The first stage of labor begins with the onset of regular
contractions and ends when the cervix is completely dilated.
The latent phase of first stage labor is the longest of the three
phases, helping the cervix dilate up to three or four centimeters as
it effaces. This can take five hours or more and dilation may move
along slowly for many hours.
In this phase, contractions last about 30 to 40 seconds, with the
interval between contractions shortening to about five minutes apart.
Typically, these contractions are mild and easy to manage. Women have
described contractions in this phase as similar to menstrual cramps.
Contractions are felt in the lower back and towards the front of the
lower abdomen.
Many women have mixed emotions during this phase. They can be
excited and happy, knowing that the end of pregnancy is near. They
also may feel some apprehension -- especially first-time mothers.
Although a woman may have a lot of energy, she should eat lightly,
drink to thirst and rest. Conserving energy is the name of the game,
especially because labor may continue longer than anticipated. This
would be the time to alert those that make up your support team.
During the middle or active phase of first stage labor, the cervix
dilates at an accelerated rate to about seven centimeters. Active
phase usually lasts around three hours. Effacement remains constant
throughout the active phase of labor.
Contractions become more intense and regular, shortening to three
to five minutes apart, lasting about 60 seconds. At this time in
labor, the mother needs to increase her concentration during
contractions, which may be feeling more painful. Some women may
request drugs at this time.
The bloody show can occur during the active phase. This mucus is
bloodier than the pinkish-tinged mucus seen in early labor. This is
not a cause for alarm. However, as this phase progresses, the mother
may become less talkative and outgoing; her focus will be more inward.
If a woman is not tired, she may sit up or walk during labor and
should be encouraged to change positions frequently -- at least every
30 minutes. Some facilities allow women to shower or relax in a warm
tub. Supportive coaching and relaxation are essential at this time.
The transition phase ends the first stage. This is the final
stretching of the cervix before the baby moves down into the birth
canal. This is a short but increasingly intense phase, usually lasting
about two hours, when the cervix dilates from eight to 10 centimeters.
Contractions become very powerful, two to three minutes apart, lasting
60 to 90 seconds. This allows little rest between contractions. At
this point, the mother must concentrate to work with her breathing and
her body's natural rhythm, and often requires direct coaching. She'll
likely become irritable and sensitive to her environment, experiencing
some trembling, hot and cold flashes, nausea, vomiting and mercurial
emotions. If the bag of waters has not already broken, it probably
will during transition. And the mother may experience the urge to push
as the baby is traveling downward into the birth canal.
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