St. Albert & Sturgeon Primary Care Network
Labour and Childbirth
From the first contraction to the birth of your baby, labour proceeds through identifiable stages that include predictable events. Understanding what is happening in your body during labour can give you confidence and help you through this experience.
What stages will I go through during labour and childbirth?
The process you'll go through during labour and childbirth can be divided into three stages:
- The first stage of labour begins with the onset of contractions and ends when the cervix is fully dilated. This stage is divided into two phases, known as early and active labour. During early labour, your cervix gradually thins out (effaces) and opens (dilates). That's followed by active labour, when your cervix begins to dilate more rapidly and contractions are longer, stronger, and closer together. People often refer to the last part of active labour as “transition”.
- The second stage of labour begins once you're fully dilated and ends with the birth of your baby. This is often referred to as the pushing stage.
- The third and final stage of labour begins right after the birth of your baby and involves the separation and delivery of the placenta.
First stage: Early labour
During the early phase, the cervix dilates to 4 centimetres. Your contractions may be irregular, progressing to rhythmic and regular. The pain felt at this early stage may be similar to menstrual pain: aching, fullness, cramping and back ache. You will still be able to walk. Walking is usually more comfortable than sitting. Most women spend these hours at home. If you come to the hospital you will be assessed then sent home. You may feel eager, excited and social. It is important that you conserve your energy for the work of labour. Be sure to drink plenty of fluids so you stay well hydrated. And don't forget to go to pass urine regularly even if you don't feel the urge. A full bladder may make it more difficult for your uterus to contract efficiently, and an empty bladder leaves more room for your baby to descend.
You may also notice increasing vaginal discharge, which may be tinged with blood. This is perfectly normal. Go to the hospital if you are bleeding (like a period) or if your water breaks.
First stage: Active labour
Active labour is marked by regular contractions that become longer, stronger and closer together over time. Most providers recommend that you go to the hospital when your contractions are five minutes or closer apart, lasting more than 60 seconds for at least an hour. Measure your contractions from the start of one contraction to the beginning of the next.
Your healthcare provider will want to know:
- How far apart are the contractions?
- How long they are lasting, and how intense?
- Has your water broken? Your provider will want to know the time this occurred, and any colour or odour.
- Has there been any discharge, such as a bloody show?
If you have had previous deliveries, the active phase of labour can proceed more quickly.
When you are in active labour, you will be concentrating on the task at hand, and will not feel like doing anything else. Your contractions will grow stronger, longer and closer together and you may have a tightening feeling in your pubic area and increasing pressure in your back.
Transition
Transition is the most difficult phase of labour, lasting from 30 minutes to two hours. The cervix is opening the last few centimetres, from 7 to 10 centimetres and the baby descends into the birth canal. All of your energy is concentrated on doing the work of labour. Try to remain calm and focused as your uterus works. At the end of transition, you may feel a strong urge to push the baby out.
Second Stage of Labour
During the second stage the baby is born. The baby's head stretches your vagina and perineum (the skin between the vagina and rectum). This will cause a burning sensation. Some women may feel as if they are having a bowel movement, and feel the urge to push, your healthcare provider will tell you when it is time to push. “Crowning” occurs as the widest part of the head appears at the vaginal opening. In the next few pushes, the baby is born. The baby will take its first breath, and may begin to cry. After birth the cord will be clamped and cut.
Third Stage of Labour
The third stage begins with the birth of the baby and ends with the delivery of the placenta. It is the shortest stage, about 15 minutes. Your contractions may stop for awhile, then resume to deliver the placenta. You will be observed closely for the next few hours to make certain that your uterus is contracting and bleeding is not excessive. Take this time to rest and get to know your new baby.