Labor and delivery is often unpredictable, especially if you’re having your first baby. By understanding the signs that labor is starting, the stages of labor, and the options available to you for pain management and other common scenarios, you can feel more prepared and confident as you welcome your baby into the world.
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As your due date nears
Most pregnancies last between 37 and 40 weeks – and if your due date is coming up, you probably have a lot of questions. What are the early signs of labor? What are contractions? What do dilation centimeters mean? And how long does it take to heal after giving birth?
Everyone’s labor and delivery experience is unique. But taking the time to learn what’s typical – even if it doesn’t end up being your exact experience – can still be very helpful for nervous parents-to-be.
Keep reading to learn what to expect during labor and delivery and what happens if things don’t go as planned. We’ll also share some steps you can take ahead of time to help your labor and delivery go as smoothly as possible. The sooner you start preparing, the better!
Early signs of labor
It’s the event you have been anticipating for months – the birth of your new baby. You may begin to notice subtle physical signs that your body is preparing for labor as your due date approaches.
Understanding these early signs of labor is crucial, especially for first-time parents. Of course, nothing is a sure thing with labor symptoms – some moms deliver hours after the first signs of early labor, while others may still have days or weeks to go.
Here are some telltale signs that labor is likely on the horizon:
Lightening
Some expectant moms feel their baby “drop” (descend lower into their pelvis) a few weeks before labor begins. If you don’t feel anything, not to worry – sometimes it’s hard to tell when your baby drops, and sometimes the baby doesn’t drop until labor begins.
Now that your baby’s head is pushing down on your bladder, you may feel the urge to urinate even more often. However, because your little one has moved away from your lungs, it may be a bit easier to catch your breath.
Bloody show
Shortly before labor, you may start seeing a thick vaginal discharge that is red, brown, or pink in color. As known as “bloody show,” the appearance of this discharge is a strong sign that labor is imminent.
When your cervix begins to dilate in preparation for labor, the thick mucus that blocks your cervical opening during pregnancy (the mucus plug) is slowly expelled. As your cervix continues to open, small blood vessels in that area may rupture – causing blood to mix with the mucus, resulting in bloody show.
Bloody show can come out in one large piece or several small ones. Some expectant moms never notice their bloody show, and some don’t have it at all until labor and delivery.
Nesting urge
It may sound strange, but many moms-to-be experience a strong urge known as the nesting instinct just before labor begins. Pregnant women who nest have a powerful desire to clean, organize, and prepare their home for the baby’s arrival.
Characterized by a sudden burst of energy, nesting can include everything from deep cleaning the house to organizing closets to setting up the baby’s nursery. Many expectant parents also stock up on baby supplies like diapers, wipes, and clothing during this time.
The biological reasons for nesting are not fully understood, but researchers believe it is an evolutionary adaptation to preparing for and protecting our offspring. Hormonal changes likely play a role in nesting as well.
Contractions
One of the most recognizable signs of early labor is contractions, the rhythmic tightening and relaxing of your uterine muscles that ultimately help push the baby through your birth canal. Contractions often feel like strong menstrual cramps or pressure in your lower back.
But are you really having contractions, or are they just a false alarm? Many expectant moms experience Braxton Hicks contractions, also known as false labor. Braxton Hicks contractions feel the same as true labor contractions, but they are irregular and unpredictable. They also do not increase in frequency or intensity over time.
True labor contractions happen at regular intervals (such as every 5-10 minutes), becoming longer and more intense as time passes. In early labor, contractions typically last around 30-45 seconds. They can range around 20 minutes apart at first, but then begin to occur more frequently. Moving or changing positions is unlikely to relieve your discomfort during these contractions.
Back pain
Back pain is common during late pregnancy due to your growing uterus, weight gain, and changes in your posture. Hormones that prepare your pelvic ligaments for labor can also make the pelvis unstable, leading to back pain.
Persistent, dull pain in your lower back could also be a sign of early labor – especially when combined with other signs like bloody show or water breaking (see below). This type of back pain is usually caused by the baby’s head pressing against your lower back and may persist during and between contractions.
Water breaking
During early labor, you may experience a sudden gush or slow leak of amniotic fluid (the watery liquid that surrounds and protects your growing fetus inside the amniotic sac during pregnancy). At first, it can be hard to tell the difference between amniotic fluid (which is pale and mostly odorless) and urine.
If your water breaks, it’s important to contact your medical provider right away. If your amniotic fluid is clear, that is a good sign. But if the fluid is discolored or has a foul odor, you could have an infection or other pregnancy complications that require immediate medical attention.
Again, it’s not always easy to tell when labor has truly begun. Some pregnant women will have shorter, weaker, and more sporadic contractions or other signs of early labor. Always check with your medical provider to be sure.
Stages of labor
Labor and delivery are typically divided into three main stages: 1) early and active labor, 2) pushing and birth, and 3) delivery of the placenta. You must go through all three phases of labor for a safe and healthy delivery.
Stage 1: Early and active labor
During early labor, your cervix dilates from 0-6 centimeters with mild to moderate contractions.
During active labor, your cervix dilates from 6-10 centimeters with stronger, more intense contractions that are closer together.
Hospital admission typically occurs during this stage.
Stage 2: Pushing and birth
At this time, your cervix is fully dilated (10 centimeters).
You will feel an urge to push. Some moms experiment with different pushing positions, such as sitting, squatting, and kneeling.
You may be asked to slow down or stop pushing at times.
Asking for a mirror to see your baby’s head crowning can be a great motivator.
The birth may last minutes or hours.
Stage 3: Delivery of the placenta
Placenta delivery occurs 5-30 minutes after your baby is born.
Mild contractions often help deliver the placenta.
You may be given IV medication to encourage additional contractions and decrease bleeding.
