DuBOIS — Whether you are just starting to think about getting pregnant or you are already expecting, there are many questions, worries and uncertainties that come along with the joy and excitement of welcoming your new baby, especially about the process of labor and birth.

“Every birth is different,” said Dr. Kristina F. Brown, a board-certified physician who practices obstetrics and gynecology with Penn Highlands Life’s Journey OB/GYN in DuBois. “But many pregnancies follow a similar pattern, and by learning about the stages of labor and what happens during each one, you can know what to expect once labor begins.”

Labor, which is when your baby leaves the uterus, is divided into three stages: contraction and labor, pushing and birth and delivery of the placenta.

Below is a general guide to the birthing process.

Stage 1 — Contraction and labor

The first stage of labor has two phases, early labor and active labor. Early labor can last between six and 12 hours. Signs of early labor may include:

• Contractions that are 5 to 15 minutes apart and last for about a minute each
• Your vaginal discharge might be clear, light pink or bloody. If you experience heavy bleeding, you should go to the hospital
• Your cervix dilates to about four to six centimeters

Active labor occurs when contractions become strong and are about three minutes apart, and it can last between four and eight hours. Most healthcare providers recommend going to the hospital shortly before active labor begins, generally when contractions are five minutes apart for one hour or more.

Signs of active labor may include:

• Contractions become strong and about three minutes apart
• Baby begins moving into the birth canal
• Feeling the urge to push
• Experiencing pain, cramping or pressure in your lower back or legs
• Water may break during active labor

Stage 2: Pushing and birth

When your cervix is about 10 centimeters dilated, the second stage begins. In this stage, you start trying to push your baby out. It can last from half an hour to several hours. Generally, your contractions will slow down to every two to five minutes and last about 60 to 90 seconds. As you push, your baby will crown, which is when their head begins to show. Your healthcare provider will guide your baby out of the birth canal and cut the umbilical cord.

During labor or delivery, your healthcare provider might decide that you need to have a C-section. This can be due to a sudden change in your health or your baby’s health and it becomes too risky for you to have a vaginal birth. If your baby is breech, which occurs when they are not positioned to come out of the vagina headfirst, your provider will generally recommend a C-section. In some situations, a planned vaginal birth of a single breech fetus may be considered.

Stage 3: Delivery of the placenta

In the third stage of labor, you will deliver the placenta. This typically happens about 30 minutes after birth, but it can take as long as an hour.The placenta is a unique organ of pregnancy that nourishes your baby, and delivery of the entire placenta is important for your health as retained placenta can cause bleeding and other unwanted side effects. You will continue to have mild contractions that are close together as the placenta moves into the birth canal. You will push gently one more time to deliver the placenta, and your healthcare provider may give you medication before or after the placenta is delivered to encourage uterine contractions and minimize bleeding.

Your healthcare provider will then examine the placenta to make sure it is intact and, if needed, remove any remaining fragments from the uterus to prevent bleeding and infection.

How long will you stay in the hospital?

“Most women who deliver vaginally stay in the hospital for 24 to 48 hours,” Brown said. “Those who have a cesarean section typically go home in 48 to 96 hours.”

Some women may develop a health issue that requires a longer stay. Your healthcare team will create a plan that is right for you.

Penn Highlands Healthcare’s Maternal and Child Center at PennHighlands DuBois was created to serve the many communities within the region as one team to provide quality care for expectant and new mothers and their babies. For more information,visit phhealthcare.org/baby.