Pregnancy, Stages of Labor and after Delivery

There is no way to determine with any certainty when your labor will start. Due dates are just an estimation and point of reference. It is normal for labor to start as early as three weeks before that date or as late as two weeks after it. The following are signs that labor is probably not far away.

  • Lightening. This occurs when your baby’s head drops down into your pelvis in preparation for delivery. Your belly may look lower and you may find it easier to breathe as your baby no longer crowds your lungs.  You may also feel an increased need to urinate, because your baby is pressing on your bladder. This can occur a few weeks to a few hours from the onset of labor.
  • Bloody show. A blood-tinged or brownish discharge from your cervix is the released mucus plug that has sealed off the womb from infection. This can occur days before or at the onset of labor.
  • Ruptured membranes. When the membrane holding the amniotic sac that surrounded 19182and protected your baby ruptures you will have a gush of water or fluid leaking from your vagina. This can occur hours before labor starts or during labor. Most women go into labor within 24 hours. Your obstetrician may need to induce labor  if it does not  occur naturally during this time frame to prevent infections and delivery complications.
  • Contractions. Although it’s not unusual to experience periodic, irregular contractions (uterine muscle spasms) as your labor nears, contractions that occur at intervals of less than 10 minutes are usually an indication that labor has begun.

diagram-stages-of-labor-and-delivery (1)

Stage 1. During this stage of labor contractions are frequent helping your cervix to dilate so your baby can pass through the birth canal. Discomfort at this stage is still minimal. Your cervix will begin to dilate and efface, or thin out. If your contractions are regular, you will probably be admitted to the hospital during this stage and have frequent pelvic exams to determine how much the cervix is dilated. As the cervix begins to dilate more rapidly you may feel pain or pressure in your back or abdomen during each contraction. You may also feel the urge to push or bear down, but your doctor will ask you to wait until your cervix is completely open. As your cervix fully dilates to 10 centimeters, contractions are very strong, painful, and frequent, coming every three to four minutes and lasting from 60 to 90 seconds.

Stage 2. Stage 2 begins when the cervix is completely opened. At this point, your doctor will give you the OK to push. Your pushing, along with the force of your contractions, will propel your baby through the birth canal. The fontanels (soft spots) on your baby’s head allow it to fit through the narrow canal. Your baby’s head crowns when the widest part of it reaches the vaginal opening. As soon as your baby’s head comes out, your doctor will suction amniotic fluid, blood, and mucus from his or her nose and mouth. You will continue to push to help deliver the baby’s shoulders and body. Once your baby is delivered, the umbilical cord is clamped and cut. 

Stage 3. After your baby is delivered, you enter the final stage of labor. In this stage, you deliver the placenta, the organ that nourished your baby inside the womb.

Each woman and each labor is different. The amount of time spent in each stage of delivery will vary. If this is your first pregnancy, labor and delivery usually lasts about 12 to 14 hours; subsequent pregnancies usually are shorter periods of time.

Just as the amount of time in labor varies, the amount of pain women experience is different, too. The position and size of your baby and strength of your contractions can influence pain, as well.  Discuss with your obstetrician methods to control pain during labor.

After you deliver your baby your body will go through transitions as you recover from childbirth. Emotionally you may experience irritability, sadness, or crying, commonly referred to as the “baby blues,” in the days or weeks after delivery. These symptoms occur in up to 80% of new mothers and may be related to physical changes (including hormone changes and exhaustion) and your emotional adjustment to the responsibilities of caring for a newborn. If these problems persist, inform your doctor or other health professional right away;  as you could be experiencing postpartum depression, a more serious problem that affects between 10% and 25% of new mothers.

If you need to have an episiotomy (cut made by your doctor in the area between the vagina and the anus) to help deliver the baby or prevent tearing or if the area was torn during birth, the stitches may make walking or sitting difficult. Ibuprofen or acetaminophen can help ease the pain. (Don’t take aspirin if you’re breastfeeding.) In some cases, particularly if you have an extensive tear, you may need prescription pain medication for relief.   Shortly after you give birth, you will be able to start taking warm soaks in the tub or in a sitz bath for 20 minutes three times a day.  Doing Kegel exercises will help to restore muscle tone, stimulate circulation, and speed healing. It’s important that you drink plenty of fluids and make sure to get enough roughage in your diet.  Hemorrhoids (swollen varicose veins in the anal area) are common after pregnancy and delivery as well as constipation. Hemorrhoids, episiotomies, and sore muscles can cause discomfort with bowel movements.  Stool softeners can help make having a bowel movement easier.

Your breasts may be swollen for several days as your milk comes in. Nursing right away in the hospital will help to decrease your discomfort and help you to bond with your baby. While nursing your baby you may experience contractions, after giving birth you will continue to experience contractions for a few days as your uterus returns to its normal size. Nursing your baby helps this process.

The most important thing to remember after you arrive home with your baby is to take it easy, don’t take on any unnecessary chores and if family and friends offer to help cook a meal or go food shopping, let them!  Save your energy for taking care of your baby and yourself, so your body can heal and you can enjoy your time with your baby!

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