1st Stage of Labor: Effacement and Dilation Explained

THE EFFACEMENT AND DILATION STAGE

The 1st stage of labor is the time where contractions start and the cervix begins to thin and dilate. Also referred to as the latent phase, this stage is concerned with the body using contractions (tightening or cramping of the abdomen) to help open the cervix (dilate) and thin out (efface). This stage is divided into the latent phase, active phase, and transition phase. Early labor typically lasts from 30 minutes to several hours, depending on the woman’s health history, physical condition, and whether it’s her first delivery or not. During this time, contractions become more frequent and intense as the body prepares for birth. As the cervix begins to open up wider, active labor starts. During this time, contractions will grow even stronger in intensity and frequency until the baby is ready to be born. At the end of active labor, a mother can expect full dilation (10 cm) of her cervix prior to delivery. Please keep reading for details on the following topics:

The latent phase

The active phase

The transition phase

Consequence of pushing before the cervix is fully dilated

Activities which can help the woman feel comfortable

Laboring positions

Laboring positions examples

THE LATENT PHASE

The latent phase of labor, the initial stage of the 1st stage, involves the early onset of contractions and the cervix beginning to thin and dilate. It typically extends from the start of contractions until the cervix is dilated to around 6 centimeters. During this phase, contractions are relatively mild and irregular, lasting about 30-40 seconds and occurring every 5-20 minutes. The cervix gradually effaces (thins out) and opens up to approximately 4 centimeters. Women may experience a clear or slightly bloody discharge called “show.” Activities to help cope with this phase include taking walks, watching movies, taking warm baths or showers, using relaxation techniques, and staying hydrated. The latent phase can last for hours to days, depending on various factors such as the woman’s health history and physical condition.

During the latent phase of labor, various activities can help ease discomfort and support the woman’s well-being:

Use of Hot Water Bottle: Placing a hot water bottle on the abdomen or lower back can provide relief from discomfort by soothing tense muscles and promoting relaxation.
Occupying Herself: Keeping occupied with activities such as reading, listening to music, or engaging in hobbies can help distract from discomfort and pass the time during early labor.
Deep Breathing Exercises: Performing deep breathing exercises can help manage pain and promote relaxation by reducing tension and anxiety.
Consuming Small, Frequent Meals: Eating small, frequent meals provides energy to support the labor process and helps maintain blood sugar levels.
Changing Positions: Lying in any comfortable position and changing positions frequently can help relieve pressure and discomfort and promote comfort during labor.
Maintaining a Positive Mindset: Staying positive and focusing on the progress of labor can help manage anxiety and stress, promoting a sense of empowerment and confidence.

THE ACTIVE PHASE

The active phase of labor follows the latent phase and is characterized by more intense contractions and further cervical dilation. During this stage, the cervix continues to thin out and open wider, typically progressing from around 4 centimeters to 7 centimeters (6cm to delivery–ACCORDING TO RECENT RESEARCH). Contractions become stronger, longer, and more frequent, lasting about a minute and occurring every 5-7 minutes. The woman may experience increased pressure in her lower back as the fetus descends into the birth canal. The active phase can last from 5 to 24 hours, depending on various factors such as the woman’s health and whether it’s her first delivery. To cope with this phase, it’s advisable for the woman to remain upright, continue ingesting fluids to stay hydrated, and take warm baths or showers for comfort. Staying positive and maintaining a supportive environment are also important during the active phase of labor.

THE TRANSITION PHASE

The transition phase of labor is the final stage of the first stage and is characterized by intense contractions and significant cervical dilation. During this phase, the cervix continues to thin out and open wider, progressing from around 8 centimeters to full dilation at 10 centimeters. Contractions become extremely strong, lasting as long as 90 seconds and occurring every 2 minutes. The woman may experience overwhelming pressure in her pelvis and may feel the urge to push as the baby descends further into the birth canal. The transition phase typically lasts from 5 to 8 hours but can vary depending on individual factors. To cope with this phase, deep breathing exercises can help manage the intensity of contractions, and refraining from pushing until the cervix is fully dilated is crucial to avoid complications. Adopting a vertical position, such as standing or being on hands and knees, can provide comfort and facilitate the birthing process. Additionally, staying positive and receiving support from caregivers and birth partners are essential during this challenging phase of labor.

👉CLICK TO WATCH A VIDEO ABOUT THE LABOR PROCESS

CONSEQUENCE OF PUSHING BEFORE THE CERVIX IS FULLY DILATED

Pushing before the cervix is fully dilated can have several consequences:

Tiredness: Premature pushing can exhaust the woman, leading to increased fatigue and reduced energy reserves for the later stages of labor.
Cervical Swelling: Pushing before full dilation can cause the cervix to swell, impeding the progress of labor and prolonging the overall process.
Risk of Tearing: Premature pushing increases the risk of cervical and perineal tears, as the tissues are not fully prepared or dilated to accommodate the baby’s passage.
Prolonged Labor: Ineffective pushing before full dilation can prolong the labor process, leading to increased discomfort and potential complications for both the mother and baby.
Hemorrhaging: Premature pushing may result in excessive bleeding or hemorrhaging due to the increased strain on the cervix and surrounding tissues.
Fetal Complications: Pushing before full dilation can also lead to complications for the baby, such as fetal distress or head swelling, due to the increased pressure exerted during premature pushing.

