Written by
Dr. Harvey Karp
The day your baby is born will likely be the most memorable and beautiful day of your life. But mums know, it is not all rainbows and butterflies. It will also likely be the bloodiest, messiest, and most chaotic day of life your life. And that is the miracle of life!
The journey of labour gets broken up into 3 stages. The first—and longest—stage begins when you start having contractions (and there will be a lot of them!)
Your uterus is a strong muscle. When you are in labour, it switches between tensing (or contracting) and relaxing. With each squeeze, your baby is pushed downwards…which presses her head against your cervix. This will cause your cervix to efface (thin) and dilate (open up), but do not expect this to happen quickly.
Labour usually starts off slow. If it is your first pregnancy—and you are low-risk—your midwife may recommend that you labour at home for most of this stage. Try to stay relaxed, drink lots of water, and fuel up with light, carb-rich meals. If you can manage to get some shut-eye…do! Giving birth is a marathon, not a sprint, so do not tire yourself out too much early on.
As your contractions begin to become more frequent, you will want to time the length of the contraction and the time between them (from the start of one to the start of the next—not to the end).
When you arrive, the midwife or obstetrician will look to see how far you have dilated. If you need to dilate more, they may send you back home or tell you to go out for a walk or to get some food.
Some women say that the beginning of stage 1 feels like period cramps or a lower-back ache, but soon, the contractions become longer, more frequent, and more intense. For new mums, this stage usually lasts about 6-12 hours, but might drag on for a day or longer. (For second-time mums, things can go a whole lot faster!)
Once you begin active labour, you will have painful contractions around a minute long and 3-5 minutes apart. You may have trouble talking or moving about. At this point, your cervix will be dilated between 3-10 centimeters. (It is common to dilate 1 cm/hr, but like in early labour, it is different for every woman.) If you are opting for an epidural, the time is…now!
Transition is the most intense stage…but also the shortest! You will be dilating those last few centimeters and your contractions will be coming often. Stage 1 ends when your cervix has stretched to 10 centimeters (fully dilated).
When you reach the second stage, things will start to speed up.
Once fully dilated, you will move on to pushing! Some women can control the pushing process, but if you are numb from an epidural, your midwife will likely coach you on when to push hard and when to slow down to allow your body to relax and open.
Throughout this stage, the baby travels from the opening of the uterus, through the fully-dilated cervix, to the opening of the vagina. From there, you will feel an immense amount of pressure.
Your obstetrician will measure your baby’s head as it comes down, centimeter by centimeter until finally, you can see the top of the head (also known as crowning). During this stage, you can gently massage the lining of the vagina (what is known as perineal massage) to help it stretch.
A baby’s head comes out in a twisting manner…just as you twist a cork out of a bottle of wine. Once the head is out doctors will ask you to push hard—again—to get your baby’s shoulders out. Luckily, the rest of her body will slide out pretty easily, like a slippery, little fish. Unless your baby requires immediate medical care, she will be placed on your chest and covered with a warm blanket.
After delivering your baby, the journey is not actually over yet…you still need to deliver the placenta. But do not fret, it is the easiest stage and usually just falls right out after a couple of minutes. This is what is known as afterbirth.
For mums who plan to breastfeed, it is best to start right away. (And, breastfeeding will cause your uterus to contract, helping to expel the placenta and shrink in size.) You will also lose a lot of blood, so your caregiver will massage your belly to get the blood out and help your uterus shrink. At this point, some women will have a catheter, but if you do not, the midwife may ask you to pee because a full bladder can prevent the uterus from draining all the way.
If you have any tears or episiotomy cuts, your healthcare provider will stitch them up. If you got an epidural, you will not feel this, but if you did not, you will be given some local anesthesia. (It rarely hurts because the whole process usually makes the labia a bit numb.)
Note: After this incredible journey, it is not uncommon to find yourself shaking uncontrollably for minutes…even up to an hour. It may feel odd but trust us: you are okay! It is believed the shaking is caused by the adrenaline of birth or sudden hormonal shifts.
Disclaimer: The information on our site is NOT medical advice for any specific person or condition. It is only meant as general information. If you have any medical questions and concerns about your child or yourself, please contact your health provider. Breastmilk is the best source of nutrition for babies. It is important that, in preparation for and during breastfeeding, mothers eat a healthy, balanced diet. Combined breast- and bottle-feeding in the first weeks of life may reduce the supply of a mother's breastmilk and reversing the decision not to breastfeed is difficult. If you do decide to use infant formula, you should follow instructions carefully.
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