Early symptoms and signs of labor include:
- Baby drops or engages into pelvis (known as lightening)
- Abdomen looks lower and more protruding
- Menstrual-like cramps
- Diarrhea or flu -like symptoms
- Braxton-Hicks contractions (false contractions) during the last week of pregnancy
- Frequent urinating
- Frequent bowel movements within 48 hours of labor
- Indigestion, nausea or vomiting a day or two before labor begins
- Sudden burst of energy 48 hours before labor starts
- Increased vaginal discharge
- Small blood-stained discharge
- Water breaks
During this stage of labor, thinning of the cervix occurs and it is completely dilated to around 10cm. Different phases known as the latent, active and transitional phases occur during the first stage:
The latent phase
In this phase, thinning of the cervix may occur over a period of weeks, days or hours. It may be accompanied by mild contractions which may be regular or irregular – sometimes you may not even be aware that you are having contractions at all. This part of labor is the least painful but the longest. Rest and relax at home until the contractions become more painful and regular.
The active phase
During this phase contractions are strong and painful. The cervix is dilated to around 7cm. They are about three to four minutes apart and last for as long as a minute. You may feel restless, find it difficult to stand, or shift birthing positions. If your water breaks or you notice vaginal bleeding, this is the time to go the hospital.
The transitional phase
The contractions are more frequent, longer, intense and painful during the transitional phase. The contractions are also closer together than before as the baby moves down. Usually, the cervix may take around an hour to dilate to the final 3cm. During this phase you are nearing the delivery process and may feel increasingly agitated, irritable, frightened and fatigued. You may also feel a strong desire to visit the toilet as the baby’s head presses against the rectum.
During this stage, the actual birth process occurs. When the cervix is dilated to around 10cm, the uterine contractions are usually regular but may slow down to every two to five minutes and lasting 60 to 90 seconds. You may feel the need to bear and push as each contraction intensifies. There may also be the need to change positions many times before you reach one that is comfortable. Immense pressure may be felt in the rectum as the baby’s head presses against it.
As the baby moves through the vagina, especially as the head crowns, a burning or stretching sensation is often experienced. As the head emerges, the medical team will turn the body to deliver the shoulders and the rest of the body will slip out. If the head appears quickly, your obstetrician may make an incision in the perineum (episiotomy) or tell you to push more gently or to stop pushing so that the baby’s head can stretch out of the vaginal opening and perineum – this will keep the perineum from tearing.
Shortly after you have given birth, the uterus contracts again. It gently loosens and pushes out the placenta or afterbirth This stage usually takes about five to ten minutes.