Your Guide to Giving Birth
Everything you must know to prepare for the big day
6) Be open-minded about drugs Knowing that effective means of pain relief are available can help lessen your anxiety about labor. — alice lesch kelly
WHAT happens during delivery? Often, the reality of childbirth only slightly resembles movie or TV depictions. Every labor is different, but here's a typical scenario.
The stages of labor
Early labor (typically 5–8 hours long)
When contractions first begin, your cervix is effacing (thinning) and dilating (opening from to 3 centimeters). On average, it opens about 1 centimeter per hour. Contractions usually are mild at first but build in strength and frequency. Once these start coming every five minutes, most doctors will tell you to go to the hospital. Generally, the nurses will hook you up to an IV to prevent dehydration and to an electronic monitor that measures your baby’s heart rate and your uterine contractions. Your doctor or midwife will do an internal exam to check your progress. You may be offered a mild pain reliever such as Demerol or Stadol; and if you want an epidural, it may be started now (though they are typically started later). Changing positions also can help relieve pain. “I moved around the room a bunch,” says Samantha Denny, 33, of Jackson Hole, Wyo. “I used the hot tub, which really helped my body relax, particularly between contractions. The birthing ball was also very effective. I wasn’t really in bed at all until I had to push, except for the few times when they had to monitor me.”
Active labor (2–8 hours)
Your cervix will dilate from 4 to 7 centimeters. Contractions will be stronger, longer and closer together, and the breathing and relaxation exercises you learned in childbirth class will come in handy.
Transition (15 minutes to 1 hour or longer) Your cervix will dilate from 8 to 10 centimeters. “This is the really intense phase of labor,” says Joan Edwards, M.N., C.N.S., assistant clinical professor at Texas Women’s University in Houston. “It’s when women say things like, ‘I can’t do this anymore!’” Swearing up a storm or becoming angry at your husband (and vowing never to have sex again) are perfectly normal during this time.
Pushing (a few minutes to 3 hours) When you’re dilated 10 centimeters, it’s time to push. You feel lots of pressure in the rectal area, as if you’re trying to pass a bowel movement. Pushing can be exhausting, but many women find it’s a relief to start. “I thought the pushing part was pretty easy, especially since the epidural had just kicked in,” says Courtenay Manes Labson, 37, of Chevy Chase, Md. “It felt productive, whereas labor prior to that point had felt more reactive. I also think being in good shape physically made pushing more doable.” As the baby’s head first begins to show, your doctor may perform an episiotomy if she feels it’s necessary.