Preparing your mind and body for labor is no small task, and it can feel overwhelming to know where to start. It’s totally normal to have some excitement alongside some anxious thoughts and fears as the big day approaches, especially if you’re expecting your first baby. It’s so much to think about!

To help ease your worry, prepare your mind, and increase your likelihood of having an empowering and positive birth experience, an essential first step is understanding the stages of labor.

In April, Lara Lasky, from Holistic Family Doulas, joined us in our monthly webinar to discuss in-depth the different stages of labor and provided a highly useful roadmap for those of us preparing to embark upon this miraculous journey! Kelly also jumped in with a few practical movements to keep mamas comfortable and labor progressing through each stage.

The process of labor and childbirth can be divided into distinct stages, each presenting its own unique characteristics, challenges, and emotions. From the initial signs of labor to the miraculous moment of meeting your little one, this journey encompasses a multitude of physical and emotional transformations.

Am I in Labor?

There are so many changes happening in your body as it prepares for your baby to make the transition to the outside. Some signs that labor might be imminent are:

• You may lose part or all of your mucus plug. As your cervix softens it’s common for the mucus plug to fall out in pieces or all at once. In total, it’ll be about 2 tablespoons worth of thick, gooey mucus that can have streaks of blood. This may or may not happen before labor, but if you experience it, you can be sure that your cervix is changing.
• You may experience bloody show. This is another sign that changes are happening in your cervix, as the capillaries in your cervix break and cause a bit of period-like bleeding. It should not be heavy or gushing - if it is, call your doctor or go to the hospital. This is more like bright red on the toilet paper when you wipe.
• You might have loose stools.
• You may have a crampy feeling, similar to menstrual cramps, but lasting a bit longer and starting to come and go in a regular rhythm.
• Some women experience prodromal labor, which is labor that starts and stops. This can be frustrating and exhausting, and can really mess with your mind.

Lara encourages you to surrender to the process and trust in your body. It knows what it’s doing, and your labor will unfold in time. It’s important to listen to your body, stay calm, and trust that the process is unfolding exactly how it should.

Movement tip! Moving your body increases oxytocin (the love and labor hormone)! Don’t overdo it by exhausting yourself with activity, but alternate between walking and resting to help keep things heading in the right direction.

First Stage, or Early Labor

Early labor is typically the longest phase, with dilation increasing from 0 to 4 or 5cm. If you have been able to go into labor naturally, ideally you are still at home for this phase, which can last 12-18 hours.

Your cramps will start to come every 15-20 mins, and it may go on like this for a couple of hours. When you feel like you’re probably in labor, taking a bath is a great idea to calm your body, nervous system, and uterus.

If, after a bath, your cramps continue to come steadily, it’s true labor! Get out of the tub and REST, because you never know how long labor will be. This is a great time for your partner to do everything they can to keep you calm. You may feel nervous, excited, or be in disbelief. Let yourself be taken care of and try to surround yourself with people who have calm, confident energy.

In addition to resting, you also need to EAT. Lara recommends protein and carbs to give you energy to sustain your body through labor. She also wants you to hydrate with coconut water or an electrolyte drink. Now is the time to fuel your body!

Eventually, your contractions (or “sensations,” as Lara likes to call them) will start to come more often, moving from just the front of your belly to wrapping around to the back. They will last about 30-45 seconds, and come in a wave about every 7-15 mins. In true labor, your contractions will get progressively longer, stronger, closer together, so be mindful of that!

It may be hard to rest, but a good position is side-lying supported with pillows, so you can rest your eyes between waves.

It’s a great idea to get back in the tub or take a shower at this point to help you stay relaxed and comfortable. This is a good time to utilize massage, a heating pack on your back, and other comfort measures. Make sure you are conserving your energy at this point.

Movement tips! Kelly suggests a wide-legged squat supported with a yoga block or books, or having your partner support you in some way. This position opens the top of your pelvis, or the inlet. Walking while in the squat is a great way to get your baby shimmied down into your pelvis!

This is also a good time to practice cat/cow and add some rocking if that feels good  - inhale while moving forward and exhale on the way back.

Resting in child’s pose w/ hips over heels like a traditional child’s pose, or hips raised over knees with your heart lower, are great resting positions. You can place your forehead on the floor or your fists to access an acupressure point between your eyes that can help to keep you calm.

Active Labor

During active labor, your contractions will last about 60 seconds with about 3-5 minutes between. This stage typically lasts from 5-8 hours.

People usually tend to head to the hospital once contractions reach a pattern of lasting one minute, with a three minute break, consistently for an hour. At this point, you may be about 5-6cm dilated.

