The first stage of labor is the initial portion of labor and delivery, as a woman's cervix starts to thin and open to allow the baby to enter the birth canal. In the second stage, the baby will be delivered, and the third stage involves the expulsion of the placenta. The first stage of labor can last hours or days, depending on the individual woman. There are a variety of techniques people can use to make labor more comfortable, ranging from taking analgesic medications to using breathing and stretching exercises to relieve pain and stress.
Physicians break the first stage of labor into three separate phases. During early or latent labor, the cervix is dilated between three and seven centimeters. Contractions are usually irregular, and the woman's water may break. Many women rest at home during early labor and may find it helpful to walk, stretch, and otherwise move around as their bodies prepare for labor and delivery. In some women, these irregular contractions and the gradual dilation of the cervix during the start of the first stage of labor can take several days.
In active labor, the cervix moves from 7 to 10 centimeters in dilation. The contractions become stronger and more rhythmic, and the woman can start to experience more discomfort. Walking and standing may be more difficult. Finally, the patient moves into transition labor, getting ready to deliver the baby. Transition labor is usually the shortest part of the process, lasting between half an hour and two hours.
When women start to notice the signs of the first stage of labor, they may call their physicians for advice if they plan to deliver in a hospital or birthing center. They will be asked for information about the intensity and timing of the contractions so the physician can make a decision about whether to admit the patient. Usually, patients in early labor are not admitted unless they have a history of progressing very rapidly through labor. Once contractions are stronger and closer together, a woman can start to labor under medical supervision.
Patients prior to 37 weeks who go into labor are at risk of premature delivery. These patients may be admitted immediately to see if it is possible to arrest the labor with medications. If it becomes apparent that the baby will be delivered, interventions can be provided to address concerns with premature infants like difficulty breathing. A Cesarean section may be recommended to get the baby out immediately and reduce stress, unless a fetal death has occurred and the patient prefers to deliver vaginally.