Labor and Giving Birth




Every woman's labor and delivery experience is unique even from one pregnancy to the next. Understanding what's typical can help you know what to expect as your due date gets closer. Sometimes, however, labor and delivery takes surprising twists and turns. You might reconsider your wishes about pain medication, or you might need an unexpected C-section. However your labor and delivery unfolds, remember that your health and your baby's health are most important. Discuss your labor and delivery preferences with your health care provider. Then look forward to welcoming your baby into the world.


Stage 1: Early Labor and Active Labor

Labor starts when the contractions create changes to the cervix. The cervix opens gradually and is measured in centimeters from 0-10. The cervix opens (dilates) and thins out (effaces) to allow the baby to move through the birth canal. This is the longest of the three stages of labor.

Early Labor

  • Mild contractions that come at regular intervals
  • Backache
  • You may notice bloody show-brown/blood tinged discharge from your vagina
  • Feelings of excitement and relief that labor has begun
  • Average length for First-time moms is 6-12 hours.

What can you do?
  • Walk!
  • Change positions frequently favoring upright positions
  • Carry on normal activities (try to distract yourself)
  • Eat and drink lightly
  • Take a warm bath or shower. Relax!

Active Labor

  • Strong contractions
  • Increased backache
  • Feeling more serious and increased concentration
  • Often lasts up to 8 hours or longer


What can you do?
  • Go to the hospital
  • Walk if comfortable
  • Sit on a birth ball or rock in a rocking chair
  • Try warm shower/bath
  • Look to your partner and health care team for encouragement and support.

Transition

  • Usually the shortest part of labor (10-60 minutes)
  • Very intense contractions
  • Chills/shaking legs/hot flashes
  • Pressure in your bottom
  • Desire to “give up or go home”
  • Feeling tired/irritable


What can you do?
  • Experiment to find your most comfortable position
  • Take one contraction at a time
  • Breathe
  • Relax and rest in between contractions




Stage 2: The Birth of Your Baby



The second stage of labor lasts from the time your cervix fully opens to the birth of the baby. Contractions during stage 2 are farther apart. Many women find the urge to bear down irresistible as the contraction builds. For most women the sensations to push are much less painful than the contractions of transition.

  • Almost uncontrollable urge to push
  • Tremendous back and rectal pressure
  • “Second wind” of strength to make pushing effort
  • Pins and needles stretching sensation as baby crowns
  • Feelings of relief, exhaustion, and excitement
  • May last from 1 contraction to 3 hours


What can you do?
  • Experiment to find the most comfortable and most productive pushing position (semi-sitting, side-lying (left), squatting, all fours
  • Relax your shoulders, neck, and jaw
  • Listen to the direction of your provider- At some point, you might be asked to push more gently — or not at all. Slowing down gives your vaginal tissues time to stretch rather than tear.
  • Open your eyes for the birth!




Stage 3: Delivery of the Placenta



After your baby is born, you'll likely feel a great sense of relief. Holding your baby skin to skin on your chest is very important and helps your baby get used to the outside world by stabilizing baby’s temperature, breathing and heart rate, and blood sugar. Cherish the moment. But a lot is still happening. During the third stage of labor, the placenta lets go of the inside of the uterus and is pushed out through the birth canal. Your health care provider will help deliver the placenta and make sure your bleeding is under control.

  • Mild contractions
  • May take 5-30 minutes
  • May feel chills or shakiness
  • Feelings of Relief the baby is here, joy, and fatigue


What can you do?
  • Relax! Breathe!
  • Hold your baby skin to skin
  • Try Breast-feeding
  • Gently push as you feel the urge or as instructed by your provider




The Postpartum Period



The first couple of hours after your baby’s birth are sometimes called STAGE 4 of labor. Your body is adjusting to its new non-pregnant state. Your uterus must contract firmly to prevent too much bleeding (like a grapefruit sized mass at the level of your bellybutton).

After months of waiting for your baby and working hard in labor and delivery, your attention shifts to caring for your new baby — but you also need to take care of yourself.

  • Vaginal bleeding (lochia) like a heavy period.
  • Afterbirth contractions/cramping especially during or after breastfeeding
  • Tenderness of perineum/bottom
  • Feelings of excitement, tiredness, and overwhelming love for your new baby.


What can you do?
  • Hold your baby skin to skin or have your partner hold baby skin to skin frequently to promote bonding, stabilize baby’s vital signs, and increase your success with breastfeeding.
  • Breastfeed your baby within the first hour of life and any time they show signs of hunger (lip movements, rooting, sucking on fingers or hands)
  • Empty your bladder every few hours to help your uterus shrink in size, decrease bleeding and rid your body of extra fluid that caused hand and leg swelling late in pregnancy.
  • Apply ice packs to your perineum for the first 12-24 hours to decrease swelling
  • Drink lots of liquids
  • Limit visitors and rest/sleep when the baby rests/sleeps




When You Go Home After a Cesarean Section



Watch for any signs of infection and call your provider for: fever higher than 100.4, severe pain unrelieved by your prescription medications or redness, swelling and drainage at your incision site or perineal tear.

  • Take it easy-rest when possible, do not lift anything heavier than the baby for the first few weeks
  • Support your abdomen- use good posture and hold your abdomen near your incision during sudden movements like coughing, sneezing, or laughing.
  • Drink plenty of fluids to help replace fluid lost during surgery, support breastmilk production and prevent constipation.
  • Take medication as needed- medications given by your provider are okay to take while breastfeeding


Disclaimer: The information contained in the pregnancy guide is not intended nor implied to be a substitute for professional medical advice, it is provided for informational purposes only. You assume full responsibility for how you choose to use this information. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition or your pregnancy. Nothing contained in the pregnancy guide topics is intended to be used for medical diagnosis or treatment. The information and materials in the pregnancy guide should not be used as a subsitute for the care and knowledge that your physician can provide to you. The information and materials presented in the pregnancy guide are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you - it is more likely that your physician is correct. He or she has the benefit of knowing you and your medical problems. You should recognize that the information and materials presented on this website have the following limitations, in comparison to being examined by your own physician:

  • You can have a conversation with your doctor.
  • Your doctor can perform a physical examination and any necessary tests.
  • You could have an underlying medical problem that requires a physician to detect.
  • If you think that you are having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!
  • And when in doubt, call your doctor NOW or go to the closest emergency department.