First Baby: What to Expect
As your expected due date approaches, you might be wondering what to expect during childbirth. While each labor and birth is unique, the process of a vaginal delivery follows four stages: First Stage (early labor, active labor and transition), Second Stage (pushing and birth), Third Stage (delivery of the placenta), and Fourth Stage (uterus returns to original size).
Attending childbirth classes at Cedars-Sinai is another way to help ease your labor fears.
First Stage (early labor, active labor and transition)
During Early Labor
What to Expect: You will begin to notice tightening sensations in your abdomen called contractions. These contractions can last up to 60 seconds and can be between 5 to 30 minutes apart. Contractions will increase in strength and frequency as your labor progresses. At this time, your cervix will start to dilate (open) and will reach 6 centimeters by the end of this phase.
How Long It Will Last: Early labor is the longest part of labor and can last 12 to 24 hours or longer if this is your first baby. Because of this, it is important to be patient and try to rest as much as possible.
Tips for Coping With Early Labor
- Pace yourself: Balance rest and activity to conserve your energy
- Distraction: Ignore labor until you can’t ignore it anymore
- Reading, cooking, puzzles, neighborhood walks, watching TV
- Comfort measures: massage, shower, music
- Eat light snacks and stay hydrated
- You and/or your partner can time your contractions: how long they last and how often they happen
Arriving to Labor and Delivery
If you are at least 37 weeks, expecting a single baby and have no medical complications, you should continue to stay at home until it is difficult to breathe through or talk through contractions.
If you arrive at Labor and Delivery in early labor, after careful evaluation of you and your baby, your doctor may recommend that you return when you are further along in labor. The earlier you are admitted in your labor process, the longer your hospital stay.
When to Call Your Doctor
Not all labor is the same; follow your doctor’s or midwife’s advice. If you experience any of the following, call your provider or come to the hospital:
- Your water breaks/membranes rupture
- You experience vaginal bleeding that is more than spotting
- You have regular, painful contractions that are less than 5 minutes apart for several hours
- You are concerned that your baby is moving less
During Active Labor
What to Expect: Your contractions are stronger, longer and closer together. Contractions can last up to 60 to 90 seconds and are approximately 2 to 5 minutes apart. Dilation typically happens more rapidly in active labor than in early labor, your cervix dilates to 6 to 8 centimeters.
How Long It Will Last: For many people giving birth for the first time, active labor typically lasts 4 to 8 hours.
What to Expect: Your contractions are the strongest, longest and closest together. Contractions can last 60 to 120 seconds and are usually 2 to 3 minutes apart. Your cervix dilates from 8 to 10 centimeters and when you reach 10 centimeters, you begin the second stage.
How Long It Will Last: This is usually the shortest part of the first stage of labor.
Tips for Coping With Active Labor and Transition
- Walking, changing positions, slow or rhythmic breathing during contractions
- Visualizations or aromatherapy
- Massage, counter-pressure or other hands-on techniques
- Pain medication (epidural analgesia) is available if you desire
- Utilize your support person for coaching and encouragement
Second Stage (pushing and birth)
What to Expect: Your cervix has fully dilated to 10 centimeters. You may feel pressure and the urge to push. Your doctor or midwife will let you know when to start pushing.
How Long It Will Last: On average this stage can last 1 ½ to 2 hours with your first baby. However, you only push when you are having a contraction and you can rest in between.
Third and Fourth Stages (after delivery)
What to Expect: Your placenta is delivered. You may experience chills or shakiness during this time. This stage can take up to 30 minutes. Once the placenta is delivered, you enter the fourth stage of labor as your uterus returns to its original size. Many people feel light cramping during this period.
Pain Management During Labor and Childbirth
Pain during childbirth is unique to each person’s expectations and goals. This can be due to beliefs about pain in labor, pain tolerance, support in labor and delivery, and previous injury or trauma. There are both medicated and nonmedicated options available. Discuss with your provider the pain management options available to you during your labor and childbirth.
If Your Baby Is Breech
If You Need A Cesarean Delivery
Most birth plans include having a vaginal delivery, however, there are times where an unscheduled, or even an emergency, cesarean delivery is necessary. A cesarean delivery is a procedure where a baby is delivered through a surgical incision in the birthing person’s stomach and uterus. Your doctor may require you to have an unplanned cesarean delivery for several reasons - labor is not progressing, contractions are too weak, the umbilical cord is pinched or wrapped, abnormal heart beat is detected in the fetus, there is an issue with the placenta, the baby is too large, or the baby is breech. Understanding what to expect with a cesarean birth will help you better prepare in the event you require this procedure.
To learn more about the risks and benefits of a cesarean delivery, watch the Elective Primary Cesarean video.
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