Now that we have gone over what to do in early labor, you may be wondering what’s next. “How will I know once I’m in active labor, and what do I do once I’m there?” are great questions many women have. I’m breaking it down to know what to expect and what options are available to you. This will help you make the best choices for yourself and your baby.
So What Is Active Labor?
Active labor is when your cervix has dilated to 6 centimeters, and your contractions are lasting for 45 to 60 seconds long, 3 to 5 minutes apart, and this is a consistent pattern for at least an hour. When you enter active labor, you will notice a difference because your contractions will get stronger. They will require more of your focus and attention. When you’re in active labor, there will be no denying you’re in labor!
When your contractions are at 5-1-1, you are entering into active labor and are no longer in early labor. 5-1-1 means that your contractions are at least five minutes apart, each contraction is one minute long, and this has been consistent for at least one hour straight.
5-1-1 is usually when doctors will tell you to go to the hospital. However, from my experience (after going to hundreds of births), it’s a much better idea to stay at home until things have really picked up. Why? Because staying at home until you have reached at least 4-1-1 or, even better, 3-1-1 reduces your chances of having more interventions, including a C-section. At home, you can also eat and drink whatever you please. You also aren’t limited to one room or have to be monitored the whole time, etc. So when you talk to your doctor or your midwife, they want you to be at least 5-1-1 before you come in. If you are not quite at that point, they will send you home because you are still in early labor.
What Does Active Labor Feel Like?
In early labor, things shouldn’t be that intense. You can walk and talk through your contractions as you feel cramp-like sensations slowly building. Active labor is when you recognize a pattern with your contractions. They aren’t going away, and they are becoming more intense as time passes. They usually begin with a dull, low pain that builds and gets stronger. It’s like a wave; it rises and gets more difficult until it reaches its peak and then falls and fades away.
Many women say that they feel contractions starting in their lower abdomen in active labor. This can feel like menstrual cramps or gas pain. Then the contraction builds and wraps around their belly to their lower back. Some women feel the start of their contractions in their lower back and ache in their pelvis and legs.
Everyone is different, but some of this can be attributed to your baby’s position. If you feel all of your contractions in your lower back (“back labor“), it more than likely means your baby is facing OP (occiput posterior). OP is when the back of your baby’s head (the occiput) is pressing firmly against your pelvis/sacrum. Ouch! When bone and bone are hitting each other, it can cause major pain, and that’s what back labor is. This is why positioning and changing your positions are so important during labor. You can help your baby be in the OA position (occiput anterior) for easier labor and delivery.
How Long Does Active Labor Last?
If I could tell women how long their labors would last, I would be a billionaire! Unfortunately, there isn’t a magic number since every woman labors differently, but I can tell you this: on average active labor lasts 4 to 8 hours. Remember, this is not including early labor, transition labor, or pushing. But we have seen cases where women in active labor go as fast as 30 minutes while others go up to 10 hours or more.
Physicians’ expectation for progress during active labor is typically 1 cm dilation per hour). Some women can achieve this goal, and others need more time. If you have gotten to the hospital too soon and are not dilating at least half that rate, your doctor may prescribe Pitocin.
If this is your second, third, or fourth child, your active labor phase will likely be much faster than your first labor. Subsequent labors and births can be half the time, and active labors for second and third babies, on average, last between 1 to 4 hours long. However, if you’re going to be induced and take Pitocin, this phase may go even faster. But if you’ve decided to get an epidural, things can be much slower. Having them both causes each woman to react differently, so it could be fast, slow, or cause your labor to refuse to progress.
Now that you know what to expect from active labor, here are some tips to help you get through it to the next phase!
6 Tips on What to Do During Active Labor
1. Change Positions & Move
Things have now picked up, so it’s time to get moving! Now that you are in active labor, your contractions are more effective. The more you move, the faster things go. Changing positions in active labor at least every hour, preferably 30 minutes, is ideal for helping baby descend, putting more pressure on your cervix to help it open/dilate. Go for a walk, climb the stairs, and sway your hips from side to side to help open your pelvis. Or, even better, do some squats or side lunges to get baby lower. There are tons of positions that you can do. Just don’t over-tire yourself since you still have the transition phase and pushing stage coming up.
If you’re not sure what positions to do, here is an excellent graphic that includes several options:
Once you have gotten to the hospital or birthing center (hopefully at 4-1-1 or 3-1-1), you want to continue changing positions since they help ease labor pain and speed up the process. Even though you’ll need to be monitored, you should still be able to move to help your labor progress.
