When your due date nears, or has come and gone, you start paying close attention to the cues your body is giving you. Perhaps your baby has dropped further into your pelvis, preparing for descent into the birth canal. Maybe you have lost your mucus plug. Or you could be experiencing Braxton Hicks contractions, preparing your body for the big day. What can you expect in this first stage of labor?
The first stage of labor is broken down into three phases; early labor, active labor and transition. These phases prepare your body to push out your baby by bringing on regular contractions, lowering the baby down into the pelvis, thinning and dilating the cervix.
How Can I Tell If It’s Braxton Hicks?
Braxton Hicks contractions are preliminary contractions that can be experienced as early as 20 weeks, but more commonly late in the third trimester. These contractions are not labor contractions. Braxton Hicks feel like a tightening of the abdominal muscles. These preliminary contractions usually are not painful. They should be short, irregular, and far apart, and wear off after some time, rather than getting more intense like labor contractions.
Braxton Hicks contractions late in your pregnancy could be a sign of your body preparing for the real thing. But if your due date is still weeks away, Braxton Hicks contractions might be a message from your body telling you to slow down and take it easy.
Experiencing pre labor contractions can be exciting, but it can also feel discouraging if you are eager to have your baby. Drinking water, or changing positions can help ease Braxton Hicks contractions. This is a great time to practice your relaxation techniques.
How Do You Know If You’re in Prodromal Labor?
Prodromal labor is when contractions start and stop. It is different from Braxton Hicks in that hydrating and changing positions will not ease the contractions. They may follow a pattern of getting more intense and closer together. But then stop. These contractions may also have an effect on the cervix, effacing or dilating it to prepare for birth (Braxton Hicks contractions do not have this effect). Prodromal labor contractions could happen regularly in the last weeks of your pregnancy before true early labor starts.
What are the Signs of Early Labor?
When your contractions are coming in more regular intervals; getting closer together and more intense as time passes, these are labor contractions. This is the real deal! You are on your way to having your baby in your arms. However, depending upon how far apart your contractions are, it is probably not quite time to drop everything and head for the birth center. These early labor contractions can be 10 minutes apart or less. They may last for about 30 to 40 seconds. You will be able to walk and talk through these early contractions as they will not be too intense.
This is the time to get your rest. The real work is coming, but it’s not here yet. So, while you may be excited and want to rush your labor along, try instead taking a bath, making some food, or ideally going to sleep. You will want to save your energy for the road ahead. Relax, rest, eat, hydrate.
Who To Call In Early Labor?
At this point in early labor it is also the time to notify your team. Call your doula, midwife and/or OB. Let them know that you are in the early stage of labor and that birth is imminent. If you have other children, call your babysitter or nanny to let them know that the time is fast approaching.
Your doula may come to your home once early labor has progressed. They will administer comfort measures and assess progress to reduce the chance of heading for the birth center too early. Some birthing parents who go to the birth center or hospital too early tend to get discouraged easily when they realize that they have not made the progress they had expected.
5-1-1 is a good rule of thumb. Contractions that are five minutes apart, one minute in duration, for one hour signal that it is time to go to your birth center or call your midwife to come join you.
What Are The Signs Of Active Labor?
At a certain point in your labor you will feel a shift. This shift comes with active labor. You may feel vulnerable and helpless all of a sudden. Your contractions are coming more quickly now, about every 5 minutes or less. They are also less manageable. You will probably be unable to talk or walk through your contractions. Some laboring people experience a mental shift. Where they were once happy and excited, they may now feel anxious and possibly overwhelmed.
Your doula should join you around this time if they haven’t already. They will be there to help you cope with your shifting mindset and the rising intensity of contractions.
How long is active labor?
Active labor can last 6 to 8 hours. Sometimes longer, especially for those who have not given birth before. Once contractions are less than 5 minutes apart, last 30-50 seconds and have progressed to a point where they are difficult to talk through, that is an indication of active labor. Most laboring individuals follow the rhythm set forth by their body to help them cope with the demands of contractions.
This is also the time when many laboring people opt for interventions such as an epidural.
What Is The Transition Phase In Labor?
When you have reached the transition phase of labor you are almost fully dilated or the full 10 cm dilated. Contractions are now 50 to 90 seconds long and approximately a minute apart. There is almost no down time between contractions. The intensity of contractions makes them impossible to get through without coping mechanisms and/or comfort measures.
Your baby is stationed much lower in the pelvis at this phase which will create a lot of pressure. You are mentally preparing to start pushing. If you feel the urge to push, tell your midwife or nurse. Pushing before reaching full dilation can swell the cervix and slow labor. If you are not fully dilated it is important to resist this urge, which can be very strong. Shallow quick breathing techniques help resist pushing the baby too low too soon.
