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Linda Murray: The first stage of labor has 3 parts to it: early labor, active labor, and transition. We'll discuss these in just a moment. Throughout this stage, you'll feel many contractions and notice them getting longer, stronger, and more frequent. By the end of this stage, your cervix, which was tightly closed and sealed with a mucus plug during pregnancy, will open all the way up so your baby can pass through it. When that happens, you're ready to push.
Now let's talk about early labor, active labor, and transition. In early labor, your contractions start coming at irregular intervals. As things progress, your contractions will get longer, stronger, and closer together, gradually opening and thinning out your cervix. The contractions might be painful or just slightly uncomfortable like cramps. You should be able to move around and talk as they're happening, and you might be able to get in a nap or a walk before things pick up. After a while, your contractions will last about 40 to 60 seconds each and come every 5 minutes or so. It's hard to say how long early labor will last. It could take about 6 to 12 hours, but it can be longer or a lot shorter too. When your cervix is 4 centimeters dilated, about the size of a Ritz cracker, you move into active labor.
Mom 1: I had wanted to labor at home for as long as I possibly could. It's my first child, so I was prepared that a lot of people go in too early and they get sent home. I didn't want to do that. Things got more regular and more intense, to the point where I'd be walking down the hallway and when a contraction came, I would have to stop and hold on to something. I had to go to the bathroom a lot. I couldn't sit down on the toilet by myself.
Mom 2: We were 2, 3 hours at the hospital, and they told me that I was not dilating, so I have to go back home. And I was telling them, "But I'm in so much pain. What am I going to do? I won't be able to sleep." It was around 10 o'clock already.
Mom 4: I woke up a couple of times during the night. I had a little bit of cramping, but I was able to get myself back to sleep. But around 6:30 in the morning, right around when our alarm went off, that's when it started getting really intense and I realized that I was in labor.
Linda Murray: Active labor is when things really get rolling. Your contractions will start to get more intense and happen even more often, and you may find it difficult to talk through them. Once you've been experiencing this for about an hour or 2, it's finally time to call your doctor or midwife and ask if you should head to the hospital or birth center, though some caregivers prefer a call sooner. To help you remember when to call, use the 5-1-1 rule. Contractions coming 5 minutes apart, lasting 1 minute each for 1 hour. On average, active labor lasts about 4 to 8 hours for first-time moms, so you'll probably be less than halfway through it by the time you see your caregiver. You can cope with the intensity of the contractions using medication or natural pain-management techniques. If you want an epidural, this is the stage in which you're likely to get it. When your cervix is 8 centimeters dilated, a little larger than the top of a soda can, you enter transition.
Mom 1: The contractions started coming ultimately about almost every 2 to 3 minutes and I started getting nauseated and I threw up a few times.
Mom 5: When I went into labor, apparently I went from 2 centimeters dilated to 10 within an hour and a half. So it was a little intense during those couple hours.
Mom 6: It shifted to the next level, and I wasn't prepared for that. And it was just like, “Oh my God, this is it,” and then tears ran down my face. I was kind of like a little scared, a little excited, a little of like, “I have no idea what's going on.” I think at that point is kind of when my body took over.
Mom 4: I said, "I can't do this anymore," and everyone around me said, "But you are doing it," and I said, "But I don't want to do it."
Linda Murray: Most women find transition to be the most intense and painful part of labor. It's when your cervix does its last bit of dilating, opening up from 8 centimeters to 10, which is about 4 inches across, roughly the size of a bagel. When you reach this point, your caregiver will say that you're 10 centimeters dilated or fully dilated. Your contractions will be very strong and last a minute or more, and between them, you're likely to have a few short minutes of rest. If you have an epidural, your lower body should be numb, so you won't feel any of this. If you don't have one, you may feel shaky, start shivering, become nauseated and even vomit. This is normal, and not a sign that there's something wrong with you or your baby. During transition, you may start to doubt your ability to handle the pain, so it's an important time for encouragement from the people who are there to support you. On the bright side, this is the shortest phase of labor, lasting on average anywhere from a few minutes to a few hours. It's helpful to take it one contraction at a time.