As cervical dilation increased, there were significant increases in self-reported pain and observed pain on all the cited measures. Pain was characterized as 'discomforting' during early dilation and as 'distressing, horrible, excruciating' as dilation progressed.
Stage 1: Early and Active Labor
Phase 1 is called early labor or the latent phase. The cervix is dilated from 0 to 3 cm. Mild to moderate contractions may be coming every 5 to 20 minutes. It can cause a backache, feeling of fullness, or menstrual-like pain.
Dilation and labor
You may have no signs or symptoms that your cervix has started to dilate or efface. Sometimes, the only way you'll know is if your doctor examines your cervix at a routine appointment late in your pregnancy, or if you have an ultrasound.
Discharging a brown or pink-tinged mucus is an early sign of cervix dilation. Effacement of the cervix causes small blood vessels to break. This causes the mucus to appear as pink or brown. It's important to seek medical advice about vaginal bleeding.
Try to insert the tips of your fingers into your cervix. If one fingertip fits through your cervix, you're considered one centimeter dilated. If two fit, you're two centimeters dilated. If there's additional space in the opening, try to estimate how many fingertips would fit to determine dilation.
The cervix can be dilated to 1 centimeter for weeks before the beginning of labor. This extent of dilation only signals that the cervix is starting to prepare for labor. Most pregnant women spend some time wondering when they will go into labor, especially as the due date draws near.
In the first stage of labor, the cervix will dilate to 10 centimeters (cm) in width. Dilation is typically gradual, but the cervix can widen rapidly over 1 or 2 days.
Some women who are 2 cm dilated may go into labor within hours. Others will remain 2 cm dilated for a few days or weeks until labor progresses.
It may be hard to talk or move easily. At this point, your cervix will be dilated 3 to 10 centimeters. (Dilating one centimeter an hour is textbook, but like in early labor, it's different for everyone.) If you're opting for an epidural, the time is…now!
Try being upright
One of your biggest allies is gravity. When you are upright—standing, sitting or kneeling—the weight of your baby presses on the cervix, encouraging it to open. An upright position may also help get your baby into the best position for birth.
The opening itself may feel smooth or have a more jagged-edged feel. If you feel around with your fingertips, the external portion of the cervix, called the ectocervix, bulges out into the top of the vagina. The "dimple" at the center is known as the external os.
During early labor, your cervix will dilate up to 4-6 centimeters. You will experience mild, irregular contractions that feel similar to period cramps.
If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn't broken on its own when you arrive at the hospital, and you're five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.
Labor contractions usually cause discomfort or a dull ache in your back and lower abdomen, along with pressure in the pelvis. Contractions move in a wave-like motion from the top of the uterus to the bottom. Some women describe contractions as strong menstrual cramps.
If you're more than 4 cm dilated: You'll be admitted to the hospital to continue your labor and delivery.
The transition phase
In this phase, your cervix will finish effacing and dilate to the full 10 centimeters. This phase may take anywhere from 10 minutes to two hours.
Insert your index and middle finger and push your fingers deep inside as far as you can to reach your cervix. Be as gentle as possible to prevent bruising or complications. Assess dilation. You're considered 1 centimeter dilated if one fingertip fits through your cervix, or 2 centimeters if you can fit two fingers.
While being told you're dilated toward the end of your pregnancy is exciting, keep in mind that it doesn't necessarily mean labor is imminent. You can walk around for weeks with your cervix at 1 cm, or go from zero to 10 cm over the course of one day.
According to Brichter, sitting on an exercise or birthing ball in neutral wide-legged positions prepares the body for labor by increasing blood flow, opening the pelvis, and encouraging cervical dilation. You can also try birth ball exercises such as circular hip rotations, rocking, and gentle bouncing.
Before labor, the cervix is typically 3.5 to 4 centimeters long. As labor begins, the cervix starts to soften, shorten and thin (efface). You might feel mild, irregular contractions or nothing at all. Effacement is often expressed in percentages.
Amniotic fluid can trickle into your underwear like a raindrop or rush down your legs like a waterfall. As contractions progress and as the fetus moves, more fluid can leak. It doesn't hurt when your water breaks, so you shouldn't feel any pain.
Women can get their water to break with the help of a doctor, but it is not safe for them to attempt to break their water at home. However, there are many natural methods that women can use to encourage labor to begin once the pregnancy has reached full term.
Typically, after your water breaks at term, labor soon follows — if it hasn't already begun. Sometimes, however, labor doesn't start. If you experience prelabor rupture of membranes, your doctor might stimulate uterine contractions before labor begins on its own (labor induction).
If you are less than 4 cm dilated and your labor isn't active enough for hospital admission, you might be sent home. Don't be discouraged. It is very common to mistake the signs of early labor for active labor.