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Stages of Labor
by William Camann, M.D., and Kathryn J. Alexander, M.A.

Medical experts divide labor into three stages. The amount of time spent in each stage varies among women. Most women will go to their hospital or birth center at the beginning of the first stage of labor or right after their water breaks. You and your obstetrician or midwife will need to determine when it is appropriate for you to arrive at your birth setting.

Did You Know? When labor first begins, if you start feeling uncomfortable, you can use a variety of pain-management strategies at home, such as walking, taking a warm shower, having your partner massage you, or just relaxing with an activity you enjoy.

The first stage of labor refers to the time from the beginning of labor up to the point of full cervical dilation, which is ten centimeters. This is almost always the longest part of a woman's labor and can last from a few hours to longer than eighteen hours in some women. This first stage of labor itself is divided into two distinct subphases known as the latent and active phases. The latent phase refers to the beginning of cervical dilation to approximately three to four centimeters and typically progresses more slowly than the next phases of labor. The active phase describes a faster rate of cervical dilation and begins when the cervix has dilated to approximately three to four centimeters and ends when the cervix has fully dilated to ten centimeters.

A transition period occurs at the end of the first stage of labor. During this time your contractions may become more intense, closer together, and (if you are without pain relief) more painful. Transition can last from a few minutes up to a few hours. Some women experience shaking, shivering, and nausea during the transition period. A very normal and common response many women experience during this part of labor is feeling out of control or thinking it is impossible to continue. During this phase women often feel physically and emotionally drained. Good labor support is vital during this period, especially for women who have opted for no medical pain relief.

The second stage refers to the time between full cervical dilation (ten centimeters) and the birth of the infant. This is the phase during which women become even more active in the birth process by pushing the baby through the birth canal. This stage can last from a few minutes to as long as several hours, and is generally shorter for repeat moms. Some women report a sense of relief of pain during this phase as they finally give birth to the baby; others find the pressure and stretching as the baby exits to be painful. The exact sensations experienced as the baby descends will vary from woman to woman and are impacted by the type of pain relief you have chosen.

The third stage refers to the time from delivery of the infant to delivery of the placenta. It is typically the shortest part of a woman's labor and usually last less than ten minutes, but many last up to thirty minutes. This final stage of labor, for most women (who do not have an effective pain-relief method), marks the end of their intense pain or discomfort; the placenta is usually expelled without much pain or effort.

Excerpted from Easy Labor: Every Woman's Guide to Choosing Less Pain and More Joy During Childbirth by William Camann, M.D., and Kathryn J. Alexander, M.A. Copyright 2006 by William Camann, M.D., and Kathryn J. Alexander, MA. Reprinted by arrangement with The Random House Publishing Group.

Visit StorkNet's interview with the authors of Easy Labor - William Camann, M.D., and Kathryn J. Alexander, M.A.

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