You will start to shift from thinking and talking normally in-between contractions to turning inward and becoming more silent and focused. This is because your brain wave states are slowing down, and you’re moving to the alpha or theta state. It is very important that you stay grounded in this mental state to keep labor progressing smoothly! Lara suggests dim lighting, soft music, relaxing scents, and a calm environment so your body can feel safe to continue turning inward and laboring efficiently.

You may also start to vocalize during this stage, expressing low groans to help you cope with the strong sensations. It is truly so important for your birth team to stay tuned into where you’re at and to follow your lead. No joking around or chit chat while you’re in this zone.

If no one has started timing contractions yet, now is the time. Although leave it up to the birth partner or doula to keep yourself in a relaxed state of mind.

You want to be changing positions every 20-30 minutes (although if something feels extra relaxing it’s fine to stay there for up to an hour). Hands and knees, resting on a ball or pillow is a good position for this stage. You can incorporate hip rotations and pelvic tilts while here, and it’s a good position for a partner to  squeeze your hips and give you back rubs and counter pressure.

Another good position is sitting on the toilet, AKA the “dilation station!” You can straddle the toilet backwards, resting your head and torso on a stack of pillows on the back of the toilet. Here, your pelvic floor muscles will naturally relax which will help your cervix to dilate more efficiently.

Movement tips! Kelly suggests movements that encourage asymmetry so that baby can wiggle down! You can try tabletop position, with one knee up on a stack of books or a yoga block.

You can also try table top with one leg out to the side, and lunging back and forth toward your extended leg. Inhale while you’re in neutral and exhale as you move outward toward your extended knee. Release your jaw with the movements as you exhale, which will automatically cause your pelvic floor muscles to relax.

In cat/cow, keep your knees together and feet apart to open the bottom, or outlet, of your pelvis. Go back and forth between cat and cow with your breath, and move to rocking back and forth, all while keeping your knees together and feet apart.

Transition

Lara considers the transition stage to be a rite of passage for the emerging mother. During this stage, labor becomes so intense that many women exclaim that they can’t do it anymore! She reassures her clients that, “the maiden in you can’t do it, but the matriarch can.”

During transition, your contractions will be 2-3 mins apart and up to 75-90 seconds long. You will only have short breaks and it can feel like your contractions are right on top of each other! This is when your cervix completes its opening to the full 10cm. Thankfully, this is the shortest stage, lasting only 45 minutes to one hour.

If your vocalizations start to sound higher pitched and more panicky, your birth partners should coach you to lower your pitch and encourage you to stay calm. You might experience shakiness, alternating between being hot and cold, vomiting, and wanting to give up or even trying to leave.

This is when your birth partners need to step up their game and take a very active role in supporting you with lots of encouraging words, helping you with position changes, and helping you to calm down and rest between contractions.

During transition, you might start to feel pressure, which is the beginning of the urge to push. Which leads us to…

Pushing

Once you reach 10 cm dilation, you might immediately get the urge to push, or you could experience a bit of a break! If your contractions do slow down, take the opportunity to rest and wait for that urge to come before pushing. This is called “laboring down” and is very much recommended to ensure that you’re not wasting energy pushing when your body isn’t quite ready.

1.5-2.5 hours is the average time pushing for a first time mom. It can take a while to get used to this - it’s something you’ve never done before! Let your team help you change positions as you figure out what works for you.

During this stage, you will feel pressure in your bottom like you have to poop. If you’re in the hospital, the staff may want to coach your pushing, which may or may not work for you. If you like the guidance of holding your breath and bearing down while someone counts to ten, great! If it isn’t working for you, you can absolutely ask them to stop and work with your own body’s urges to move your baby down.

Some helpful positions for pushing are side-lying, hands and knees, and squatting (request a squatting bar on your hospital bed). Your partner can put a sheet or towel around the bar which is great to pull on to help you generate more force.

Many women enjoy this stage of labor because you can finally actively take part and engage with what your body is doing! Some women like a mirror to see their progress, and some find it helpful to reach down and touch their baby’s head while it’s crowning. Your team can help you with all of these things.

Once your baby is born (!!!) you will have to deliver the placenta, usually about 5-20 minutes after the birth.

There you have it! Hopefully this has helped you to gain some insight into the stages of labor, and you feel more equipped with the knowledge that the wonderful Lara has shared with us. We hope that this not only helps to alleviate your fears and uncertainties but also empowers you to be an active participant in your birth process.

Remember, every labor is a unique and deeply personal experience. While understanding the stages of labor provides a framework, it's important to recognize that the journey may unfold differently for each individual. However, by arming yourself with knowledge and support, you can embark on this transformative adventure with a sense of strength and determination.

You’ve got this, mama.