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    Childbirth: The Stages of Delivery

    It's perfectly normal to feel a bit nervous about giving birth, but knowing what to expect during each stage can make delivery go that much smoother.

    Stage One: Active Phase

    What to expect: At this stage, contractions are stronger and more painful, occurring about three minutes apart and lasting approximately 45 to 60 seconds. Your cervix is dilating much more rapidly, about 1.2 centimeters an hour, says Moore-Simas.

    When your cervix dilates from 8 to 10 centimeters, you are in "transition stage," the last part of stage one labor; contractions now come approximately every two to three minutes and last for a minute or more. You may feel nauseous and have increased back pain.

    How to manage: At the hospital, your vital signs (temperature, blood pressure, pulse) will be taken. External monitors to check the baby's heart rate and your contractions will usually be placed on your abdomen. A nurse or doctor will do an internal exam to check dilation.

    You may be offered various pain management options, including an epidural, an anesthesia that blocks pain.

    Practical tips: Warm showers, particularly with a hand-held showerhead, can help reduce lower back pain. Gently bouncing on a birthing ball, receiving massage from a partner, listening to soothing music, and practicing deep breathing exercises can also help. Some women find relief by changing positions, walking, or getting down on their hands and knees.

    Stage Two

    What to expect: Often called the pushing stage, this part can last up to three hours if you've had an epidural -- up to two hours without it. At 10 centimeters (about 4 inches), you're fully dilated. Contractions may last longer than a minute and will usually occur every two to three minutes. As the baby's head descends into the pelvis/vagina area, you may feel pressure in your rectum (like the need to have a bowel movement) and the urge to push.

    How to manage: "You don't ever want to push until somebody has told you you're fully dilated," says Moore-Simas. Otherwise, pushing can cause the cervix to swell. "Often the pushing happens in spurts of three over the course of one contraction," she says. "You take a big, deep breath, and you want to push like you're really constipated, with all your effort in your bottom."

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