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. These contractions become stronger, more regular and more frequent over time.
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.
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.
The Active Phase of Labor
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.
When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.
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.
Dilation is checked during a pelvic exam and measured in centimeters (cm), from 0 cm (no dilation) to 10 cm (fully dilated). Typically, if you're 4 cm dilated, you're in the active stage of labor; if you're fully dilated, you're ready to start pushing.
95% of women took less than 2 hours to dilate one centimetre during active labour. Most hospitals and health care providers have now updated guidelines to acknowledge these new findings.
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.
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).
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!
Try being upright
One of your biggest allies is gravity. When you are upright—standing, sitting or kneeling—the weight of your baby presses on the cervix, encouraging it to open. An upright position may also help get your baby into the best position for birth.
It may be hard to talk or move easily. At this point, your cervix will be dilated 3 to 10 centimeters. (Dilating one centimeter an hour is textbook, but like in early labor, it's different for everyone.) If you're opting for an epidural, the time is…now!
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.
Laboring down is the process of not actively pushing once the second stage of labor and intense contractions begin. Some people wait one to two hours before pushing, which allows the baby to naturally move down the birth canal. Laboring down has risks and benefits.
“The trend is, the larger the baby, the harder it is to deliver,” she says, “but that's actually just one factor in many that affect how the birth goes.”
Your cervix is also dilated by around 4 to 7 centimeters. Someone who has never given birth before may be in active labor for around three to six hours; a person who's done it before might take one to three hours.
Pushing Can Feel Like Relief
Your baby's head may press on nerves that desensitize the pelvis, and many people report feeling a numb sensation before the "ring of fire" (when the baby's head begins to emerge from the vaginal opening, a stage known as "crowning"). Some even say it feels good, similar to orgasm.
A C-section is major surgery. The procedure can increase complications for the mother and raise the risk during future pregnancies. Women giving birth for the first time should be allowed to push for at least three hours, the guidelines say. And if epidural anesthesia is used, they can push even longer.
Active labor usually lasts about 4 to 8 hours. 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.
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 time between dilating to 1 cm and giving birth varies from woman to woman. One woman may go from having a closed cervix to giving birth in a matter of hours, while another is 1–2 cm dilated for days or weeks. Some women do not experience any dilation until they go into active labor.