The Five Stages of Dilation


Natural Childbirth

Stage 1: DENIAL. Mild discomfort starts to poke you where the sun don’t shine, as if you were having your period. Things are a little sore and tender, but it’s nothing to worry about. You get optimistic and hopeful, and even think your delivery will be pretty, even glorious. You know, like what childbirth might look like if the tampon commercial people were to film it. You consider the thought that it might not even hurt at all. Perhaps that mild discomfort is just your positioning. I’ll just adjust my legs over there. Or run through a meadow, Julie Andrews-style. Yeah, that’s the ticket!

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Stage 2: ANGER. “WHATTTAAAF…” You’re lucky if you even finish the sentence. Contractions spike into a whole new motherfucker of intensity level. You aren’t – can’t be — prepared for this. Like when you eat so much, and so many different types of food, that it’s all going rotten in your intestines. You want to scratch the wall, your breath is shallow and you can’t wait to shit it all out, because a pain a hundred times worse than food poisoning creeps out and around you. It’s a migraine in your gut, all-powerful, all-consuming. One pain to rule them all. Frickin’ ouch, mother fucker.

To aggravate matters, after hours of begging, pleading, swearing and sweating, you’re told you’re only dilated about one centimeter. Nine more to go, sweet cheeks, but hold in there. You’ve never felt more desire to punch someone more than in this moment. Wait, did I say punch? I meant to say rip the beating heart out of the chest of an unsuspecting, innocent human being. You croak out, “Honey, could you come here a minute?”

Stage 3: BARGAINING. You start questioning the integrity of the measurements. They’re subjective, even lazy. They’ve gotta be. C’mon! How can two fingers put together know that you are barely one centimeter dilated? You demand a re-count. Those fingers are huge! They’ve gotta be five or six centimeter, at least. Get a damned protractor up there. A tape measure, something. The ripening pain in your abdomen makes you think that a fallopian tube just exploded. “I know I said I didn’t want drugs until the last possible minute. But yeah, I want ‘em. Gimme.”

Hopefully you are in better luck, unlike me. My midwife, she said I should wait until at least four centimeters. “WHAT DO YOU MEAN I CAN’T HAVE DRUGS YET?”

Demand a recount.

Stage 4: DEPRESSION. You’re not progressing as your delusional self thought it would happen. The pain keeps increasing, as if someone is reaching inside your abdomen through your vagina, trying to detach your uterus with rusty, jailhouse-sharpened spoons. Repeatedly. Every four minutes.

By now, you feel there’s nothing you can do, other than… wait. Squeezing your eyes might help. Those massages, that breathing pattern, those pressure points, are your onlyhelp.




Stage 5: ACCEPTANCE. You realize you’ve managed to make it for close to 12 hours under all that shitting-fallopian-explosion-uterus-extraction pain. You don’t know if your body has given up or gone numb.

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You know help will come, you will only need to stay focused until that happens. Because it HAS to happen. It HAS to.

Months from now, you’ll hear stories about yourself. Stories that you have a starring role in. Stories that are vaguely familiar, but you don’t. Remember. Doing that.

Like when you release your husband’s ears and order him, on pain of death, to fetch the epidural guy…

Related post: Pooping During Childbirth: You’ll Survive It


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  1. 1

    Ariana says

    OMG its all true, I laughed. And I laughed at the memory #3 conjured. I was in labor 3 days with my twins, and if I recall correctly, they measured my dilation about 1/hr. I had this one nurse with really short, really really really fat fingers. Every time she walked in I wanted to cross my legs and bar her from my bedside. Never so glad then when she would go off duty!

