What to expect and how to navigate the first stage of vaginal childbirth


If you intend to have a vaginal birth, and if all things go smoothly for your labor and delivery, you can expect your body to pass through three distinct stages of delivery. This birthing process takes place naturally. Knowing a little about each stage can help you to feel more prepared and less fearful of uncertainty. Yes, there are many factors in labor and delivery that you have no control over, but, you do have the option to educate yourself before you are in the delivery room, immersed in the quick orders for staff and the confusions of the moment.

Empower yourself before you are ready to deliver and give yourself the comfort of knowing you are as prepared as you can be. Knowledge truly is power.

This article will address the first stage of delivery, what is normal, what to expect, and some things you may need to be aware of in order to make educated decisions in the moment. So grab a cup of tea, your notebook and a pen, and get ready for a conversation about the early stages of laboring for childbirth.

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The FIRST stage of delivery

The first stage of labor and delivery is a variable one. For some women this stage of labor can last several days. It can be a tricky time when you are feeling uncertain about whether or not you are or are not in labor. Some women have Braxton-Hicks contractions which make it even harder to know if you’re actually in labor or if you are experiencing what doctors will often call “false labor.”

So, how can you know for sure if you are in the earliest stages of labor? Here’s a bit about what to expect during this stage of labor, what happens during this stage of labor and a bit about some of the complications that you could face during the first stage of labor.

Defined:

First stage of delivery: The duration of labor during which the cervix begins dilation and reaches 10 cm dilation. Often called the “dilation” phase of labor and delivery.

What to expect:

Although it differs a bit between women, the first stages of labor are very important. Think of it as your body preparing to do the most challenging work it has ever done. Your body is setting the stage for the most beautiful thing you’ve experienced; childbirth. Everything that is happening throughout your body during this phase of labor is preparing for that monumental occasion; the birth of a child.

To begin, your cervix must be prepared for the delivery of a baby. Most of the activities occurring during this first stage of labor have to do with the releasing of the mucous plug, and the expansion and dilation of the cervix to prepare for birth.

Mucus “plug” releases

In the days leading up to your labor and delivery you may notice a bit of a pink, squishy substance that has passed through your vagina. Some people call this the “mucous plug” and others call it the “bloody show,” but when you see it you will know labor is impending. Up until this moment, your cervix has had a protective seal that is the body’s natural way of protecting the pregnancy. In the days or hours leading up to labor and delivery, that mucous plug will loosen and release. It opens up the cervix and kicks off the process of dilation.

Contractions begin/cervix goes through dilation and effacement

When you feel those first contractions, the alarm sets in and you may panic and race off to the hospital ready to have that baby right away. However this particular stage of labor can go on for hours or days. You may even be experiencing Braxton-Hicks contractions which are contractions as the body is feeling them, but they are not progressive contractions which are pushing labor along. Think of it as muscular tightening and releasing with no result.

Early progressive contractions begin the dilation process of the cervix. Effacement is also occurring which means that the lining of the cervix thins and softens and prepares for the baby to enter the birth canal. In order for a baby to be delivered the cervical opening must be stretched and opened typically to about 10 cm. When you first go into the hospital and explain that you’re having contractions, what they will do is examine your cervix to see if this process has begun. Many women are able to labor at home on their own terms well into this first stage of labor.

Those early few centimeters of dilation can occur over a period of hours or even days. Sometimes, it can occur rather quickly. If you have a history of fast births yourself or if there is a history of fast births in your family, it’s possible you want to be a little more urgent in your actions when your contractions begin.

For example, My mother had five vaginal births ranging from 45 minutes to just under six hours. These are considered quick births. When I went to the hospital to have my first son I was dilated at 8 cm when I arrived at the hospital. I had Braxton-Hicks contractions for approximately three days before I went into labor and from the first hard contraction, it was one hour and ½ before delivery. This is a remarkably fast labor and had I waited too late to go to the hospital, I may have delivered at home by mistake!

For most women, the first stage of contractions typically will progress in a manner that is fairly regular and predictable. As you move into the second stage of labor the contractions will change a bit in intensity. But during this first stage of labor as you are timing your contractions and paying attention to when they come and how long they are, you may find it’s a bit difficult to predict when the next ones will occur. If they are irregular, do not worry, this is normal. Everybody is different and every birth process is a bit different.  They become more regular as labor progresses.

For these early contractions you may want to check with your doctor to confirm that you are in fact in the early stages of labor. They may send you back home from the hospital with an excited “it will be soon” and as frustrating as it is to wait a bit longer, go home, take a few walks and do your best to relax while your body prepares for that big moment.

It becomes difficult to get comfortable or rest.

As labor progresses it becomes more difficult for you to get comfortable or to rest because your body is doing this contracting and releasing process that can be quite painful. It’s important during this time to get as much rest as possible and to stay as relaxed as you can. Being rested and relaxed will help to reduce your pain. You may walk around during this process which can help to ease your discomfort and take your mind off of the contractions. You will want to relax as much as possible so that your body is prepared for the work of delivery.

You may want to play some music or keep yourself distracted with your phone. Whatever makes you feel more calm as you are simply waiting out the dilation process. Keep in contact with your doctor so that you know when the time is important for you to be at the hospital or to have your midwife and Doula arrive at your home. Get your last-minute preparations ready and when it’s time, make your way to the place that you have chosen for your delivery to occur. And yes, call your family. These are exciting times and you will want to get the word out that your baby is coming!

