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    Pregnancy and the Stages of Labor and Childbirth

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    Pregnancy labor happens in three stages and lasts on average 12 to 24 hours for a first birth. Usually, labor is shorter for subsequent births.

    The First Stage of Labor

    The first stage is the longest part of labor and can last up to 20 hours. It begins when your cervix starts to open (dilate) and ends when it is completely open (fully dilated) at 10 centimeters. When the cervix dilates from 0 to 3 or 4 centimeters, contractions get stronger as time progresses. Mild contractions begin at 15 to 20 minutes apart and last 60 to 90 seconds. The contractions become more regular until they are less than 5 minutes apart. This part of labor (called the Latent Phase) is best experienced in the comfort of your home.

    When the cervix dilates from 4 to 8 centimeters (called the Active Phase), contractions get stronger and are about 3 minutes apart, lasting about 45 seconds. You may have a backache and increased bleeding from your vagina (called the "bloody show"). Your mood may become more serious as you focus on the hard work of dealing with the contractions. You will also depend more on your support person.

    Tips to help you through the Active Phase of labor:

    • Try changing your position. You may want to try getting on your hands and knees to ease the discomfort of back labor.
    • Soak in a warm tub or take a warm shower.
    • Continue practicing breathing and relaxation techniques.

    If your amniotic membrane ruptures -- or your "water breaks" -- the contractions may get much stronger. When the cervix dilates from 8 to 10 centimeters (called the Transition Phase), contractions are 2 to 3 minutes apart and last about 1 minute. You may feel pressure on your rectum and your backache may feel worse. Bleeding from your vagina will be heavier.

    It may help to practice breathing and relaxation techniques such as massage or listening to soothing music. Focus on taking one contraction at a time. Remember that each contraction brings you closer to holding your baby.

    It is during the active phase of labor that you will go to the hospital or birthing center. Upon arrival, you will be asked to wear a hospital gown. Your pulse, blood pressure, and temperature will be checked. A monitor will be placed on your abdomen for a short time to check for uterine contractions and assess the baby's heart rate. Your health care provider will also examine your cervix during a pelvic exam to determine how far labor has progressed.

    An intravenous (IV) line may be placed into a vein in your arm to deliver fluids and medications if necessary.

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