Labor is separated into three distinct phases. The commencement of contractions indicates the first phase, and can be further dissected into two subsequent chapters: Early labor, cervical thinning and expansion; and active labor, which can be felt when the time between contractions decreases and they increase in intensity. The final portion of active labor is known as transition. Phase two is actualized by complete dilation and concluded on the baby’s delivery. Phase three spans from the moment the baby is born until the placenta has been discharged. This entire process can deviate from 10-20 hours for new mothers and on average advances faster for subsequent births.
Early labor is heralded by the onset of consecutive contractions and can be confused with Braxton Hicks contractions, which are identified by their infrequency in contrast to the regularity of true labor. Early labor contractions become increasingly frequent and acute. When time between them is 5 minutes long, they occur for up to 60 seconds in length and early labor comes to a close. Women are usually able to move around and engage in light activities during this time, and spend early labor at home. This phase is endured for 6-12 hours on average and lengthier for new mothers. Rest, liquids and frequent bladder voiding are advised during this phase.
During active labor dilation occurs more rapidly to 8-10cm and contractions heighten in power and duration, occurring every 3 minutes or less. This phase takes 4-8 hours on the average and the mother is advised to enlist the aid of a helper, either the partner, a friend or close family member. At the end of active labor (transition) the infant has moved down partially, creating strain on the bowels and urging one to push. This stage lasts between several minutes to several hours, decreased by prior births. The pain of labor can be reduced by, gas and air, a caesarian or more natural techniques such as visualization, massage and cool packs.
During the second stage, contractions become more infrequent, and the physician will ask the mother to push in the late part of this stage once the baby has fully descended into the pelvis. It is advisable to wait until urged by the body to push in order to save energy, and to settle on the most comfortable birthing position. Once the infant’s head is conspicuous, the compulsion to push increases though a more gradual labor prevents the tissue around the vaginal opening from rupturing.
After the head appears, delivery hastens; the shoulders pivot inside the laboring mother and she is asked to push hard. The delivery of the baby will then be complete and the umbilical chord clamped. Several contractions will be felt during which time the placenta is dislodged from the wall of the uterus and discharged. The uterus will then retract and become harder in order to break down the blood vessels previously attached to the placenta, which keep bleeding after birth. Contractions should fade quickly for those who have previously birthed or over a few days for new mothers.
