How important is Labor and delivery
When a woman becomes pregnant, she becomes aware that a new life is growing within her for the next nine months. Millions of women give birth to healthy babies every day. On the other hand, one often hears of women who have miscarriages, or who give birth to stillborn children or children with birth defects. This acts as a constant reminder of just how fragile and delicate the process from conception to childbirth is. Therefore, it is very important that a pregnant women understand the stages of labor and delivery very carefully.
As expectant parents research their options for birth, take classes and write a birth plan, it can be helpful to have a guide for labor to refer to when questions arise.
The four stages of labor and delivery are based on changes in the uterus and cervix. The beginning and end of each stages of labor and delivery are described below:
The First Stage of Labor
A. Early Labor
Early labor is defined by cervical dilation of 0-3cm, contractions in the range of 5-20 minutes and lasting for about 30-45 seconds.
Signs and Symptoms - Mothers typically notice several possible labor signs such as back ache and nesting urges. Contractions progress over time by getting longer, stronger and closer together. Mothers may notice some mild-moderate intensity during contractions, however, in between contractions she is able to converse and behaves normally.
In most cases, mothers can safely stay home during early labor.
B. Active Labor
Active labor is defined by cervical dilation of 4-8cm, contractions 3-5 minutes apart and lasting about 60 seconds.
Signs and Symptoms - Active labor is the beginning of intense contractions. Other symptoms include trembling, nausea and/or vomiting and some mild discomfort in between contractions.
Encourage position changing, relaxing and slow breathing or vocalizing during contractions, drinking fluids and/or eating light foods if desired or allowed, as well as pain relief techniques such as hot/cold packs and massage.
C. Transition
Transition is defined by cervical dilation of 8-10cm, contractions are about 2-3 minutes apart and last for approximately 60-90 seconds.
Signs and Symptoms - Extremely intense contractions that occur with little rest in between. Contractions may be accompanied by rectal pressure if the baby's head is low. Mothers will often face lot of difficulty coping in this phase and need lots of encouragement and guidance from near ones. Other signs can include shaking or trembling, nausea/vomiting.
Verbal encouragement may be needed with every contraction.
- The Second Stage of Labor
A. Resting Phase
The resting phase can occur for some women after 10cm of dilation. A period of about 10-20 minutes without contraction or without an urge to bear down is often seen.
B. Descent Phase
Descent occurs with contractions 3-5 minutes apart, lasting about 60 seconds.
Contractions are accompanied by a strong urge to bear down several times with each contraction. The baby's head descends with each contraction and then recedes.
C. Crowning
The baby's head descends to the opening of the vagina and does not recede with contractions.
The crowning phase is extremely intense for the mother with a sense of stretching followed by burning.
- The Third Stage of Labor
This stage occurs about 10-20 minutes after the baby is born. Some cramping and slight pushing takes place to deliver the placenta.
- Fourth Stage of Labor
Begins with delivery of the placenta and ends one-to-two hours after delivery.
After Delivery
After the completion of the different stages of labor and delivery, the doctor stitches up any tears in the cervix, vagina, or nearby muscles and tissues. The woman is then moved to the recovery room.
Often, a baby who does not need further medical attention stays with the mother. Typically, the woman and her baby remain together in a warm, private area for 3 to 4 hours so that bonding can begin. If a woman needs a rest, she may have the baby taken to the nursery.