Until recently, women have been asked to start pushing as soon as the cervix has dilated to 10 centimeters, but as long as you do not have a fever and your baby's heart rate is normal, there are many benefits to waiting to push until you feel the need to push.
The cervix must be 100% effaced and 10 cm dilated before a vaginal delivery. The first stage of labor and birth occurs when you begin to feel persistent contractions.
The final part of the active phase of labor (transition) is from eight to 10 centimeters, or full dilation. This may be the shortest phase of labor for many women, but it may also be the most intense. Strong contractions occur every two to three minutes and last for 60 to 90 seconds.
Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated. In a 1st labour, the time from the start of established labour to being fully dilated is usually 8 to 12 hours. It's often quicker (around 5 hours), in a 2nd or 3rd pregnancy.
In general, once the active stage of labor kicks in, it's a safe bet to expect a steady cervical dilation every hour. Many women don't start really dilating more regularly until closer to around 6 cm. The first stage of labor ends when a woman's cervix is fully dilated to 10 cm and fully effaced (thinned out).
During the active stage of labor, your cervix dilates from around 6 cm to the full 10 cm. (The last part of active labor, when the cervix dilates fully from 8 to 10 cm, is called transition.) This process takes about 5 to 7 hours if you're a first-time mom, or between 2 and 4 hours if you've had a baby before.
Until recently, women have been asked to start pushing as soon as the cervix has dilated to 10 centimeters, but as long as you do not have a fever and your baby's heart rate is normal, there are many benefits to waiting to push until you feel the need to push.
If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn't broken on its own when you arrive at the hospital, and you're five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.
During the transition phase of labor, the cervix dilates to the following sizes: 8 cm, the size of an apple. 9 cm, the size of a donut. 10 cm, the size of a large bagel.
Stage 2: Pushing and Birth
The second stage of labor begins once you are fully dilated to 10 cm. Your provider will let you know that it is time to start pushing your baby out. This stage can be as short as 20 minutes or as long as a few hours.
The first stage of labor ends and the second stage begins when your cervix is 10 centimeters dilated. This is usually the most difficult stage of labor because you start trying to push your baby out. It can last anywhere from half an hour to several hours.
A fully dilated cervix is 10 centimeters open. This means that when your cervix is measured with two fingers, they can be stretched 10 centimeters across. When you're fully dilated, it's time to push and have a baby.
Active labor
It starts when your contractions are regular and your cervix has dilated to 6 centimeters. In active labor: Your contractions get stronger, longer and more painful. Each lasts about 45 seconds and they can be as close as 3 minutes apart.
Doctors have to wait until the cervix is at least 4 centimeters dilated before doing an epidural. Otherwise, the epidural will slow the process down too much. However, once the cervix becomes fully dilated it is too late for an epidural to be given.
That's highly unlikely. If you're 4cm dilated and feeling a strong continuous urge to push (very unlikely) - then that's not ideal…often any pushing urge this early passes if you change position. But if you're close to 10 centimeters dilated the research suggests it's not an issue.
For first-time mothers the average length of pushing is one-to-two hours. In some instances, pushing can last longer than two hours if mother and baby are tolerating it. Normally, the baby is born with his face looking toward mother's back (referred to as an anterior position).
Transition phase
It usually takes from 15 minutes to an hour for the cervix to dilate from 8 to 10 centimeters. Contractions are 2 to 3 minutes apart and last about 1 minute. You may feel pressure on your rectum and your backache may feel worse.
If you're more than 4 cm dilated: You'll be admitted to the hospital to continue your labor and delivery.
At 10 cm, your cervix is as wide as a small cantaloupe. Cervical dilation and effacement go hand in hand. Like effacement, dilation is also caused by uterine contractions. Your cervix must be 100% effaced and 10 cm dilated before the pushing stage of a vaginal delivery can begin.
-If women aren't too tired, allow them to push at least two hours if they have delivered before, three hours if it's their first baby. They may push longer if they had an epidural as long as the doctor can see progress.
Getting up and moving around may help speed dilation by increasing blood flow. Walking around the room, doing simple movements in bed or chair, or even changing positions may encourage dilation. This is because the weight of the baby applies pressure to the cervix.
Can you feel your cervix dilating? As your cervix starts to thin and soften, you may or may not notice twinges and sensations in that area of your pelvis. This can be as much you trying to convince yourself something is happening though!
Three to four pushing efforts of 6 to 8 seconds in length per contraction are physiologically appropriate (AWHONN, 2000; Roberts, 2002; Simpson & James, 2005). When the time is right for pushing, the best approach based on current evidence is to encourage the woman to do whatever comes naturally.
Some women will instinctively push before their cervix is fully dilated. This is often treated as a complication, and a common approach is to encourage the woman to stop pushing due to fear that cervical damage will occur. However, there is no evidence to support this concern.
The timing of pushing didn't affect the odds of a normal vaginal delivery or harm the baby. It also didn't change the need for forceps or vacuum or the need for cesarean delivery, the researchers found.