Stages of Labor

The stages of labor are often made to seem as if they are separate, distinct parts of labor. In actuality, pregnancy, labor, and birth exist along a continuum and the stages of labor flow gradually into one another. So it can be hard to tell where one leaves off and another begins.

Prodromal Labor

This very early labor is sometimes called false labor. There is really nothing "false" about it. I like to call it practice contractions, or a warm-up to active labor.

This early labor is felt as a tightening throughout the belly (also called Braxton-Hicks contractions), and are usually not uncomfortable or painful. Prodromal or early labor can start several weeks before birth.

You might think that active labor is beginning, and the contractions may make it harder to get comfortable to sleep at night. If the contractions don't start to become more intense and more frequent you will know it is prodromal labor. Usually if you lie down during prodromal labor, contractions will significantly slow or stop altogether.

Of all the stages of labor, it is important to be able to identify prodromal labor for what it is, as you don't want to go to the hospital too early only to be sent home again. Even worse you don't want to be admitted and put on pitocin to speed up a labor that is only just beginning.

First Stage of Labor

--early labor

This is the opening phase of labor--the job of the contractions during this phase of labor is to draw open the cervix. The contractions will begin to increase in intensity, duration, and frequency. You can still talk during contractions and go about your business as usual. You still have the ability to focus on other things.

--active labor

The intensity, frequency, and duration of contractions has increased still further and they begin to take your full attention. You are not able to converse during contractions and you may need to breathe or vocalize during them.

--transition

Of all the stages of labor, transition can often be the most difficult. It can be very hard to get comfortable during transition. Contractions are coming almost one on top of the other with very little break in between.

During transition you can get very restless, it can be hard to find a position that feels good or a way of coping that helps. The full force of your body doing this incredible thing cannot be escaped--it must be faced. It is incredible how in the moment birth can make you be.

At this stage of labor it is easy to be irritable with those around you and irritable with the whole birth process. You may wonder why you are not done yet and why you have to keep going.

Your body may be starting pushing contractions, but not completely (hence why it's called transition--you are transitioning from opening contractions to pushing contractions). You might feel like you are getting mixed messages from your body. Take your time to work your way through this. You will figure out how to integrate the sensations eventually.

This is why I believe it is especially important for caregivers not to take over or forcefully direct a woman at this time in labor. It is part of how you find your own way through birth, part of how you find your birthing power.

Second Stage of Labor--Pushing

I describe it as throwing up, but instead of throwing up your body is throwing down--the "urge to push" is that uncontrollable.

As you work with your body and your baby to bring your baby down you will begin to feel their head in the birth canal. When baby's head starts to crown at the vaginal opening, you will likely feel a burning sensation as your perineum stretches around the baby's head. If you allow for gentle stretching and don't forcefully push the baby out--there is much less likelihood of tearing.

All of this is assuming an un-medicated birth in which you can feel what your body is doing so you will know how best to work with your body. If you have an epidural or other medications, you will not be getting the feedback from your body that will enable you to give birth in the easiest and most efficient manner.

Third stage of Labor--Birth of the Placenta

It is important that the mother and her baby be skin to skin and initiating breastfeeding at this time. This close contact between mother and baby and the breastfeeding helps the uterus to contract and clamp down the open blood vessels left when the placenta shears off. This is very important in keeping after-birth bleeding to a minimum.

If there is much intervention at this stage, such as tugging on the cord (known as cord traction), or pressing on the belly, it can cause the placenta to partially detach. A retained placenta or pieces of placenta left in the uterus can cause infection and hemorrhage. It is often best to let the body do what it needs to do without outside interference.

Now baby is born and you have your reward for all your hard work! Baby begins his fourth trimester of life, and you and baby can snuggle in for your Babymoon...

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