After teaching the Stages of Labor to my various Childbirth Education students, I've noticed that it can be quite complicated, confusing, and daunting. I've looked for a clear and creative way to teach it for some time, disappointed at all the various infographics and options that I found available due to one reason or another. One confused Phases with Stages, one skipped phases all together, and each one had a different idea of which phase included what amount of Dilation, and so on! So what's the real deal? What is what, and when is what! Let's clarify:
Firstly what exactly is Pre-labor?
Pre-labor, also known as prodromal labor, consists of what people like to call "False Labor," or "Braxton Hicks." It can mimic real labor in a very deceiving way. Often a women will feel semi-consistent contractions all night, and then they will suddenly stop at 6 am, as the sun comes up. You may think this is happening just to mock you, but the reality of the matter is that most of the time even BH contractions, or contractions one feels during "false labor" are actually doing a lot! They are preparing (albeit slowly, and maybe painfully) your uterus and baby for the real thing. Each minor contraction helps tone the uterus, so that when Game Day comes around, the contractions you feel are more effective, and hopefully more efficient. They also help your baby wiggle into the right position, sinking deeper into your pelvis.
Next comes the 4 Stages of Labor:
I will try and color-coat this, so things will be easier.
Stages- Each Labor Stage will be in purple.
Cervix- What is happening with your cervix with be in green.
Contractions- What contractions are like at this point in labor.
Pro Tips will be in red
Stage 1- Dilation
Stage 1 of Labor consists of 3 phases.
1A. Latent Phase, or early labor.
1B. Active Phase, or active labor.
1C. Third Phase, or Transition.
1A: During the Latent Phase of Stage 1, the first thing that needs to happen is effacement. Don't forget about Effacement- the softening and thinning of the cervix, and the movement of the cervix from facing backward to forward! The thinning and softening of the Cervix helps your cervix to easily dilate. Your Cervix moving from back facing to front facing creates a direct path for baby to the birth Canal, and needs to happen before your cervix can dilate. During this phase, your cervix dilates from 0-6 centimeters. The contractions during this phase will begin to get longer, stronger and closer together, but you may be able to distract yourself by reading a book. This is a good time to practice some of those coping techniques and comfort measures you learned in your Childbirth Education Course!
Pro Tip: If you're feeling discouraged because your doctor or midwife told you that your dilation hasn't progressed, ask them about your effacement. This is a step professionals often forget to mention to laboring women, but is essential before dilation can really progress.
1B: During the Active Phase of Stage 1, your cervix will dilate from 6-8 centimeters. Don't worry! I know what you're thinking! This phase generally goes by much faster than the previous phase. The Active Phase can often even be half the time, or less, of the previous phase. During this time, contractions will likely be 4-5 minutes apart lasting a minute long, for at least an hour. They will feel very strong, stop you in your tracks, and often require you to find a comfortable rhythm, and ritual to get you through them. Remembering to keep moving with your body's instincts will often help your baby wiggle into the right positions, to help labor progress.
Pro Tip: Check out Penny Simkin's article on the Three R's of Labor.
1C: During the Third Phase, or the transitional phase, your cervix completes it's dilation from 8 to 10 centimeters. This phase has the longest, and most difficult contractions, lasting up to 90 seconds, with a distance of only 2 minutes apart. Often during this stage women get nauseas from the sudden rush of catecholamines, or stress hormones, (sometimes causing them to vomit,) that help them to push their babies out fast! The good news is this is the shortest phase of labor, and while it progresses you enter into the Second Stage of Labor, which is birthing your baby!
Pro Tip: Keep Chapstick, a fan, and wet washcloth nearby during this phase. Because of the hormone rush, women often feel very warm, thirsty and like they need help staying refreshed! This is also the time to pump up the encouraging remarks, many women feel overwhelmed and ready to give up at this point!
Stage 2 of Labor- Birthing Your Baby
Stage 2 also consists of 3 phases.
2A. Latent Phase, or Resting
2B. Active Phase, or descent
2C. Transitional Phase, or Crowning and Birth
2A: During the Latent Phase of Stage 2, many women experience a sudden calm. This is the pause where the baby has engaged in the pelvis, and the uterus now needs to catch up, shrinking down to the size of the baby. This may be a welcome break point, as contractions suddenly disappear or quiet down for a few minutes. Not every woman experiences this.
Pro Tip: If you experience this, use this time to REST REST REST! Even if this is only 5 minutes, this is your bodies way of giving you time to muster up energy for pushing! Take Advantage.
2B: During the Active Phase of Stage 2, the baby's head descends and rotates through the pelvis, movement of the hips during this stage helps the baby to be able to wiggle into exactly the places he needs to be to descend most easily.
Pro Tip: The more movement the better at this point- try pushing in a squatting position- this widens the pelvis by 30%! Leaving more room for baby to make his way down, and reducing the pain.
2C: During the Transitional Phase of Stage 2, the baby's head will no longer keep slipping back into the birth canal, but rather finally stay visible, and eventually come out! The baby's head will come out, followed by each shoulder, one at a time, and then the rest of the body usually slips out easily.
Pro Tip: Doing Perineal Massage for the weeks leading up to birth will reduce the burning sensation, or the "Ring of Fire," as well as tearing, caused by the widest part of the babies head stretching the perineum to its maximum, as it passes through!
Stage 3 of Labor- Delivery of the Placenta
This is stage is pretty straight forward- at this stage you have to once again begin to push, and push the placenta out. Getting the placenta out is usually much easier, and considerably less painful than the delivery of the baby. This can take anywhere from 5-30 minutes after birth. If the Placenta takes longer than thirty minutes, often the midwife or doctor may inject Pitocin into the leg, to help with the removal of the placenta, and to reduce the risk of hemorrhaging.
Stage 4 of Labor- Recovery
This stage is often overlooked, and under appreciated. The first hour after birth is the time when your baby first learns the skills to breastfeed. Research shows that mothers who spend time within the first hour after birth working with their baby to learn proper nursing techniques, are more successful at nursing afterward, and nurse for longer. Also mothers who spend time with their babies within the first hour after birth are more likely to easily understand their baby's queues, and are more easily able to bond with them.
There you have it! A clear post on the stages of Labor! It came out a bit longer than I had planned, but I hope it is clear and straightforward as you read through it!
Happiest of Days,