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What Happens During Labor & Delivery?
Early phase

What's happening: regular contractions about every 15 to 20 minutes, increasing to 5-minute intervals later in this phase. Your cervix will dilate to 2 to 3 centimeters and your water will break.

What to do: relax! Take a shower; try cleansing breaths; listen to soothing music. You won't be allowed to eat during active labor, so now is the time to snack on a light meal, such as toast with jam or yogurt and fruit. In addition, be sure to fill up on water. Move around—walking can help speed labor at this stage—and call your doctor or midwife to let them know what's going on. Dad should be loading your hospital bag into the car and helping you time your contractions (from the beginning of one to the beginning of the next). And, though you'll be tempted, hold off on calling everyone on your 'baby alert' list, as baby could still be a long time coming. When your water breaks, it's time to head to the hospital to register and get settled into your birthing room.

Active phase

What's happening: your cervix dilates to 4 to 7 centimeters and contractions become stronger and more frequent—about 2 to 3 minutes apart and lasting about 45 seconds. The pain also intensifies; you might have a hard time concentrating on anyone but yourself. The nurse will be checking you to see how your dilation is progressing.

What to do: stay in motion—walk, rock your body—and change your position frequently. Whatever you can do to keep yourself upright and in motion will help speed labor. Your partner should help you practice your breathing and relaxation techniques, and keep you comfortable. To that end, try sitting backward in a straight chair, kneeling on all fours, or standing and leaning against your partner.

Try to relax: close your eyes and breathe deeply; have your partner give you a light back massage or read to you. Suck on ice chips or popsicles for refreshment. And try to go to the bathroom once an hour—an empty bladder will allow the baby's head to move into position more easily. If you're in a lot of pain, now is the time to request your preferred method of pain management. And make sure to discuss all of your options with your doctor well in advance; you want to have a clear idea of each method before you actually need any relief. (Your labor partner should also be informed.)

Transition phase

What's happening: The cervix dilates to 8 to 10 centimeters, its maximum width. Your contractions are coming fast and furious now—some less than a minute apart—and are lasting a minute or more. You may be nauseous and have the chills, and the sweats or shakes. You'll probably feel an incredible urge to push during this time, an urge you need to resist.

What to do: concentrate on your breathing and relaxation techniques—they will help you manage the pain and stay focused. Have your partner verbally help pace your breathing if that helps you. Focus on the contraction you're in at each moment, not what's coming up next. Take heart, this phase is the shortest, and it means baby is just about ready to make a debut!

What should I expect during delivery?

What's happening: you are fully dilated and the baby's head becomes visible to your partner and hospital team. You can push (finally!); each contraction will last about 60 to 90 seconds. Once the baby crowns (the top of the head shows without slipping back), you'll stop pushing and the doctor or nurse will do perineum massage to help the area between the vagina and anus to stretch. They may need to do an episiotomy, or make an incision in the area, to avoid tearing.

What to do: if you'd like to watch the delivery, ask for a mirror. Relax and rely on your partner for support and feel free to shout, scream, sing—whatever helps you get through your delivery. Push only when the doctor asks you to; when you're not pushing, let your body go limp to save energy. Some doctors allow Dad to 'catch' baby, an opportunity he might not want to pass up (but if you need him near you for support, emotional or otherwise, tell him so). Once you've delivered, ask to hold baby immediately—this is your time.
Dr. Bettye M. Caldwell Ph.D. Professor of Pediatrics in Child Development and Education