Birthing - Labor
Labor is marked with the beginning of regular contractions of the uterus. In some women this will be similar to the Braxton Hicks contractions they have been experiencing during the days preceding labor. For others the true labor contractions will be much harder and much more severe in pressure and duration.
During the initiation of labor the contractions will be some distance in time apart—up to a half hour. Contractions may be regularly spaced or may come irregularly. Because of the possible differences in pressure and duration, some women do not recognize the early stages of labor.
Contractions should come more rapidly, eventually getting to a pace of every five minutes. The contractions are slowly opening the cervix (dilatation) and thinning the cervical muscle (effacement) to allow for the passage of the baby into the vaginal canal. The muscle will eventually thin and open to 10 centimeters during the last part of labor.
Call your doctor when you know labor has begun. Most doctors recommend that women wait out this period at home. Talk to your doctor about what activities are recommended and what should be avoided during this phase. Since the latent phase of labor can last up to one full day, resting is important.
The contractions come more rapidly, last longer, and are stronger in pressure. The contractions force the cervical muscle to dilatation of 7 centimeters. If the amniotic sac did not break during the latent phase, it will break now. The attending physician may choose to break the sac to help the baby's head to crown . Crowning occurs when the baby's head moves into the pelvic bone region and becomes visible through the vaginal canal. The act of crowning will normally break the amniotic sac if it has not already ruptured.
By the active phase you should be attended by your health care person. Contractions will reduce to every two or three minutes and may last one full minute. If the attending physician decides that the vaginal canal is not wide enough to accommodate the size of the baby's head, he or she may decide to perform an episiotomy . This procedure involves a small incision in the tissue between the vagina and the anus or off to the side of the vagina. The majority of first births have this procedure; about half the women who have given birth before have an episiotomy again.
This can be the most difficult part of the birthing process because it comes at the end of the hard work of labor. The extremely strong contractions are still two to three minutes apart but are now lasting over a minute. The contractions have peaks in pressure that are much stronger than previous contractions. The cervix dilates to a full 10 centimeters, usually in less than an hour. This is the point where breathing exercises learned in birthing classes will come in handy. You may be too anxious, annoyed, or fatigued to consider them though. The coach is there to help with this. At the end of the transition the baby's head forces through the canal and the largest width of the head passes the cervical opening.