Preparatory Phase and Active Phase
Would you like to read through the text one more time?
You can do that below!
If you go to the structure When looking at the labor process, you can divide labor into different stages. The preparatory stage, or latent phase is the first stage. This is the stage during which your body mainly does the preparatory work for childbirth. During this stage, your cervix shortens and softens, and you begin to dilate by 1–3 cm. This stage does not always progress to active labor; sometimes the contractions eventually subside completely, and it can take several hours, days, or even longer for labor to truly begin. Once this stage begins and the contractions build in intensity and continue, it lasts an average of 4–18 hours. You can recognize the preparatory phase by the following: the contractions last less than 1 minute; the breaks between contractions are 5 minutes or longer; and in many cases, the contractions are not yet very strong during this phase. Sometimes, for example, you may still be able to keep talking or continue what you were doing during a contraction.
During the latent phase, your body often still reacts strongly to what’s happening around you: someone walks in, the kids wake up… this can cause your contractions to (temporarily) subside. It can be helpful to take a warm shower during this phase. Warmth helps you relax: if you’re actually in labor, relaxation helps your body produce more oxytocin, which has a positive effect on your contractions—they become stronger and increase in duration and frequency. If they’re false labor contractions, the warmth and relaxation can actually cause your contractions to subside a bit. If your contractions do indeed subside, you haven’t missed your chance to give birth—your body simply wasn’t ready yet to let the contractions continue all the way through to actual labor.
The phase that follows the preparatory phase is the active phase. You can recognize this stage by the following: the contractions in this stage often last 60 seconds or longer; your contractions come regularly; your contractions are strong. For a first-time birth, we assume you’re in the active phase if you’ve been having contractions every 3 minutes for one hour. Your contractions last one minute, followed by a 2–3-minute break until the next contraction begins. For subsequent births, we assume you’re in the active phase if you’ve been having contractions every 5 minutes for an hour. Each contraction lasts one minute, followed by a 4-minute break until the next one begins.
During the active phase, the cervix continues to dilate. Dilation progresses from about 3 centimeters to full dilation. If this is your first birth, the average time required for dilation is 12 to 14 hours. In subsequent births, dilation usually progresses more quickly. We’ve noticed that the first 5 centimeters, in particular, tend to take the longest. Once dilation reaches 5 centimeters, it often speeds up, and we generally expect you to dilate about one centimeter per hour. Keep in mind that all the times we mention are averages; your labor may progress more quickly or may take longer. During labor, we’ll monitor how the baby is doing, how you’re doing, and whether labor is progressing. This allows us to assess your needs as labor progresses and, if—for example—your dilation takes longer than expected, to develop a plan in a timely manner to ensure the best possible care for you and your baby.
The limit in terms of exclusion is full access. We refer to full dilation when the cervix is dilated to about 10 centimeters and the cervix can no longer be felt during an internal exam. Imagine the progression of dilation and the intensity of your contractions as a mountain you’re climbing: at first, the climb is easier, but the closer you get to the top, the steeper the path becomes. In other words: the further along your labor progresses, the stronger your contractions become. But it also means you’re getting closer to the birth of your baby and the end of labor! The reason your contractions are getting stronger is that your body is not only creating dilation but also moving the baby deeper into your pelvis. We call this the baby descending. The path the baby takes through the pelvis is a bit like a slide with a curve at the bottom. During the active phase, the baby goes down the ‘slide.’ The baby navigates the curve while you’re pushing, but we’ll discuss that in another video. You’ll often feel the baby dropping yourself, either because the pain from the contraction feels different or because you feel a lot of pressure in a specific spot. When a baby descends, you’ll first feel it in your lower back and later near your tailbone. Toward the end, you’ll feel it in your buttocks and around your anal sphincter; you may even feel like you need to go to the bathroom to have a bowel movement—even before you feel the urge to push. During the dilation contractions, that pressure can be very intense, but you can still breathe through it. During pushing contractions, the urge to have a bowel movement becomes unbearable, and your abdomen will push along with it. We discuss what the urge to push is and how to recognize it in the video about the urge to push and pushing.