FIRST STAGE: EARLY LABOR
Early labor is the longest phase of the first stage of labor and lasts about 6-12 hours. During this phase, the contractions are mild and spaced apart and open the cervix from 0-3 centimeters (some of this cervical change starts prior to labor). You may feel excited that your labor has finally begun, but anxious about how the rest of your labor will progress. Most expectant parents feel more comfortable if they stay home during early labor. This is a good time to drink water, rest, or take a short walk. A warm shower or bath may feel nice, but check with your healthcare provider before getting in the tub if you think your water has broken.
When should you go to the hospital?
It’s likely that you won’t need to go to the hospital until your contractions are 5 minutes apart, last 1 minute each, and continue in this pattern for 1 hour. Use 511 as a general guide, but always follow your healthcare provider’s instructions.
Early Labor Contractions
Call Your Healthcare Provider
YOU NEED TO CONTACT YOUR HEALTHCARE PROVIDER AND GO TO THE HOSPITAL SOONER THAN ‘511’ IF YOU:
- Vomit with contractions
- Feel rectal pressure
- Are unable to walk or talk through contractions
- Think your bag of waters has broken
- Have vaginal bleeding
- Tested positive for Group B Strep and need additional time at the hospital for the administration of antibiotics
- Live far from the hospital
- Progress quickly (Call 911 and get into a side-lying position if you are having an extremely fast labor!)
FIRST STAGE: ACTIVE LABOR
A change in the intensity and regularity of your contractions lets you know that you are progressing to the active phase of the first stage of labor. These stronger contractions open the cervix from 4-7 centimeters. Active labor lasts an average of 3-5 hours. Remember that this is only an average, and having a shorter or longer active phase is perfectly normal. You may be more serious and focused during active labor than you were earlier.
When you get to the hospital, your dilation will be measured during a pelvic exam. Active labor contractions may produce spots of blood, called show, as the cervix dilates. This spotting is normal and indicates that your labor is progressing. If the bag of waters did not break at the onset of labor, it may break during active labor due to the force of the contractions.
As active labor progresses, the baby starts a process called internal rotation. In order to fit through the bottom of the pelvis and into the birth canal, the baby’s head usually turns so she’s facing her mother’s back. This is called the anterior position. In some births, the baby’s head turns to the posterior position, which means she’s facing the front of the pelvis. If this happens, the back of her head puts additional pressure on her mother’s back, which may cause painful “back labor” and slow progress. A posterior baby usually turns to the anterior position with the help of stronger contractions, the shape of the pelvis, and the use of labor positions that encourage fetal rotation.
PARTNER TIP: SUPPORT DURING LABOR
Help Mom time the contractions and rest, take a walk together, or offer her books, card games, or other calm activities.
ACTIVE LABOR & TRANSITION
Offer increased emotional support by giving her encouraging words. Assist her in changing positions, and suggest and help her use relaxation and comfort measures. Provide focus during contractions by using direct eye contact and brief instructions. Help her rest between contractions.
Help her move into comfortable, productive positions. Provide focus and emotional support. Tell her, “Just a few more pushes” or “You’re almost there!” Help her rest between pushes.
Active Labor Contractions
FIRST STAGE: TRANSITION
The third and final phase of the first stage of labor is called transition. Ever stronger, more frequent contractions make this phase the most intense part of labor and cause the cervix to complete its dilation from 8-10 centimeters. You can take comfort in knowing that transition is usually the shortest phase of the first stage, lasting as little as 30 minutes and as long as two hours. Chills, shaking, and nausea may be physical side effects of your body working hard during transition, and you may feel frustrated and more dependent on your support people.