First Stage of Active Labor

Childbirth Class

Obie Editorial Team

What to expect during the first stage of labor

When the first stage of labor begins, the cervix responds to hormonal changes and contractions start to take on a more patterned interval. Cervical dilation and bloody show will be present as well. Contractions that occur in the first stage of labor are different from Braxton Hicks contractions which are felt often in the latter stage of pregnancy. Braxton Hicks contractions do not come at regular intervals or progress the cervix toward dilation and effacement. If contractions seem to be more pronounced than usual before the 37th week of pregnancy, you should immediately call your attending physician.

Contractions

Contractions may start at intervals of 10 minutes or more. Gradually, the intensity of the contractions will increase and pain and pressure will last longer. At the same time, contractions may slowly move closer together. By the end of the first stage of active labor, contractions may come every five minutes and last up to one minute each.

Bloody show

Women may notice bloody show during the first stage of active labor. Bloody show is a mixture of vaginal mucus and a small amount of blood. Bloody show does not look the same as blood during a menstrual cycle. If you have bright red blood you should seek medical attention.

Cervical dilation

The first stage of labor ends when the cervix is dilated 4 centimeters as measured via pelvic exam. Centimeters dilated are determined by how many fingers the doctor or nurse can fit into the cervical opening.

Women can feel safe staying at home during a normal first stage of active labor. Faster progression begins in the second stage, which is commonly the stage most women will head off to the hospital. The first stage of active labor can last up to 24 hours or more.