Surely you have already asked your friends who have given birth about how long labor is taking . Some told you a saga in the spirit of “and the day lasts longer than a century” (and were not far from the truth if there was a protracted labor), others brushed it off - she gave birth, they say, and did not notice. Which is also partly true if it was a case of rapid labor, and repeated ones at that.
How long does labor actually last?
The duration of labor depends on many things, and it is impossible to accurately predict the time it will take to give birth to a baby. The age of the mother, the position of the fetus, and the health status of both play a role here. Also, the duration of labor is influenced by emotions, physiological characteristics of the woman, even the use of painkillers. And this is not the entire list.
Doctors, however, determine the average time of normal labor in this way. If you are giving birth for the first time, the process will take 6-10 hours according to some sources, 15-20 according to others. This discrepancy, it seems, is due to the fact that in the first case, the active phase of labor itself is considered, and in the second, all stages.
Therefore, I propose to consider all periods of labor, their characteristics and duration.
Harbingers of childbirth
The first signs of approaching labor appear in primiparous women 1-2 weeks before the baby is born. At this time, the pregnant woman:
- the stomach drops. The child, preparing to leave the mother's womb, changes its position, lowering its head into the pelvis. Thus, the fetus moves down, and the abdomen, which previously supported the stomach and lungs, moves down;
- shortness of breath decreases. The woman begins to breathe more freely, because as a result of the lowering of the abdomen, the compression of the lungs decreases;
- lumbar pain appears or intensifies. A baby who has changed his position puts more pressure in the pelvic area, thereby causing pain;
- the urge to urinate becomes more frequent. The bladder is under increased pressure from the fetal head, and therefore cannot fill 100%, which causes frequent visits to the toilet;
- fetal mobility decreases. The baby simply feels cramped in his mother’s tummy, and he prefers to behave quietly;
- the cervix softens. This is facilitated by a decrease in progesterone and an increase in estrogen levels - thus the body gives a command to all organs to end pregnancy.
During this period, false contractions may appear. They differ from true ones in that they are painless and have an irregular nature. 1-2 days before the onset of labor, the mucus plug peels off and comes out - a thick, viscous substance that was in the cervix and protected the woman and fetus from infections. From this moment on, you can expect the onset of prenatal contractions.
The further you go, the more difficult it gets.
Professor Luciana De Lauretis from another Milan clinic explains that “the number of ovulations is “given” by nature for each woman in a certain amount, embedded in the genes. Over the years, only the percentage of the probability of fertilization changes. For example, if at the age of 23 it is 28%, then at the age of 40 the probability of pregnancy drops to 12% and subsequently decreases by several percent every year, gradually disappearing.”
At the same time, the risk of spontaneous abortions in the early stages increases: before the age of 40, their number in healthy women does not exceed 20%, while after forty it doubles. It is men who can remain fertile up to 80 years, but for the weaker sex everything is strict: after the half-century mark, only two women per million can become pregnant in the usual way. It is interesting that psychologists, unlike gynecologists, welcome late births and note that 40-year-old mothers monitor their health more carefully, and also take a more conscious approach to the birth of a child and his upbringing, without at all pampering him to the point of insanity, as is commonly believed in people.
How long does the first birth last?
The duration of labor in primiparous women is 15-20 hours; For those who have already given birth, the birth of a baby takes 1.5-2 times less time. What is this connected with? While experiencing the first birth , the body adjusts the functioning of the organs involved in the process of childbirth. During all subsequent births, only the reproduction of the program compiled and stored in memory occurs.
The first birth is divided into three stages:
- Contractions. In first-time women, they last about 18 hours, in all others - 11. Contractions are a contraction of the muscles of the uterus, as a result of which the birth canal opens.
- Pushing and fetal release. If you are giving birth for the first time, this period will take you 1 to 2 hours. Women who go through the birth process again will need half as much time.
- Disposal of the placenta and membranes. This stage takes the same amount of time for both those who are in the delivery room for the first time and those for whom this is not the first time, and lasts about half an hour.
All the figures we give are averaged. There are cases when the first birth proceeds much faster, but there are also women for whom this process lasted a whole day. The main thing is to be in time under the supervision of doctors who will make sure that your first birth proceeds normally.
Now let's take a closer look at how childbirth takes place .
Birth stages
The physiological process that completes a woman’s pregnancy includes three stages:
- first (beginning of contractions);
- second (fetal delivery);
- third (rejection and release of placenta).
How quickly all stages will pass depends largely on the physiological characteristics and health status of the mother and fetus. It is believed that for women giving birth for the first time, the process may be more protracted than for those who are expecting a baby more than once.
