Stages of Labour During a Vaginal Childbirth

The impatience to hold your baby is natural after you have crossed nine months of the rollercoaster journey of pregnancy. However, the last stage is the most crucial one, and you will need to bear labour pains before you see your baby. If the position of your baby is favourable, you are most likely to be in for a vaginal delivery. Let us understand the stages of labour, and how you can deal with each stage to ensure a smooth vaginal delivery.

What Is Labour?

Labour includes the contractions known as labour pains, which you experience before the delivery, and which continue until you deliver. Labour is primarily divided into four stages. It is important for an expectant mother to understand the process of labour and delivery to be able to deal with the different stages.

Signs of Labour

The early signs of labour are often accompanied by symptoms that your body starts showing with the onset of labour. Some of the most common signs of early labour, and some pre-labour symptoms, are:

1. Lightening

In the last stage of pregnancy, you may find it difficult to breathe as usual due to heaviness. Once the baby’s head drops into the pelvis, it is the onset of your delivery, and you may find that breathing is easier than before. You may also feel like urinating frequently, since your baby is pressing on the bladder. You can experience these symptoms from a few weeks to a few hours, after the onset of labour.

2. Bloody Show

Most expecting mothers release a brownish discharge. The discharge coming from the cervix is called the mucous plug, which seals the cervix and protects the womb from infection. In early labour or before the onset of labour, the plug might start leaking and pass through your vagina. This jelly-like, pink, sticky mucous may be discharged in one blob, or in several pieces. It is pink in colour because the mucous is blood-stained. This is called a show. If you are losing more blood, rush to the doctor. A show is a sign that the cervix is starting to open, and labour is imminent, or it may take a few days. However, some women do not have a show at all.

3. Diarrhoea

In the last stage, you may experience loose bowel movement, which could mean that you will soon be in labour.

4. Water Breaking

You may suddenly find fluid gushing from your vagina, which could mean your water has broken. This happens when the membranes of the amniotic sac surrounding your baby are ruptured. This is one of the signs of labor pain, and most women go into labour within 24 hours of this happening. If labour does not occur naturally within 24 hours, you may be induced to prevent infections or complications. The amniotic fluid is clear, and can appear as a pale straw color with a little blood. If the water is smelly or accompanied with blood, immediate attention may be needed. In the absence of amniotic fluid, your baby is not protected, and this carries a risk of infection.

5. Contractions

It is not uncommon to get periodic or irregular uterine muscle spasms as you are nearing labour. Initially, contractions occur at intervals of 10 minutes or so. During contractions, your uterus tightens and relaxes, and this tightening is called Braxton Hicks or ‘false labour’. Regular contractions that are painful and strong may indicate labour if they last longer than 30 seconds. As you get into actual labour, the contractions tend to become longer, stronger and more frequent. You can feel the abdomen becoming harder and the pain more intense. Even as the pain fades away with the muscles relaxing, you can feel the hardness ease if you touch your belly. For the baby, it means the contractions are pushing him down, and in the process, opening the entrance to the cervix.

6. Backache 

You may experience a backache, or feel heavy like you do during your monthly period.

Stages of Labour in a Vaginal Delivery

A normal delivery is divided into 4 stages of labour. Each of these normal labour stages follows a set pattern, and knowing about them will help you prepare for delivery. Read on to learn about the stages of labor you will experience.

1. First Stage of Labour

The 1st stage of labor is the longest, and is further divided into the early, active and transitional phases. Let us understand each phase of labor and how to deal with them.

Early Phase or Pre-Labour

The early phase is called pre-labour or the latent period. In this phase, your uterus starts contracting or tightening regularly, and it may gradually become painful. However, each body reacts differently, and the intensity and pace of labour vary from person to person. There are times when you may not realize the very early contractions and may find that you are already several centimetres dilated when you reach the hospital, while others may experience painful contractions from the beginning. When the cervix starts dilating, its position in the pelvis also changes and it gradually moves forward and softens.

