Although there are common stages and phases that occur in labor, these rules of thumb are all generalizations. Different births can look unique to what I am going to describe. Use this as a guide, and remember that you are the professional of your body and your birth.
The First Stage
The first stage of birth is early labor and active labor. Early labor often starts as uncomfortable uterine cramping accompanied by contractions that initially tighten your belly but may not feel painful. Over time, your contractions will become longer, more robust, and closer together. During early labor, contractions work hard to help your cervix efface, dilate, and soften. Early labor is often defined as any part of birth from 0cm-6cm of dilation. As these changes occur in your cervix, you may see light pink-tinged mucus when you use the restroom. This is normal and a good sign that progress is occurring. Early labor is notoriously the longest phase of labor and the most unpredictable. It is often encouraged for birthing parents to stay home, sleep, and eat during this phase of labor. If sleeping is not an option, I encourage parents to go about their daily activities, ignoring the contractions until they can no longer.
Active Labor
The second part of the first stage of birth is active labor. In active labor, your cervix will go from 6cm to complete or 10cm of dilation. During active labor, your contractions will become longer, stronger, and closer together, and in many cases, a clear pattern can be noticed. Some sensations individuals experience in active labor are hot and cold flashes, leg cramping, nausea and vomiting, back pressure and pain, their waters breaking, and increased pelvic pressure. If you are not birthing at home, now is the time to head to the destination you plan to birth in. It can feel good to change positions often, utilize hydrotherapy like a tub or shower, and get hands-on support during this phase of labor. You might notice yourself going more inward, seeking darkness and solitude, and vocalizing through contractions. Trust your instincts. Each of these things occurs for a reason.
The Transition
Transition is one of the last parts of this stage of labor. During the transition, your contractions are the longest and strongest throughout your birthing experience. This is the phase of labor where most birthing individuals state, “I can’t do this any longer” or “I want an epidural.” This is normal; by saying this, you signal to your care provider that you are almost there. After the transition occurs, there can be a phase that birth workers call the “rest and be thankful” phase. The body decides to rest before pushing begins and provides the birthing parent with a nap. It can be as short as a cat nap for 5-10 minutes or as long as an hour. This is another opportunity to trust that your body knows what it needs to do to prepare for the second stage of labor, pushing.
The Second Stage
The second stage of labor is pushing until birth. For most first-time parents and parents with epidurals, pushing can take longer than those with subsequent babies. Pushing can last anywhere from five minutes to three to four hours, depending on the situation. Many birthing parents enjoy the pushing phase because they can work with the contractions rather than just experiencing them. There are many different positions you can push in, and it is a good idea to try out a few so that you can find what works best for you.
Some positions that many enjoy are squatting, hands and knees, kneeling, and sitting. Some individuals find that curling around their belly while they push is helpful, while others have better luck arching away. Tug-a-war can also be beneficial, as well as utilizing a mirror or even having a provider place their fingers internally on the baby’s head as you work to push their fingers out. There is no one size fits all, so experiment with different styles of pushing until you find the right way for you. In most cases, your care providers will give you feedback on whether your pushing is helping to bring your baby earthside.
The Third Stage
When your baby is born, you enter phase three of birth, the phase that exists from birth to the birth of your placenta. Most commonly, the placenta is delivered in less than 30 minutes, but in some cases, it can take up to an hour. Birthing the placenta is much easier than birthing the baby because it is like birthing a jellyfish. There are no bones to get through your pelvis. In some cases, standing and using gravity or giving reasonable pushing effort can help get the placenta delivered quicker. Once delivered, your care provider will examine it to ensure that all looks well, and then you can do what you wish with it.
The Final Stage
Now that you have made it through each phase of labor, you are officially in your postpartum period. This phase lasts from the birth of the placenta until up to two years. There are different phases throughout postpartum, and we commonly call the first forty days the fourth trimester, as it seems to be a crucial time of attachment and nourishment for a newborn. While experiencing your postpartum, remember that this, too, is just a phase and is temporary. Trust that the difficult moments will pass and that sleep eventually finds you.
Lastly, I will repeat this: birth is unique to the person and the infant going through it. We do not give birth by numbers. The phases mentioned above should be used as guideposts, not rule books. Relinquishing control and trusting the process are crucial aspects of giving birth.
