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Stages of Labor

Active labor begins when your cervix is dilated to between four to seven centimeters. You should be at your delivery destination already and if your water did not break earlier, it will be broken now. Your contractions are getting longer, stronger, and closer together. They will be between one and three minutes apart and may last 60 to 75 seconds. You will be very seriously and intensely focused on them. Seek reassurance, good music, a massage, and anything that will keep you comfortable. Concentrate on relaxing. The more relaxed you are, the easier it will be to dilate and thin out your cervix. Standing up and walking around will help, too. Walk to the bathroom every hour to empty your bladder. You'll be in this stage of delivery for 12 to 16 hours if you are a first-time mom, and maybe six to eight hours if you've already been through this once before.

Transition is the most difficult part of labor, but it is also the shortest. Your uterus is no longer opening the cervix; it's pushing the baby out. This could last as few as 10 minutes, and it probably won't last longer than an hour. Your contractions will be hard and strong, about one minute apart and somewhere between 90 and 120 seconds long. There may be multiple peaks to them rather than a wave-like action, and you may not have a break between contractions. You will be dilated between seven and 10 centimeters, and you will probably be irritable and teary. Panic, disorientation or nausea may set in. You may get hot or cold flashes, and your legs might tremble. You will be feeling rectal pressure, and may have a premature urge to push. Your coach will be there to offer support and to remind you that it is not long now. The moment in which you think you cannot wait or survive another second, you don't have to.

Upon arrival at the final stage of labor, birth and afterbirth, you will be fully dilated and ready to push. Your contractions will be wavelike again, giving you three to seven minutes of resting time in between them. They will be about a minute or so long, and your doctor, midwife, or nurse will tell you when and when not to push.

Whether upright, squatting, or lying on your side, you will push evenly and intensely from the diaphragm downward, and keep the vaginal canal as relaxed as you can. Depending on what kind of medication you have or have not taken, you may feel your baby in your birth canal during contractions, and you may experience a stretching almost burning sensation as your perineum is widened, allowing your baby to pass through into the world.

Once your baby is born, your uterus will continue to contract gently for another half hour to push out your placenta. You may not even notice these last minutes of labor. You are a mom now and the most beautiful baby in the world may be all you have the time or energy to think about.


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