First birth: contractions
Almost everyone knows how labor begins: the first thing that signals the baby’s readiness to leave the mother’s womb is the appearance of regularly recurring painful contractions. Sometimes they are preceded by lower back pain and nagging pain in the lower abdomen.
The first contractions last only a few seconds and are interspersed with 20-30 minute periods of painless relaxation. Childbirth will not come soon, you have time to pack your things, take hygiene procedures and go to the maternity hospital.
Gradually, the process progresses: the breaks between uterine contractions decrease, and the spasms themselves become longer and more painful. At the end of the first stage of labor, the duration of contractions reaches 1 minute, and the respite time between them is 3 minutes. As soon as you notice a similar frequency of uterine contractions, feel free to call the midwife and say that you are giving birth.
You cannot influence the frequency of contractions, but you can reduce the degree of pain - this is taught to expectant mothers at school, when they instill the skills of proper breathing during childbirth.
Tips before going to the hospital
After the onset of even remote pain resembling contractions, a woman is not recommended to overload her stomach with food. It is better to avoid eating food on the eve of childbirth altogether.
Before going to the obstetric facility, you should take a shower and shave yourself or ask your loved ones to do so.
Doctors do not recommend doing an enema at home, as this may contribute to a faster onset of the physiological process, and the woman may not have time to get to the maternity hospital.
Attempts during the first birth
During the dilatation of the cervix, amniotic fluid pushes through the amniotic sac, breaking through it, after which the woman's water breaks. This is the beginning of labor. Although this order is also not a dogma. Sometimes the water breaks during contractions, and there are times when the bubble does not burst, and then the doctor opens it with the help of instruments.
As the cervix dilates, the fetus begins to move through the birth canal. Periodic spasms of the muscles of the uterus and abdominal wall actually push the baby towards the “exit”, accelerating its movement. The doctor monitoring the progress of labor must measure the degree of dilatation of the cervix. If it has dilated less than 12 cm, the fetal head will not fit through it, and then the woman may have a caesarean section.
Sometimes contractions do not intensify over time, but weaken or do not begin at all, although the amniotic fluid has already receded. This situation should be alarming, as it poses a threat to the baby. In this case, doctors stimulate labor using special medications.
When the baby is born, the mucus from the respiratory tract is sucked out and the umbilical cord is cut.
There is no rush to give birth in Milan
Fresh statistics were recently published by one of the maternity hospitals in Milan.
It turns out that in this city the majority of women giving birth are over 35 years old - 48.4%, and we are talking about first-time mothers. Dr. Piero Rossi , the hospital's chief physician, says that giving birth for the first time at the age of 30 has already become the norm. Also, according to Rossi, 40-year-old mothers are under intense pressure from the maternal instinct, which, figuratively speaking, drives them to give birth as soon as possible, while there is still some opportunity left.
First birth: delivery of the placenta
After the birth of a child, the body receives a short break, so contractions return, although not as strong as before. The body now gets rid of the placenta. In cases where this does not happen, the “baby spot” is removed by a doctor. The woman in labor remains in the delivery room for another 2 hours, during which time the obstetrician must make sure that the woman is not bleeding. Having safely given birth, begin the duties of a mother - feed the baby and take care of his health.
The first birth does not always go smoothly; sometimes it is accompanied by complications, which we will discuss later.
What to take with you to the maternity hospital
Before going to the maternity hospital, a woman should be interested not only in the duration of labor, but also in what she will need in the obstetrics and gynecology department. The expectant mother must have with her things that she and the child will need. This will make you feel more calm and comfortable after the woman in labor gets to the maternity hospital. A woman will first need a shirt, pads, elastic bandages, a towel and nursing bras. Just in case, you should also purchase a breast pump. The baby will need diapers, wet wipes, a pacifier and clothing.
Full readiness for the most important process in a pregnant woman’s life will allow childbirth to proceed safely and more easily.
Ways to speed up the process
During a vaginal examination, the gynecologist assesses the condition of the cervix. Polyhydramnios is usually diagnosed shortly before birth during a routine ultrasound. If excess amniotic fluid interferes with acceleration, a decision is made to perform an amniotomy. In most cases, after the bladder is punctured, normal contractions begin within 1-2 hours.
Upon transition to the active phase of opening, stimulation with oxytocin begins. In the earlier period, the hormone is used less frequently, so that acceleration does not lead to cervical ruptures. If the body responds well to stimulation, with the transition to the deceleration phase, oxytocin is stopped or temporarily slowed down.
The introduction of antispasmodics facilitates the opening of the cervix and reduces pain. Drotaverine solution is used during childbirth. It helps well in women in labor when the fetal head puts a lot of pressure on the cervix, and it looks tight and swollen.
