Stages of Labor
Not all labors are created equally,
but many of them follow the same pattern.
For first time vaginal births, more often than not the labor may take a while. A 24 hour labor is not surprising. Does this mean you will be in agony the entire time? No!
It’s important for you and your support team to understand the stages of labor and the pattern your body will most likely be following, and how to identify them without a hitch.
Physical Changes
Cervical change. You may begin to pass a sticky, snot-like, or possibly chunky substance. The color may range from yellow, to brown, to pink, or bloody. You may notice this in your underwear, when you wipe, or in the toilet. This is indication that your cervix is dilating. That does not necessarily mean labor is imminent though, as you may begin to pass cervical mucus or your “mucus plug” days or weeks in advance. Pink or blood tinged mucus is a bit more promising that labor is coming soon, especially if you notice other symptoms as well. Cervical change will happen throughout the entire duration of labor as you progress to full dilation (10 centimeters).
Fetal Position. Your womb may feel different when labor is approaching. It may feel heavy, like baby has “dropped” into your pelvis. That’s because it has! Your baby’s head (unless breech-another variation of normal) is now engaged and you may feel less pressure on your ribs and lungs. This is the start of your baby’s final turn through the birth canal. Your baby will need to twist and turn its body to make it through the narrow areas of your pelvis. Luckily your pelvis is more flexible from all of that relaxin hormone produced during your pregnancy! It’s always a good idea to practice a few positional techniques to encourage optimal positioning for your baby. Cat-cows, inversions, and other techniques such as The Miles Circuit and Sidelying Release can be very helpful.
Contractions. Contractions can be described differently by other people. Some will feel a tightening in the belly, often wrapping around the back, some feel an intense pressure deeper in the pelvis, some feel nothing at all! Contraction is typically an intense feeling that lasts 30-60 seconds. In the beginning of labor it is common for them to be very spaced out. You won’t need to be too concerned until they are consistent, do not stop, and with increasing intensity and frequency. These contractions have an important purpose. That purpose is to tighten ligaments that will squeeze the baby downward. The pressure you may feel below is the babys head beginning to travel through the birth canal. Let your support people know where you are feeling any discomfort, as they may be able to help provide relief. If your plan is to avoid pain medication and interventions, try using the shower or bath as a comfort measure. Water can help relieve up to 70% of the pain! If you are not birthing at home, most people will wait until their contractions are at least 4 minutes apart, lasting 1 minute long, for about an hour before heading in. (Remember 4-1-1) In my experience the best way to manage a contraction is not to tighten up and fight it, but to relax into it. Remembering to keep your shoulders, face, and fists relaxed can help ease the tension you may experience. Believe it or not smiling helps too! You should feel no pain in between your contractions (aside from any normal pregnancy aches and pains). Use that time to rest.
Membranes Release/Rupture (AKA “Water Breaks”). Only about 15% of women experience their water breaking in the beginning of labor. More often it releases later in active labor, before or as you push your baby out. Your amniotic sac contains two layers. Sometimes only one layer breaks causing a slow leak, sometimes both will and larger gushes will happen. Your babys head as it becomes engaged will “plug” the exit and you may not experience much more leakage until your baby is born. Wouldn’t be a bad idea to wear a pad during labor in case you leak. Fluid may appear clear to pink, often with strands of blood. This is normal! Be sure to stay hydrated, as your fluids will regenerate the more you do. You do not need to rush to the hospital when your water breaks. If it happens before labor, you may feel a rush of adrenaline. you may feel shaky, nervous, or have loose stools. This too is normal! Take a deep breath and notify your doula. Rest as you wait for contractions. The risk for infection is low as long as cervical exams are limited.
Once in a while a baby will pass its first stools(meconium) in utero. More often than not this is not a huge concern if you labor pattern is consistently progressing, and that you and baby feel great. The bigger worry in relation to meconium is if the baby breathes that in once it’s born. By insisting on a vaginal delivery that risk becomes lower as your baby will have that great squeeze out of the birth canal.
Emotional Changes
Labor brings on a complex variety of emotional changes. We just mentioned how you may feel once(if) your water breaks. Anxious, nervous, and excited may be how you feel at the first signs of labor. It’s important to breathe and remind yourself that everything is going to be alright. You planned for this, you are going to get through it and meet your baby soon! Comfort and calming techniques are important in early labor. You should use this time to rest as much as possible. Sleep, eat, take a bath, go for a walk, or go about your day as usual, until contractions pick up consistently and you cannot ignore it anymore. Mind over matter plays a huge role in early labor. Anxiety may trick your body into feeling more pain, and make you more vulnerable or irritable. Remember you are strong and have support ready to help you through it!
Oxytocin (AKA the love hormone) is the hormone you produce during very happy moments. Moments such as an orgasm, extreme laughter, and also breastfeeding! Ever laugh (or orgasm) so uncontrollably you start to cry? That is an oxytocin overload and is exactly wheat will help you birth your baby! Talk with your partner ahead of time so they understand that romance is needed during this time. I always say the same mood that makes a baby is the same mood that’s needed for it to be born!
As labor picks up, you way feel like talking less. Your support people may begin only asking yes or no questions. Let them know if you need something, or if anything they are doing bothers you or doesn’t help. As transition occurs, you might feel a sense of self doubt, anxiety, or panic that “you can’t do this anymore” or something similar. This is a good sign that baby is almost here! Just keep breathing and relaxing into your contractions. Take the advice from your doula to try new positions to help you through the hard times. You may also begin to feel very sleepy. Allow yourself to doze off in between contractions. Your labor pattern may break for a few extra minutes to let you rest before pushing begins. If you have older children, you may yearn for their company because it will help you produce even more oxytocin. Don’t forget to smile and think happy thoughts, this won’t last forever!
Fetal Ejection Reflex
Fetal Ejection Reflex happens when you allow your body to do its thing. All you need to do is wait for it. Your baby will come. Your body will begin pushing all on it’s own! No instruction or coaching necessary! There really isn’t a “clean” way to describe this sensation so bare with me..but it’s similar to what you feel before vomiting. You know it’s coming, and you know once it starts there is no way to stop it. Most pushing you’ve seen on TV is exaggerated and unnecessarily coached. Same with many of the real life stories you may have heard from friends and family. Doctors often encourage mothers to start pushing as soon as they reach 10cm but this is not ideal. If your body truly isn’t ready to push it will be harder to do so, and can take hours or lead to undesirable interventions.
Babies know how to be born. Once in a while they may need some assistance getting into the right position, but in most cases if you simply trust the process, and trust your ability, all will be well. All of the pain you felt before will dissapear within the first sign of relief that it’s over, your baby will be in your arms, and then the hard part begins! (Just kidding!! Sorta!! LOL)