As your body prepares for birth, there are many signs that you can watch for. Knowing these signs, as well as the stages of labor, can help you feel more confident and relaxed going into the delivery room.

Signs of Labor

Stages of Labor

 

Signs of Labor

You may or may not notice any of the early signs of labor. When they occur, how long they last, and how they feel can also vary greatly. These signs can be expected around your due date. Keep in mind that the due date is a doctor’s best estimate. It is perfectly normal for labor to begin 2 weeks before or 2 weeks after that date.

Signs that labor is coming are:

Dropping or Lightening

When the baby drops or "lightens," they move lower into your pelvis. It will ease pressure on your lungs and stomach. You may find it easier to breathe. Heartburn may also decrease if it had been a problem. However, pressure on the bladder will increase. You may need to urinate more often. This may happen many days or weeks before any contractions.

Dropping is determined by the doctor during a pelvic exam. The doctor will describe how far your baby has dropped using stations:

  • -3 station means that the baby’s head is not yet in the pelvis
  • 0 station means that the head is at the middle of the pelvis, also called engaged
  • +3 means the head is beginning to emerge from the birth canal during delivery and is also called crowning

Effacement

Effacement is the thinning of your cervix. The cervix is the opening to the uterus where the baby is carried during pregnancy. You cannot feel effacement. The doctor will measure it during a pelvic exam. Effacement is reported as a percentage. If you are 50% effaced, your cervix has thinned to half of its original thickness. When you reach 100% effaced, the cervix is completely thinned out and ready for a vaginal delivery.

Changes in the Cervix During Pregnancy
si55551477_96472_1

© Nucleus Medical Media, Inc.

Dilation

The cervix must open, or dilate, to allow the baby to pass. It is measured from 0 to 10 centimeters (cm). Dilation may begin slowly in the days or weeks before birth. Once active labor begins, the cervix dilates to 10 cm. You will not feel dilation. Your doctor will measure it. Delivery can happen before reaching 10 cm if the baby is preterm and smaller than a full-term baby.

Show, Bloody Show, or Loss of Mucus Plug

A thick plug of mucus fills the cervical opening during pregnancy. This plug is here to keep bacteria out of the uterus. As the cervix thins and opens, this plug may fall out. It may appear as stringy mucus or a thick discharge that is brown, pink, or reddish. Labor usually begins within 72 hours of this show.

Water Breaking or Rupturing of Membranes

The baby is surrounded by a fluid-filled sac called the amniotic sac. This sac can break before labor begins. You may feel water running out of you or your underwear may be constantly wet. The flow can be dripping or gushing. The doctor should be called once water has broken.

Braxton Hicks Contractions (False Labor)

These are contractions may occur toward the end of pregnancy. They may help your body get ready for the real event. Not everyone will have braxton hicks.

The contractions may become stronger and more painful as you near your due date. There are a few ways to tell Braxton Hicks (false labor) contractions from contractions of early labor:

  • Braxton Hicks contractions are irregular and do not get closer together
    • True labor contractions come at regular intervals and get closer and closer together
  • Braxton Hicks contractions may stop when you walk or change positions
    • True labor contractions continue no matter what you do, including walking
 

Stages of Labor and Delivery

Labor and delivery often progresses through 3 stages. The first stage of labor starts when true labor contractions begin.

Stage 1: Early and Active Labor

During stage one, the cervix dilates and effaces to prepare for birth. This stage is divided into 2 phases. Phase 1 is called early labor or the latent phase. The cervix is dilated from 0 to 3 cm. Mild to moderate contractions may be coming every 5 to 20 minutes. It can cause a backache, feeling of fullness, or menstrual-like pain. Phase 1 is the longest section of labor. It may last from hours to days for first-time delivery. If this isn't the first delivery, there is an average of 8 hours in this phase.

Phase 2 begins once the cervix is 3 or 4 cm dilated. It is called active labor. The contractions are stronger than phase 1 and occur more often. It is important to time your contractions. You may be asked to come to the hospital when contractions last more than 60 seconds, occur 5 minutes apart, and persist for at least 1 hour. The cervix dilates from 7 to 10 cm by the end of this phase. These last part of cervical opening occur fairly quickly, but can be quite difficult. Contractions are stronger and more frequent This will put pressure on your lower back and rectum. You may feel anxious, exhausted, and irritable. You may also feel the urge to push, but your doctor may ask you to wait. Pushing too soon may cause your cervix to tear or swell.

Stage 1 is the longest stage of labor and delivery. Pain medication can be given during this time. Relaxation techniques can also be used to ease discomfort.

Stage 2: Your Baby’s Birth

This stage can take a few minutes or a few hours. It tends to take longer for first time delivery and those who have epidurals for pain control. The doctor will encourage you to push. At times you will be asked to stop pushing.

First, the baby will crown. This means that the widest part of the baby’s head appears in the vaginal opening. As the head is pushed through, the vagina and perineum are stretched. It may cause a burning sensation. Once the head is out, the baby’s mouth and nose will be suctioned with a syringe to clear out mucus. Shortly after, the rest of the baby’s body is delivered. You may hear your baby’s first cry. The umbilical cord, which connects the baby to the placenta, is clamped and cut.

Crowning of Baby's Head
DW00035_96472_1

© Nucleus Medical Media, Inc.

Stage 3: Delivery of the Placenta

This stage usually takes only a few minutes but can take up to half an hour. You may continue to have mild contractions. The doctor will massage your lower abdomen to help the uterus contract. You may need to push one more time. The placenta comes out with a small burst of blood.

While you are resting and greeting your baby, your doctor will examine the vagina. Stitches may be put in if needed. You may also be given medications to help the uterus contract and ease bleeding.

Postpartum Care

You and your baby will get care and check ups while you are in the hospital. Take advantage of this time to get some rest. Ask any questions to help get ready for the next few weeks at home.

RESOURCES:

Office on Women's Health
https://www.womenshealth.gov

The American Congress of Obstetricians and Gynecologists
http://www.acog.org

CANADIAN RESOURCES:

The Society of Obstetricians and Gynaecologists of Canada
https://sogc.org

Women's Health Matters
http://www.womenshealthmatters.ca

REFERENCES:

Childbirth and beyond. Office on Women's Health website. Available at: https://www.womenshealth.gov/pregnancy/childbirth-and-beyond. Accessed January 29, 2021.

Managmement of normal labor. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/normal-labor-and-delivery/management-of-normal-labor. Accessed January 29, 2021.

Management of routine labor. EBSCO DynaMed website. Available at:http://www.dynamed.com/topics/dmp~AN~T905272/Management-of-routine-labor. Accessed January 29, 2021.

The process of labor: labor stages. Sutter Health website. Available at: http://www.babies.sutterhealth.org/laboranddelivery/labor/ld_stages.html. Accessed January 29, 2021.

Last reviewed September 2020 by EBSCO Medical Review Board  Last Updated: 1/29/2021