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 active phase
Your cervix is also dilated 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.
Epidurals are usually placed during the first stage of labor when you are having regular contractions. Epidurals are usually placed while you are in a sitting position, or you may be lying on your side.
Although it is the shortest phase, the transition phase is the most challenging. Transition typically lasts 30 minutes to 2 hours as your cervix fully dilates from 8 cm to 10 cm.
If you are bleeding heavily or are suffering from shock, you will not be given an epidural for safety reasons. 2 Since many women tend to have lower blood pressure with an epidural, this may be made even more dangerous with the lowered blood pressure of some of these problems.
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.
An epidural can generally be performed at any stage; it is never too late. This is, however, not the case if baby's head is crowning (within the birth canal).
Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated. In a 1st pregnancy, the time from the start of established labour to being fully dilated is usually 8 to 18 hours. It's often quicker (around 5 to 12 hours), in a 2nd or 3rd pregnancy.
During the active stage of labor, your cervix dilates from around 6 cm to the full 10 cm. (The last part of active labor, when the cervix dilates fully from 8 to 10 cm, is called transition.) This process takes about 5 to 7 hours if you're a first-time mom, or between 2 and 4 hours if you've had a baby before.
The widest stretch of the two fingers is about 7 to 8 cm. At 10 cm (full dilation), the cervix should not be present in front of the presenting fetal part (typically the head).
Typically, you can receive an epidural as early as when you are 4 to 5 centimeters dilated and in active labor. Normally, it takes about 15 minutes to place the epidural catheter and for the pain to start subsiding and another 20 minutes to go into full effect.
You can have it when you want it — at the beginning of labor, in the middle, or toward the end. The anesthesiologist will want to be sure that you are actually in labor and that you can stay still for the few minutes they need to precisely place the epidural catheter.
The potential for a quicker labor, delivery and recovery – For some people, a natural birth may go more quickly. While it depends on several different factors, like how relaxed you may be, in some cases medications can interfere with contractions and prolong labor.
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.
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.
Early dilation often feels like menstrual cramps as the cervical changes cause pain and cramping noticed in the lower part of the uterus. It is the same sensation and location as menstrual cramps. Active labor tends to be felt in a larger area but can be a similar sensation as cramping (with more intensity of course).
The urge to push is initiated by the position of the baby's head within the pelvis (Roberts et al 1987). Therefore, the cervix can be fully dilated without the baby descending deep enough to initiate an urge to push. Alternatively, spontaneous pushing can begin before the cervix is fully dilated.
Does an epidural slow down labor? There's no evidence that an epidural will slow down labor, but getting one may extend the length of the second stage of labor by an hour or more with your first baby and less with subsequent children, according to some research.
A fully dilated cervix is 10 centimeters open.
This is about the size of a bagel, and means that when your cervix is measured with two fingers, they can be stretched 10 centimeters across.
It is possible! I have been with many women in labour through the night and helped them fall asleep. They have continued on to have positive, healthy births and feel super proud of their efforts, albeit ready for a good sleep afterwards!
Active labor
This is when you head to the hospital! Active labor usually lasts about 4 to 8 hours. It starts when your contractions are regular and your cervix has dilated to 6 centimeters.
If the injection goes too deep, it might make a hole in the protective layers (dura) around the spinal cord, and spinal fluid might leak out. If too much fluid is lost, it can cause severe headaches that may last up to a few days. This happens in about 1 out of 100 women who have an epidural.
Complications from epidurals are extremely rare, and pushing with an epidural is generally not a problem because you will still be able to feel pressure (rectal pressure, that is!) despite not feeling any pain or contractions.