The Three Stages of Labor

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How to identify the signs and symptoms of labor

As expectant parents research their options for birth, take classes and write a birth plan, it can be helpful to have a guide for labor to refer to when questions arise. How do you know if labor is progressing? How do you know when to go to the hospital or birth center? What arcae some differences between early and active labor? What does pushing feel like? For these answers and more, please find this helpful guide to the stages of labor as well as the entire series on the topic of Stages of Labor.

The First Stage of Labor

A. Early Labor

Definition: Early labor is defined by cervical dilation of 0-3cm, contractions in the range of 5-20 minutes and lasting for about 30-45 seconds.

Signs and Symptoms of Early Labor: Mothers typically notice several possible labor signs such as back ache and nesting urges. Contractions progress over time by getting longer, stronger and closer together. Mothers may notice some mild-moderate intensity during contractions, however, in between contractions she is able to converse and behaves normally.

What Support People can do: Encourage mothers to rest, eat lightly and conserve energy. Assist with relaxing activities such as reading, walking, breathing exercises during contractions as needed. In most cases, mothers can safely stay home during early labor. Check with your care provider regarding their recommendation for you.

B. Active Labor

Definition: Active labor is defined by cervical dilation of 4-8cm, contractions 3-5 minutes apart and lasting about 60 seconds.

Signs and Symptoms of Active Labor: Active labor is the beginning of intense contractions. Other symptoms include trembling, nausea and/or vomiting and some mild discomfort in between contractions. In active labor, moms have difficulty making conversation even between contractions due to the intensity of labor. Remind mother to drink fluids and empty her bladder often. This is often the best time to go to your place of birth.

What Support People can do: Encourage position changes, relaxing and slow breathing or vocalizing during contractions, drinking fluids and/or eating light foods if desired or allowed, as well as pain relief techniques such as hot/cold packs, massagehydrotherapy, etc..

C. Transition

Definition: Transition is defined by cervical dilation of 8-10cm, contractions are about 2-3 minutes apart and last for approximately 60-90 seconds.

Signs and Symptoms of Transition: Extremely intense contractions that occur with little rest in between. Contractions may be accompanied by rectal pressure if the baby’s head is low. Mothers will often have the most difficulty coping in this phase and need lots of encouragement and guidance from support people. Other signs can include shaking or trembling, nausea/vomiting and intense emotions.

What Support People can do: Encourage position changes, vocalizing, other comfort measures as needed. Verbal encouragement may be needed with every contraction. Reassure mother that she is close to the end and that all of the intense sensations are indeed normal.

The Second Stage of Labor

A. Resting Phase

Definition: The resting phase can occur for some women after 10cm of dilation. A period of about 10-20 minutes without contraction or without an urge to bear down is often seen.

Signs and Symptoms: Few noticeable contractions without an urge to bear down.

What Support People can do: Encourage rest, review pushing positions, remind mother to empty bladder if unmedicated, drink fluids and wait for the urge to bear down. May need to request that mother be able to “labor down” if urge is not strong enough or baby’s head is still high.

B. Descent Phase

Definition: Descent occurs with contractions 3-5 minutes apart, lasting about 60 seconds.

Signs and Symptoms: Contractions are accompanied by a strong urge to bear down several times with each contraction. The baby’s head descends with each contraction and then recedes.

What Support People can do: Encourage position changes as mother prefers or if no noticeable progress, rest in between contractions, drinking fluids, etc.

C. Crowning

Definition: The baby’s head descends to the opening of the vagina and does not recede with contractions.

Signs and Symptoms: The crowning phase is extremely intense for the mother with a sense of stretching followed by burning.

What Support People can do: Ask if mother can have cool compress to perineum for comfort, remind her to slow her pushing to ease baby’s head out. Review ways to avoid an episiotomy.

The Third Stage of Labor

Definition: This stage occurs about 10-20 minutes after the baby is born.

Signs and Symptoms: Some cramping and slight pushing to deliver the placenta.

What Support People can do: Offer encouragement, congratulate mother on her effort and enjoy the baby, initiate breastfeeding if the baby is showing signs of readiness.

Did your labor fit this pattern? If not, how was it different? Share your story.

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