Did I just pee on myself or did my water break? I have read the books about the show and what I should feel, and yet I am not quite sure about a lot of things that are happening to my body. The one thing I am sure of right now is that it is not pee, my water did break. After a frantic cry to grab the bags, take a quick shower and put on fresh clothes, we got through the door having almost stepped on the cat twice.
I felt nervous even though I thought I was prepared and had some idea of what was to happen in labor. Books give a general idea, but every person has a unique experience. When we got to the hospital we were greeted by my midwife, Nurse Allen. She took a history about my pregnancy which was now 39 weeks and did an examination of my abdomen and vagina. She also checked my blood pressure, heart rate, and breathing rate, these are called vital signs. In addition, the baby’s heart rate was also checked to make sure he was okay. It was confirmed, I was indeed in labor.
My nurse explained that labor starts with regular contractions and ends when everything inside my tummy is expelled. It was further explained that labor has four stages and that I am in stage one. Stage one has three phases, but I was told not to be too concerned about all those details at this time. I felt the nervous feeling inside beginning to dissolve as I entertained this informative teaching session.
In stage 1 the latent (first) phase, my mild to moderate contractions (abdominal cramps) would feel a bit stronger than my regular Braxton Hicks contractions. Braxton Hicks were felt throughout my pregnancy but were not related to being in labor. The contractions being felt in the latent phase, would occur between 5 to 30 minutes apart and can last for 10 to 45 seconds long. I was feeling some already and it felt manageable to me. These important contractions I was told would cause my cervix to efface (thin and soften) and to dilate (open) from 0 to 3 cm over a 6 to 8-hour period.
My membranes had already ruptured (my water broke) at home so the nurse said they did not have to help me with that here. My midwife further explained that by the time I got to the active (second) phase my contractions would begin to feel more intense. These contractions would now occur every 3 to 5 minutes apart and would now last a whole 40 to 70 seconds and this phase might go on for 3 to 6 hours. My cervix at this time would be even thinner and would dilate from 4 to 7 cm.
In the transition (third) phase of stage one, my contractions and pain would become very intense and painful. These contractions would be 1.5 to 3 minutes apart and would last all of 45 to 90 seconds long. My cervix would continue to dilate from 8 cm to the maximum 10 cm. this phase takes place over 20 to 40 minutes. I would now be at the end of the first stage of labor.
Nurse Allen went on to explain that throughout the first stage, she would be monitoring both me and the baby by checking the baby’s heart rate and my vital signs. Managing also the fluids I would receive from my IV and any urine I passed would be very important. The best news was that I would receive the pain medication my doctor and I agreed upon. I was beseeched to practice my deep breathing exercises to help me relax and cope with pain during this stage.
By now I was having mixed feeling with a bit of anxiety as I wanted to hear all about the important stage 2 labor. In stage 2 of labor my cervix would now be fully effaced (thin) and it would have dilated to a full 10cm. My contractions she explained would be very strong and would be 2 to 3 minutes apart and would last 60 to 90 seconds. The length of this stage would be 20 to 50 minutes. The urge to push would begin here and become very intense as it would be necessary to propel the baby down the vaginal canal.
Nurse Allen stressed the importance of following all instructions given by the medical team. They would instruct me to deep breathe and push through each contraction which would allow the baby to ease through the canal smoothly. I was advised to preserve my strength by resting in between each contraction. The baby and I would continue to be monitored closely during these break periods. I would continue through these pushing and rest periods until the baby’s head, shoulders and body was fully delivered.
I was brought back from my thoughts of touching my baby’s skin as Nurse Allen continued her explanation about the third stage of labor. In this stage the remaining cord and placenta would be delivered. This would occur within 5 to 10 minutes of delivery of the baby. She said the shape of my uterus (fundus) would become round and firm to touch. There would be a gush or trickle of dark red blood before the umbilical cord would slowly lengthen. The cord would continue to lengthen until the placenta is seen at the entrance of the birth canal and then it would then be delivered.
This takes us to the fourth and final stage of labor. This stage occurs from the placenta is delivered and up to 4 hours after giving birth. During this stage I would be monitored carefully with special care given to prevent excessive bleeding. Medication might be given to prevent this from occurring and the uterus is often massaged to help it remain contracted and firm. During this time mommy and baby time would be facilitated to encourage bonding. My vital signs would be checked frequently especially in the first hour after delivery. This stage is all about checking to ensure that everything is in order and that I am safe and no post-birth complications occur.
The nurse asked if I had any questions or anything to say, I told her that everything was explained clearly. I understood that in stage 1 of labor, my contractions would help to thin and dilate my cervix to 10 centimeters. In stage 2 off labor, my baby would make his way through the birth canal and into my arms. In stage 3 of labor, the cord and placental would be expelled and in the final fourth stage, I would be monitored very carefully for any complications that could occur after delivery. Now that I have a better understanding of what to expect in all four stages of labor I am feeling more relaxed and excited about meeting my son.
Author: Katerina Reid RN