The labor and delivery process can be long and an emotional rollercoaster. You may feel excited about finally meeting your baby but also anxious or in pain.
At UPMC, our renowned labor and delivery hospitals support you at every stage. We monitor you closely and offer various medical and non-medical pain relief and comfort options.
We explain each step of labor, respect your wishes, and provide reassurance. Here is what to expect during your labor and delivery with UPMC.
Labor is the process where the fetus, umbilical cord, and placenta come out of the uterus. That's according to the National Institute of Child Health and Human Development. In a C-section, a doctor removes the baby and placenta through an incision.
In a vaginal birth, the baby and placenta come out of the vagina. The "labor" aspect is the process of the cervix opening up and thinning out due to contractions of the uterine muscles. This process is what most people mean when they refer to "going into labor."
Generally, when talking about labor, most people mean the labor of vaginal birth.
The pain of labor varies from person to person. It also changes from early to late labor.
Many people find the pain of labor during a vaginal birth to be severe and describe it as extreme menstrual camps. Still, in a survey, half of respondents said the pain of their first birth wasn't as bad as they were expecting.
How painful labor is depends on many factors, including:
Most women surveyed say the contractions in active labor are the most painful aspect of labor. However, about one in five say the pushing or post-birth phase was worse.
Active labor is when the cervix dilates from six cm to ten cm. Compared to the earlier stage of labor, contractions are stronger and more frequent.
A National Center of Excellence in Women's Health, UPMC offers a full range of labor and delivery services. Our obstetricians, midwives, and nurses cater their services to your wishes and medical needs.
We also offer a wide variety of pain medication during birth.
Pain medication options include:
Labor and delivery can last hours or days. Here's what you can expect during the early labor, active labor, pushing phase, and after the birth of your baby.
You may not recognize the earliest signs of labor at first. Many women experience Braxton Hicks contractions, or "practice contractions," in the third trimester. It can be hard to tell the difference between early labor contractions and Braxton Hicks contractions.
Here are some signs of early labor to look out for:
If you think you're in labor, call your doctor or midwife. They will ask about how often and strong your contractions are. If you're still in the early labor phase, they may advise you to rest at home and wait for labor to progress.
Generally, you should go to the hospital as soon as:
Don't hesitate to call your provider if you're concerned about vaginal bleeding, reduced fetal movement, or any other symptom. You can also go straight to the emergency department or labor and delivery unit.
There are three main phases of labor. In the first stage, the cervix fully dilates. In the second stage, the baby moves down the birth canal and is born. In the third stage, the placenta comes out of the uterus through the vagina.
On average, the pregnant person goes through all three stages of labor within 12 to 18 hours for their first baby. Subsequent labors are usually shorter, around eight to ten hours.
However, labor can be much shorter (a couple of hours) or much longer (24 hours or more). Here's what you can expect in each stage of labor.
The first stage of labor consists of two parts: early labor (or latent labor) and active labor.
Early labor is the longest phase and can make up half to two-thirds of the entire labor. During this time, your cervix dilates from 0 cm to 6 cm. Whether you're at home or in the hospital, it may be possible to nap, listen to music, or chat with your partner some of this time.
Once you arrive at the hospital, your doctor or midwife will perform a vaginal exam to see how much your cervix has dilated. A cervical check may involve simply looking at your cervix or inserting one or more gloved fingers to assess dilation.
Your providers will also monitor how often and how long your contractions occur. Your nurse or midwife will explain how your labor is going, and any tests they need to perform.
If early labor takes too long, your provider may suggest speeding up labor. They can do this by breaking the water (if it hasn't yet broken) and with medication that increases the strength of contractions.
You will be able to walk around and change positions if you don't have an epidural or require continuous fetal heart rate monitoring. Your nurse, midwife, or doula can help with pain management, such as breathing techniques, massage, or water therapy. You can also request an epidural at this time, which delivers pain medication through a tiny tube inserted into your lower back.
Active labor is when the cervix dilates from six cm to ten cm. During the active phase, your health provider will perform routine vaginal exams, usually every two hours, to see how quickly the cervix is dilating. Your provider will also routinely check the fetal heart rate to ensure the baby isn't distressed. Higher-risk or induced births may require continuous fetal heart rate monitoring.
Those who wish to labor without medication can engage in breathing techniques and position changes during this time. Some find rocking or swaying on the bed or an exercise ball to be helpful.
If you didn't request an epidural in the early phase, you can still request it in the active phase. It takes about 20 minutes to work.
Toward the end of the active phase, uterine contractions are more painful and occur about every three to four minutes. Toward the end of active labor, what some call the transition phase, you may feel an intense contraction every one and a half to two minutes. It is often the most intense phase of labor.
The second stage of labor begins when the cervix is fully dilated. The baby can then move out of the uterus and down the birth canal. Your contractions will be strong but a little less frequent than at the end of the active phase of labor.
You will also feel the urge to push. If you have an epidural, the urge to push may be less strong due to the numbing effects of the medication.
Either way, your care team will guide you on how and when to push. This pushing phase can take up to two or more hours if it is your first baby. The process is usually much faster with subsequent babies.
Pushing can be tiring. It helps to focus on breathing between pushes. You can also request water or ice chips. If you don't have an epidural, it may help to try different positions, like squatting or kneeling.
Your care team will tell you when they can see the baby's head beginning to come out of the vagina (called crowning). If you wish, you can ask for a mirror to see your baby crowning.
The obstetrician or midwife will gently guide the baby out of the vagina. If the baby is stuck in the birth canal, the provider may need to use forceps or a vacuum suction device to assist the birth. This may also require an episiotomy.
The final stage of labor is the delivery of the placenta. This stage usually begins five to ten minutes after birth. With the excitement of seeing your baby, you may not even notice this part.
If you don't have an epidural, you may feel contractions again at this time, but they're typically less severe. Your provider may ask you to push when they see the placenta emerging.
This stage is very short, usually lasting less than 20 minutes.
After giving birth, the care team will clamp and cut your baby's umbilical cord. Your partner or support person can help with this part if they'd like.
If your baby doesn't need any medical support, you can ask your care team to put your baby on your chest right away. Or you may prefer that the care team first wipe off any blood and wrap your baby in a soft blanket first.
Your care providers will pick up the baby to check their weight and assess their overall health. This check usually only takes a few minutes.
Within hours of birth, they will administer a vitamin K injection which helps to promote blood clotting and prevent bleeding. They will also ask if it's OK to put an ointment on the baby's eyes to prevent an eye infection.
If your baby needs medical support after birth, this may happen in the delivery room or nearby. Your baby may benefit from extra oxygen for a few minutes after birth. Preterm babies or babies born with a health problem may need to go to the NICU right away.
If there was a vaginal tear that occurred naturally in labor or you had an episiotomy, the doctor will stitch the wound closed. They will put numbing cream so you don't feel the stitches. Your care team will continue monitoring your health and blood pressure as you recover.
When you're ready, your care team will take you, usually by wheelchair, to your postpartum recovery suite. Here, your baby can stay in a bassinet in your room. There is also a fold-out chair for your partner or another support person to stay the night.
You may wish to try breastfeeding shortly after birth, in the labor and delivery room, or your postpartum recovery room. You can also eat or drink shortly after birth and walk around once the effects of the epidural wear off (if you had one).
You will stay in the hospital for another day or two for monitoring and support as you recover from birth. You may stay longer if you have risk factors like high blood pressure or more bleeding after birth than usual.
Last reviewed by a UPMC medical professional on 2024-09-05.
