As you approach labour, there are a few signs that labour and delivery are imminent.
While labour can be fast and furious, or slow and steady, all labours proceed through the same stages. For a first birth, the process usually lasts around 12-14 hours, once regular contractions are established. Subsequent labours and deliveries are usually shorter. The duration of first stage of labour (opening of the cervix) increases with maternal age and body mass index.
There are three parts to this stage of labour:
Latent phase (0-4 cm). This stage involves irregular, increasingly frequent contractions. These contractions make your cervix thin (efface) and start to open so that your baby can pass through. This is the longest stage of labour. This is the longest stage of labour, and in a healthy term pregnancy you will typically be at home through this phase.
Active phase (4-8 cm). In this phase your cervix dilates more quickly, and your contractions become regular and more intense. You may feel strong pain or pressure low in your abdomen or in your back. For women delivering their first baby, progress of at least 0.5 cm per hour is considered normal. If you have a healthy, term pregnancy, you will usually be admitted at the beginning of this phase, once your cervix has dilated to 4 cm.
Transition (8-10 cm). This final phase of Stage 1 involves the full dilation of your cervix to 10 cm. Your contractions are very strong, intense, and frequent. They are 3-4 minutes apart and last from 60-90 seconds. You may start to feel the urge to push or feel strong pressure as you get close to being fully dilated.
Once your health care provider has determined that your cervix is fully dilated, you will be able to push. With your contractions, you will push your baby out of your uterus and through your vagina until you’ve delivered. As the baby descends you will feel a natural urge to push. With an epidural you may not have this sensation and may need to be coached when to push. Delivery takes around an hour for first babies but only about 15 minutes for subsequent deliveries.
Cutting the cord. Once the baby is born he or she will usually be placed on your chest to stay warm and be close to you. Delaying clamping of the cord will give the baby an extra supply of iron-rich blood. When it is time to cut the cord, this can be done by your partner or health care provider.
After your baby is delivered, mild contractions continue to help your placenta to come out. The routine administration of oxytocin to stimulate these contractions at this time reduces the chance of major bleeding after delivery.