Pregnancy Step 9 Labor and Delivery
Labor is the process that results in the delivery of the infant.
Although most women recognize when "true labor" begins, nobody can predict when it will start, or how long it will last. First time deliveries are particularly difficult to predict. The labor tends to last longer and progress more slowly compared to women who have experienced childbirth in the past.
Doctors divide labor into three stages.
The first stage of labor occurs when the cervix dilates. This is necessary since the opening to the cervix must become larger to accommodate the passage of the infant. First-time mothers usually have about 12 hours of first-stage labor. Women who have delivered children before average about 6 hours in first-stage labor. Your doctor will perform periodic checks of your cervix to see how much you are dilated. You will not be able to deliver your baby until the cervix is completely dilated (usually 10 centimeters or more).
The second stage of labor is the actual birth itself. It usually begins after the membranes have ruptured, at which time you will leak a large amount of clear fluid from your vagina. This is the amniotic fluid that the baby floated within during the prior 9 months of development. The second stage of labor is when the baby is pushed from the uterus due to the strong contractions of the uterine muscles. The length of the second stage is also variable. It may last as little as 3 to 5 minutes or take as long as 2 or 3 hours. Your doctor will be closely monitoring the status of the baby through the second stage of labor.
After you deliver your baby the third stage of labor begins. This is the time when you deliver the afterbirth, or placenta. After delivery, the placenta will loosen its grip on the wall of the uterus and be pushed out of the uterus with the remaining contractions. Most women don't notice this event, since they are so preoccupied with the delivery of their child.
- Blenning CE, Paladine H. An approach to the postpartum office visit. Am Fam Physician. 2005 Dec 15;72(12):2491-6. 
- Condous GS, Arulkumaran S. Medical and conservative surgical management of postpartum hemorrhage. J Obstet Gynaecol Can. 2003 Nov;25(11):931-6. 
- Magann EF, Evans S, Hutchinson M, Collins R, Lanneau G, Morrison JC. Postpartum hemorrhage after cesarean delivery: an analysis of risk factors. South Med J. 2005 Jul;98(7):681-5. 
- Malamitsi-Puchner A, Boutsikou T. Adolescent pregnancy and perinatal outcome. Pediatr Endocrinol Rev. 2006 Jan;3 Suppl 1:170-1. 
- Nanda K, Peloggia A, Grimes D, Lopez L, Nanda G. Expectant care versus surgical treatment for miscarriage. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003518. 
- Ozkaya O, Sezik M, et al. Placebo-controlled randomized comparison of vaginal with rectal misoprostol in the prevention of postpartum hemorrhage. J Obstet Gynaecol Res. 2005 Oct;31(5):389-93. 
- Tierney JP, Welsh J, Owen P; Effective Gynaecology in Glasgow Group. Management of early pregnancy loss--a complete audit cycle. J Obstet Gynaecol. 2006 Apr;26(3):229-32. 
- Vitzthum VJ, Spielvogel H, Thornburg J, West B. A prospective study of early pregnancy loss in humans. Fertil Steril. 2006 Aug;86(2):373-9.