In movies, pregnant women experience a dramatic rush of fluid as their water breaks. But in reality, very few women will have their water "break" (which is actually the breaking of the amniotic sac). Most of the time, the nurse or midwife will break the amniotic sac once labor has already begun.
Signs of labor include:
- Contractions that increase in frequency, duration, and intensity
- Lower back pain that doesn't go away
- Cervical dilation (opening up), revealed during a pelvic examination
A mother has many options when it comes to giving birth. She can deliver in a hospital or birthing center with the help of an obstetrician or midwife, or at home with the help of a midwife. She can also hire a doula -- a trained professional who offers support during the birthing process. Doctors recommend that women with high-risk pregnancies deliver in a hospital, because medical facilities are best equipped to handle emergencies should they occur.
The labor process typically consists of several stages.
During early labor, the mother will feel the first contractions. Her cervix will gradually efface and dilate in preparation for delivery. The contractions will be more frequent and become more painful. For many women, the early stage of labor can last for hours, and doesn't necessarily require an immediate trip to the hospital. The contractions come more frequently during active labor. They are also more painful -- sometimes too painful for the mother to talk through. Once the contractions start coming about every five minutes for an hour, the mother should call her doctor and get ready to go to the hospital. The mother's cervix continues to ripen -- it must stretch from about three centimeters to the full 10 centimeters before delivery can begin. Once she reaches the hospital and is dilated sufficiently, the mother can have medication for her pain if she chooses to do so. Options include an epidural (anesthesia injected into the woman's spinal cord, which blocks sensation in her lower body) and an intravenous pain reliever.
In the transition stage, the cervix reaches its full dilation as contractions become stronger and even more frequent. They may come every three minutes and last up to a minute each. The baby is also descending into the birth canal in preparation for delivery. As the baby moves down, the mother may feel pressure (as if she needs to have a bowel movement), and an urge to push. This stage may last anywhere from a few minutes to a few hours. Labor typically progresses more slowly for first-time moms.
Next, we'll look at delivery.