There are no special methods to speed up the second period. Pressure on the abdomen is not used in modern maternity hospitals. This method may cause injury to the baby or mother.
The succession period also cannot be accelerated artificially, and pressure on the uterus or twitching of the umbilical cord is dangerous due to massive bleeding. If this period is prolonged, the placenta is manually separated under anesthesia.
Why is it dangerous to wait too long?
In modern maternity hospitals, it is customary not to wait as long as possible after the onset of contractions in order to avoid complications. They try to allocate 12 hours to complete the birth. The maximum duration of labor allowed by clinical protocols is 18 hours. During this time, the doctor has the opportunity to assess the condition of the fetus and mother and make a decision on stimulation or transfer to the operating room. The following factors influence the decision:
- dynamics of contractions (whether they increase in strength and duration or not);
- cervical opening speed;
- fetal CTG data;
- maternal concomitant diseases;
- whether the amniotic sac is preserved or not;
- color of amniotic fluid;
- dimensions of the mother's pelvis.
Prolonged contractions tire the woman and child. Good strong contractions deplete the energy resource of the myometrium and calcium reserves. Therefore, they gradually weaken and turn into secondary generic weakness. Stimulation with oxytocin is useless at this point. Then the doctor decides to complete the birth by cesarean section. Less commonly used is a special anesthesia sleep, which gives the woman in labor the opportunity to rest.
Opened amniotic fluid leads to contact of the fetus with the contents of the vagina. In the presence of vaginitis, sexually transmitted infections, and symptoms of herpes, the risk of infection of the child increases. An anhydrous period of more than 12 hours is not recommended by WHO and requires the use of antibiotics to prevent infection of the fetus.
2. How it all began
I gave birth to my first child exactly at term (forty weeks).
A week before the expected date of birth, I was admitted to the perinatal center. Doctors observed me all week. Time passed quickly and according to the doctors’ calculations, I was due to give birth the next day.
I was called into the examination room. There were no warning signs of labor. They told me to return to the ward, and added that if tomorrow you don’t start giving birth on your own, we will administer the gel.
What is a gel? Where should I enter it? I was completely at a loss.
Returning to the room, I asked the girls who knew what the gel was? Those who have already given birth explained that this is a process of artificially inducing contractions.
In the evening I felt a nagging pain in my lower abdomen. The pain was very similar to what happens during the menstrual cycle.
I didn't pay any attention to this pain. The time was about eight o'clock in the evening.
When I went to bed, it was about ten o’clock in the evening, but the pain in my lower abdomen became even stronger. But even then I didn’t pay attention to them.
I barely slept all night. My stomach hurt, then pulled, then let go. By five o'clock in the morning the pain became simply unbearable. I got up and went to the reception to see the nurse.
I explained the whole situation to her, told her that it started yesterday. She immediately called the doctor on duty, and they both began to scold me. They scolded me for telling them about my pain so late.
They explained to me that these were contractions and that I was already five fingers dilated. For those who do not understand what five-finger dilatation is, I’ll explain that this is almost the same time when the baby is ready to be born.
I was urgently transferred to the delivery room and all this time the contractions were intensifying. At half past eleven I gave birth to my first baby.
According to doctors, labor is counted from the beginning of the first contractions until the birth of the baby. But now it’s not difficult to calculate how long my first labor lasted – 15.5 hours!
Deviations from the norm and possible consequences
The above-described option for the birth of a baby is physiological, correct and most favorable for the condition of mother and child. However, sometimes obstetricians have to deal with pathological labor: rapid or protracted.
Rapid labor
There may be a misconception that the sooner a child is born, the better for him and for the woman. However, getting ahead of events when a baby is born is very dangerous, because during the longest first stage, total preparation of the female body occurs.
Check out the list of necessary things for the maternity hospital, when women in labor are discharged and why a birth certificate is needed.
A number of hormones are released that trigger contractions, promote muscle relaxation, relieve pain, the bones of the pelvic floor also open, and the fetus takes the necessary position for a smooth birth.
Childbirth is called rapid if it occurs in less than 6 hours in primiparous women and in 2-4 hours in multiparous women. Rapid labor can be recognized by the following signs:
- frequent and painful contractions, the duration of muscle contraction is about 10 seconds, the frequency is 3-5 times in 10 minutes;
- rapid pulse;
- heavy, rapid breathing.
Among the reasons for this phenomenon, doctors identify the following:
- genetic predisposition;
- age less than 18 or older than 30 years;
- the presence of any gynecological diseases;
- history of abortion;
- neuroses, psychoses and increased excitability;
- any disturbances during pregnancy.
