Childbirth—the first stage of labor
The first stage of labor is that your body is preparing for childbirth, with signs such as bursting of the water bag, initiation of contractions, and "symptoms."
regular contractions
When you have a contraction, your uterus narrows and then relaxes. You may have experienced contractions throughout your pregnancy, especially near the end. During pregnancy, these painless tightenings are called Braxton Hicks contractions.
When you experience regular, painful contractions that feel stronger and last more than 30 seconds, labor may have begun. As labor continues (consolidates), contractions tend to become longer, stronger, and more frequent.
During contraction, your uterine muscles contract and the pain increases. If you put your hand on your stomach, you may feel that it is getting harder. When the muscles relax, the pain fades, and your hand will feel stiff. The contractions push your baby down and open the cervix (uterine entrance) in preparation for your baby to pass through it.
Your midwife or doctor will likely advise you to stay home until the contractions recur. When your cramps come every 5 minutes, it's time to go to the hospital.
Back pain
You may experience either back pain or the intense pain that some women feel with their period.
Width'
During pregnancy, there is a mucus plug in the cervix. Just before labor begins, or early in labor, the tampon comes out and may pass it through the vagina. This small amount of viscous, pink, jelly-like mucus is called "crosswise."
They may come out at one point or in several pieces. It is pink because it is stained with blood, and it is normal to lose a small amount of blood mixed with mucus. If you're losing more blood, it could be a sign that something is wrong, so call the hospital or midwife's nurse immediately.
A symptom indicates that the cervix has begun to open; labor may follow quickly, or it may take a few days. Some women have no symptoms.
Your water is breaking.
Most women's water breaks during labor, but it can also happen before labor begins. The embryo develops and grows inside a fluid sac called an amniotic sac. When it's time for your baby to be born, the cyst bursts and the amniotic fluid is released through the vagina. This is your water exploding.
When this happens, contact your doctor or midwife so they can ask you a few questions and check your condition.
You may feel a slow drip or a sudden flow of water that you can't control. To prepare for this, you can keep a sanitary napkin (but not a tampon) handy if you intend to go outside and put a plastic sheet on your bed.
The fluid surrounding the fetus is clear and the color of the straw is pale. Sometimes it is difficult to distinguish between amniotic fluid and urine. When the water bag bursts, the water should be clear or slightly pink. If it looks greenish or bloody, consult a doctor or hospital immediately, as this may mean that you and your child need urgent attention.
If your water sac bursts before labor begins, contact your midwife or hospital for advice. Without amniotic fluid, your baby is no longer protected and there is a risk of infection.
Coping at the beginning of labor
At the beginning of labor:
You can get up and move if you feel like it.
You can drink fluids and you may find isotonic drinks (some sports drinks) that help keep your energy levels high.
You can also snack, although many women do not feel very hungry and some feel sick.
When the contractions become stronger and more painful, you can try relaxation and breathing exercises—your birth partner can help you by doing them with you.
Your birth partner can rub your back, as it may help relieve pain.
Extend
The cervix needs to be opened about 10 cm so that the baby passes through it. This is called "fully expanded." Contractions at the beginning of labor help soften the cervix so that it gradually opens.
The smoothing process can sometimes take several hours before it goes into what midwives call "steady labor." Hard labor is when your cervix expands to more than 3 cm. If you go to the hospital or delivery center before labor is established, you may be asked if you prefer to go home again for a while rather than spending extra hours in the hospital or delivery center. If you go home, you need to make sure that you eat and drink, because you will need energy.
At night, try to feel comfortable and relaxed. If you can, try to sleep. A warm bath or shower may help you relax. During the day, keep your straightness and activity gentle. This helps the baby move down into the pelvis and helps the cervix dilate.
Once labor begins, the midwife will examine you from time to time to see how you are progressing. In first labor, the time from the onset of static labor to full expansion is usually between 6 and 12 hours (about 8 hours on average). It is often faster in subsequent pregnancies.
The midwife will tell you to try not to push until the cervix is fully open and the baby's head can be seen.
To help you cope with the urge to push, try blowing slowly and gently, or if the urge is too strong, into a small puff. Some people find this easier when lying on their side or on their knees and elbows to reduce the pressure of the baby's head on the cervix.
Fetal heart monitoring
Your baby's heart rate will be monitored throughout labor. The midwife will monitor any noticeable change in rate, which can be a sign that the baby is sad and that something needs to be done.
Read more about how to monitor your baby's heart during labor.
Acceleration of labor
Your labor may be slower than expected if the contractions aren't frequent or strong enough or because your baby is in a critical position. If this is the case, your doctor or midwife will explain why they think labor should be accelerated and may recommend the following techniques to get things moving:
Breaking the water bag (if this has not already happened) during a vaginal examination—often this is enough to move things.
If that doesn't work, you may be given a drop containing a synthetic copy of the birth hormone oxytocin (a drug called Syntocin), which is fed into a vein in your arm to encourage contractions—you may want some pain relief before it starts dripping.
After the drip is connected, your contractions and your baby's heartbeat will be constantly monitored with an electrocardiogram (CTG).