A few days ago we saw that the first phase of labor is early or latent dilation, which gives way to the active dilation phase. Here the cervix will pass 3 to 10 centimeters dilatation to open the birth canal and allow the baby to leave.
In this phase, the contractions are already rhythmic, strong and more followed, although in each woman their intensity and rhythm will vary, resulting in dilatations of very different duration. One centimeter per hour can be dilated, but it can also be advanced more quickly, especially if it has already been delivered before.
It will expand until it reaches approximately 10 centimeters, which will be when the baby can already poke the head and leave in the next phase, the expulsive. At this time it is convenient to implement all the pain relief techniques, such as breathing and other non-pharmacological techniques, or deciding if we want epidural.
It is also important the mental attitude and relaxation, since I could help overcome an agonizing dilation and make it more bearable. Our birth attendants have a fundamental role in this regard, including hospital staff who accompany us if necessary.
The pain that accompanies this phase is because the efforts of the uterus are very concentrated and when the uterus contracts strongly it tends to expel all the blood that is in its muscle fibers, which are squeezed. The absence of blood produces a lack of oxygen in the muscle and that is what determines the pain.
When the contraction ends the muscle expands, relaxes and returns to receive the blood supply, oxygenating again, being when the pain ceases momentarily.
In this period of erasure and dilation, two stages can be distinguished: accelerated dilation up to 5-6 centimeters and advanced dilation up to 10 centimeters. Let's look at each of these stages.
- Dilation up to 5-6 cms.
We are in a period of acceleration is in which the contractions begin to become more painful. We go from the initial centimeters achieved in the latent dilation phase to true labor. During the contractions the pain is considerable, and the mother may not be able to speak while suffering or need to squeeze something with her hands. It helps many women to focus on breathing work. Each mother will cope with these moments differently, and the perception of pain will also not be the same or located in the same places (it can be more intense in the abdomen, in the kidneys, spread through the legs ...).
Between contraction and contraction, the pain usually disappears and the mother can take the opportunity to continue with her pain relief and relaxing techniques, because it is convenient to take strength for the next stage in which we will not have rest.
It is at these times when the epidural is usually administered in the event that the mother wishes, since after 5 centimeters the process will go much faster.
- Dilation of 5-6 to 10 cms.
It is also called advanced active dilation or transition dilation, since it takes us to the next phase, the expulsion. This is the stage of maximum speed, when it expands in a short time at high speed and increases the sensation of pain due to the increase in the intensity of contractions. It is probable that the mother already finds few moments of absence of pain, since the contractions practically arise chained to each other, although you always have to try to keep calm
At this time the hospital staff usually considers that the administration of the epidural is no longer convenient. Let us think that it is usual for the last 3 centimeters of dilatation to occur in 15 or 20 minutes. And the baby is about to be born.
The mother usually feels great pressure on the lower back and / or on the perineum, which causes some intense desire to push, and although it is not yet time to do so, you will only have to wait a little longer. If we push when the cervix is not yet fully dilated we could cause it to swell, which could lengthen the delivery.
Instead of thinking about what we have left, we can look back and see everything we have already gone through, the great road we have already traveled. Take out strengths of weakness and keep the mood. In a few minutes we will see our baby for the first time.
