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Normal vaginal spontaneous delivery is divided into 3 stages. The first stage of labor starts when you experience true labor contractions (as opposed to false labor). This is when you experience stronger and more frequent abdominal cramps that somehow puts more pressure on your pelvis, which causes your cervix to dilate slowly. This is the longest part of the 3 stages and is the most tiring as it requires a lot of effort and stamina to get through this phase. Not to worry though, we’ll guide you on what to expect and how to get through it as comfortable as possible.


Stage one

The first stage of labor involves the occurrence of contractions to the full dilation of your cervix which is 10cm. It is divided into 3 phases: the early labor phase, active labor phase and transition phase. Each phase is divided according to the dilation of the cervix and are characterized by different emotions and physical challenges.


Early labor phase

Early labor phase starts at the onset of contractions until your cervix dilates to 3cm and thins out. You will notice that your cramping episodes may last for about 30 to 45 seconds, with 5-30 minutes of rest in between, in which your cramps grow stronger in intensity. It lasts for approximately 8-24 hours.

It is during this phase that relaxation and comfort is a must. You don’t need to rush to the hospital just yet and you can still do some light activities like walking around the yard or cooking. Do not overexert yourself as you need all the energy that you can get for the other stages of labor.


What to expect:

• More backache, indigestion and diarrhea.
• Bloody show usually occurs on this stage.
• Contractions feel like menstrual cramps and pressure may be felt in the pelvic area.
• Frequent urinating

It is advised that you eat a light snack to feel more energized and keep on counting your contractions to keep track of your cervical dilations and to be able to tell when you are transitioning to the next phase. Relaxation or deep breathing techniques may be helpful to keep you distracted and lessen the exhaustion from the long labor process. Your partner/husband/support person’s presence is helpful in itself. It will make you feel assured and gives you comfort and support.


Active labor phase

It is during active labor that you should be heading to the hospital as your cervix is already dilated up to 7 cm. Contractions typically last for 40 to 60 seconds and occur every 3-4 minutes with a slightly regular pattern. This phase lasts from 2 to 3 ½ hours.


What to expect:

• You will experience even more painful contractions and backache than that in the early labor phase.
• You may also experience leg discomfort or heaviness and fatigue from the long duration of labor.
• Your water may have ruptured at this time. Make sure to check for the color, odor and when it happened. It should be colorless and odorless.

This is the time for the partner/husband/support person to give you moral support and encouragement, massaging of the abdomen and the lower back is helpful too. You may also practice some breathing techniques that can be useful during delivery. Also, a pillow supporting your back and frequent change in positions can help relieve the back pain. Listening to music, reading a book and playing cards all be helpful distractions. Some other ways to deal with the pain aside from those techniques are:

• Creating white noise by singing chants, hums, and moans when you feel like it.
• To help progress your labor, try standing and leaning against your partner, sitting and leaning over a chair, walking slowly or just taking a warm, comforting shower.
• Water therapy is also useful. Relax in a jacuzzi, bathtub or shower for long stretches.
• Drink lots of fluid to replace fluids lost, and to keep you from having a dry mouth.
• If you are not hooked to a catheter, pee regularly because a full bladder can prevent your labor from progressing.

At the hospital, you will be monitored as needed to keep track of your cervical dilation and to prevent any complications that might arise during childbirth. If the labor is too slow or goes beyond 3.5 hours, your doctor might suggest augmenting your labor. Prolonging it may deprive your baby of oxygen and cause complications.

Transition phase

Transition phase is the most intensive part of labor. During this time, the cervix dilates from 7cm to being fully dilated at 10cm. It is the shortest of the 3 phases of labor. It lasts from about 15 minutes to about 2 hours. The contractions will be strong/intense and long. They will last for 60 to 90 seconds with a 30 second to 2 minutes rest in between. And because the relax period is short, you will feel like you barely had any rest at all when the next contraction occurs.

If you opted to have an epidural or other pain relief options, you will not feel any pain during this stage. But if not, you are expected to feel the following:

o Strong urges to push will put pressure in the rectum, lower back and the perineum.
o Increase in bloody show or bleeding as the capillaries rupture during the descent of the fetus in the vaginal canal and pelvis.
o Due to the long-standing labor, you may also feel uncontrollable cramps in your legs.
o Fatigue, exhaustion and drowsiness may also occur.
o Warm, sweaty and shaky feelings.

This is the last phase! Don’t worry, soon you’ll meet your little one. But for the meantime, continue focusing on your breathing techniques. Doing the right breathing techniques, with the help of your doctor or anyone who is assisting you in the delivery room, at the right time, will make this stage so much easier for you. Pushing during the peak of contractions is ideal, try to rest in between contractions to save and gain more energy. Also, don’t hesitate to speak up if you feel that you need help.

For more insights read about Childbirth: Stage Two and Childbirth: Stage 3 Delivering a Placenta.


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Astley Golosinda profile photo
Astley Golosinda

My background is in the field of medicine and I have a Bachelors Degree in Nursing. My thesis in Nursing was also published on Journal of Gerontology

For the past 4 years, I continued my studies and dedicated my time to acquiring a Doctorate of Medicine. I was a working student all throughout my post-doctorate degree. I have clinical experience in the hospital both as a nurse and now as a medical student.