Stages of birth

There are three stages of birth. The names of each stage relate to the process that is happening in your body: 

Stage one – the up stage.
Stage two – the down stage.
Stage three – birthing the placenta.

Stage one: the up stage 

This stage is actually split into two: early birth and active birth. Early birth takes you from 0 – 7cm dilated whilst active birth takes you from 7cm – 10cm by which point your cervix is fully dilated. 

This stage can last hours, days or even weeks. 

During the up stage the horizontal muscles of the uterus, which are condensed at the bottom of the uterus throughout pregnancy, are pulled to the top of the uterus. Early birth can take hours, days, or even weeks in some cases. Some people can reach 4cm dilated without even feeling much, whilst others will be aware of the muscles moving up. When you get close to 7cm dilated things can become much more intense. At this point, you enter into active birth which can last hours or days. Active birth is very powerful and this is when you need to really focus on your breathing and visualisations because your muscles are doing the hardest part of the work that needs to be done to open and give birth to your baby. 

Transition to stage two

An important transition happens between stages one and two. For a few minutes, a shift takes place: mentally, you will probably have feelings of wanting to give up and be convinced that you cannot “do this” anymore. Be encouraged – this actually means you’ve made it to stage two! Your birth partner can be a huge encouragement at this point by recognising this signal and encouraging you that you’ve made it. Your medical team will also be used to this stage and know it is almost time for the baby to make an appearance. 

Physically, there is a massive rush of adrenaline here too; for our early ancestors, it would have been their last chance to find safety quickly before the baby comes. Then, the contraction feelings change and you start to feel the urge to push down.

Stage two: the down stage

Once you’ve reached 10cm dilated, the sensation will feel very different and you will start to feel the urge to push. You’re now in stage two of birth, the down stage. 

This is when all of the muscles you had at the bottom of the uterus are now at the top and act as a piston to push the baby down. It is during this stage that your baby is born. This stage can take minutes or hours. 

This is the most intense stage of birth.

Stage three: birthing the placenta

After you give birth to your baby, your placenta should still be inside of you and attached by the umbilical cord. It can take up to 45 minutes to birth your placenta but it normally happens within 15 minutes. 

You will feel the urge to push again, and your placenta will come out. Your placenta can be birthed naturally or you can have medical assistance. If you do not want medical assistance to birth your placenta, this should be on your birth plan so your care provider knows. If your placenta is still inside after 45 minutes, you will be advised to have it medically removed. This is because if any part of your placenta stays inside you for too long after the baby is born you can suffer from toxic shock.

During The Positive Birth Group courses, you will learn a lot about the physiology of birth so you know what to expect. 

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