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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 continued...

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."

If necessary, you may have an episiotomy, a small cut in the area between the vagina and the rectum to ease delivery. This practice isn't done as much as it once was, says Moore-Simas, who estimates only 5% of her patients require episiotomies.

The progress of the baby's descent through the pelvis is measured in numbers called stations until the baby crowns (when the top of baby's head becomes clearly visible at the opening of the vagina).

Stage Three

What to expect: The shortest stage of labor can take moments or last for 30 minutes. Contractions won't be as strong as you deliver the placenta (or afterbirth). If you have an episiotomy or you've torn tissue during delivery, you will be stitched up now.

Labor may be different for every woman, says Moore-Simas. But "at the end of the day, the goal is a healthy mom and baby. It's such a beautiful day and such a beautiful experience." 

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Reviewed on May 12, 2011

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