The fourth part of this series is going to cover the natural process of “Labor”. Now labor can happen many different ways and feel different for every woman. This is the phase that is the most unpredictable, and it is often a source of stress for new mamas. Disclaimer: This blog post is written in the form of generic, for typical populations; there are always special situations that dictate strong variations of labor. Now labor itself is the physiological process of childbirth from uterine contractions through delivery. According to the American Pregnancy Association, they break labor down into three phases: early labor, active labor, and then the transition phase.
If you have seen any movie, ever, with a pregnant woman in it – they always RUSH to get to the hospital at the first sign of labor. That’s not real life. If this is your pregnancy then you are in for a full surprise that when labor actually starts, it can take hours to days! Honestly I think this is the most understated phase, we all spend a significant time preparing for delivery and the actual pushing the baby out of a vagina, but nobody talks about how different laboring can look like for women.
Early labor is defined as the onset of contractions until the cervix is dilated to 4-6 cm (then it transitions to active labor). In early labor normally the first sign that it has begun is uterine contractions. The uterus is comprised of smooth muscle tissue that is controlled by the nervous system. This is different than the muscle tissue of your bicep – you can actively force a contraction of that muscle, but you cannot of your uterus. So when your body decides it is time for that baby to start coming out, you better roll with it because you can’t really talk your uterus out of it.
Let’s discuss contractions. You can talk to 5 different women, and they will all probably give you 5 different answers on how the contractions felt. Some women have contractions and barely feel them until they are 7-10 cm dilated… However some feel the contractions significantly from the very beginning, and they only worsen. Needless to say, contractions are going to feel different to every woman, so try not to base your decisions or birth plan off of what other people have to say. Nobody can predict what you will feel – but you can plan for what you want, and then what you need should problems arise. Contractions will also start at least intensity, for short durations (less than 30 seconds) and will have long intervals. True contractions (NOT Braxton Hicks) will begin to get closer together = shorter intervals, increase in intensity, and also begin to last longer (not fun).
Key points is that doctors typically ask their patients not to prepare on coming into the hospital until their contractions are 5-7 minutes apart, lasting one full minute, and have to maintain that for one hour. This is roughly 10 intense contractions in one hour… It is important to remember that this can also take hours to days to achieve. This is a great time to highlight the importance of a birth plan! I could do a whole other post on how to plan for labor, but let us just agree that having a plan in place for how you would like to deal with this process of pain, discomfort, natural miracle, whatever you would like to call it – is going to put your mind at ease when all of it begins to happen.
If you are experiencing contractions, your cervix is likely beginning the process efface (thin) and dilate (widen) in preparation for the baby to crown and delivery. Your doctor or midwife has likely checked your cervix at one of your later appointments to see if it can indicate how close you are to labor, but that is not always a reliable estimation. In this first (longest) phase, it lasts until the cervix reaches 4-5 cm dilated. Then it transitions to Active Labor, and this is when doctors or your delivery team wants to bring you into the hospital. Active Labor is where the process of contractions continue, the baby also begins to descend as the cervix dilates more, reaching up to 7 cm dilated. As your cervix dilates further, this correlates to more intense uterine contractions to help the baby descend. This process continues, and there is a variety of medical interventions that could happen during this phase but that will be touched on in a different blog 🙂
The phase that involves the cervix going from 7 cm dilated to 10 cm dilated is called the Transition Phase. This is typically the most intense phase by far physically, but it is also the shortest! This is when the baby is descending deep into the pelvic inlet, and this time frame can also vary for women. It’s average time frame is 30 minutes to 4 hours. This is the part where women get a “feeling to push”. The baby will begin to crown and the body will naturally feel a need to push and deliver the baby. This is where delivery occurs and you get to meet beautiful baby!