You can choose to get an epidural or other pain medication during active labor. If you decide to get an epidural or other pain medication, it is still important for you to move. You will be unable to get out of bed, but changing positions every half hour or so from your left side to your right side to sitting up in bed is necessary. It is important to continue helping baby rotate and move down into your pelvis. Movement is the best way to achieve this. Laying in one position for too long can cause things to stall and “fail to progress.”
2. Stay Nourished & Hydrated
As I noted in what to do in early labor, staying nourished and hydrated in active labor is just as important. You need that fuel to keep going. If you are still at home, you will have access to all of your snacks (have these snacks ready for your labor and delivery) and beverages that keep you feeling good and strong (see labor-aide recipe). You can continue to eat and drink at the birthing center since it’s been proven that women should continue to eat and drink during labor. But in the hospital, more than likely, you will be restricted and only allowed to eat ice chips. If you’re lucky, they will get you a sugar-free popsicle. Again, another reason to stay home as long as possible is so you can continue to have fuel for energy.
3. Use Comfort Techniques
Whether you want to have a natural birth or a medicated birth, it’s good to know some comfort measures for labor. Why? Sometimes epidurals fade, and sometimes they don’t work (I’ve had a few clients whose epidurals didn’t take). And other pain medications only dull the contractions and don’t take the pain away. Learning some pain management techniques to help you get through labor can make it much easier for you and speed up the process. And active labor is when things get intense, so this is a great time to use the relaxation techniques you learned in your childbirth education class(es).
Here are some comfort techniques that can help you through active labor and also through transition:
- Breathing: Take big deep breaths (with your diaphragm), or you can do accelerated chest breathing (hee-hee, hee-hee blow)
- Positions: Walking, sitting on a birth ball, climbing stairs, “slow dancing” with your partner while they rub your back, hands-and-knees, knees-to-chest, sitting up, leaning over, rock in a rocking chair, lunging, squatting, supported squat
- Touch: Massage, counter pressure (double hip squeeze or pressing your sacrum), acupressure points
- Hydrotherapy: Getting in the shower or a bath is fantastic. Again, generally, you shouldn’t stay in the tub for more than 1 ½ hours at a time since it can slow labor. It’s best to get in the tub when you are in transition. But if you have been laboring for a while and need a break and want to submerge your belly underwater, you can have your support person or doula pour water over your belly during contractions.
- Visualization: Imagine being at the beach or in your favorite place. Also, you could visualize each contraction like a wave rising and falling or imagine your cervix opening and blooming like a flower. Our minds are powerful, so visualization can help.
- Vocalization: Making noise can help and make you feel better too. Moaning, saying chants or mantras, or singing songs are helpful. If you find yourself making high-pitched cries, try to bring the tone down to deep belly sounds. This helps you breathe from your abdomen, staying more centered and less anxious.
- Heat & Cold: A heating pad or cold pack on your lower back or belly is relieving and can help with the discomfort. A cold washcloth on your forehead is also very refreshing.
- Sensory Distraction: You can play music to create a fun or relaxing environment (see our birth playlist here), light candles (or have electric candles if you are in the hospital), or look at a focal point to distract yourself and stay focused. Counting can also help and be a good ritual to get through each contraction, aromatherapy to ease the pain/ increase contractions and help with nausea, etc.
- Hypnotherapy: If you take a childbirth hypnosis course (like Hypnobabies or Hypnobirthing), you can use those tools during your labor to really relax.
4. Go to the Bathroom
Going to the bathroom at least once an hour is a good idea because it makes sure that your bladder is not blocking baby’s descent. A full bladder can hold baby’s head up, which then causes you not to dilate as fast since your baby’s head is not putting the pressure on your cervix that it needs to dilate. So you want to continue drinking your fluids and using the restroom every hour to keep baby low.
5. Get Ready to Go
Remember, don’t rush to head to the hospital or birth center. Active labor can still take hours, so it’s better to complete most of it at home to reduce your chances of needing unnecessary interventions. At the same time, don’t take too long because I don’t want you to have your baby in the car. Listen to your body and get ready to go when your body says it’s time. (4-1-1 or 3-1-1 — for more information on when to go to the hospital in labor, READ HERE.)
6. Have Good Continuous Support
Labor is tough. That’s why they call it labor. Having positive, continuous support is vital during active labor. Women need it to be able to continue. Ensure that you have people around you during active labor that will support your choices, help you have a positive experience, and help you get through to the next phase. Positivity and loving words can encourage you to keep going so your support person can say, “You’re doing a great job. I’m so proud of you. You’re relaxing your body so well.”
If the people you plan on having with you during labor aren’t sure of the best ways to support you or know what options are available to you throughout labor, you may want to consider hiring a doula. You and your support person do not have to go through this alone.
What was active labor like for you? Did you use any of these tips to help you through it? We want to know!