Let’s take a more detailed look into what is going on during the labor process from the time we are pregnant and full term (37 weeks or greater) and awaiting labor to begin.
I will preface this blog saying that this information pertains to mamas who will be having an uncomplicated, vaginal birth. I do not talk about Cesareans here (that will be in another blog). I do not talk about possible complications or variations of labor (that will be in another blog). Lastly, I do not talk about newborn complications after birth here (that will be in another blog).
Hold onto your baby belly and let’s get started!
First of all I must declare… Please be aware of the following while you are awaiting labor to being: decreased fetal movement, if your contractions never seem to go away and your uterus stays hard even between peaks in contractions, if you are having bright red vaginal bleeding, if there is a discolored fluid leaking from your vagina, if you get the feeling that something isn’t right and if you see signs of something your provider has told you to be watching for. Never hesitate to get in touch with your provider at any point during prelabor or labor to ask questions or to be seen for an examination for reassurance. Also, before 37 weeks of pregnancy, if any prelabor signs are present, it is worth a call to your provider to talk about your individual signs/feelings/situation.
Here are some signs labor may begin within hours or days:
Dropping of your baby bump, unfamiliar low back ache that comes and goes, frequent urination, soft, frequent bowel movements, mild abdominal cramping, swelling, bursts of energy, increased vaginal discharge, Braxton-Hicks contractions (non progressing in length, frequency & intensity over time), bloody show, leaking water and the nesting urge.
Here are a few pre-labor (labor may be coming within hours) signs:
Non progressing contractions, bloody show, leaking amniotic fluid.
Here are a few positive labor (labor is officially beginning) signs:
Progressing labor contractions, rupture of membranes as a gush of fluid, change in cervical dilation as confirmed by a vaginal examination.
Here is your prodromal labor warning. Sometimes (more often in a first time mother’s labor) there can be a very drawn out early labor consisting of a day or two of contractions that are not progressively getting stronger or more frequent. This prodromal labor typically effaces (thins out) the cervix over this period of time so at least it’s not for nothing! This latent labor can be difficult physically and emotionally as it may still keep mama awake and possibly needing some comfort measures. I actually had a couple days of prodromal labor with my 2nd pregnancy. In my experience my contractions began immediately following a virus I had suffered at 37 weeks pregnant and left me having non progressing contractions for 2 days before finally turning into early labor, progressive contractions. If you’re having trouble interpreting whether you’re in actual labor or possible labor do not hesitate calling your birth provider to ask for guidance.
If your water breaks:
Notify your birth provider. Don’t put anything into your vagina (no tampons, no douching, no sex). Shower instead of soaking in a bath (unless it’s your own home bathtub or birth tub to which your body is already accustomed to the environment & germs present). Note the time, amount, color and any odor of the amniotic fluid. Follow instructions given by your provider if you are a GBS + mama. For most women, most of the time, it is okay to continue to labor at home with your water broken and doesn’t have to be a situation where you need to hurry to the hospital. It is a good idea to make your provider aware that your water has broken and allow them to give you further guidance and things to be aware of.
I am going to break down the labor process simply & to the point. Here are a few of my (old) Instagram posts to help.
First Stage of Labor
Stage 1 is defined by three phases:
- Latent/Early: Latent or early labor brings contractions that gradually increase in frequency and intensity. Most first time mamas experience a gradual onset of increasing intensity but please be aware that some do experience a hard and fast labor onset (that was the case for me and my first labor!). Contractions come closer together typically 5 minutes apart and lasting for 30 to 90 seconds. You may experience back ache, loose bowel movements, bloody show, restlessness or even your water breaking. You can expect to begin to feel the roller coaster of labor emotions including excitement, anticipation, apprehension.
- Active: Active labor phase has begun after stronger, longer and more frequent contractions have arrived to stay. This phase takes you to about 7 to 8cm in dilation. This phase can be overwhelming due to the intensity of the contractions which will most likely demand all of your attention. If you haven’t already, this is the time when you should call for your midwife’s presence or get to your chosen birthing facility. This phase is typically shorter than the early phase but mama please know your body and baby are on their own unpredictable timeline. Be calm and patient.
- Transition: Your body is almost ready for you to push your baby out. Your cervix is dilating the last few centimeters to accomplish complete dilation of 10cm. Your body is preparing your cervix to be pulled over your baby’s head and pushing your baby through the vaginal canal. This is widely agreed upon to being the most intense part of labor. It is normal to feel like you can’t do it anymore when you get to this phase. You will feel maximum pressure in your vagina and rectum which often makes you feel like you have to poop. For real mama, if you are having great pain and feeling great pressure like you need to poop, just know you are almost to the end! Know that more often than not women do poop during this part of labor (I did during both of my births!), but please hear me when I say, this cannot be controlled, is a regular part of the birth process and should not make you feel embarrassed. Feelings of doubt and loss of control can be overwhelming when you are experiencing transition. Timing of contractions and constant intense pressure leave mama with little to no breaks from the pain. But, you can do hard things and this is typically the shortest phase of stage 1! Expect to be irritable, but cope the best you can. Anticipate having nausea & possible vomiting. I experienced this with both my labors. Also, expect this to be the point in labor which you are the most vocal with moans and grunts. This is (in my opinion) the hardest part of labor.