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  2. 2

    Jamie Knupp says

    Oh man this is scary accurate. Only, with my second baby i waited too long to get to the hospital and they wouldn’t let me have an epidural. I could write part two of this one – the stages are the same – Denial that you’re really about to push something (HOW BIG???!?!) out of your hoo-ha, Anger at your significant other/ doctor/ mother/ the world, Bargaining with your doctor to just cut you and make it easier, Depression when you realize you can’t push anymore and you’re going to be pregnant FOREVER and then Acceptance when the head finally comes out

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  3. 3

    Deena Blumenfeld E-RYT, RPYT, LCCE says

    This may have been *your* labor, but it’s not that way for many women… myself included. As a Lamaze Certified Childbirth Educator, I take issue with this post. This creates fear. We don’t need to gloss over reality – labor hurts! But at the same time, we don’t need to tell women it’s impossible to do it without an epidural. If you need an epidural, you should get one. But, wow… this post is a potentially damaging shock to the system of a pregnant mom. I see the humor in it, I do. But I also am a childbirth professional. Humor is often a way to cover pain or fear. This post mentions nothing of the joy, the expectation the preparation and the great support of a partner or doula. If you are open to it, I’d love to write a rebuttal for you… the stages of dilation from the positive perspective.

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    • 4

      september says

      Thank you, excellent reply. I just gave birth last week. 21 hours of labor. 1 hour of pushing. No meds. Nothing. I was prepared. I had taking Bradley classes and had options for laboring. It was not like this post at all. Was it hard? Yes. Painful? Yes. But doable. I didn’t fight the contractions. I’m glad I felt my daughter being born as I pushed. It was wonderful and I would absolutely have an unmediated birth the next time too.

      I too see the humorous side of this, but agree that stuff like this just perpetuates the notion that its hell to give birth and we must immediately ask for drugs. I think most women could labor longer than they think without drugs if they were prepared and not scared.

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        • 6

          Kristine P says

          Not me. I gave birth 4 times without an epidural. I was young and naive. Nobody ever offered one and I didn’t ask. I was taught to be afraid of the drug – that it could harm the baby. The pain I went through was enough to make me delirious and I have very little memory of any of the births. In fact, after my first, very long labor with the baby positioned backwards, both the baby and I went into shock. I was extremely unskilled in my ability to relax and breathe. And that followed through for the next 3 births, although they were all a bit easier than the first. However, I think an epidural would have helped someone like me and I wish I was more educated about my options. (I gave birth before the internet. I went to library constantly to try to learn everything I could.)

          P.S. I think you could have “taken offense” to this article in a more positive manner. This is a humorous account of somebody’s true experience. We all have the right to vent and say things as we feel they should be said. :)

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    • 7

      Elisha says

      I was 16 years old when I had my first daughter and I didnt have any kind of pain meds nothing and I went in on a saturday and on saturday night I started labor and I had my daughter on monday at 3:27 pm! I did it! I have 3 kids and never had a drop of anything while I was in labor, Now afterwards I did, but not during!

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    • 8

      Heather says

      I felt the same way reading this. Yes, it’s funny but that wasn’t really my experience either. I labored at home as long as I could manage (home alone with my 7 year old). Then I called my husband and best friend and said it was time to go. I was having a VBAC and didn’t want anyone giving me pitocin or getting an epidural too soon as it might slow things down and land me in the ER again. I got an epidural at the last possible moment, rested for a couple hours after that and then pushed for about 45 mintues. If I had the chance to do it all again, I wouldn’t get the epidural. So, this is not quite how it is for everyone and would put fear in the first timer. But, yes, it is comical.

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    • 9

      Sooveritall says

      Everyone’s experience with each Labor is different. Nadia is just telling everyoen how it was for her, on her blog. While mine were nothing like this, for many it is. Telling everyone “they can do it”, “it doesn’t hurt that bad” or “you don’t need drugs”, is just as harmful as telling them it’s always horrible, painful, etc. I know more mom’s who feel like failures because they needed the epidural, because they went to a doctor/ hospital instead of a mid wife, etc. I know very few who feel like failures because they did it naturally. It’s not us against them, we should just support all moms no matter what.

