The Journey of Labor.

The journey of pregnancy labor is an incredible and unique experience that differs from every mother to another. It is a process that involves three stages. Understanding these stages can help expectant mothers prepare for childbirth and make informed decisions about their labor and delivery.

Labor, also called "parturition", is the process of delivering the baby. First starts with uterine contractions and ends with the delivery of the placenta. Labor typically begins when the fetus is full term and that is between 37 and 42 weeks of gestation. Before labor starts, pregnant woman may experience the "loss of a mucus plug" or the "rupture of the amniotic sac" they call it the "water breaking". These can trigger the onset of true labor contractions that progress in frequency, duration, and intensity. It can be felt like waves that build up and decrease in tension. These contractions cause the cervix to thin and dilate, to allow the fetus to leave the uterus. For a first-time pregnancy, it usually takes about 12 to 18 hours, while subsequent pregnancies take about half that time. However, the duration of labor can vary between pregnant women.

Labor is divided into three stages:

I. The first stage: is the longest and most challenging, lasting an average of 12 to 14 hours for first-time mothers. This stage is further divided into three phases:

• Early labor: During this phase, contractions usually last up to 20 hours, or until the cervix dilates by up to 4 centimeters.
• Active labor: This phase is presented with an increase in contractions, that vary widely in time periods. Contractions often come moderate to strong, every 2 to 3 minutes, and last 50 to 80 seconds.
• Transition: This is the most intense phase, but the shortest one. It is presented with strong contractions that may come every 1 to 2 minutes. With almost no break between them, and last around 60 to 90 seconds.

II. The second stage: Also called "pushing stage". This stage depends on the following three Ps: Power, Passenger, and Passage.

- Passage and power refer to forceful uterine contractions.

- Passenger refers to the fetus.

The relationship between the newborn's head and the bony pelvis is so critical, that human babies have developed an unfused skulls to ensure a large head and for brain development.

And the factors that determine the passage of the fetus with no difficulties are:

• Fetal size: is the most critical factor.
• Attitude: refers to the fetal body's flexed position.
• Fetal position: is ideal if the long axis of the fetus is along the maternal long axis. But transversal or oblique positions can delay the progression of labor.
• Presentation: is the first fetal part to descend into the pelvic inlet. And the most common and optimal presentation the vertex position. The fetus can make several positional changes which is called "cardinal movements", and it include: descent, flexion, internal rotation, extension, restitution, and expulsion.

III. The third stage: involves the placenta delivery, where the uterus contracts and the placenta separates from the wall. Then the placenta and any remnants are carefully removed to ensure a smooth and healthy delivery.

Finally, few hours after delivery, the uterus starts returning to its pre-pregnancy state and the body responds to the significant physiological changes and adaptations to the blood loss during delivery which causes contractions.

Medical disclaimer: The information provided should not be used for diagnosing or treating a health problem or disease, and those seeking personal medical advice should consult with a licensed physician. Always seek the advice of your doctor or other qualified health provider regarding a medical condition.

Here is a video for more information on this topic.

https://www.healthyparentshealthychildren.ca/im-pregnant/labour-and-birth/stages-of-labour