ body. The mother will have to push hard for the baby to be born.

With the contractions of the womb, the baby’s head will move down the pelvis and will at the same time turn around so its face is facing outwards from the mothers belly. The area beneath the pelvis is diamond shaped so the head must rotate 90 degrees. As the baby’s head moves downwards and turns, it will press down on the amniotic sac located between the back of the womb and the baby’s head, so at this point the amniotic sac will rupture. After this, the birthing canal will have some surplus matter attached to the sides. The baby will enter the birthing canal and prepare to be born. The mother will now need to be transferred to the birthing room.

When the contractions start and you push down with the muscles in your abdomen, you will finally see the baby’s head emerge from the mother’s body; this is called ‘crowning’. As the mother continues to push, she can feel the baby slowly moving outwards. Be patient and don’t stop pushing, otherwise the baby will return to the womb. During this stage you must be careful not to damage the vagina because the birthing canal is too narrow the baby will be squeezed. For this reason, the doctor will often cut the vagina.

Correct Conservation of Energy will make the Birth Easier

At this stage, the most important thing is to push when the contractions come. To push without contractions is to waste your strength. If there is no pushing when the contractions appear, it will cause the labor to be delayed.

When the contractions come, you must follow the instructions of the doctor and nursing staff and push when instructed. Between pushes, there is only time to take one deep breath, hold it and then push. When pushing, you must push with your bum muscle, not with your abdomen. It will have a similar feeling to passing feces.

As the vagina is cut open, follow the doctors instruction to breathe quick, shallow breaths. When the baby’s head has completely emerged, there is no need for further pushing as the rest of the body will slide out easily. If you continue to push, more amniotic fluid will slide out.

General Guidance: Second Stage of Labor

Before labor begins, the pubic hair will need to be trimmed to prevent germs spreading to the mother and child. You may also be catheterized. As the baby’s head presses on the urethra, you will feel the need to pass urine, but it is not possible to do so at this point. If you resist the need to pee, it can prevent the baby entering the vagina. When you can see the baby’s head, the vagina will be cut open and disinfected.

3rd Stage of Labor: Afterbirth

  • This is when the placenta is ejected from the body
  • Stage Beginning: 15-30 minutes
  • Stage Duration: 10-20 minutes

Afterbirth and Expulsion of the Placenta

After the birth, the placenta and the umbilical cord will follow shortly afterward. This is the third stage. Even after the baby is born, in order to expel the placenta, the womb will continue to contract once every minute. There is a slight feeling of the womb being lifted and then the placenta will detach. After the placenta is detached, the veins in the womb and the muscle fibers will immediately contract. The muscle and tissue will act as a tourniquet and will stop bleeding.

Stitching the vagina and Moving to the Recovery Room

If the placenta is removed cleanly and completely, and the birthing canal has no abnormalities, the vagina will then need to be stitched. At this point, the mother will feel a little prick of pain. After the stitches, you will be moved to the recovery room and will undergo some preventative measures for blood loss and inflammation. The womb will be monitored for two hours in order to check if it has contracted back to normal. If there are no problems, you can be moved back to your room on the ward.

Urination after Labor

You will feel a strong urge to urinate approximately two hours after a natural birth. If after 8 hours there has been no urine passed, it is possible there is a urinary infection and may need to be catheterized. It is possible the bladder has been exhausted resulting in a lack of sensation to urinate, but you must try your best to pass urine. If there are blood clots or any other abnormalities in the urine, you should report to your doctor.

General Guidance: Third Stage of Labor

At this point, the doctor must confirm whether or not the placenta has been completely removed. After the baby is born, the mother’s belly should be pressed and the placenta should slide out. If there is no problem, then the vagina can be stitched together.

3 Common Knowledge in Labor

Birthing Canal

The birth canal comprises of the pelvis to the cervix and vagina including the muscle and soft tissue surrounding the vagina. When birth approaches, the pelvic muscle and the pubic bone will become loose, and the birth canal will become soft and stretchy. Mothers over 35 years old may have more problems with the softening of the birth canal, so it may be more difficult to have a natural birth.

Push to help the Womb Contract

Because contractions will make the baby push down towards the opening of the womb, the mother will reflexively push down. If the pushing action is too weak, the period of contractions will be longer and the labor will be slower. If the womb hasn’t completely contracted, after one hour it will be unable to expand to 1 cm, so then it is necessary to burst the amniotic sac by hand in order to proceed with the labor.

Strength of the Baby

Because the baby needs to pass through a narrow winding birth canal, the baby will twist and bend accordingly. The baby’s skull is made of five parts and as it passes down the birth canal, the five sections will adjust together to allow the head to pass. If the baby’s condition is not favorable and doesn’t have the strength to pass down the birth canal, tongs or a vacuum pump can be used to help draw the baby out.

Those are the information needed to know regarding pregnancy labor.

Sandra Henderson
 

Editor-in-chief at Babiology and a proud mother of four passionate about sharing pregnancy and baby growth knowledges

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