Understanding Labor

It is important to understand what labor is, what to expect when labor occurs and what to do when labor begins.

Labor is the dilatation (stretching and expanding) of the cervix. This occurs because the uterus tightens to squeeze out the baby. As it pushes the baby out, the cervix stretches. It may be possible to feel tightening, contractions or cramps, but it technically is not labor until there is a change in the cervix.

Braxton-Hicks Contractions, False Labor and the Real Deal

Braxton-Hicks contractions are painless, non-rhythmical contractions you may be able to feel when you place your hand on your abdomen. These contractions often begin early in pregnancy and are felt at irregular intervals. They may increase in number and strength when the uterus is massaged. Like false labor, they are not positive signs of true labor.

False labor often occurs before true labor begins. False labor contractions can be painful and may appear to be real labor to you.

In most cases, false labor contractions are irregular. They are usually short in duration (less than 45 seconds). The discomfort of the contraction may occur in various parts of your body, such as the groin, lower abdomen or back. With true labor, uterine contractions produce pain that starts at the top of the uterus and radiates over the entire uterus, through the lower back into the pelvis.

False labor is usually seen in late pregnancy and seems to occur in women that have been pregnant before. False labor usually stops as soon as it begins and does not appear to harm you or the baby in any way.

There are several ways to tell the difference between true labor and false labor. Be sure that you talk to your doctor or midwife about knowing the difference between the two. Here are some indicators of false and true labor.

False Labor True Labor
Contractions do not get close together. Contractions get closer together.
Contractions do not get stronger. Contractions get stronger.
Contractions tend to only be felt in the front. Contractions tend to only be felt all over.
Contractions do not last longer. Contractions last longer.
Walking has no effect on contractions. Walking makes the contractions stronger.
Cervix does not change with contractions. Cervix opens and thins with contractions.

How Long Will Labor Last?

The length of the first and second stages of labor, from beginning of cervical dilatation to delivery of the baby, can last 14-15 hours or more in a first pregnancy.

For every story of a woman barely making it to the hospital or having a one hour labor, there are many women whose labor lasted 18-24 hours or longer.

The bottom line is that it is almost impossible to predict the amount of time that will be required for labor.

Timing Contractions

To time how long contractions last begin timing when the contraction starts and end timing when the contraction lets up and goes away.

It is important to know how often contractions occur. There are two basic methods for timing contractions:

  • Note the time period from a contraction starts to the time when the next contraction starts. This is the most commonly used method and typically the most reliable.
  • Note the time when the contraction ends and when the next one starts.

Ask you doctor which method they prefer. It is important to time your contractions before you call your doctor so they can decide when you should go to the hospital.

Stages of Labor

  • First Stage

    This begins when you start to have regular contractions that increase in frequency and intensity. Make sure you know how to time contractions. Usually labor will start off slowly, and you may not be sure that it is true labor. When the contractions are more intense and come more frequently, then you will be in the active phase of the first stage of labor.

    Your doctor will give you guidelines as to when you should call. Some want you to go to the hospital as soon as your water breaks and some ant you to call when you have steady contractions that are a certain number of minutes apart.

    The next phase of the first stage of labor is transition. Transition is the short, but hard part of labor. Your contractions will come very close together, but are not usually any stronger than the contractions of the active phase. By the end of transition, your cervix will be completely dilated to 10 centimeters, big enough for the baby's head to pass through.

  • Second Stage

    This stage begins when you are completely dilated. You will begin pushing the baby out of your body and your contractions will get further apart and feel differently. Most women feel the urge to push, if they have not had too much medication. If you have been medicated, you might or might not feel the urge to push. Your labor nurses will help you get ready to push at the right time (during a contraction). The end of the second stage will be marked by the birth of the baby.

  • Third Stage

    Soon after the baby is delivered, the placenta will detach from the wall of the uterus. This can happen five minutes to an hour after delivery. You will be asked to give a few small pushes to help get the placenta out.





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