Waters may “break”

For some women, the membranes rupture releasing the amniotic fluids. If this occurs during these early hours of contractions, make sure you give your doctor a call because likely they will want you to come on in. If you have vaginal discharge that concerns you, you can go ahead and call your doctor as well. But when the waters break it is typically a warm and sometimes gushing release of a pool of fluid. Some women may think that they have urinated and may be confused at first about what is actually happening.

Once the early labor has progressed, your body moves into what some call active labor. This is the period of time where your cervix is dilating from 6 to 10 cm. Contractions get more intense and will be more close together. It becomes increasingly difficult to relax and your breathing will intensify and become more labored, typically during the hardest contractions. Rely on the breathing techniques and laboring techniques that you have learned during your pregnancy to help you get through this painful and uncomfortable time. Active labor can range in duration for different women but typically lasts between 4 to 8 hours with roughly 1 cm of dilation occurring per hour. This is the part of labor when you will actively work to breathe through your contractions and will help your body to stay relaxed and focused. Make no mistake, this is hard work for your body.

Your doctor may offer pain relief medications during this time to help ease your pain and discomfort. During this time your baby will be monitored with a fetal monitor that will help to indicate any issues of duress for the baby.

During this time:

-Lean on your support team.

-Focus on staying as relaxed as possible.

-Do not push or strain until directed by your medical team to do so.

-Communicate with your medical team as clearly and calmly as possible.

 Possible complications:

 ●     Braxton-Hicks contractions:

Braxton-Hicks contractions are not so much a complication but an annoyance. Because they can confuse you and can lead to multiple trips to the hospital at the end of your pregnancy and being sent home multiple times, told by the doctors that you are not actually in labor. The pain can be very real and it’s just a frustrating thing to have to deal with. Just remind yourself if you are experiencing Braxton-Hicks contractions that your body is practicing for labor and delivery. While it may be annoying I  personally believe that having suffered three days of Braxton-Hicks contractions, my body was fully prepared for labor and delivery which went by very quickly. The important thing to remember is to rest and sleep as much as you’re able during this time so that you are rested enough for labor and delivery.

●     Failing to dilate/prolonged labor

For some women, in spite of all of the contractions, the cervix simply is very slow to dilate. If the woman is particularly uncomfortable or if labor has progressed for a long period of time, your medical staff may choose to give you some medication to help speed along the process of dilation. “Arrest of labor” refers to a failure to dilate for more than 4 hours in spite of contractions continuing to occur. These conditions are more common for first deliveries and for women over the age of 35 or when morbid obesity is present in the mother.

This is a condition where there is difficulty to progress labor due to the size difference between the size of the baby and the size of the pelvis/birth canal. This can cause labor to stall and become difficult.

Other complications include (and will be monitored by your medical team)

  • Fetal distress due to lack of oxygen

Fetal distress can be caused by placental abruption or placental insufficiency, or the placenta being compressed. Pressure or twisting of the placenta causes less oxygen to reach the baby which creates a condition known as “fetal distress.” This is a serious condition and should be immediately addressed by your medical team. Fetal monitoring is crucial during labor and delivery to determine if there is distress to the fetus.

  • Fetal risks due to positioning of the placenta

Choking is also a hazard if the placenta becomes wrapped around the baby’s neck during delivery, called a nuchal cord condition. It could cause birth asphyxia. It could lead to birth injuries such as hypoxic-ischemic encephalopathy (HIE).

  • Sepsis

Sepsis is an inflammatory response to infection which could be life-threatening for either the mother. Prolonged labor or the existence or a UTI or other infection could lead to sepsis.

  • Excessive / heavy bleeding
  • Malposition– refers to an unfavorable positioning of the baby for delivery

CONCLUSION

Many labor and delivery complications are treatable with adequate monitoring and quick response from your medical team. It is important to be calm and communicative, although it is understandably hard to do under duress and the stress of labor. This is a good time for your partner to also be attentive to your needs and to help you get your message across if you are frustrated or lashing out in pain. It is normal to worry and to be a bit fearful for the health and safety of your baby, but many complications can be addressed successfully with the modern advancements of medicine and maternal care.

Labor and delivery are stressful yet joyous occasions. With an understanding of what you could be facing, keeping a positive, informed, and flexible attitude you can face the difficulty with a strength you never even knew you had.

Best of luck and care for you and your baby on delivery day and we hope you’ll check out some of our other articles on labor and delivery. We hope to keep you up to date on all the latest. Knowledge is empowering! Thank you for reading.

 For more reading:

Is Childbirth in Water a Good Idea?

Considering Natural Home Births and Doula Services | Babienet Blog

Should You Create a Birth Plan? | Babienet Blog

What to Expect During Labor | Babienet Blog

Birth and Labor Stories–Why Do Women Share? | Babienet Blog

Resources:

National Women’s Health–Stages of Labour.

Labor complications: 10 common problems

This article is brought to you by our contributing writers and parents here at the Babienet Parenting Community, where we value the stories of parents just like you! We welcome you to share your journey with us.

Author Bio:

Christina M Ward is a mom, grandmother, and writer of lots and lots of words. When she’s not busy obsessing over writing poetry and well-living articles, she is out in nature exploring or doing needlepoint crafts in front of Netflix. She loves books and reading, learning geeky things about nature, and helping other people live their best life.

What is the First Stage of Birth? discusses the first stage of delivery for vaginal birth. Helpful guide for pregnant women.