How to Tackle This Phase

If you can walk, take a stroll. You can also take a warm shower. Most importantly, try to relax and have lots of snacks. It is best to eat carbohydrate-rich foods such as rice, bread, paranthas, pasta, potatoes, idlis and raisins which could provide energy to last.

If you find the contractions are difficult, experiment with different lying positions and find the one you are most comfortable in.

Active Phase of Labour

You enter into active phase of labour when your cervix has dilated to 3 cm or 4 cm. This is when you will feel contractions getting stronger, frequent and longer. Eventually, they may occur every three to four minutes and continue for 60 to 90 seconds.

How to Tackle This Phase

At this point when contractions seem to be too frequent, you might be looking to quench your thirst or want to use the toilet. It is suggested that you practice breathing exercises and try relaxing with the help of your nursing staff or husband. You may also consider taking a warm shower because it may ease the pain of labour.

You may reach a point in labour where you find that the rate at which the cervix is dilating has slowed or even stopped. Ask the doctor if you can walk because keeping straight and mobile helps the baby’s head move right down onto the cervix and help it dilate. If your water hasn’t broken yet, your doctor may decide to break the water to check if this speeds up the labor process. Remember that once the water breaks the contractions could be more intense.

Transitional Phase of Labour

When you enter the transitional phase, the cervix should have dilated from 8 cm to 10 cm and contractions now last for over a minute and come in a span of two to three minutes.

How to Tackle This Phase

Whenever the contraction fades away, try to relax and breathe in through your nose and blow out through your mouth.

2. Second Stage of Labour

This is the hardest phase of labour. You enter the second stage when your cervix has dilated to 10 cm.

What Happens During the Second Stage of Labour

This is when your doctor asks you to push the baby out to help him gradually slide down the birth canal. After you have crossed the first stage, you may find that the contractions have stopped. Use this time to relax. When the contractions start again, you can feel the pressure of your baby’s head between your legs. Your doctor may ask you to push stronger and harder during each contraction. You can feel the baby’s head is almost close to the pelvis and stretching the opening of the vagina, there could be a hot, stinging sensation and the doctor will see the baby’s head has ‘crowned’. As your baby’s head begins to appear, you would be asked to stop pushing and just pant. This helps the baby to come out gently and reduces the risk of tearing your perineum or the need for an episiotomy. If you are delivering for the second time, this stage may only take five or ten minutes. If it’s your first time, this stage may take hours.

How to Manage This Stage

You may be asked to keep pushing with each contraction. The doctor might suggest the best position for you which could be lying on your back or in a semi-reclined position with your head and trunk raised so that you could push the baby down. It is easier to push when you are more upright.

If you have opted for epidural, your doctor will guide you when to push and suggest not pushing further if the baby’s head is visible.

3. Third Stage of Labour

After the baby is pulled out, you enter the 3rd stage of labour, when you deliver the placenta.

What Happens During the Third Stage of Labour

You may feel contractions that are less intense. These contractions usually cause the placenta to detach from the wall of the uterus and drop down into the bottom of your uterus. You may have the urge to push, after which the placenta along with membranes of the empty bag of waters should come out through your vagina. This process takes less than 15 minutes, but can extend to one hour depending on whether you have a managed or a natural third stage.

How to Manage This Stage

Once the baby is in your arms, you offer it the breast, which stimulates hormones that help the placenta to separate. You have almost reached the end of your journey and will feel exhausted due to the adrenaline rush. You could be emotionally drained, sleepy or hungry. So, take some rest.

4. Fourth Stage of Labour

The fourth stage of labour is the first hour after the placenta is removed.

What Happens During the Fourth Stage of Labour

Your body starts to stabilize and the baby also adjusts to life outside your womb. You are usually kept under observation to ensure there are no complications like bleeding, difficulty in passing urine and swelling of the episiotomy wound.

How to Manage This Stage

You would be asked to offer the breast, but the baby may not be interested, so try touching and snuggling to help begin the process.

It is normal to be apprehensive about labour and birth if you are having your first child. Consider signing up for antenatal classes, and share your fears with your partner or close friends to ensure that you are mentally and physically prepared.

Also Read: Guide to Speed up Labour