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Bringing your baby into this world

It's exciting when labor finally begins, but it's also a busy time. When you arrive at the hospital, the labor and delivery staff may perform a physical examination to determine the size and position of the fetus and a cervical examination to check the progress of labor.

Intravenous fluids are sometimes given during labor to prevent dehydration. The intravenous line, a thin plastic tube inserted into a vein (usually in the forearm), can also be used to administer medications. Intravenous fluids are also needed when a woman has epidural anesthesia. During the labor and birth process, your vital signs (i.e., blood pressure and pulse), the frequency and intensity of your contractions, and your baby's fetal heart rate will all be monitored.

Although each woman and each birth is different, most labors follow a similar pattern and are divided into three stages: Stage One, Stage Two, and Stage Three. The amount of time in each stage will vary, but overall, labor in a first pregnancy usually lasts about 12 to 14 hours. Labor is generally shorter for subsequent pregnancies.

Learn what to expect from the three stages of labor

Stage one

The first phase of the first stage of labor is called the latent phase, when contractions are becoming more frequent (usually 5 to 20 minutes apart) and somewhat stronger. However, discomfort is minimal. The cervix dilates (opens approximately three or four centimeters) and effaces (thins out). Some women may not recognize that they are labor if their contractions are mild and irregular.

The latent phase is usually the longest and least intense phase of labor. The mother-to-be is usually admitted to the hospital during this phase. Pelvic examinations are performed to determine the dilatation of the cervix.

The second phase of the first stage (active phase) is signaled by the dilatation of the cervix from 4 to 7 centimeters. Contractions become longer, more severe, and more frequent (usually 3 to 4 minutes apart).

The third phase is called transition. During transition, the cervix dilates from 8 to 10 centimeters. Contractions are usually very strong, lasting 60 to 90 seconds, and occur every few minutes. Most women feel the urge to push during this phase.

In most cases, the active and transition phases are shorter than the latent phase.


Stage two

The second stage of labor begins when the cervix is completely opened and ends with the birth of the baby. The second stage is often referred to as the "pushing" stage. During the second stage, the woman becomes actively involved by pushing the baby through the birth canal to the outside world. When the baby's head is visible at the opening of the vagina, it is called "crowning." The second stage is shorter than the first stage, and may take between 30 minutes to 2 hours for a woman's first pregnancy.

Stage three

After the baby is born, the new mother enters the third and final stage of labor-- delivery of the placenta (the organ that has nourished the baby inside of the uterus). This stage usually lasts just a few minutes and involves the passage of the placenta out of the uterus and through the vagina.


What is an episiotomy?
Sometimes a change in the baby's condition requires a more rapid delivery and an episiotomy may be performed. This is an incision through the vaginal wall and the perineum (the area between the thighs, extending from the anus to the vaginal opening) to widen the opening and aid in delivery.


Cesarean birth

Some women will need to have a cesarean section--an incision in the mother's abdomen used to deliver a baby in an operating room or a designated delivery room. Some cesarean sections are planned and scheduled, while others may be performed as a result of complications that occur during labor.

Conditions that may make having a baby by cesarean section more likely include:

  • Previous cesarean section
  • Fetal distress
  • Abnormal delivery presentation of the fetus (e.g., breech, shoulder, face)
  • A labor that fails to progress or does not progress normally
  • Placental complications (e.g., placenta previa, in which the placenta blocks the cervix)
  • Twins or other multiples

If you are having a cesarean birth, chances are good that you can be awake for the surgery. Only in rare situations will a mother require general anesthesia for delivery. This means she is not conscious for the birth. Most cesarean deliveries today are done with a regional anesthesia such as an epidural or spinal. With this type of anesthesia, only part of the body is numbed for surgery and the mother is awake and able to hear and see her baby as soon as he or she is born.


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