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      • 11

        halcyon says

        Amen, this happened to me. I ended up feeling like a total failure which caused bad postpartym depression. I kept wondering why my body had failed me when I had done so much prep work and really believed all the natural birth hype. I used to be really judgy of other moms who were planning for pain meds until my birth experience. I wanted a natural birth so bad that when i finally broke down after 15 hours of natural labor i kept crying and appologizing to everyone in the room becuase i felt like i had let everyone down. I had a birth plan that said my doula, my midwife, and my husband were not allowed to let me have pain meds just becuase i asked for them unless they all agreed I needed them, as an added precaution. On the plus side my awful experience was humbling and made me less snobby about natural birth. It also helped me decide to become a postpartum care nurse and a lactation consultant. I never want another woman to have to feel like I did. I don’t think posts like these are scary. Sometimes the truth is scary. I think it’s better to prepare for the worst and hope for the best.

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    • 12

      Jen says


      Such debbie downers. No, my labor wasn’t like hers. I didn’t ask for or want meds. I wasn’t mean to anyone or want to hurt anyone, I hated having my dilation checked, yada yada.

      But this article is funny and it’s obviously written in jest. I doubt that any first-time pregnant mom’s are going to read this and think that this is a scientific article meant to teach people how it is.

      Smile. Laugh, Lighten up.

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      • 13

        Kimberly says

        Perfect answer! As a labor and delivery RN of over 23 years I can tell you that I’ve seen it all. Medicated, unmediated, screaming, sobbing, laughing, humming, moaning, begging, self hypnoses, pushing on arrival, and being sent home still pregnant to everything else. Having a sense of humor can really help coping with pain.

        One thing I will say, I truly dislike when women say they were a failure and gave in, and got an epidural. You wouldn’t let your dentist drill on your teeth without local, or a surgeon remove your appendix without anesthesia, or at least most wouldn’t. I can tell you all this, your baby is bigger than your appendix, and it’s coming out of your happy place! That is not a give in, not a failure, it’s a beautiful thing to witness, no matter how you coped with your pain.

        Labor is hard enough, lets just remember to smile, laugh, and lighten up.

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        • 14

          Angela says

          You are a labor & delivery nurse and you’re comparing birth to getting your teeth drilled and having your appendix removed?

          Let’s break it down…

          Having a cavity filled (I assume that’s what you are referring to) is not a natural process. The pain from the drill and in your tooth is constant, unlike the pain of labor. There are no endorphins to help you cope with the pain.

          Appendicitis…again, the pain is constant. No breaks. Surgery is *required* and again, not a natural process. No endorphins to help us cope.

          Contractions hurt. Pushing a baby out hurts for most women. But it’s normal, and healthy to do so. Labor is not a disease. If a woman wants to have an epidural, so be it…but let’s be honest and not compare the process of birth to a process of disease and decay.

          And her “happy place” stretches to allow the passage of the baby, and the fetal head molds…unfortunately we have no such processes in place to deal with rotting teeth and organs.

          Peace out.

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      • 16

        Brandi says

        Thank you SO MUCH Jen for your response. I am a first time mom and due in about 8 weeks. I do have a lot of natural fears over labor but articles like these help lesson the fear and make me see it for what it all is…a part of the process! A natural process. And I am glad that after that process I can one day look back and laugh and realize it isnt as bad as I make it out to be. Thats what this article does for me…makes me actually less scared.

        And honestly I think Deena just wanted to boast her credentials. So..yea. debbie downers for sure!

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    • 17

      Ace says

      My labor was 3:45 long. And it was glorious! Sure it was painful. I was in labor suddenly without warning with crazy strong contraction right on top of eachother! I was in denial at first.

      My husband got home about 30 minutes into my labor. I wasn’t sure if it was the real thing. He assured me it was. I spent most of my labor in my bathtub. Hubby says I was roaring during contractions! I felt like a roaring lion. :)

      After a bit of contracting (yes it was beyond painful and I was getting tired) I went to the bed on my hands and knees and started pushing. Crowning didn’t really hurt. I could feel a tingling like it should hurt. But the sensation was so dull. The contractions did hurt. I thought to myself that the only way out is through it. And I was able to focus on pushing. It took me 15 minutes.

