---

There are three stages of labor. Stage-1 occurs from the time true labor begins until the cervix is completely dilated and effaced. Stage-2 is when the baby is delivered. Stage-3 takes you from the baby's birth through the birth of the placenta.

First Stage

This stage of labor is the longest, and it is commonly divided into three phases: Early, Active & Transition.

Early Labor

During the early or latent phase, the cervix dilates to 4 centimeters. The duration of the first phase is the longest, averaging around 8 hours. Your contractions may be irregular, progressing to rhythmic and methodical. The pain felt at this early stage may be similar to menstrual pain: aching, fullness, cramping and backache. You will still be able to walk. Walking is usually more comfortable than sitting. Most women spend these hours at home, or they may be checked at the hospital and sent home until labor becomes more active. You may feel eager, excited and social. It is important that you conserve your energy for the work of labor.

Active Labor

Active labor is marked by regular contractions that become longer, stronger and closer together over time. Most providers recommend that you go to the hospital when your contractions are five minutes apart, lasting more than 60 seconds for at least an hour. Measure your contractions from the start of one contraction to the beginning of the next.

Your physician will want to know the following:

• How far apart are the contractions?
• How long are they lasting, and how intense?
• Are you using breathing techniques to manage the pain?
• Has your "bag of water" broken? Your provider will want to know the time this occured, and any color or odor.
• Has there been any discharge, such as a bloody show?
• If you have had previous deliveries, the active phase of labor can proceed more quickly. Your physician may want to be contacted sooner.

When you are in active labor, you will be concentrating on the task at hand, and will not feel like doing anything else. Your labor partner's support is important at this phase. Contractions are growing stronger, longer and closer together. Contractions will be about 3-4 minutes apart, lasting 40 to 60 seconds. You may have a tightening feeling in your pubic area and increasing pressure in your back. If you have learned breathing techniques, begin using them now, if you haven't already. Pain medication is often given at this stage. If you have chosen to have an epidural anesthetic, it is usually given at this stage.

Transition

Transition is the most difficult phase of labor, and fortunately, the shortest, lasting from 30 minutes to two hours. The cervix is opening the last few centimeters, from 7 to 10 centimeters. The pain may be intense, as the cervix stretches and the baby descends into the birth canal. All of your energy is concentrated on doing the work of labor. Try to remain calm and focused as your uterus works. At the end of transition, you may feel a strong urge to push the baby out. The baby is ready to be born.

This marks the end of Stage-1. The cervix should now be dilated to 10-centimeters. For first-time mothers, this stage usually lasts 12 to 16-hours. For women having second or subsequent children, the first stage lasts around 6-7 hours.

If your experiencing a fever or elevated temperature, especially in conjunction with an increase in heart rate, please be sure to speak with your attending physician.

Second Stage

During the second stage the baby is born. This stage of labor lasts anywhere from one contraction to up to two hours. The baby's head stretches your vagina and perineum (the skin between the vagina and rectum). This may cause a burning sensation. Some women may feel as if they are having a bowel movement, and feel the urge to push, or bear down. The labor nurse or physician will tell you when it is time to push. It is important that you not push until instructed. Pushing too early will cause the cervix to become edematous, or swollen. "Crowning" occurs as the widest part of the head appears at the vaginal opening. In the next few pushes, the baby is born. Mucous and amniotic fluid will be removed from the baby's mouth and nose with a bulb syringe. The baby will take its first breath, and may begin to cry. Immediately after birth, the baby is still connected to the placenta by the umbilical cord. The cord is clamped and cut.

Third Stage

The third stage begins with the birth of the baby and ends with the delivery of the placenta. It is the shortest stage, lasting from 5 to 15 minutes. Your contractions may stop for awhile, then resume to deliver the placenta. You will be observed closely for the next few hours to make certain that your uterus is contracting and bleeding is not excessive. The nurse will massage your uterus, or your lower abdomen to check that the uterus is contracting. Take this time to rest and get acquainted with your new baby.