A QUICK REFERENCE GUIDE

What is Labor ?

Labor is the work that your body does to allow your baby to be born . Labor is made up of three stages ( first , second and third ), described on the back .

Your Body Changes

Your baby has grown inside of your uterus ( the red outline ), and your cervix is the opening of the uterus . During pregnancy , the cervix is long and closed to keep your baby inside . Toward the end of pregnancy and during labor , hormones and contractions cause the cervix to shorten or thin ( called effacement ) and open ( called dilation ).

Effacement & Dilation

Effacement is measured as a percentage , with 0 indicating a cervix that is still long , and 100 % being completely thinned out . Dilation is measured in centimeters , from 0 ( completely closed ) to 10 centimeters , also called “ complete ” or completely dilated . During a cervical exam , your care provider will evaluate the cervix for these changes , as well as determining the station , or position of the baby ’ s head compared to your pelvis .

0 % effaced 1 cm dilated

cervix

100 % effaced 4 cm dilated

When Will Labor Begin ?

It is impossible to predict exactly when labor will start , but most babies are born between 37 and 42 weeks of pregnancy . Recent research shows that babies do a lot of developing and growing in the final weeks , and if there are no medical concerns , it is best to let labor begin on its own .

Pre-labor vs . Early Labor

Pre-labor contractions ( also called Braxton Hicks or “ false ” labor ) may occur in the days and weeks leading up to labor . Pre-labor contractions can be noticeable , but usually do not cause significant pain or change the cervix . Pre-labor contractions generally :

• Vary in how often or how long they last , although they can be regular / consistent at times .

• Do not get closer , stronger or longer over time .

• Slow down or stop with a change in activity , such as resting , eating or drinking .

• Are felt as a tightening primarily in the front or on just one part of the belly .

In contrast , early labor contractions ( which lead to cervical change and ultimately to birth ) typically :

• Become regular and predictable .

• Get steadily closer , stronger and longer .

• Do not stop or space out with resting , eating or drinking , but may get stronger with walking or moving .

• Are often felt in the front and back .

It can be difficult at times to tell the difference between pre-labor and early labor , so once you are past 37 weeks , it is wise to try not to focus on your contractions . Instead , simply go about your normal routine for as long as you can . If it is true labor , your body will let you know . Try going for a walk or sitting on an exercise ball to help move labor along . Take a bath or shower , or rest to save your energy for later .

This information should not be construed as medical advice , nor is it intended to replace the individual care of a health care professional .

Timing Contractions

Contractions are the rhythmic tightening of the uterus that can feel like a hardening of the belly . As labor intensifies , contractions get stronger and it becomes easier to feel the build up , peak and relaxation of each one . This is an example of how to time your contractions :

How long / duration ( start to finish ) = 1 minute

How far apart / frequency ( start to start ) = 3 minutes

Discuss preferences with your care provider , who may advise you to be in contact when contractions get to 5-1-1 : 5 minutes apart , lasting 1 minute and they have been consistent for 1 hour .

Warning Signs

If you experience any of the following symptoms , contact your care provider right away .

• Persistent vomiting , fever or flu-like symptoms .

• Vaginal bleeding ( blood-tinged mucus in labor is normal ), itching or foul-smelling discharge .

• A gush of fluid or continuously leaking fluid indicating your membranes have ruptured ( increased discharge is normal ).

• Severe or persistent headaches .

• Persistent blurred vision or dizziness .

• Sudden , severe swelling of face and hands .

• Four or more contractions in one hour before 37 weeks of pregnancy .

• Burning while urinating or difficulty urinating .

• Severe , sharp or persistent abdominal pain .

• Noticeable decrease in baby ’ s movement .

• Pain , swelling or redness in leg ( s ).

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First Stage : Dilation

First Stage : Active Labor

First Stage : Transition

Second Stage : Pushing

Labor is divided into three stages . In the first stage , the cervix dilates to allow the baby to enter the birth canal . There are three phases within first stage labor ( early , active and transition ). As labor progresses , contractions steadily get stronger and closer until second stage ( pushing ) begins .

First Stage : Early Labor

• Early labor is usually the longest part , lasting from a few hours to a few days .

• Characterized by noticeable but mild contractions , which may feel like cramps or a low backache .

• It is generally possible to carry on with normal activities during early labor , and most mothers can talk through contractions .

• You may notice loose stools , blood-tinged mucus or more discharge and / or a nesting instinct .

• Active labor may last anywhere from an hour to eight hours or more .

• Characterized by more intense contractions that continue to grow stronger , closer and longer .

• The growing strength of labor may require that you become inwardly focused and you may need to use coping techniques : breathing , positions , self-talk , visualization , pain medication , etc .

• Changing positions is helpful , especially alternating between upright and resting positions .

• Using movement ( rocking , swaying , walking ) can encourage the baby to come down and shorten labor , as well as keep you more comfortable .

• A peaceful environment will help you stay relaxed and focused : music , dim lights , and support .

• Your support team should focus entirely on you as labor intensifies .

• Transition is usually the shortest and most challenging phase of labor , lasting 10-60 minutes .

• Characterized by intense , long contractions that may “ double peak ” and have little break between .

• You may feel hot , shaky and / or nauseous .

• During transition , the baby usually drops very low into the pelvis . You may feel a lot of pressure in your bottom and begin feeling an urge to push .

• Use your most effective coping techniques ( ball , shower / bath , heat , massage , pain medication ).

• Relax and breathe in between contractions , take one at a time , and remember that you are almost at the end of labor .

• Have a calm and encouraging partner or labor support person to help you stay focused .

• Eliminate noises or any other distractions that are bothersome during contractions .

Second stage is the process of pushing the baby out of the mother ’ s body once the cervix is completely dilated . Second stage may last a total of a few minutes to five hours or more .

Some women get a break from contractions after full dilation , referred to as the “ resting phase .” Others continue to have contractions without the urge to push , called “ laboring down .” At some point , most women feel a strong urge to push with contractions :

• With each push , the baby ’ s head comes down , then slides back up in between pushes . Gradually , the baby moves lower and lower .

• Follow your body ’ s cues to push , and between contractions , rest , breathe and drink water .

• When the baby ’ s head is clearly visible from the outside and no longer goes inside between pushes , this is called crowning .

• Once the baby is crowning , birth is very close . After the head emerges , the rest of the baby ’ s body is born shortly .

Third Stage : Placenta

Early Labor Contractions Frequency : 5-20 + minutes Duration : 30-45 seconds Dilation : 0-6 centimeters

Active Labor Contractions Frequency : 3-5 minutes Duration : 45-60 seconds Dilation : 6-8 centimeters

Transition Contractions Frequency : 2-3 minutes Duration : 60-90 seconds Dilation : 8-10 centimeters

Pushing Contractions

Frequency : 3-5 minutes Duration : 60-90 seconds Dilation : complete