Phases of Labor

May 13, 2008

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Phases of Labor

by Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.

Most people think of labor and delivery as being one process, but there are actually a few different phases included in this event.

The latent phase
This is the earliest phase of labor. During much of it, you may be trying to figure out whether you are experiencing true labor or Braxton-Hicks contractions. This is generally a lengthy phase with slow progress. Most women can manage the contractions without much difficulty. Contractions can last 30-60 seconds, and can vary in frequency from 5 to 20 minutes apart. However, it is possible that your contractions may start closer together or further than 20 minutes apart. This phase can last about 6-8 hours for first labors, but can also be shorter or much longer.

Symptoms that may occur during the latent phase

You may see some blood-tinged mucus, also called bloody show
Rupture of membranes. This could be a gush of amniotic fluid or a slow leak. If you are home and not sure if your membranes ruptured, call your practitioner
Contractions may be experienced in your lower back or abdomen. They may feel similar to menstrual cramping
Increased pelvic pressure due to the descent of the baby into the pelvis
Increased vaginal discharge
Frequent, soft stools

The active phase
Generally, you are considered to be in the active phase of labor, when your cervix is 4-5 centimeters dilated. Once you have reached this point, you can estimate that your cervix will dilate at least 1 centimeter an hour. Contractions will be more frequent, becoming as close as 2-5 minutes apart. They usually last 45-60 seconds. These contractions last longer than in the latent phase and are more intense, requiring more control from the mother-to-be. The contractions have a longer and stronger peak and a shorter rest period.

Symptoms that may occur during the active phase

Continued bloody show
If your membranes have not ruptured, they may rupture spontaneously, or your practitioner may rupture them. You may want to ask your practitioner if your membranes need to be ruptured for medical reasons, or if you can wait for spontaneous rupture. The amniotic fluid contained within the intact membranes acts as a cushion, which makes contractions less painful. Labor is typically more manageable, but longer, if your membranes remain intact for the majority of labor
Continued pelvic pressure as the baby descends further into the pelvis
Nausea and possibly vomiting
Your body may react to increased stress with increased respirations and heart rate. You may perspire
Many women have muscle tension throughout their body
As labor persists, fatigue will increase

Transition
The cervix dilates from 7 or 8 centimeters to 10 centimeters. This can occur very rapidly. Contractions will typically continue to be about every 2-3 minutes apart, lasting 60-90 seconds. They will be intense and require much control. This can be the most difficult part of labor. Because of the strength and frequency of the contractions, many women suffer physical and emotional symptoms.

Symptoms that may occur during transition

Increased pelvic and rectal pressure as the baby moves down further into the pelvis. You may feel the urge to push even though the cervix is not fully open
Pressure or pain in your back
Nausea and vomiting
Trembling throughout your body
Exhaustion
You may feel overheated
Restlessness. Finding a comfortable position may be difficult
You could be uncooperative and demanding. Many women may seem ungrateful for the help of their coach or others
You may feel discouraged and believe that you cannot continue. You may cry
You may be totally focused on yourself and what is happening to your body
Inability to concentrate. You may have to be told something several times before you actually hear it

You may wish, at this point, that you had never heard of transition and do not want to experience it. Try to remember, however, that all of these things do not happen to every woman. Transition is hard, but it is the shortest phase of labor. Soon you will be moving on to the pushing stage and your baby will be born.


RELATED INFORMATION

			Fatigue During Labor
			The Birth of Your Baby
			Events of Labor

Created September 13, 2000
Reviewed August 19, 2004

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