What is Labor?
Labor is divided into three stages.
1. The period during which the mother has contractions in her uterus and her cervix changes
2. The birth of the baby
3. The delivery of the placenta.1
First Stage of Labor (Contractions)
The first stage of labor for most women is the longest. If this is her first baby, the “average” first stage of labor can last from 6 to 12 hours. For subsequent births, the first stage is often shorter, averaging anywhere from 4 to 8 hours.
Early Labor usually begins with mild contractions that are 5 to 15 minutes apart and last from a minute to a minute and a half each. During this period the cervix dilates from 0 to 4 centimeters.
Active Labor is characterized by stronger contractions that start to come closer together (every 3-4 minutes). The water may break at this point, which will cause contractions to become even stronger. There may be some blood from the vagina as the cervix continues to open. During this period of labor the cervix will dilate from 4 to 10 centimeters.2
When you know that you are truly in active labor (contractions 3-4 minutes apart and each lasting a minute), it is time to check into the hospital should you be planning for a hospital delivery or phone your midwife should you be delivering at home.3
Second Stage of Labor (Birth)
When the cervix has dilated fully to 10 centimeters, the second stage of labor begins. This is when the woman will need to begin to “push” her baby out. She will feel the urge to bear down with each contraction, and should do so when given the “go-ahead” by her doctor, to help move the baby along the birth canal. For some women a few good pushes is all it takes before the baby is born. For others, it can take a few hours of pushing before the baby is born.4 The birth of the baby signals the end of the second stage of labor.
Third Stage of Labor (Delivery of the placenta/afterbirth)
This is the shortest stage of labor and can last from just a minute or two up to twenty minutes. The mother will still experience some contractions. They will be closer together than when she was pushing and usually less painful. These contractions help to get the placenta down into the birth canal. Once there, a push or two will help expel the placenta.
What is a Cesarean section?
About 1 in 4 babies are born by cesarean delivery. This means that the baby is delivered through an incision in the mother’s abdomen and uterus, instead of through the birth canal as in a vaginal delivery5. The situations in which a cesarean section might be needed are the following:
- Previous cesarean birth
- if a woman has already had a cesarean delivery
- Certain medical conditions
- such as an active case of genital herpes infection
- Multiple pregnancy
- the risks associated with vaginal birth go up with the number of babies
- Size of baby vs. size of mother’s pelvis
- the baby is too big to pass through the woman’s pelvis
- Position of the baby
- the baby is breech (buttocks or feet are closest to the vagina), or the baby is transverse (lying sideways in the uterus instead of head-down)
- Umbilical cord problem
- the cord becomes pinched and the baby may not get enough oxygen
- Placenta problems
- the placenta blocks the baby’s exit from the uterus
- Labor fails to progress
- sometimes a woman’s labor slows down or just stops
- Labor is too stressful for the baby
- the baby begins to show signs of stress during labor