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Stages of Labor

Managing early labor at home

Your uterus may contract for hours or days before your cervix begins to dilate. Try not to worry about how long it takes. Be patient and confident. This will not go on forever. There is nothing wrong with a long pre-labor. Think about other things. Try not to react each time you contract. While you are waiting and timing, eat lightly and drink fluids. These high carb choices are easy on your stomach and provide fuel for the work to come:

  • Toast with jam
  • Yogurt
  • Cereals
  • Pancakes
  • Pasta
  • Fruit juice
  • Tea with sugar or honey
  • Sherbet or gelatin desserts

Follow your normal routine or try these ways to rest or distract yourself:

  • Go for a walk
  • Go shopping
  • Watch TV or go to a movie
  • Clean, straighten up, pay bills
  • Play games
  • Fix meals and freeze them
  • Have friends over
  • Rest or nap
  • Soak in the tub (Hot water is okay)
  • Enjoy a shower massage

Timing contractions

As your labor proceeds, contractions should come more often, feel more intense and last longer. When you call Labor & Delivery, a nurse will ask you these questions about your contractions:

  • How often do they come? Time from the start of one to the start of the next.
  • How long does each one last? Time a contraction from when it begins to when it ends.
  • How strong are they? A good guide to use at home is:
    • Mild contractions: pressing a hand on your stomach will feel like pressing on your nose
    • Medium contractions: pressing a hand on your stomach will feel like pressing on your chin
    • Hard contractions: pressing a hand on your stomach will feel like pressing on your forehead

When to come and where to enter

Call Labor & Delivery at (608) 775-3167 when:

  • Contractions keep getting stronger
  • They have been coming every 5 minutes or less for an hour
  • Each one lasts 60 seconds or longer
  • You are simply too uncomfortable to stay at home
  • Your water breaks. This may be a sudden gush or slow leak of clear or muddy-colored fluid. Note the time it happens, as well as the color, odor and amount of fluid. It is important that you call us and come in whether or not your uterus has begun to contract.

We will get your room and medical record ready.

To get to Labor & Delivery

  • Use the La Crosse hospital main entrance
  • Park using either Valet Parking (available Monday-Friday, 4:45 a.m. to 8 p.m.) or self-park in Parking-Blue (above-ground parking ramp connected to the hospital)
  • Take Elevators A to Level 5
  • On Level 5, follow the signs to Labor & Delivery

Early labor

This takes about two-thirds of your total labor. Your cervix thins and starts to open. It goes from being tightly closed to 3 centimeters or about 1½ fingers in diameter. Contractions follow a pattern. They come about every 5-15 minutes. Each lasts 30-45 seconds. They are mild at first but they get stronger.

Your responses:

  • You may be excited and eager; you are likely to talk a lot
  • You may feel anxious and somewhat nervous
  • You are very aware of where you are and what is going on
  • You can focus and breathe slowly during some contractions

How to manage pain and cope:

  • Rest and relax, save your strength
  • Walk or do normal activities; do not do too much
  • Try taking a warm bath or shower
  • Eat and drink lightly
  • Begin a breathing pattern when you need to
  • Lightly massage your abdomen

Active labor

This may last several hours. The length of time may vary widely and still be normal. Your cervix will dilate from 4-7 centimeters (up to four fingers in diameter). Your cervix will thin out completely. The baby will begin moving down the birth canal. Contractions are closer together. They are stronger and last longer. They may come every 2-4 minutes and last 60-75 seconds.

Your responses:

  • You will become more serious with each contraction
  • You may be tense and more uncomfortable
  • You need to focus, concentrate and breathe with each contraction
  • You want and need your labor partner close by
  • You may feel sick to your stomach or throw up

How to manage pain and cope:

How your partner can help:

  • Drive to the hospital
  • Massage you as needed
  • Use encouraging words
  • Remind you to take one contraction at a time and relax; after each one, take a cleansing breath
  • Remind you to drink fluids
  • Breathe with you when needed; help you stay focused
  • Support you and help you change position

Transition or late labor

The cervix dilates from 8-10 centimeters (full dilation). The baby keeps moving down the birth canal. Transition can last from 30 minutes to 2½ hours. Contractions are now very intense. They come every 1-1½ minutes and last 60-90 seconds. They peak quickly and may even peak twice. There is more bloody show.

Your responses:

  • You may feel sick to your stomach or throw up
  • You may doze between contractions
  • You may have chills and shaky legs
  • You may feel crabby and overwhelmed; you may want to give up
  • It is hard to relax
  • You may feel hot or cold
  • Your labor partner needs to help you keep your breathing pattern
  • You may feel rectal pressure

How to manage pain and cope:

How your partner can help:

  • Remind you this is the shortest part of your labor, you are almost done
  • Help you take one contraction at a time
  • Breathe with you; pant-pant-blow pattern is helpful at this time
  • Be positive, tell you that you are doing a good job; the baby will soon be here
  • Try not to talk during a contraction
  • Tell you that you are loved
  • Stay by your side
  • If you start to panic, "get in your face"
  • Speak in a calm voice; give short, simple commands

Pushing and delivery

This stage comes as a relief to some women. Others may find it even harder. Pushing may bring strong feelings of stretching, burning or great pressure. One mighty push is enough for some, but most other women have to push again and again. This is an important time to be patient and let your body do its work. This stage may be short or long. Your doctor or midwife and nurses will work with you to cope with this intense part of labor. Contractions may be 3-5 minutes apart and last 60-90 seconds. The perineum and rectum start to bulge. There may be more bloody show.

Your responses:

  • You may feel more energy and strength; you know you will soon be done and holding your baby
  • Being able to push gives you something to do during contractions
  • You may still feel shaky
  • You may feel stretching and burning as your baby moves down the birth canal
  • You may fall asleep between contractions

How to manage pain and cope:

  • Find the position that gives you the greatest comfort and pushing power. It may be:
    • Sitting up part of the way (C-position)
    • Lying on your side
    • Squatting with or without the aid of a bar
    • Kneeling on all fours
  • Push with each contraction; relax in between.
    • When you push, try not to hold your breath but let the air come out of your mouth gradually as you push
  • Open your eyes so you can watch your baby emerge
  • Other comfort measures and pain control

How your partner can help:

  • Support you in the pushing position you use
  • Encourage you and give you moral support
  • Encourage you not to hold your breath but exhale gradually with each push
  • Give you ice chips and water; wipe your face with a cool washcloth
  • Help you to pant-blow when the baby's head comes out and you are told to stop pushing
  • Cut the umbilical cord when your baby is born (This is your choice)
  • Take pictures

After delivery

The placenta usually comes out within 30 minutes after the baby. It must first detach from the wall of the uterus. There may be mild cramps as it comes out. Contractions slow and become mild as the uterus shrinks to the size of a large grapefruit.

Love + Medicine

Every day, Gundersen Health System delivers great medicine plus a little something extra—we call it Love + Medicine.

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