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How the pain changes
Labor pain usually comes on gradually and builds up as you progress through the stages of labor:
Early labor (up to eight hours or longer):
Your cervix dilates, or opens, to 3 centimeters to 4 centimeters and begins to thin (efface). Typically, mild-to-moderate contractions last 30 to 60 seconds and occur every five to 20 minutes, becoming stronger and occurring more frequently.
Active labor (approximately two to eight hours):
Contractions continue to become longer, stronger and closer together, and your cervix dilates to 7 centimeters. This is when most women request pain medication, though sometimes it’s given earlier.
Transition (up to an hour):
Pain tends to be strongest as your cervix finishes dilating to 10 centimeters. In addition to intense, closely spaced contractions, you may feel pain in your back, groin, even your sides or thighs, as well as nausea.
Pushing (a few minutes to three hours):
Intense pain is eclipsed by major pressure as you feel a great urge to bear down and push your baby out—some women describe it as “like pooping a watermelon or bowling ball.” Although pain continues, many women say it’s a relief to push because it helps relieve the pressure. When the baby’s head crowns, or becomes visible, you may experience a burning, stinging sensation around the vaginal opening as it stretches.
Placenta delivery (up to 30 minutes):
This stage tends to be relatively easy, as mild, crampy contractions ease the placenta out. At this point you’re focused on your newborn anyway.