The Four Stages of Labour: What You Need to Know

By Jenna Armstrong

November 4, 2019

My name is Jenna and I am am The Mama Coach in Winnipeg, MB. I am a Registered Nurse, lactation counselor, sleep coach, prenatal educator, CPR instructor, and a mom of 3 little ones! I am here to help!

You have waited a long time for this and now its time for your baby to be born! Every labour and delivery are similar in the way that they all consist of four stages.  Sometimes that’s about the only similarity! When I teach prenatal classes I always say each birth is unique and even if you have had a baby before the next time could be completely different!!

Stage One of Labour

The first stage of labour is your uterus starting to contract and causing your cervix to efface (thin out) and dilate (open).  Stage one consists of three parts: early labour, active labour, and transition.  

Part one

Early labour is when the cervix (bottom of the uterus felt by an internal exam through the vagina) is open 1-3 cm.  Early labour consists of the first contractions a mom feels! They typically start out a little irregular and spaced apart and then they build!  They become more of a regular pattern, they start to come closer and closer, lasting longer and longer, and increasing in intensity.

Commonly, moms will describe early labour to feel like they were coming down with flu.  The uterus is a big muscle and when it starts contracting blood flow to it increases. This means that less blood flow is going to the stomach so food will be slower to digest and moms may, therefore, feel nauseous. As the uterus contracts, it can irritate the bowels causing moms to experience diarrhea.  

Everyone is different, but for most mom’s early labour can take some time.  It is important to keep hydrated and keep your energy up by eating small frequent meals or snacks.  This is often the longest stage and can lead to frustration and exhaustion for mom!  

It is important to have some coping techniques for the pain in this stage because it is often done at home.  A purposeful firm touch from your partner such as counterpressure on your lower back or a hip squeeze can be helpful.  Positioning such as on an exercise ball or hand and knees will take some of the pressure and pain off your lower back and hips and help the baby get into a good position for labour. 

Warmth such as a shower or hot pack can feel good. Some mamas find music relaxing and breathing is probably the most important coping technique that you can use starting in this stage all the way through labour.  You want to take those nice slow deep breaths through the contraction, this will help you focus and cope with the pain.

Part two

Active labour is when the cervix is open to 4-7 cm.  Research shows once you are in active labour you should dilate about 1 cm an hour!  This is the point where you would want to contact your health care provider and/or make your way into the birth center or hospital.  If delivering in a hospital, this is the point you would be admitted into a labour and delivery room. You can continue to use the above techniques to manage the pain as well as the pharmacological options that are offered in the hospital.

Part three

The transition is 8-10 cm!  You’re almost there!! This stage is intense as there is a lot of pain and rectal pressure, but it usually goes by a little quicker. Contractions are back to back now and you are starting to feel the urge to push!

Second stage of Labour

You are 10 cm or fully dilated!  Time to start pushing and have that baby!  Pushing will usually feel better as you can do something about all the pain and pressure you have been feeling.  Normal pushing time is 1-2 hours for first-time moms. Once baby is born standard practice is delayed cord clamping for 1 minute followed by skin to skin for the first hour.  

Third stage of Labour

The delivery of the placenta, the lifeline to your baby! Once baby is born, the placenta separates from the uterine wall within 5-30 minutes, comes down through the birth canal and you may need to push once or twice to get it out.  After, your health care provider will check for tears to your perineum. There are different degrees of tearing and any tear is repaired with dissolvable stitches. If your bottom is sore you can apply ice and take some Tylenol and/or Naproxen for the discomfort.

Stage four of Labour

The stage after delivery is called postpartum. You will experience vaginal bleeding and it could continue for 4-6 weeks postpartum. If you plan on breastfeeding, you will likely try within the first hour. Don’t be surprised if you struggle a bit, breastfeeding takes practice for both mom and baby to learn the skill! After delivery, you may feel sore and contraction type pain as the uterus shrinks back down to pre-pregnancy size.

Becoming a parent is a big adjustment. It is normal to feel exhausted and overwhelmed after labour, delivery and those early postpartum days…you are doing some of the hardest work you will ever do! It all can be scary, exciting, and unpredictable all at the same time! Reach out to the Mama Coach in your area for a prenatal class! Learning as much as you can ahead of time will help you feel more prepared and ready for when the time comes!!

 

 

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