ACTIVITIES THAT CAN HELP THE WOMAN FEEL COMFORTABLE

During labor, various activities can help the woman feel more comfortable and cope with the intensity of contractions:

Taking a Walk: Walking can help distract from discomfort and promote relaxation by encouraging gentle movement and changing scenery.
Rocking in a Chair: Rocking back and forth in a rocking chair can provide rhythmic movement and help alleviate tension in the body.
Doing Puzzles: Engaging in puzzles or other mentally stimulating activities can divert attention from pain and promote a sense of focus and relaxation.
Communicating with Baby: Talking or singing to the baby can foster a sense of connection and reassurance during labor.
Taking a Shower or Bath: Immersing in warm water can provide soothing relief for tense muscles and help alleviate discomfort during contractions.
Slow Dancing: Gentle dancing movements with a partner can provide comfort and distraction, as well as promote relaxation and bonding.
Relaxing Between Contractions: Using relaxation techniques such as deep breathing, visualization, or progressive muscle relaxation during breaks between contractions can help manage pain and promote calmness.
Changing Positions Often: Experimenting with different positions, such as standing, kneeling, or leaning forward, can help find the most comfortable and effective posture for coping with contractions.
Staying Hydrated: Drinking water, juice, or clear liquids can help maintain hydration and provide energy during labor.
Using Comfort Measures: Applying heat or cold packs to the lower back, receiving massages from a partner, or applying counterpressure to the hips or lower back can help alleviate pain and discomfort.
Engaging in Positive Self-Talk: Encouraging and reassuring oneself with positive affirmations and thoughts can help maintain a positive mindset and reduce anxiety during labor.
Practicing Relaxation Techniques: Practicing relaxation techniques such as mindfulness, meditation, or guided imagery can help manage stress and promote a sense of calmness and control.
Using Lip Balm: Keeping the lips moist with lip balm can prevent dryness and discomfort, especially during prolonged labor when hydration is important.
Watching a Movie: Distraction techniques such as watching a movie can help divert attention from labor pains and provide entertainment during the waiting period.
Holding Hands with the Birth Partner: Physical touch and emotional support from the birth partner can provide comfort and reassurance, helping the woman feel supported and connected during labor.
Praying: For women who find solace in spirituality, prayer can offer emotional strength, peace, and a sense of connection during labor.
Sucking on a Sour Lollipop or Popsicle: Sucking on a sour lollipop or popsicle can provide relief from dry mouth and throat, as well as offer a distraction from discomfort during contractions.
Using a Washcloth with Ice Water: Applying a cold washcloth dipped in ice water to the forehead or neck can help cool down the body and provide relief from heat and discomfort during labor.
Using the Bathroom Often: Emptying the bladder regularly can prevent discomfort and reduce pressure on the pelvis, providing greater comfort during labor.
Using Ice Packs, Heat, or Alternating Hot and Cold Compresses: Applying ice packs or heat pads to the lower back or abdomen can help alleviate pain and muscle tension during labor. Alternating between hot and cold therapy can provide additional relief.
Applying Counter Pressure to the Lower Back: Gentle pressure applied to the lower back can help relieve back pain and provide comfort during contractions, especially for women experiencing back labor.
Performing Positive Self-Talk: Encouraging oneself with positive affirmations and self-motivation can help maintain a positive mindset and reduce anxiety during labor, empowering the woman to cope with the challenges of childbirth.
Thinking of Meeting Baby: Visualizing the moment of meeting the baby can provide motivation and encouragement during labor, reminding the woman of the ultimate reward awaiting her at the end of the birthing process.

LABORING POSITIONS

Laboring positions refer to the various postures or stances that a woman can adopt during childbirth to help manage pain, facilitate labor progress, and optimize comfort. Different positions can affect the dynamics of labor by utilizing gravity, opening up the pelvis, and providing relief from discomfort. Some common laboring positions include:

Standing or Walking Around: Being upright and mobile allows gravity to assist in the descent of the baby through the birth canal, promoting progress in labor.
Rocking on a Chair or Swaying Back and Forth: Rocking movements can provide rhythmic motion and help soothe the woman during contractions.
Squatting: Squatting opens up the pelvis, making more room for the baby to descend. It can also help reduce pressure on the woman’s back and provide relief from back pain.
Sitting on a Bed, Chair, or Birthing Ball: Sitting positions can ease the pain of contractions by opening up the pelvis and allowing gravity to assist in bringing the baby down into the birth canal.
Being on the Knees: Kneeling positions, such as leaning forward over a stack of pillows or kneeling over a chair or birthing ball, can encourage the baby to move forward, alleviating pressure on the woman’s back.
Being in an All Fours Position (On Hands and Knees): This position not only opens up the pelvis but also allows the birth partner to provide back massage and counterpressure, offering comfort during labor.
Side-Lying: Lying on the side can relieve pressure on major blood vessels, reducing the risk of decreased blood flow to the baby. It also allows for easy access for back massage and provides relaxation between contractions.
Lying Down: While lying down is not typically recommended during active labor due to reduced blood flow to the baby, it may be suitable for rest periods between contractions, especially during the 1st stage of labor.

The best position is the one most relaxing to the laboring woman

Disclaimer: The information provided in this content is for general informational purposes only. It is not intended as medical or healthcare advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare professional with any questions you may have regarding a medical condition or healthcare decisions. 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage 1st stage