When most people think about labor and childbirth, they think that it starts with contractions and/or water breaking and then eventually a baby comes out, and that’s about the extent of it. As it turns out, there are actually FOUR different stages of childbirth, each one with its own important roles to help create a healthy and safe birthing experience.
Stages of Childbirth – Stage #1
The first stage of childbirth is all about the cervix; more specifically, it’s all about the ripening of the cervix. Throughout the first stage, uterine contractions and hormones work to prepare the cervix for birth. This stage is actually made up of three additional stages. The first of these three stages is often referred to as the early stage because it is the time when the cervix is thinning, softening, and dilating from zero to six centimeters. The early stage can take anywhere from hours to weeks to complete.
The second stage is the middle stage, which involves continued dilation of the cervix from six centimeters to eight or nine centimeters. Finally, the third stage is the transition stage where the cervix reaches complete dilation of ten centimeters, and the urge to begin pushing starts to arise. Sometimes, there is a period of time between when the cervix becomes fully dilated and the time to push begins because the baby needs to move further down through the pelvis and into the birth canal before pushing can be effective. The position of the baby in the pelvis is referred to as the baby’s station, and it’s usually measured from -3 to +3; -3 being that the baby’s head has just barely entered the pelvis and +3 being that the baby’s head is crowning. If a baby is still at a -2 or -1 station, it is possible to begin the pushing stage, but it is likely going to take a lot more effort and time to push the baby out than it would if baby were at a station of 0 or higher. Sometimes, it’s better to simply allow time for contractions to continue to move baby lower prior to pushing.
Stages of Childbirth – Stage #2
The second stage is the pushing baby out stage. It’s common for the person giving birth to feel a great increase in pressure and/or an urge to push when this stage is beginning. While it may seem daunting to think about pushing a fully grown infant through a relatively small space, it’s important to remember that both the baby’s head and the pelvis of the person birthing are actually flexible! The bones in both the pelvis and the baby’s head are connected by flexible ligaments, which allow both to move in the ways that they need to in order for birth to occur.
If you’ve seen any Hollywood production of a childbirth scene, you may have seen a doctor or nurse instructing the birthing patient on when to push and counting to let them know how long to push. You may have also heard the doctor tell the patient to hold their breath while pushing. While this may be the norm in some places and for some medical providers for how the pushing stage goes, it certainly is not the only way. Pushing can also be guided simply by the urges and intuition of the person giving birth. In fact, when pushing is patient-directed (or spontaneous) instead of provider-directed, the pushing stage is typically a lot calmer and it can also greatly help to prevent or lessen tearing.
Stages of Childbirth – Stage #3
The third stage of childbirth is the birth of the placenta. It’s often surprising to birthing people that they continue to feel contractions after the baby has been born. Those contractions continue because they are now working to separate the placenta from the uterine wall and then push it out through the vaginal canal. While the human body is well-equipped to complete this process on its own, sometimes situations may arise in which assistance may be needed from a care provider. Fortunately, the placenta is soft and boneless, unlike a baby, so its birthing should be relatively less difficult than the birth of the baby. It’s most common for the birth of the placenta to occur between fifteen minutes and one hour after the birth of the baby.
Stages of Childbirth – Stage #4
The fourth and final stage of childbirth is the postpartum stage. While this stage is officially known as lasting for just six weeks after birth, it lasts for as long as it needs to last for the person who just gave birth to properly heal and recover. There are so many changes that occur in a person’s body after they have had a baby, and it’s important that they are given the time, space, and support necessary to deal with those changes. It can also be quite difficult to adjust to caring for a newborn during this trying stage.
Keeping all of that in mind, if you find yourself to be in this stage of childbirth or preparing to be in it, be sure to communicate to those closest to you what your needs are so that they can support and help you through what many describe as the most difficult part of childbirth. A postpartum doula is actually a wonderful resource to help you through the postpartum period.