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Pregnancy: Stages of labor

In many ways, your pregnancy is just like you: unique. Expect your labor and delivery to be just as personal and distinctive.

But that doesn't mean everything that happens on that special day will be a surprise. No one can know exactly what will happen beforehand. But learn some of the basics now. It can help you be better prepared for your baby's arrival.

Delivery nears

There are several signs that labor is weeks or days away, according to the American Pregnancy Association (APA). You may not notice every sign. But watch for:

Lightening. This happens when the baby drops or settles deeper in the pelvis. You'll have less pressure on your diaphragm, so it'll be easier to breathe. But there will be more pressure on your bladder, so you may have to use the bathroom more often.

Effacement. Usually in the final month or two, the cervix begins to thin and stretch. This allows for easier dilation during labor. While you won't notice this, it's something your healthcare provider can check during an exam.

Dilation. Also in the final couple of months, your healthcare provider may check to see how many centimeters your cervix has dilated. Ten centimeters is considered fully dilated. That means you're ready to give birth.

Loss of the mucus plug. The mucus that has protected the cervical opening during pregnancy may come out days, hours or just minutes before labor begins. It may look stringy or appear as a clear, pink or blood-tinged discharge.

Membrane rupture. This is when your water breaks. Often this appears as a constant trickle. But some women experience a more sudden gush of fluid. You should contact your healthcare provider at this point, according to the American College of Obstetricians and Gynecologists.

Of course, there will come a time when you know delivery is imminent. Having frequent, regular contractions is the clearest sign.

Experts divide childbirth into three stages.

Stage I

According to the APA, this is the longest stage of labor. It's divided into three phases.

Early labor lasts about 8 to 12 hours. It occurs when contractions last about 30 to 45 seconds and are spaced 5 to 30 minutes apart. Contractions are usually mild and irregular, but they get stronger and come closer together. They may feel like:

  • A lower backache.
  • Menstrual cramps.
  • Pressure in the pelvis.

Expect your water to break during this stage.

You usually don't need to go to the hospital at this stage, according to the APA. It's OK to continue simple routines, but try to conserve energy. Drink plenty of water, and eat small snacks.

Keep track of your contractions. And note when your water breaks.

Active labor lasts about three to five hours. Contractions are stronger. They last about 45 to 60 seconds with three- to five-minute breaks in between. This is usually the time to go to the hospital.

The transition phase lasts between 30 minutes and two hours. Contractions are long, strong and intense. They last about 60 to 90 seconds with 30-second to two-minute breaks in between.

You may also have:

  • Hot flashes.
  • Chills.
  • Nausea.
  • Vomiting.
  • Gas.

When you feel an urge to push, let your healthcare provider know.

At the end of this phase, your cervix will be fully dilated and ready for birth.

Stage II

This stage involves pushing and delivery of your baby. It usually lasts between 20 minutes and two hours. Contractions last 45 to 90 seconds with three- to five-minute breaks in between.

You'll likely be told to push when you feel a strong urge to do so and to stop when the baby's head is visible.

Stage II ends with the delivery of your baby.

Immediately after birth, your baby may:

  • Have a cone-shaped head from passing through the narrow birth canal.
  • Have puffy eyes from nine months of soaking in amniotic fluid.
  • Be coated with a cheesy-looking substance from the uterus.

A nurse will clean your baby's nose and mouth. And the umbilical cord will be clamped and cut.

Stage III

At this point your work is almost done. This final stage is delivery of the placenta. At between 5 and 30 minutes, it's the shortest stage of birth. After delivery, small contractions signal the placenta is ready to separate from the uterus.

Once the placenta is delivered, you may shake and shiver. Don't worry. This is normal.

Finally, it's time to relax and meet your new baby. Congratulations, Mom.

reviewed 8/9/2019

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