The first stage of labor is the longest and involves three phases, early, active and transition. Early labor is the onset of labor until the cervix is dilated to 3 cm. Active labor continues from 3 cm until the cervix is dilated to 7 cm and transition continues from 7 cm until the cervix is fully dilated at 10 cm.
The second stage is often divided into a passive phase, an active phase, and the actual birth of the baby. The passive waiting phase of the second stage of labor is a period of rest, sometimes called “laboring down” when the baby rotates and descends toward the pelvic floor. The passive phase happens when the mother is fully dilated but waiting for the urge to push. It is important to wait for the active phase before starting to push or pushing can cause an anterior lip to develop.
The active pushing phase is when the baby’s head is on the pelvic floor and the mother pushes spontaneously. Essentially the mother cannot not push. A lot of mothers prefer active pushing over dilation because they feel like actively involved and they can feel their baby descend. It can take a lot of effort. Pushing can last two or three hours. If can be helpful to put chin to chest, curl around the abdomen, and grab legs behind the knees. Ultimately listen, your body knows what to do!
Once burning or the ring of fire is felt, avoid pushing and instead use horse lips and let the tissues expand. Waiting this short time protects the perineum and can prevent tearing. Sometimes extremely high levels of adrenaline can trigger the fetal ejection reflex. This surge triggers strong, rapid contractions which move the baby from the uterus and into the birth canal. The baby is born quickly and easily without voluntary pushing from the mother.
The third stage is the delivery of the placenta and is the shortest stage lasting about 20 minutes. Mothers wait until they feel some cramping, then push out the placenta. Having the baby play at the breast or squatting can help.