Labor is a good lesson in rolling with the punches. Unless you have a scheduled induction, there’s no way to know when it’s going to happen or how long it’s going to last.
A full-term baby might arrive anytime between 37 and 42 weeks, and some babies will be born earlier. Even once it’s clear the big day is here, the length of labor is still unpredictable. First time moms might labor from sunup to sundown while other lucky ladies will go from 1 centimeter to pushing in a matter of hours. To be as prepared as possible on such an impossible-to-prepare-for day, familiarize yourself with the process of L&D so you can track your progress through each stage and manage your pain—and expectations—accordingly.
During early labor, your cervix begins to dilate (open) and efface (thin out). You’ll begin having regular contractions that will increase in intensity, but they likely won’t be painful enough to stop you in your tracks just yet. You might also notice a “bloody show,” a mucusy vaginal discharge tinged with blood, when you go to the bathroom.
You may opt to stay at home through early labor since it’s a comfortable setting. (Once you’re admitted to the hospital, you’ll be there for the long haul.) Use the time to relax. Consider taking a warm bath if your water hasn’t broken, or watch a movie while resting on the bed. Be sure to drink plenty of fluids and save up your energy for the Olympic event that’s soon to follow.
Unless your doctor has advised you otherwise, you should plan to give him a call and head to the hospital at the beginning of active labor (when your contractions are consistently occurring five minutes apart and lasting 40 to 60 seconds). During this stage, your cervix dilates from 4 to 8 centimeters and contractions are longer, stronger and closer together. You won’t be able to talk through your contractions anymore, and it will be obvious that you’ve reached the part where things really get going.
To deal with the increased discomfort, try breathing exercises and walking. If your birthing room is equipped with a tub, a warm bath is still a good option assuming your membranes are intact. Planning to have an epidural for pain management? Discuss your desires with the medical staff when you arrive at the hospital so they can put in the request at the right time.
This is the most intense part of labor for many women, when the cervix is dilating from 8 to 10 centimeters. Contractions are intense and might be coming every two to three minutes and lasting a minute or more, so there’s very little time for rest between them. Expect to experience shivering and shaking, and don’t be surprised if you’re nauseated or need to vomit. Rectal pressure is also common, which is a signal that it’s almost time to push.
Lying flat on your back can be excruciating, so try changing positions to ease discomfort. Many moms find relief in squatting or getting on all fours (a particularly good position for alleviating back pain), but this won’t be an option if you’ve had an epidural.
When you are fully dilated and effaced, your doctor, midwife or delivery nurse will coach you through the pushing stage. If you had an epidural, you might prefer to have it turned down slightly to allow more feeling below the belt; being in tune with your surges can make pushing more instinctive and productive.
You might hear, “I can see the head!” only to find that it recedes slightly after the contraction subsides. But don’t be discouraged: The combined force of your uterus and abdominal muscles contracting will move your baby down through your birth canal and into your delivery attendant’s hands. As his head and shoulders push out of your body, you’ll feel a strong burning sensation often referred to as “the ring of fire.” Once delivered, your baby will be placed in your arms, so you can revel in the life you’ve created.
After a few minutes, your uterus will begin to contract again. These contractions will separate the placenta from your uterine wall, and one or two additional pushes will likely expel it entirely. With delivery complete, you’ll be ready to move onto the next stage of the process: motherhood!