First Stage of Labor

Going through the birth of your child is a wonderful and unique experience. No two deliveries are alike and there is no way to tell how your delivery is going to be. What we can tell you is the stages you will go through during this process and what you can generally expect. Childbirth can be broken into three stages:

First State: Begins from the onset of true labor and lasts until the cervix is completely dilated to 10 cm.

Second Stage: Continues after the cervix is dilated to 10 cm until the delivery of your baby.

Third Stage: Delivery of your placenta.

First Stage:

The first stage of labor is the longest and is broken down into three phases:

Early labor phase: Starts from the onset of labor until the cervix is dilated to 3 cm.

Active labor phase: Continues until the cervix is dilated to 7 cm.

Transition phase: Continues until the cervix is fully dilated to 10 cm.

Each phase is full of different emotions and physical challenges. It is one big adventure you are about to take and we would like to give you a guide for it.

Early Labor Phase:

What to do:

During this phase you should just relax. It is not necessary for you to rush to the hospital or birth center. It will be more comfortable for you to spend this time at home, in familiar territory. If early labor is during the day you should do simple routines around the house. Keep yourself occupied but still conserve some of your energy. Drink plenty of water and eat small snacks. Keep track of the time of your contractions.

If early labor begins during the night it is a good idea to try and get some sleep. If you can’t fall asleep, do things that will distract you like cleaning out your closet, packing your bag, or making sack lunches for the next day.

What to expect:

  • Duration will last approximately 8-12 hours
  • Your cervix will efface and dilate to 3 cm
  • Contractions will last about 30-45 seconds, giving you 5-30 minutes of rest in between contractions
  • Contractions are typically mild, somewhat irregular, but progressively stronger and closer together
  • Contractions may feel like aching in your lower back, menstrual cramps, and pressure or tightening in the pelvis area
  • Your water may break; also known as amniotic sac rupture (this can happen any time within the first stage)

When monitoring contractions observe the following:

  • Growing more intense
  • Following a regular pattern
  • Lasting longer
  • Becoming closer together

When your water breaks (amniotic sac ruptures) note the following:

  • Color of fluid
  • Odor of fluid
  • Time rupture occurred

Tips for the support person:

  • Practice timing contractions
  • Be a calming influence
  • Offer comfort, reassurance, and support
  • Suggest activities that will distract her
  • Keep up your own strength, you will need it!

Active Labor Phase:

What to do:

It is about time for you to head to the hospital or birth center. Your contractions will be stronger, longer and closer together. It is very important that you have all the support you can get. Now is also a good time for you to start your breathing techniques and try some relaxation exercises for you to use in between contractions. You should switch positions often during this time. You may want to try walking or taking a nice bath. Continue to drink water and remember to urinate periodically.

What to expect:

  • Duration will last about 3-5 hours
  • Your cervix will dilate from 4cm to 7cm
  • Contractions during this phase will last about 45-60 seconds with 3-5 minutes rest in between
  • Contractions will feel stronger and longer
  • This is usually the time that you head to the hospital or birth center

Tips for the support person:

  • Give your undivided attention
  • Offer verbal reassurance and encouragement
  • Massage her abdomen and lower back
  • Keep track of contractions (if she is being monitored, ask how the machine works)
  • Go through the breathing techniques with her
  • Help make her comfortable (prop pillows, get her water, apply touch)
  • Remind her to change positions frequently (take her for a walk or offer her a bath)
  • Continue with distractions (music, reading a book, playing a simple card game)
  • Don’t feel badly if she is not responding to you

Transition Phase:

What to do:

During this phase you will rely heavily on your support person. This is the hardest phase but it is also the shortest. Think “one contraction at a time.” This may be hard to do if the contractions are very close together, but just think about how far you have come. When you feel an urge to push, tell your health care provider.

What to expect:

  • Duration will last about 30 min-2 hrs
  • Your cervix will dilate from 8cm to 10cm
  • Contractions during this phase will last about 60-90 seconds with a 30 second-2 minute rest in between
  • Contractions are long, strong, intense, and may overlap
  • This is the hardest phase but thankfully the shortest
  • You may experience hot flashes, chills, nausea, vomiting, or gas

Tips for the support person:

  • Offer lots of encouragement and praise
  • Avoid small talk
  • Continue breathing with her
  • Help guide her through her contractions with encouragement
  • Encourage her to relax in between contractions
  • Don’t feel hurt if she seems to be angry, it’s just part of transition!
Last Updated: 09/2008

Compiled using information from the following sources:

William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 17.

Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 9.

American Pregnancy Association, http://www.americanpregnancy.org

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