Childbirth: the Stages Of Delivery

It's perfectly normal to feel a bit nervous about giving birth, but knowing what to expect during each stage can make delivery go that much smoother.

Labor and delivery aren't scripted, unlike in Hollywood movies. Although hormones may play some role in labor's initiation, no one really knows what causes it. And though labor is divided into three stages, each woman may not go through it the same way. Labor can take anywhere from 12 hours to 24 hours for first time moms. It will vary from one woman to another. These are the facts.

Stage One: Latent Phase

What to expect: This stage of labor is the longest and can range from 12 to 20 hours for women having their first baby. You will feel the first signs of labor when you experience uterine cramps. These may appear mildly at first and occur every 15 to 20 minutes. Your cervix then begins slowly dilation and thinning. The labor ends after your cervix has dilated between 3 and 4cm (approximately 1-3 inches).

The duration of a contraction can last between 30 and 70 seconds. It may feel similar to a backache, or menstrual cramps. Contractions become more frequent and intense as labor progresses. They occur every 7-10 minutes at first, then every 5 to 7 minutes.

Watch out for the following: A normal discharge is when your cervix opens. You may notice this discharge days ahead of or during labor.

According to Tiffany A. Moore-Simas (MD, MPH), MEd, FACOG and director of the Obstetrics, Gynology and Research Division at University of Massachusetts, Medical School, the rupturing of amniotic cells can happen spontaneously during stage one labor.

What to do when your baby starts to cries? You should call your doctor if you feel the need, but it's not necessary to take them to the hospital. Moore-Simas says that healthy, first-time mothers can often go through the stage at home. What is the best time to go to the hospital Moore-Simas says that if you feel like your body is contracting five times per minute, it's time to go in. If you have leaking fluid it may be time to call the doctor.

You can also rest, listen to music and take a soak in the warm tub.

Phase One, the Active Phase

Expectations: These contractions, which last between 45 and 60 seconds, are more intense and painful than normal. They occur about every three minutes and take approximately 3 to 5 minutes. Moore-Simas says that your cervix is dilation faster, at 1.2 cm per hour.

If your cervix is 8 to 10 cms dilates, then you're at "transition stage." This stage refers to the final part of stage 1. Contractions now occur every 2 to 3 minutes. They last about a minute. Your back may hurt more or you might feel nauseated.

How do you manage: Your vital signs, such as temperature, blood pressure and pulse, will be checked at the hospital. An external monitor will be used to measure the baby's heartbeat. A contractions monitor will also be fitted on your abdomen. To check for dilation, a nurse or doctor may perform an internal exam .

There may be a variety of pain management options available, such as an epidural or an anesthesia which blocks pain.

Tips and tricks: Warm showers can reduce lower back pain, especially if they are handheld. You can help by gently bouncing on a ball or receiving massages from your partner. Deep breathing exercises and listening to soothing music are also helpful. Some women find relief by changing positions, walking, or getting down on their hands and knees.

Stage two

Expectations: The pushing stage (also known as the "pushing" stage) can take up to 3 hours, if you have had an epidural and 2 hours without. Fully dilated is at 10cm (about 4inches). The duration of contractions is not limited to one minute. They can occur approximately every two to three seconds. As the baby's head descends into the pelvis/vagina area, you may feel pressure in your rectum (like the need to have a bowel movement) and the urge to push.

Management: Moore Simas states that pushing is not a good idea until your doctor has confirmed you are fully dilate. If you push, your cervix can swell. She says that pushing often happens in three spurts over the course one contraction. Take a big deep breath. Then push with your entire effort into your bottom.

If necessary, you may have an episiotomy, a small cut in the area between the vagina and the rectum to ease delivery. Moore-Simas estimates that only 5% need episiotomies.

The progress of the baby's descent through the pelvis is measured in numbers called stations until the baby crowns (when the top of baby's head becomes clearly visible at the opening of the vagina).

The Third Stage

Expectations: A labor stage that is short can last just minutes or for as long as 30 minutes. The contractions will be weaker if you give birth to the placenta or afterbirth. You'll be stitched up immediately if an episiotomy has been performed or you are suffering from tissue damage during birth.

Labor may be different for every woman, says Moore-Simas. Moore-Simas says that the ultimate goal of labor is for a healthy mother and her baby. This is a wonderful day, and a lovely experience.