Labor and Delivery
Labor occurs in three stages.
There are three phases to the first stage of labor, which begins at the onset of true contractions and completes with the full dilation of the cervix. The three phases include:
- Early phase. Also called the latent phase, this time involves contractions every 5 to 20 minutes. Contractions increase in frequency and intensity. At first, contractions will last 30 to 45 seconds. This will increase to 60 to 90 seconds as contractions occur about every 5 minutes. The cervix gradually dilates to about 3 to 4 centimeters. Because the early phase can last hours or even days, it usually takes place at home.
- Active phase. Discomfort increases during the active phase as 45- to 60-second contractions occur every 3 to 5 minutes. The cervix will become dilated to 8 to 9 centimeters during this phase.
- Transition. During the transition phase, 60-second contractions will occur every 2 to 3 minutes. Cervical dilation will complete, reaching about 10 centimeters. It is important to alert your nurse if you have the urge to push. Do NOT push until the medical staff directs you to do so.
The stage in which you are fully dilated and can actively push and deliver your baby can take anywhere from a few minutes to a few hours.
After you deliver your baby, the final stage of labor involves the expulsion of the placenta. This usually occurs within 20 minutes after your baby’s birth.
Is it false labor or true labor?
In false labor, contractions:
- Are irregular and do not increase in frequency
- Go away when you change position or lie down
- Are felt only in the lower abdomen
- Do not increase in intensity
In true labor, contractions:
- Begin in your back and stretch around and up the abdomen
- Last from 40 to 60 seconds
- Increase in frequency and intensity
- Occur at regular intervals
- Are accompanied by a gush or leak of fluid
- Do not diminish when you change position or lie down
About 15 to 20 percent of deliveries occur via cesarean section. This surgical procedure involves delivery through an incision in the abdomen. Reasons that a cesarean section may be necessary include:
- You have had a previous C-section delivery
- The baby is breech, or in a transverse position
- Active genital herpes infection
- The baby is too large for a safe vaginal delivery
- You have placenta previa
When to Call the Doctor
After 37 weeks, call the doctor if:
- Contractions lasting 45-60 seconds are coming at 5-minute intervals for an hour.
If you were more than 3 centimeters dilated at your last exam, have a history of fast delivery, or live more than 30 minutes from the hospital, call when contractions have been 10-minutes apart for an hour.
- Your baby is not moving at least 10 times an hour. If you notice decreased movement, lie on your side and count the number of kicks you feel in an hour. If less than 10, have a snack and something to drink, then lie back down and do another count. If still less than 10, contact us.
- Membrane rupture. If you suspect that your water has broken, call us immediately. An evaluation will likely be conducted in the hospital.
- Vaginal bleeding. Minor spotting is normal after sexual intercourse or a pelvic exam. This may also indicate that you have lost your mucus plug. Any other vaginal bleeding should be reported to your doctor.
- If you have lost your mucus plug, you DO NOT need to call us unless you are having other signs of labor.