Labor for most women is painful and exhausting. Sometimes it’s easy to forget that this is what your pregnancy has been leading up to and that you are going to meet your baby for the first time.

Labor is different for older women. Some of these differences are positive and wonderful. After the age of 35 you arc more likely to be better educated about what will happen during labor and more likely to have an extensive support network. Knowledge and support are power not only helping you participate more fully in health care decisions during labor, but ensuring that you have support for the decisions that your make. On the other hand, you may be more likely to enter labor with a medical complication where interventions such as electronic fetal monitoring are more likely, and you are at increased risk of having a cesarean delivery.

Coping With Labor

As a woman over 35 you may be well informed about the various options for coping with the pain of labor. For first time moms, it’s hard to imagine what labor will be like, and there’s a chance that you are more likely to get exhausted than when you were younger. Being informed of all the options for coping with the pain before you go in to labor from simple breathing techniques to epidural’s is really important. Information gathering is an important part of your preparations for labor, and you can incorporate your wishes in to a carefully considered birth plan.

Medical Intervention

First time mothers over the age of 35 are significantly more likely to have medical interventions during labor. These may range from electronic fetal monitoring to medications for speeding up of labor to cesarean delivery. The reasons for a higher cesarean rate in over 35s may be in part because more women are likely to have complications, such as previous surgery for fibroids or placenta previa (where the placenta blocks the cervical opening) that result in the need to avoid labor.

Being informed about possible interventions before labor and thinking about decisions you may have to make ahead of time will make you feel more in control.

The early stage of labor is followed by three distinct stages. Some evidence indicates that in older women who haven’t had a baby before, the first stage of active labor can take longer than that of a younger first time mother. But on the whole, the principles of labor remain the same irrespective of age.

Early Labor

During early labor, which can be short or last for several days, your body readies it self for the main event. You may notice an increase in braxton hicks, or practice, contractions. The muscle cells in your uterus are getting ready to act together to create strong, organized contractions. At the same time, your cervix is remodeling it self from a firm, inflexible protective gate to become softer and more stretchy. You may notice the loss of your mucous plug as the cervix thins out and opens slightly.

When To Go To The Hospital

If your pregnancy is low risk, you are almost certain to be more comfortable at home in early labor. However, yon should call your care provider and go to the hospital immediately if.

• you have regular contractions every, 2-4 minutes that are so strong you cannot talk during them.
• you have vaginal bleeding that is more than just a little pink on the toilet paper.
• you have a gush of fluid from your vagina.
• your baby is not moving.

If your pregnancy is high risk, your baby is not head down, you have had a prior cesarean delivery, or if your baby is growth restricted, you should go to the hospital if you have regular contractions, even if they are not painful.

Getting To The Hospital

Do not drive your self to the hospital if you can possibly avoid it. When you get to the hospital, you will get checked in and the nursing staff will either put you directly in to a labor room if you look like you are in active labor, or in to an assessment bed if they are not sure. A labor nurse will take your vital signs and check your cervix, often a blood specimen will be drawn for routine tests.

If your provider decides that you are staying, you will usually have an intravenous (IV) line inserted. If you are still in early labor, you may be sent home. This does not mean that you were silly to come to the hospital it is important for your care providers to know where you are in the labor process and to make sure your baby is doing well.

Active Labor

Every woman is different and enters active labor at a different point. Traditionally, care providers call labor active when a woman’s cervix is around 4cm dilated. Most women are in considerable pain by the time they enter active labor and are having regular strong contractions every 2-3 minutes. During active labor, your cervix should open at a minimum of 1 cm per hour. If your cervix does not change as much as expected, there are two possible explanations.

• Your contractions are not strong enough.
• Your baby is not coming down the labor canal to place pressure on your cervix and affect change.

Later in active labor, you may feel the urge to push or bear down as the baby’s head starts to descend.

Pushing And Delivery

Your care provider will ask you not to push until your cervix is fully dilated (1ocm) and out of the way. Pushing against a cervix that is not yet fully open can cause tears and bleeding. When your cervix is fully dilated, you can begin to push. Usually your midwife, doula, and your labor nurse will teach you how to do this. In many cases you can feel an urge even with epidural analgesia, if your dose is lightened. There are many different ways to push, including on your back, squatting, on your side, and on your hands and knees. Pushing is hard work, and with a first baby it can take up to 2 hours with out and up to 3 hours with epidural analgesia. Lots of emotional support and cheerleading are key.

Delivering The Placenta

The last stage of labor involves delivering your placenta. The placenta is soft and squishy and easy to deliver compared to a baby. In most cases, the placenta will start to separate from your uterus and be delivered with in 30 minutes of your baby being born. Finally, your care provider will need to repair any tears that happened during the delivery. He or she will also make sure that any bleeding has stopped.

Stages Of Labor

The active stage of labor can be divided in to three distinct stages.

First stage

This is the time when the neck of the uterus or cervix, opens up to let the baby through. It is the longest part of labour particularly in a first pregnancy.

Second stage

The cervix is now fully opened and the baby is moving down the birth canal toward the vagina and the outside world beyond. During the second stage you are pushing your baby out. On average, your second stage is longer during a first delivery than in subsequent ones.

Third stage

The baby is now born, but you still need to deliver the placenta. Your care provider will help by massaging your uterus and placing gentle traction on the umbilical cord. Usually the placenta takes 5-10 minutes to deliver, but the process can take up to 30 minutes.