The following is an excerpt from Natalia Hailes and Ash Spivak’s Why Did No One Tell Me This?: The Doulas' (Honest) Guide for Expectant Parents. Reprinted by permission of Running Press, part of the Perseus division of Hachette Book Group. Copyright 2020 Natalia Hailes and Ash Spivak.
You’ve likely read about the “stages of labour” before based on the dilation of your cervix. We’d like to present them to you in a different light; after all, the numbers don’t give us that much information anyway, and you can’t do cervical exams on your own.
Instead, we want to turn your focus to the experience of labour—the key indicators of how the body and emotions may change throughout the process—so you can get a sense of where you are without focusing as much on the time or whether you’re moving fast enough.
Also keep in mind this is based on physiological birth. Things may feel different if and when interventions are introduced, though you may still be able to note some of these markers. Remember every body is different, so it may not happen exactly like this for you.
How long: A few weeks to a few days before the onset of labour. Or you may never experience it at all.
Braxton-Hicks or “practice contractions” feel different from labour contractions. Braxton-Hicks contractions feel like a tightening and release: your belly becomes as hard as a rock, and then it is soft again. Labour contractions have a wave-like shape: building, peaking, and coming down. They will also become longer, stronger, and more consistent over time. Sometimes increased B.H. contractions can be a sign of dehydration, so drink up. While not everyone experiences B.H. contractions, if you do, it’s a great opportunity to practice taking nice long inhales and exhales as a way to cope with the sensation.While annoying, B.H. contractions also have a benefit! They help strengthen your uterine muscles to prep for labour. #gouterusgo!
Tip: Be sure to go to bed at a reasonable hour once you are at 37 weeks. You don’t want the one day you stay up till 1 a.m. to be the day labour starts!
How long: Can last for a few hours to a few days. For many, it starts in the middle of night.
How long: Lasts for hours, not days.
At least two of the following are happening . . .
How long: Typically lasts for hours, in the single digits.
All of the above, plus:
Tip: This is typically a good time to go to your birthing place, ensure your midwife is at your home, or get an epidural if you are choosing one.
Tip: If at any point you feel like something is off, see green or brown in your fluids, or (and remember, this is very rare!) see excessive bleeding, feel stillness (you will likely feel your baby move less at this point—this is normal), or aren’t sure, trust your gut. Check in with your provider.
How long: Minutes to a few hours
The average for first-time pushers is at least two hours. If this isn’t your first time, it may move more quickly. Regardless, we are talking a few hours in the single digits, tops.
How long: 10–30 min, or not at all
Body: Some people experience this “resting phase” right before pushing. Though you are fully dilated, your contractions may slow down and space out.
Emotions: You may feel energized, more aware of your surroundings, or perhaps scared of pushing. Take advantage of this period as much as you can. Rest up!
How long: Minutes to a few hours
Body: Remember that pubic bone? Well, getting baby’s head to come down and under it is usually the longest phase of pushing. Baby’s head has to “prairie-dog” it for a while, meaning the head comes down under the bone when you push, and then gets sucked back up as soon as you stop pushing. That bone is really in the way! While this can certainly feel frustrating, it’s good to remember that you are moving forward. Even though it can be a slow process, you are moving two steps forward and one step back until baby makes it past that pubic bone for good. It’s typically smoother sailing from there.
Emotions: Determination and also WTF?! Why is it taking so long?! Get outta there baby!
How long: Minutes
Body: You made it past the pubic bone! Yahoo! Next comes the sensation of your perineal area stretching as baby’s head crowns. Remember the sensation is actually protective—it allows you to slowly stretch before baby’s head plops out.
Emotions: Holy shit. Holy shit. Holy shit.
How long: Seconds to minutes
Body: Generally, there’s a brief break once baby’s head makes it through—if you stare down between your legs, you’ll literally see baby’s head just chilling out there, but their body is still inside you! What a wild reminder that you are passing a human being through your body. Take it in! Baby’s body generally slips out pretty quickly from here.
Emotions: These are your final pushes, and they won’t be nearly as intense as the ones that came before. You may feel excited to finally meet your baby, excited for it all to just be over, a little anxious that you’re about to officially be a parent, and/or totally out of it and not very conscious of what you’re feeling at all. When baby is born, some people are ready straightaway to bring their baby to their chest and snuggle, and other people need a second. You do you!
How long: It typically takes between 5 and 45 minutes before the placenta is ready to be born. Once it is, birthing it usually takes only a few minutes.
Body: You will still feel contractions once baby is born (albeit they won’t feel nearly as strong as labour contractions and you’ll likely be quite distracted by your baby). For the most part, birthing the placenta is a pretty easy breezy process in comparison to everything else you just went through—remember placentas don’t have bones! But sometimes, the placenta needs a little help being born. In this case your provider may need to put their hands inside of you to help the placenta detach and massage your uterus externally to help it contract. This kind of sucks, but usually moves quickly. (Just a warning!) Once that placenta is born, you will feel the sweet, sweet relief of emptiness inside you.
Emotions: OMG, I had a baby!