A rapid labor process is associated with enormous risks, primarily for the woman’s health:
- rupture of tissue of the cervix, external genitalia and perineum is the mildest consequence;
- divergence of the pelvic bones;
- placental abruption or retained placenta.
Important! One of the most dangerous consequences of rapid and rapid labor is the development of severe bleeding during rapid labor as a result of rupture of the body or cervix, or placental abruption. In particularly severe cases, they resort to removing the reproductive organs, which leaves the woman infertile.
But for a child, the risks when born quickly are no less:
- possible damage to the head, spine and musculoskeletal system;
- brain hypoxia;
- intraorgan or cerebral hemorrhages.
Prolonged labor
A protracted labor process is also a pathological deviation. Its duration is determined in different ways - recently there has been a tendency towards an ever-increasing reduction in the duration of labor, therefore labor that lasts more than 18 hours in first-born women and 12 hours in women giving birth again can be considered protracted.
Protracted labor is a labor that occurs on time, starting with good, growing contractions, which for various reasons weaken or stop altogether.
With weak labor, the child gets stuck in the narrow birth canal, with strong pressure on his head and body. The woman in labor herself becomes very tired during the long process.
There are many reasons for weak labor:
- diseases of the endocrine system (including excess weight);
- age under 18 years or after 30;
- history of abortion;
- inflammatory diseases of the reproductive system;
- polyhydramnios in the current pregnancy or in history.
There are also other reasons for weak labor, the result of which is the same - the production of the hormone oxytocin, which is a stimulant of contractions, decreases. If from the very beginning the contractions are weak and infrequent and do not increase, then they speak of primary weakness of labor.
Did you know? Prolonged labor accounts for 5 to 20% of all cases in all countries of the world.
The danger of prolonged labor:
- increased risk of infection;
- compression of the fetal head with impaired blood circulation in the brain;
- increased risk of injury for women;
- danger of retaining the placenta in the uterus;
- the risk of postpartum hemorrhage increases.
When the duration of the first or second labor period exceeds acceptable standards, doctors resort to stimulating labor with oxytocin-based medications.
If the child is already in the birth canal, special forceps or a vacuum extractor are used for obstetric care.
In what cases is stimulation used during childbirth?
If the mother runs out of strength or labor is not strong enough to avoid complications, doctors have to resort to inducing labor with drugs. This decision largely depends on the woman’s condition, the conditions of the maternity hospital, as well as the qualifications of the doctor leading the birth.
With the introduction of stimulants, contractions become stronger and more painful, which leads to the need to use painkillers during childbirth. But there are cases when it is impossible to do without stimulation. For example, if after the water breaks there is no labor activity.
You should not be afraid of any of these situations. These are exceptions rather than the rule. In most cases, both the first and subsequent births proceed normally for everyone. But you need to know these nuances in order to be prepared for the fact that at some point you may need medical intervention to help keep you and your baby healthy. And it doesn’t matter how long your labor will take, the main thing is that it goes without complications and you finally see the baby you want.
Features of the second, third and subsequent births
The second, third and subsequent births differ from the first due to both physical and psychological factors. A multiparous woman is often calmer, more confident and relaxed.
She is aware of what will happen in the coming hours, so the level of stress and anxiety is lower.
How long does the second birth last?
From a physiological point of view, the second birth is easier due to the following changes and factors:
- the inner and outer rings of the throat open simultaneously;
- greater looseness and elasticity of the cervix;
- the opening of the pharynx occurs within 6 hours;
- expulsion of the fetus occurs within 15 minutes;
- pain is less pronounced compared to the first birth.
How long does the third and subsequent births last?
If the first and second time a woman gave birth on her own, and not through, then the third birth in most cases goes even faster: on average, the whole process takes women 4-5 hours.
By that time, the cervix becomes very elastic and trained, so its dilation occurs as quickly as possible.
Important! If a woman is completely healthy and her age is less than 35 years, the third and subsequent births are much easier, faster and less traumatic than the previous ones. Otherwise, there may be an exacerbation of existing chronic diseases, weakness of labor, suture dehiscence and an increased risk of bleeding.
However, it is worth considering that by the time of the third birth, the likelihood of gaining excess weight increases, which has a very negative impact on the process. Also, by the time of the third pregnancy, the muscular apparatus of the uterus and anterior abdominal wall is stretched and contracts less effectively.
In approximately 1/3 of cases, contractions weaken significantly at the moment when the width of the pharynx reaches 5 cm. In this case, drug stimulation is used. If there are pathologies of the reproductive sphere, it may be quite difficult and painful to remove the placenta.
