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with each pregnancy. But all women in labor go through the same three stages. Labor involves contractions, the progres-


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sive tightening and relaxing of the uterine muscle in a rhythmic pattern that opens the cervix and pushes the baby through the birth canal. The process can last about 15 to 20 hours with a fi rst baby, and about 8 hours with a second. From early pregnancy, you might notice a tightening and relaxing of your uterus, followed by what is often described as pressure. These Braxton-Hicks contractions are normal and become more frequent as your pregnancy advances. It’s not always easy to tell if labor pains are


the “real thing.” True labor often resembles false labor, except that false labor does not result in progressive dilatation of the cervix and resolves with hydration, sedation and rest. From a few hours up to a week or two be-


fore labor, lightening, which usually occurs with a fi rst pregnancy, may happen as the fetal head engages in the pelvis. An expectant mom’s breathing is sometimes easier as a result. Since the fetus presses more on the bladder, you may feel an increased urge to urinate. The loss of the mucous plug often signi-


fi es that the onset of labor is near. This may occur hours or up to two weeks before true labor begins. The mucous plug forms during pregnancy to seal the cervix, but as the cervix begins to open, mucous seeps into the vagina as a thick or blood-tinged discharge. A loss of clear liquid may mean a rupture of the mem- branes, and you should call your provider.


Stage 1: Early Labor, Active Labor and Transition The fi rst stage of labor — in which the cervix


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sk ten mothers to describe their labors, and you’ll hear ten different stories. Labor is unique, varying in length and intensity for each women and


opens from zero to ten centimeters — lasts the longest, and has its own three stages. Early labor begins when the cervix thins (effaces) and opens (dilates) to three to four centime- ters, preparing for the fetal journey from the uterus through the birth canal. Contractions, which last from 30 to 60


seconds and occur every 5 to 20 minutes, may be mild, moderate or intense. This period may last only a few hours, or, for fi rst-time moms, a day or more. A labor lasting over 24 hours is not normal. Some women are not aware that their cervix is opening. Their fi rst sign of labor may be an upset stomach, diarrhea, a lower backache or a blood-tinged discharge from the vagina, known as a bloody show. You can continue with daily activities — or


relax, listen to music, watch TV, shower or practice slow breathing. Drink water and uri- nate often to avoid dehydration. Avoid eating a large meal in case anesthesia is required. Ask when you should call your provider and what to do if your membranes rupture. You will be asked to come to the hospital


or birthing center during the active phase of labor. Active labor brings stronger contrac- tions every two to four minutes lasting from 45 to 60 seconds, or even longer. The cervix opens from seven to ten centimeters and is thus completely dilated. This phase averages from three to eight hours. Don’t be afraid to ask for medication to


stay in control or to assist in the delivery. Meanwhile, walking may help, stopping to take slow breaths during contractions. Your labor partner can apply ice or warm compresses to your lower back. For lower back pain, try roll- ing on a birthing ball or changing positions. Transition is marked by strong, frequent


contractions that reach peak intensity and last about 90 seconds each. By the time one contraction ends, it seems another begins. This phase may last from 15 minutes to 3 hours. The cervix stretches from seven to ten


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