The first stage of labor and birth occurs when you begin to feel regular contractions, which cause the cervix to open (dilate) and soften, shorten and thin (effacement). This allows the baby to move into the birth canal. The first stage is the longest of the three stages. It's actually divided into two phases of its own — early labor (latent phase) and active labor.
During early labor, your cervix dilates and effaces. You'll feel mild, irregular contractions.
As your cervix begins to open, you might notice a clear, pink or slightly bloody discharge from your vagina. This is likely the mucus plug that blocks the cervical opening during pregnancy.
How long it lasts: Early labor is unpredictable. For first-time moms, the average length varies from hours to days. It's often shorter for subsequent deliveries.
What you can do: Until your contractions increase in frequency and intensity, it's up to you. For many women, early labor isn't particularly uncomfortable. Try to stay relaxed.
To promote comfort during early labor:
- Go for a walk
- Take a shower or bath
- Listen to relaxing music
- Try breathing or relaxation techniques taught in childbirth class
- Change positions
Your health care provider will instruct you on when to leave for the hospital or birthing center. If your water breaks or you experience significant vaginal bleeding, call your health care provider right away.
Now it's time for the real work to begin. During active labor, your cervix will dilate from 6 centimeters (cm) to 10 cm. Your contractions will become stronger, closer together and regular. Your legs might cramp, and you might feel nauseated. You might feel your water break — if it hasn't already — and experience increasing pressure in your back. If you haven't headed to your labor and delivery facility yet, now's the time.
Don't be surprised if your initial excitement wanes as labor progresses and the pain intensifies. Ask for pain medication or anesthesia if you want it. Your health care team will partner with you to make the best choice for you and your baby. Remember, you're the only one who can judge your need for pain relief.
How long it lasts: Active labor often lasts four to eight hours or more. On average, your cervix will dilate at approximately one centimeter per hour.
What you can do: Look to your labor coach and health care team for encouragement and support. Try breathing and relaxation techniques to combat your growing discomfort. Use what you learned in childbirth class or ask your health care team for suggestions.
Unless you need to be in a specific position to allow for close monitoring of you and your baby, consider these ways to promote comfort during active labor:
- Change positions
- Roll on a large rubber ball (birthing ball)
- Take a warm shower or bath
- Take a walk, stopping to breathe through contractions
- Have a gentle massage between contractions
If you need to have a C-section, having food in your stomach can lead to complications. If your health care provider thinks you might need a C-section, he or she might recommend small amounts of clear liquids, such as water, ice chips, popsicles and juice, instead of a large, solid meal.
The last part of active labor — often referred to as transition — can be particularly intense and painful. Contractions will come close together and can last 60 to 90 seconds. You'll experience pressure in your lower back and rectum. Tell your health care provider if you feel the urge to push.
If you want to push but you're not fully dilated, your health care provider might ask you to hold back. Pushing too soon could make you tired and cause your cervix to swell, which might delay delivery. Pant or blow your way through the contractions. Transition usually lasts 15 to 60 minutes.