Your medical provider will examine the placenta to make sure it is complete and healthy. Any fragments left behind in your uterus could cause postpartum hemorrhage or other complications.
Common interventions during labor and delivery
Your body is designed to deliver a baby naturally, but sometimes nature and medicine have other plans. Labor and delivery is not an easy process, and it is your medical provider’s responsibility to get you and your baby through it safely.
There are a number of interventions that may help your labor and delivery go more smoothly. Some of these interventions can be lifesaving in certain situations.
Pain relief
It’s normal to feel anxious about pain during labor and delivery, especially if you’ve heard descriptions of severe or excruciating pain. Keep in mind that every woman has a different pain threshold and pain tolerance – and that some women do describe the pain as manageable.
Thankfully, there are many options to help relieve your pain throughout labor and delivery:
Gentle massage, taking a warm shower or bath, or using breathing and relaxation techniques are natural ways to reduce pain.
Walking or changing your sitting or lying positions can also help.
IV medications, such as opiates, may be used for pain relief during early labor but can affect your baby’s ability to breathe if given too close to delivery.
Epidural anesthesia is often recommended for planned C-section deliveries.
General anesthesia is required in the event of complications that require an emergency C-section delivery.
Monitoring
Once you arrive at the hospital, your medical provider keeps a close watch on your baby through continuous or intermittent fetal heart monitoring. Your provider also performs cervical exams to track your dilation (1 centimeter dilation, 2 centimeter dilation, and so on) until you are ready to deliver.
Induction or augmentation
Labor induction initiates your labor when it hasn’t started naturally, while labor augmentation speeds up and strengthens labor that isn’t progressing as it should.
For instance, your medical provider may perform an amniotomy (breaking your water) if it doesn’t occur naturally within a certain amount of time. Medications like Pitocin can also be given by IV to strengthen contractions and move your labor along faster.
Assisted delivery
If your labor still is not progressing – or your medical provider is concerned about the baby’s well-being during delivery – they may use forceps to grasp and guide the baby’s head or vacuum extraction to gently pull the baby out.
Or, your medical provider may recommend an emergency or planned C-section delivery, a surgical procedure that delivers the baby through incisions in your abdomen or uterus.
What to expect emotionally and physically
You will likely experience a range of emotions during labor and delivery, including anxiety, excitement, fear, and euphoria. Hormonal changes during labor can intensify your emotional sensitivity, leading to crying spells and mood swings. So, go easy on yourself – it’s normal to feel emotional highs and lows during this time, including after the baby is born.
You will likely endure a great deal physically during labor and delivery as well, including severe cramps, pressure, and the urge to push. Shaking, chills, and vomiting can also occur when you are in active labor.
For some, labor and delivery is over in a matter of hours. For others, a long and difficult labor can test their limits of emotional and physical stamina – and that’s where your support team comes in.
Your support team
It often takes a village to have a baby! The purpose of a support team is to create a safe and positive birthing experience, offering you support and encouragement from start to finish.
Your support team usually includes:
Your birthing partner (spouse, partner, family member, or close friend) or doula
Nurses and other labor and delivery staff
Your obstetrician or midwife
A pediatric care team for your baby, especially if any complications arise
Research shows that women who have continuous labor support are less likely to use pain medications or have C-section deliveries, proving that support teams truly can make a difference.
After your baby arrives
The moment you’ve been anticipating for months is finally here, and your baby has arrived. Now what?
If you deliver your baby without complications, you should be able to spend the first hour or so after childbirth with your newborn. The first exchanges of touch, sound, and eye contact between mother and baby are an integral part of the bonding process. Your obstetrician or midwife will also take numerous steps to ensure the baby is healthy and begin your healing process.
Immediate skin-to-skin contact
If possible, your obstetrician or midwife will immediately place your baby on your bare chest after delivery. This skin-to-skin contact in the first moments of your baby’s life helps regulate their body temperature, heart rate, and breathing and begins building the bond between you right away.
Baby assessments
Your pediatric care team will measure the baby’s weight and length and determine their Apgar score – a quick test performed on newborns shortly after birth to assess their physical condition and initial adaptation to life outside the womb.
Post-delivery care
If you had a challenging delivery, your uterus may need to be massaged to reduce postpartum bleeding. You may also need stitches if you tore during delivery or had an episiotomy, a surgical incision made in the perineum (the area between the vaginal opening and anus) during childbirth to enlarge the vaginal opening.
Delaying cord clamping
Depending on hospital policy, your pediatric care team may delay clamping your baby’s umbilical cord blood to increase the amount of nutrient-rich blood delivered to your newborn. Doing so also decreases your baby’s risk of anemia.
First breastfeeding attempt
Attempting breastfeeding soon after delivery – ideally within the first hour – is highly recommended. These first drops of breast milk, which are called colostrum, are rich in nutrients and antibodies that offer crucial protection and nourishment for your newborn baby.
Other tips for expectant parents
There’s no way to know what your exact birthing experience will be, but there are things you can do ahead of time to help labor and delivery go as smoothly as possible.
Ask questions. You are your own best advocate.
Make a birth plan so you feel prepared, but also stay flexible. Despite best intentions, your circumstances could change.
Pack a hospital bag in advance, so you’re ready to go at any time.
Know who to call when you think you are in labor. Prepare a list of phone numbers, including your obstetrician or midwife and any family members you would like to have with you.
Rest and stay well-hydrated during early labor to save your energy for delivery.
Lean on your support system. Labor and delivery can be scary, whether it’s your first baby or your fifth. Your support system is there to motivate you and keep you relaxed and calm.
Even the most prepared parents are often scared and nervous about labor and delivery. Embrace the unknowns and focus on the end result – finally holding your newborn baby in your arms.
