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The Three
Stages Of Labor
Labor is described in three stages,
and together these stages complete the delivery and the passage of
the placenta.
Stage One
The first stage is the process of
reaching full cervical dilatation. This begins with the onset
of uterine labor contractions, and it is the longest phase of labor.
The first stage is divided into three phases: latent, active, and
deceleration.
- In the latent phase, the
contractions become more frequent, stronger, and gain regularity,
and most of the change of the cervix involves thinning, or
effacement. The latent phase is the most variable from woman to
woman, and from labor to labor. It may take a few days, or be as
short as a few hours. We typically expect the latent phase to be
10 to 12 hours for a woman who has had children. For first
pregnancies, it may last closer to 20 hours. For many women, the
latent phase of labor can be confused with Braxton Hicks
contractions. Membranes may spontaneously rupture in the early- to
mid-portion of the first stage of labor. If they rupture, the
labor process usually speeds up.
- The next portion of the first
stage of labor is the active phase, which is the phase of
the most rapid cervical dilatation. For most women this is from 3
to 4 centimeters of dilatation until 8 to 9 centimeters of
dilatation. The active phase is the most predictable, lasting an
average of five hours in first-time mothers and two hours in
mothers who have birthed before.
- Finally, there is the
deceleration phase, during which the cervical dilation
continues, but at a slower pace, until full dilation. In some
women the deceleration phase is not really noticeable, blending
into the active phase. This is also a phase of more rapid descent,
when the baby is passing lower into the pelvis and deeper into the
birth canal. The deceleration phase is also called transition,
and, in mothers with no anesthesia, it's often punctuated by
vomiting and uncontrollable shaking. These symptoms can be
frightening to watch, but they're a part of normal birth, and they
signal that the first state is almost completed.
Stage Two
The second stage is the delivery
of the infant. During the second stage, mom actively pushes out
the baby. For first time mothers, this can take two to three hours,
so it's important to save your energy and pace yourself. For second
babies and beyond, the second stage often lasts less than an hour
and sometimes, only a few minutes.
Stage Three
The third stage of labor is the
passage of the placenta, which can be immediate, or take up to
thirty minutes. The process may be sped up naturally by
breastfeeding (which releases oxytocin), or medically by
administering a drug called pitocin.
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