You may feel extreme fatigue during the transition phase. Nausea is also very common, and some will vomit.
At this phase many laboring parents want to give up, and feel like they can’t go on any longer.. It helps to remember that meeting your baby is moments away. Transition typically only lasts 30 minutes to 3 hours. You are so close.
How Should Contractions Be Timed?
When you notice that your contractions start to grow longer, stronger and closer together you will want to start timing them to keep track. It is important that you time contractions correctly so that you can give your care providers accurate readings. Time your contractions from the start of one contraction to the start of the next contraction. So you are not timing the duration of the contraction, but the span of time from the beginning of one to the beginning of the next.
What is a Mucus Plug?
Your mucus plug is a stopper at the opening of the cervix. It protects the amniotic sac. Loss of mucus plug signifies cervical change. You can lose your mucus plug weeks before you go into labor, therefore it is not a definitive sign of labor. Alternatively, your mucus plug can shed while you are in labor. It is regenerative, so you may see mucus even after you have lost your plug.
How Can I Tell If My Water Broke?
In movies and television shows it is common to see labor commence with a gush of water between one’s legs. It rarely happens quite this way in reality. Typically the first signs of labor will be your contractions, or loose bowel movements. If your bag of water breaks in early labor it is important to note the smell, color, amount of fluid and the time. Your care provider will likely ask you these questions. Some may confuse it with urine. If it is colorless and odorless it is likely amniotic fluid. Your water can break with a gush of liquid or it can trickle out. After your water breaks your care provider may want to keep track of the time to prevent exposure to bacteria.
Sometimes care providers (midwives, OB/GYNs) will decide to puncture your amniotic sac themselves. This is called the artificial rupture of membranes. This is done for several reasons. Sometimes it is performed to augment labor progress, or to insert a fetal monitor.
What Are The Fetal Descent Stations
Station refers to how low your baby is in your pelvis. Your baby can be stationed anywhere between -5 and +5, in relation to your ischial spines. Station 0 is when the baby is fully engaged in the pelvis. Anywhere between 0 to positive stations are when you start pushing your baby out with your contractions (with a fully dilated cervix). +5 station means that baby’s head is visible emerging from the vaginal canal..
What Are Cervical Changes
Prostaglandins, hormones released in labor, initiate the cervical changes required to give birth vaginally. These, along with your contractions bring about effacement and dilation of the cervix.
How Does Effacement Work
Effacement is the thinning of the cervix to make way for baby. The cervix must become as thin as paper before baby can pass. But this needs to happen in conjunction with dilation of the cervix for birth to happen. Your cervix will efface from 0-100.
What Happens When Your Cervix Is Dilating?
Dilation is the opening of the cervix. Baby cannot fit through a cervix that is less than 10cm dilated. Your cervix may dilate slowly or very quickly. The first few centimeters may happen over the last couple weeks of pregnancy. The rest happen during active labor and transition. But a fully dilated cervix is not the only necessary change for baby to come into the world.
How Does The Cervix Move During Labor
Your cervix must also change position from back to front. If the cervix is fully dilated and effaced, one can still not give birth if it is facing their posterior. As with all cervical change, this can be encouraged by changing positions, walking, bouncing on a birth ball etcetera.
When to Call Your Care Provider
Precipitous Labor
If you believe you are in precipitous labor you should call your doctor or midwife. Precipitous labor is very quick; under 5 hours, can be less than 3 hours. Most people might think that this sounds favorable, as they wish to avoid long labors. Though it can be entirely physiological, it can also pose some risks including increased instances of vaginal or cervical tears, and increased risk of hemorrhage in the birth parent. It can also be rather shocking or even traumatic for the birth parent. If your contractions are coming on really intensely really quickly after labor begins, you might be in precipitous labor.
Meconium in Amniotic Fluid
When your bag of waters breaks it is important to note the color. If your amniotic fluid is tinged with dark color it may have meconium. Meconium is your baby’s first bowel movement. If there is meconium in the amniotic fluid it is important to get checked by your care provider to make sure that baby is okay. This could be a signifier that baby is stressed.
Fever
If during early or active labor you spike a fever you should inform your care provider. This could indicate infection. The work of labor and contractions make the body warm anyway. But a fever is a sign of an underlying issue. The risk of infection also rises after your bag of waters breaks.
Vaginal Bleeding
There might be some light vaginal bleeding in early labor. Your “bloody show” is another way to refer to losing your mucus plug. But if you have heavy bleeding, like you would during menstruation that is a reason to call your doctor.
In Summary
The first stage of labor is the longest and most difficult to get through. It can last days, or as little as a few hours depending on many different factors. You may feel excited, anxious, scared, overjoyed or in awe at what your body is doing. Once you have passed through the first stage of labor you are likely a few pushes away from meeting your baby.