You’re nearing that time when it might be hard to tell if the sensations you are experiencing are false labor, often referred to as prodromal labor, or early labor. If you have been having braxton hicks contractions for a while, it might be even tougher to distinguish whether or not it’s go time! Let’s get into the nitty gritty on the different stages of labor, and what to expect for each one. My hope is that you will go into your birth feeling educated and empowered knowing what your body is doing in each stage.
Stage One
If you don’t know for sure whether you are in labor, you are probably in the very early stages! Ignore it until you can’t anymore! Stage One of labor lasts the longest, and early labor can last up to 12 hours for some women. The hardest part about preparing your mind for labor is not knowing what cards you will be dealt. Labor is like a marathon, except it could be shorter or longer than 26.2 miles. You won’t know until you go through it! That is why it is so important to conserve energy and hydrate well in early labor.
The first stage of labor is defined by the period of time it takes to go from zero centimeters dilated to fully dilated. Contractions, or surges, may start slow and infrequent, occurring between five and 30 minutes apart and lasting around 30-45 seconds each time. The surges in early labor are mild to moderate, and get gradually stronger and closer together. This is how you will know it is the real deal! If it were prodromal labor, contractions would start and stop in an unpredictable manner; this could sometimes last for days!
You might experience some cramping, diarrhea, and the loss of your mucus plug. Fun fact: only about 10% of women have their water break before labor begins, and most women experience a slow leak of fluid rather than the sudden gushing you see in the movies!
Stage Two
Stage two of labor is often described as the “pushing stage,” as your cervix has reached full dilation and effacement. It is marked by the time you reach 10 centimeters until your baby is born. By this point, contractions have reached peak intensity. Each surge is longer and stronger, and you will experience less of a break in between the surges.
Your perineum has stretched quite a bit at this point, so you might be feeling some burning sensations as the baby crowns. Research shows that performing perineal massage starting around week 34-36 in first time mothers reduces the risk of tearing in labor. Bonus: it also gets you used to that burning sensation you will feel during the pushing stage! Additionally, studies show that laboring in a birth pool reduces the likelihood of tearing. You can achieve the same effect by having a member of your birth team apply a warm, wet rag on your perineum!
It is important to note that just because your cervix is dilated to 10 cm does not necessarily mean your body is ready to push. Women who labor down without an epidural often wait until they feel the urge to push. It is harder to feel that urge when you have an epidural, which is why coached pushing is sometimes necessary! Next week, we will explore how to labor down, how to breathe during contractions, and how to push without straining your pelvic floor.
Stage Three
Congratulations! Your baby is here, and now you need to birth your placenta. This is the marker of the third and final stage of labor. It sometimes can take up to 30 minutes for your body to expel the placenta, during which you will feel more contractions. If you are in the hospital, a nurse might perform a fundal massage by pressing on your uterus to help your body along. Once the placenta is birthed, the baby’s cord will be clamped. How long you want to wait to clamp the cord is up to you and your birth plan!
Sara French, ACSM CPT, NASM CNC
Sources
https://www.hopkinsmedicine.org/health/wellness-and-prevention/labor
