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Childbirth usually occurs in three stages:

First stage: The time of the onset of true labor until the cervix is completely
dilated to 10 cm.

Second stage: The period after the cervix is dilated to 10 cm until the baby is
delivered.

Third stage: Delivery of the placenta.

First Stage
The first stage of labor is the longest and involves three phases:

Early Labor Phase -The time of the onset of labor until the cervix is dilated to 3
cm.

Active Labor Phase - Continues from 3 cm. until the cervix is dilated to 7 cm.

Transition Phase - Continues from 7 cm. until the cervix is fully dilated to 10 cm.
Each phase is characterized by different emotions and physical
challenges. Think of it as a big adventure with some important guidelines.

Early Labor Phase


What to do:

During this phase you should just try to relax. It is not necessary to rush to the
hospital or birth center. Try to enjoy the comfort of the familiar surroundings
at home. If early labor occurs during the day, do some simple routines around
the house. Keep yourself occupied while conservingcyour 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 to get some sleep. If
you are unable to fall asleep, focus on doing some light activities like cleaning
out your closet, packing your bag, or making sack lunches for the next day.

What to expect:
Early labor 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
between contractions

Contractions are typically mild, somewhat irregular, but become progressively


stronger and more frequent

Contractions can feel like aching in your lower back, menstrual cramps, and
pressure or tightening in the pelvic area

Your water might break. This is known as amniotic sac rupture and can happen
any time within the first stage of labor.
When experiencing contractions, ask if they are:

Growing more intense

Following a regular pattern

Lasting longer

Becoming closer together


When your water breaks (amniotic sac rupture) 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 simple activities to draw her focus from the labor

Keep up your own strength. You will need it!

Active Labor Phase:


What to do:

Now is 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
plenty of support. It is also a good time to start your breathing techniques and
try a few relaxation exercises for use between contractions. You should switch
positions oftenduring this time. You might want to try walking or taking a
warm bath. Continue to drink plenty of water and urinate periodically.

What to expect:

Active labor will last about 3-5 hours

Your cervix will dilate from 4cm to 7cm

Contractions during this phase will last about 45-60 seconds with3-5
minutes rest in between

Contractions will feel stronger and longer

This is usually the time to head to the hospital or birth center


Tips for the support person:

Give the mother your undivided attention

Offer her verbal reassurance and encouragement

Massage her abdomen and lower back

Keep track of the contractions (if she is being monitored, find out 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 from labor such as music, reading a book, or playing a
simple card game

Dont think that there is something wrong if she is not responding to you

Transition Phase
What to do:

During this phase the mother will rely heavily on her support person. This is
the most challenging phase but it is also the shortest. Try to think one
contraction at a time (This may be hard to do if the contractions are very
close together). Remember how far you have already come, and when you feel
an urge to push, tell your health care provider.

What to expect:

Transition 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 can overlap

This is the hardest phase but also the shortest

You might 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 between contractions

Dont think that there is something wrong if she seems to be angry. It is a normal
part of transition.

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