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These are the five different stages of childbirth
It is an unknown phenomenon that childbirth consists of different phases. Some people see it as one long event, and sometimes see the delivery as “very long” while that may not always be the case. Every phase is different and they all have their own function. In this blog we take you through these different ‘birth phases’.
Phase one: the latent phase
The first stage is the latent stage. The big question that comes with this phase is: is it really going to start now? Because in most cases this phase starts with irregular contractions, only 10% of the deliveries starts with the water breaking.
What exactly is a contraction? A contraction is a contraction of the uterine muscle. The contractions often build up slowly, first about every 15, then every 8 and after a while every 5 minutes. Moreover, the latent phase can differ quite a bit in duration. There are women who have irregular contractions for hours, which we also call ‘rumbling’, and sometimes it happens that you get contractions that are already regular and fairly intense. In them, the latent phase will therefore quickly change into the active phase. There is also a difference between women who give birth for the first time and those who have given birth before.
In the latent phase, the cervix will soften and expire. This means that the cervix becomes softer and shorter. When that has happened completely, dilation can arise. In the latent phase you reach about 3 cm dilation.
What can you do best during this phase? Relax! Watch a nice series, do a relaxation exercise, take a shower or bake an apple pie for the midwife 😉 Look for as much distraction as possible when the contractions are still irregular and not so intense. If you are already fully focused on each contraction, the labor will only take longer for you. The partners are also allowed to take their rest during this phase. And if it’s nighttime, go to sleep!
Phase two: the active phase
And then you feel it changing, gradually or suddenly: it becomes more intense. The realization that it has now really started comes in slowly and ‘phew, that last contraction was pretty tough’, and exactly 5 minutes after the last one. Welcome to the active phase.
The name says it all: you are actively giving birth. At this point you are already at least three centimeters dilated, the contractions come every 3, 4 or 5 minutes and last an average of one minute. The intensity of the contractions and the dilation will increase. On average, a woman gains 1 centimeter of dilation per hour with a first child, with a second birth it will all go a bit faster.
Everything is now a bit more spicy, because your body is now going to do all kinds of things, such as the production of endorphins. This hormone has a pain-relieving effect and ensures that you get into a sedation and become more inwardly focused. Endorphins work closely with oxytocin, the hormone that causes contractions, among other things. These two hormones reinforce each other: when you make more oxytocin, you get more and better contractions, so your body produces more endorphins so you can relax more. And when you relax more, your body can make more oxytocin and you get better contractions. Isn’t this system beautiful? And your body does it all by itself.
In this phase, your baby descends deeper and deeper into the pelvis, and turns with his or her head in the correct position to be born. The skull seams of the baby slide a little over each other, this is called moulage. It makes the cross-section of the head smaller and it fits better through your pelvis. A wonderful trick of nature! During this phase, and sometimes towards the end of the latent phase, you may feel nauseous or have problems with your bowels. Don’t be alarmed if you have to vomit a lot or if you get diarrhea. This is another nice trick of your body: your body works everything out so that all the attention and energy can go to your uterus.
Phase 3: the transition phase
The active phase lasts until the pressing phase starts. But just before you start pushing, you also enter a transition phase.
This phase is described by most women as the most intense phase of labor. You are about 9 cm dilated and the contractions come every 3 minutes. You may be nauseous and your lower back may be hurting because the baby is pushing on your tailbone.
Because you are now moving towards the pressing phase, your body produces the hormone adrenaline. That will give you extra power for pressing. But the adrenaline decreases the production of endorphins. You will become a bit clearer, so that your experience of pain changes and you feel the contractions more. So it gets a little tougher.
Right now it is very important that you keep a positive mindset. And that is sometimes really difficult since you have of course worked hard for a long time. As a partner you can now really play an important role by providing continuous and positive support. This phase lasts on average a maximum of one hour and moreover: after this you can push, your baby is almost there!
Phase 4: the pressing phase
For the pressing phase you need to be 10 cm dilated, in other words, fully dilated. The cervix has been pushed back and is no longer in front of, but around the baby’s head.
From this moment on you will get contractions, also known as reflex pressure. Those are muscle contractions of your uterus that are unstoppable. It’s similar to when you have to throw up, there’s no other way! As your baby descends deeper and pushes on your rectum, the urge to push feels like you need to poop. That feeling sometimes takes some getting used to. Know that it is normal and it is a positive sign that the first real meeting with your baby is going to happen really soon.
During the pressing phase, you push along with these contractions, doubling your strength. Your uterus and you squeeze together. When you give birth for the first time, you squeeze an hour to 1.5 hours on average. If you have given birth vaginally before, this usually goes a lot faster.
You push until the head is standing, and thus almost born. This is the moment that your midwife will coach and guide you more intensively. To prevent tearing, it is important that this moment does not go too quickly. Pretty intense, but remember here again: the baby is almost here! So when you feel a burning sensation, from now on you think ‘come on baby’. Your baby will be born in the next or second contraction that follows.
Phase 5: the afterbirth phase
And then… Your baby has been born and lies comfortably on your bare chest. Then only the placenta will follow. We always have the umbilical cord knocked out, because there is still blood flow with oxygen-rich blood from the placenta to the baby. As soon as the placenta releases, this blood flow stops, the umbilical cord is cut (unless you want a *lotus delivery) and the placenta will be born with 1 or 2 more pressings.
A very nice fact is that the placenta has developed from the fertilized egg as well as a baby, and that the placenta has ensured that your baby grew and was safe. A beautiful and brilliant system.
If it takes longer for the placenta to arrive, or if there is extensive blood loss, your midwife may advise you to give synthetic oxytocin an injection in your thigh (or through the IV if you already had an IV). This ensures that your uterus can contract better, allowing the placenta to detach more easily. Synthetic oxytocin can also be used after the birth of the placenta so that the wound is closed better and you therefore have less blood loss.
What makes this final birth stage very special is that during this process you, as new parents, are falling in love with your beautiful baby.
* In a lotus delivery, the umbilical cord is not cut, but the baby remains attached to the placenta, until it falls off on its own after about a week. A half lotus delivery is also possible, where you cut an umbilical cord after the birth of the placenta at a chosen moment, for example immediately after the birth of the placenta, or a few hours later.
Written on behalf of ouders.nl.
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