MDWF 2030 Labor, Birth and the Immediate Postpartum
Assignment 2.1 Client Handout: Stages of Labor
Stages of Labor, Birth and the Immediate Postpartum
Stage of What your uterus is
Labor doing:
Pre-labor -Braxton Hick’s contractions
become more noticeable, are
irregular, and last less than 60
seconds.
-Cervix may start to open
(dilate) and thin (efface)
-May have blood tinged
mucous discharge (mucous
plug/bloody show)
Early -Uterus begin to contract
First more regularly, more
Stage intensely, and lasting longer
-Cervix pulls forward lining
up with the vagina, dilates and
effaces
Active -Uterus continues to contract
First effacing and dilating the
Stage cervix
Transition -Uterine contractions begin to
change from opening the
cervix to pushing the baby out
What your hormones are
doing:
-the ratio of estrogen to
progesterone increases
making the muscle of the
uterus more sensitive to
stimulus causing contractions
-Relaxin increases loosening
joints and cartilage so the
pelvis can expand as the baby
descends
-Oxytocin is released causing
contractions
-Prostaglandins are released
adding to uterine strength
-Endorphins are released
aiding in pain management
-Cortisol levels increase
-Adrenalin increases
-Continued hormone increases
as labor progresses
-More hormones released
What you may be
experiencing:
-Baby may drop into the
pelvis (lightening)
increasing pelvic pressure.
-May have a burst of energy
(nesting)
-May have loose stools
-Contractions often are low or
felt in the back, often
described as feeling like
menstrual cramps
-Bloody show occurs
-Bag of water may break
-Contractions are felt
throughout the whole uterus
and are about 5 min. apart
lasting at least 60 seconds
long and continue to get
closer together and increase in
intensity
-Bag of water may break
-Contractions can feel right on
top of each other.
-May be shaky from hormone
release
Skaidre Brown
1/22/2018
Possible needs and
comforts:
-Eat well
-Stay hydrated
-Hot shower or bath
-Practice relaxation and
massage
-Alternate periods of rest with
periods of activity
-Try and sleep if it is night
time
-Lots of movement
-Eat and drink frequently
-Alternate periods of rest with
periods of activity
-Try and sleep if it is night
time
-Needs lots of encouragement
-Change position at least
every hour
-Deep relaxation during the
contraction
-Stay hydrated and go to the
bathroom often
-May want dim lights,
encouraging words or
complete silence, massage or
no touch at all
-Body sensations are intense
so lots of encouragement is
needed
-Reminder that labor is almost
over
MDWF 2030 Labor, Birth and the Immediate Postpartum Skaidre Brown
Assignment 2.1 Client Handout: Stages of Labor 1/22/2018
-May feel nausea or even -Stay hydrated
vomit
-May feel overwhelmed or
like you can’t do it anymore
-Bag of waters may break
Second -Cervical dilation and -Oxytocin is continuing to be -Urge to push -Wait for urge to push
Stage effacement is complete released -Bag of waters will break if it -Change positions often
-Baby’s head drops down and -Endorphins released with hasn’t yet -Follow your body
puts pressure on the rectum birth -Perineum will bulge with -Push at the peak of the
(Ferguson reflex) -Adrenalin decreases pushing contraction
-Contractions are expulsion -Renewed sense of energy -Completely rest in between
contractions contractions
-2nd stage ends with birth of
the baby
Third -Uterus continues to contract -Oxytocin continues to be -Will feel cramping or -Drink and eat to replenish
Stage to expel the placenta released and is stimulated by contractions to expel placenta after a hard labor
-3rd stage ends with delivery breastfeeding, to involute the -There will be some bleeding -Let birth team know when
of the placenta uterus and control bleeding, -perineum will be sore and you are cramping
and enhance bonding swollen -Push with the cramping
Resources
Ina May’s Guide to Childbirth by Ina May Gaskin Natural Childbirth the Bradley Way by Susan McCutcheon
Birthing from Within by Pam England & Rob Horowitz YouTube.com search Natural Childbirth Videos

References
Dixon, L., Skinner, J. & Foureur, M. (2013). The emotional and hormonal pathways of labor and birth: intergrading mind, body and
behavior. New Zealand College of Midwives, 48: 15-23 Retrieved from http://dx.doi.org/10.12784/nzcomjnl48.2013.2.15-23

Marshall, J. & Taynor, M. (Eds.). (2014). Myles textbook for midwives (16th ed.). New York, NY: Churchill Livingstone Elsevier.

Posner, G.D., Dy, J., Black, A.Y., & Jones, G.D. (2013). Oxorn-Foote human labor and birth (6th ed.). New York, NY: McGraw-Hill
Medical.