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What's Happening During Labor?

During labor, your baby travels out of the uterus, through the birth canal and out of the vagina. The cervix (or neck of the uterus) thins & opens, and the muscles of the uterus contract, pulling the cervix up and shortening your uterus. Your uterus continues to contract, pushing your baby through the pelvis and down and out through the birth canal. After your baby is born, the placenta separates from the uterine wall and is expelled.

Labor and delivery is commonly divided into 3 stages, which are detailed a little farther down the page.

Timing Your Contractions

We recommend keeping a written log of your stronger contractions, to help identify the time you are entering into labor. This will also help you answer questions when you arrive at the hospital or birthing center. Make two columns, one for the beginning and end of each contraction. This makes a nice indicator of the length of each contraction, the time between contractions. Logging you contractions will help you prepare for the next likely contraction.

Knowing how long contractions are lasting and how frequent they are can be useful in determining the right time to go to the hospital. Beyond that, there is no real need for you to keep a lengthy record listing each contraction especially if it keeps your partner from providing other kinds of support you need.

Cervical Ripening

The cervix needs to soften in order to allow the baby to pass through it. This process is called "ripening." Cervical ripening may shorten the time it takes to induce your labor, or may actually cause labor to begin. Cervical ripening is achieved by using medicines that are placed in your vagina, or other procedures such as a balloon-tipped catheter that is placed just inside your cervix and inflated with water.

During this process, you must lie in bed for a time while your baby is monitored. Depending on which method is used and/or on how your cervix responds, you may or may not be sent home.

Breaking "The Bag of Waters"

To speed-up labor, a doctor or nurse-midwife may break the amniotic sac (or "bag of waters"). This is called an amniotomy. The amniotic sac is broken with a plastic hook during a vaginal exam. You'll feel just a warm gush of fluid when this occurs, but it is not painful. Breaking the bag is also performed to enable the use of a fetal monitor or to check the color of the amniotic fluid.

After your water breaks, you'll be monitored for a minimum of 20-30 minutes out of every hour. If your baby's heart rate is fine and your blood-pressure is normal, you may walk or shower to try to start contractions. Contractions should begin within a designated time-frame, or your doctor/nurse-midwife may give you a medicine called Oxytocin.

Oxytocin (common brand-name Pitocin®) is a medicine that stimulates uterine contractions. It may also be used to induce labor, improve its progress, or minimize bleeding after birth. It is given through an IV infusion. For labor induction, a nurse will increase your Pitocin® rate about every 15 to 30 minutes until you are in active labor. You will probably have to stay in or near your bed or chair because you and your baby will need to be monitored often. Your IV will stay in during labor and is usually removed at the end of your recovery period, an hour or two after your baby's birth. If Oxytocin is used in your labor, you may notice that contractions become intense rather quickly. You may have to step up your breathing technique to the next level and use more comfort measures.

Typically, labor is not induced for your convenience or for the convenience of your health care provider. Generally, it is best to let your labor begin naturally. Having labor induced can limit your ability to get up and move around during labor because of the need to monitor your baby. But there are also good reasons to begin labor by induction or to speed up a slow labor by using induction methods:

• Your amniotic sac, ruptured without help and labor has not yet begun. Your health care provider will monitor you closely and consider induction if labor doesn't begin on its own.
• You have been in labor for some time and are tired but your contractions are not actively dilating your cervix.
• You are ill and your baby needs to be born.
• You have a history of very short labors. Your health care provider may wish to admit you to the hospital and induce labor to be sure you'll give birth in the safety of the hospital.