Here are my personal tips for you as an unmedicated birthing mama x2:
- Early labor tips: Try to stay comfortable and rest as much as you can manage to. Take a shower and grab a healthy snack. Enjoy a walk. Prepare your hospital bag and notify your birth team. Encourage oxytocin release for natural labor progression by stimulating your nipples and kissing your partner. Don’t be afraid to dig into your pain relief and relaxation tool bag early on! Use the techniques you’ve learned through birth prep, don’t wait!
- Tips for active labor & transition: Don’t watch the clock. Fuel your body as needed and as feels right. Relax! Especially making an effort to rest and recover between contractions. Encourage oxytocin release for natural labor progression by stimulating your nipples and kissing your partner. Change positions often in a way that feels right for your body. Stay mobile. Speak aloud your birth affirmations and positive birth mantra.
Second Stage of Labor
At this point mama has reached full cervical dilation and the next step is pushing the baby out. Once you push your baby out, the second stage of labor is completed.
- This stage may still take more than an hour so patience and focus is still warranted. You may feel worried that you won’t have enough energy to get to the finish line and be relieved at the same time that you can now push and take action with your pain. I personally felt this relief when I was able to start pushing. It helped get my focus off my contraction pain and apply my effort in an active way rather than a relaxing way.
- It is common at this point and maybe even just before you reach full dilation that you have the urge to push or bear down. Your provider may want to do a cervical exam prior to having you do any pushing to be sure the cervix has gone behind the baby’s head completely. Pushing before the cervix is behind your baby’s head can cause it to swell and prevent further dilation. So remain patient and relaxed from mouth to toes.
Pushing is most effective when done at the same time you are having a contraction. Don’t begin a set of pushes until you feel the urge to push during your contraction. Short and frequent pushes ( 2 to 3 pushes for 5 to 10 seconds each per contraction) will spare your energy and be most effective. If you are unable to feel your contractions due to having an epidural, your birth team will instruct you on when to begin each set of pushes.
- Remember mama, it is not helpful or necessary to strain with all your might when pushing. Use the least amount of effort that gives you good progress. If it’s possible to be in an upright position during the pushing process this will allow gravity to help, decrease pressure on your perineum and allow your coccyx bone to flex to accomodate for the baby moving through the birth canal.
- When your baby’s head is almost through the birth canal you may feel a burning sensation (the ring of fire), even if you do have an epidural. At this moment, expect to be directed not to push any more. You should breathe through the pain (not push) to allow the baby’s head to emerge gradually in hopes of decreasing the risk of perineal tears.
Third Stage of Labor
Stage 3 is defined as after the birth of your baby until the delivery of your placenta.
- This stage is usually quick (averaging between 5 to 30 minutes) and often even goes unnoticed by mama.
- After your baby has been born, your uterus will then begin contracting again to expel the placenta. These afterbirth contractions are painful for some mamas, but may not be for others. Once the umbilical cord is clamped, your body will naturally begin the expulsion of the placenta from the uterus. This is a natural process and your hormones can complete the process without the help of synthetic pitocin administration. With that being said, more than likely in a hospital birth you will be given synthetic pitocin to speed up the expulsion of the placenta and to diminish immediate postpartum bleeding. During this stage of labor you can also expect vigorous fundal rubs which are massages given by your provider on the top portion of the uterus to assess and ensure firm uterine tone and to aid placenta delivery. Fundal rubs will continue throughout your immediate postpartum period. Once the placenta is out, your physical birth process is finished! Congratulations mama!
What exactly is happening to my cervix doing during all of that labor process?
Here are the cervix’s 6 steps to birth:
- Your cervix moves into an anterior (forward) facing position
- Your cervix ripens (or sofens)
- Your cervix effaces (or thins out)
- Your cervix dilates to 10cm
- Your baby’s head rotates and tucks to prepare for decent
- Your baby descends through your pelvis and is born
Fourth Stage of Labor
This stage is often defined as beginning immediately after the baby is born and the placenta has been expelled and lasting into several weeks postpartum. Mama’s condition is stabilizing and working hard to normalize after birth. This is when you and your baby belong together. Get as much skin-to-skin time as possible. Initiate breastfeeding. Oxytocin, endorphins and prolactin will be soaring through your body. Caregivers will be tending to your perineum to assess for tears & completing necessary repairs. You will experience vaginal bleeding and abdominal cramping as your uterus begins the healing process and returns to its non pregnant size. Fundal rubs will continue during the immediate postpartum period and you may experience some uncontrollable shivering. This is when you are entering into motherhood, parenting and beginning to process your birth experience. Covet this time. Give yourself grace. Allow others to help support you. You are now a mama with a baby in your arms and you don’t have to do it all alone.
Well that is it for the blog all about the labor process! I hope I have helped you learn something new here. Come find me on social, send me an email, or post a comment if you’d like to or have any questions you want to ask me.
Talk to you soon friend!
