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.
Once the cervix has reached 10 cm, it is time to push the baby out. Contractions continue but also produce a strong urge to push. This urge might feel like an intense need to have a bowel movement. This stage can last anywhere from a few minutes to a few hours.
Although it is the shortest phase, the transition phase is the most challenging. Transition typically lasts 30 minutes to 2 hours as your cervix fully dilates from 8 cm to 10 cm. Contractions will last roughly 60-90 seconds with only 30 seconds to 2 minutes between.
Active Labor Phase: Continues from 3 cm until the cervix is dilated to 7 centimeters. Transition Phase – Continues from 7 cm until the cervix is fully dilated to 10 centimeters.
But if you're close to 10 centimeters dilated the research suggests it's not an issue. Evidence suggests it's more of a theoretical fear that just adds additional stress and in some cases results in an epidural (or a higher dose of epidural) to mask that urge.
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.
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.
(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. The exact duration of this stage is different for everyone.
During active labor, your cervix will dilate from 6 centimeters (cm) to 10 cm. Your contractions will become stronger, closer together and regular. Your legs might cramp, and you might feel nauseated.
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.
The second, pushing phase of labor continues after the cervix is fully dilated (open) to 10 cm until the delivery of your baby. It averages 4 to 8 hours but can be as short as several minutes.
The cervix generally needs to be dilated to 10 centimeters before it's ready for the baby to pass through. Your cervix can be dilated to a couple of centimeters for a few weeks before delivery. This softening can cause the mucus plug to be dislodged and come out.
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.
However, women who delayed pushing experienced longer labors and higher risks of severe postpartum bleeding and infections. Their babies also were more likely to develop sepsis—a serious complication related to infection. The study appears in the Journal of the American Medical Association.
Purple pushing, coached pushing, holding your breath, all mean basically the same thing. Mothers being instructed on pushing causes them to hold their breath and push down into their bottom. Another more normal and less exhausting option would be “breathing or bearing down” working with the contractions.
The transition phase is short, but also intense and painful. 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.
In figure D, the cervix is 90% effaced and 4 to 5 cm dilated. The cervix must be 100% effaced and 10 cm dilated before a vaginal delivery.
A fully dilated cervix is 10 centimeters open.
This is about the size of a bagel, and means that when your cervix is measured with two fingers, they can be stretched 10 centimeters across.
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.
In some women, the foetal head is not in the right position and doesn t apply aptly to the cervix, which is why the cervix doesn t open. This can lead to difficulty in dilation.
The pain experienced during dilation is similar to that of menstruation (although markedly more intense), as period pains are thought to be due to the passing of endometrium through the cervix. Most of the pain during labor is caused by the uterus contracting to dilate the cervix.
Many people choose to get an epidural during the first stage of labor once their cervix has dilated to around 4-5 centimeters – this is right before active labor typically begins. If you're eight or more centimeters dilated, it's likely that your care team won't have enough time to place the epidural.
An epidural can generally be performed at any stage; it is never too late. This is, however, not the case if baby's head is crowning (within the birth canal).
You'll likely still feel the pressure of your contractions (which will be helpful when it's time to push) and be aware of (but not bothered by) vaginal exams during labor. And you'll still be able to feel your baby moving through the birth canal and coming out.