Stage one includes early labor and active labor. It is the longest stage of the three and it is when the cervix opens (dilates) and thins out (effaces) to allow the baby to descend into the birth canal and start the journey out into the world.
Early labor is the stage when contractions start and your cervix begin to dilate. Contractions may last 30 to 60 seconds and come every 5-20 minutes. As your cervix begins to open you may notice your mucus plug has passed (also known as bloody snow.) This stage is unpredictable and may last for hours or even days. The level of discomfort varies between one woman to another and even between one pregnancy and another, for the same woman.
Active labor starts when your cervix dilates to 10 centimeters. At this point contractions will become stronger and progressively longer. If you haven’t already, get yourself to the hospital now. This stage may last up to several hours. On average it lasts up to eight hours. This is the time to use the breathing techniques you have learned in your birth preparation classes and to get encouragement from your partner and the healthcare team.
Stage two includes the birth! This is the time to start pushing with each contraction. This stage could take, from a few minutes to several hours, or more. It usually takes longer for first time moms. The best birthing position is the one that works best for you; if you are uncomfortable lying down, try squatting or sitting. When pushing, be sure not to hold tension in your face. Bear down and concentrate on pushing when it counts. You will feel a great sense of relief after your baby is born, so Push! Push! Push!
Stage three includes the delivery of the placenta, after your baby is born. At this point you may already be holding your newborn and thinking it is all over, while in actuality your obstetrician is still delivery the placenta and ensuring your bleeding is normal and under control. This stage usually takes about 5-10 minutes, but can take up to 30 minutes, in some cases.
Your health care provider will massage your lower abdomen to help your uterus contract and expel the placenta. You may be asked to push one more time to deliver the placenta, which usually comes out with a small gush of blood. You will be asked if you want to see the placenta. If you tore or had an episiotomy and need to be stitched, your doctor will do so now.