      And then the flood of endorphins hit. I was tired and sore while I labored. But the moment she was out I was as high as a kite. I was over the moon. I felt like I could do anything.

      Yes labor was hard. Sure it hurt. But I’m not afraid of pain. It comes and then it goes. I spent some of my labor bighting on a rag and it helped so much! I moved around. I roared. I felt powerful and in control of myself. I felt more in love with my husband than ever. I was never angry in my labor.

      Labor is hard work. Sometimes there is a great amount of pain involved. But that doesn’t mean it is awful. If my next labor can be something like the one I recently had I’m all for doing it again.

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    • 18

      Diane says

      I gave birth 4 times and had a D&C all without meds. It really does have a lot to do with accepting that your body is going to do it anyway and relaxing really does speed things up. I also get that it was comical, but it would have scared me even if I were still pregnant with my fourth. Labor and delivery is something easier seen on this side of things, no matter how many times you’ve gone through it already.

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    • 19

      halcyon says

      All of you who got to have natural unmedicated births don’t know how lucky you are. For many women who wanted to have a more natural birth experience but didn’t get it, you all pointing out how easy your births were, or how powerful you felt, or how high your pain tolerance is, like a slap in the face. This post was obviously not meant for you, it was for the rest of us who didn’t get what you got. You’re not better, you’re so lucky and you don’t even realize it.

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      • 20

        Mom2three says

        Thank you Halcyon. My last child we tried everything to birth naturally but still wound up with a c-section after 3 days of labor. That was 16 years ago, and it still hurts that my body failed me so miserably. But I am thankful everyday that I ended up with a health 10lb baby girl.

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    • 21

      Bree says

      This article doesn’t create fear, it’s true. Too many posts don’t talk about the reality of childbirth, they lead first time mothers, like myself, go in there thinking “Oh everyone said it wasn’t too bad”.

      The word “Pain” doesn’t accurately describe what childbirth feels like. This post comes mildly close to reality. Yes everyone knows childbirth is painful, but why does everyone feel the need to mask exactly how painful it is? Lying to first time mothers does NOT help. Calling it a “positive experience” is utter bullshit.

      It hurts, and it hurts like no pain you have ever felt in your life. You will want to re-define the word pain in the dictonary after you experience childbirth.

      Let’s be honest, it is of course worth it in the end when you have your beautiful new baby in your arms, but getting to that point is horribly painful and lying about it, or calling it some “beautiful experience” is misleading and simply not true. It hurts…a lot.

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  4. 22

    Joanne says

    Thanks for reminding me of what I’m about to go through again. At least I got my epi as soon as I got to the hospital: didn’t even get triaged I was screaming so much.

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  5. 23

    KatyBug says

    Oh, I begged and pleaded…threatened, even. But that darn birth plan :)

    I tease, because my husband and doula talked me down from my drug demands when I was 7cm and facing down transition. I would have paid any amount for the epidural but now, with 10 months in the rearview, I’m glad they didn’t listen and I had my kid without the epidural.

    But I still went through each stage, just as you describe. And it sucked.

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    • 24

      Brandee says

      This is a funny article, but I feel some what differently. I have had three children. All three of them being completely natural with no pain meds or epidural. It was an amazing experience for me. Yes painful but amazing. Women in my opinion are meant to feel those things. With my second child I rember saying I’m don’t I don’t want to do this but when I seen her beautiful face all that pain was so worth it.

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  6. 27

    Tammy says

    Wow can I relate to this.. I dont care how many baby classes you take and breathing lessons.. Child birth SUCKS.. yep.. and Men should have to do it too!!! I went into labor with my daughter while I was at our last baby class touring the maternity ward.. little did I know I would be in it 12 hours later.. Got home at 10:00pm and by midnight realized I was in labor.. was at the hospital at 8am and did not deliver until 7pm that night!!! My epideral man is on my Christmas card list.. YEP!! I love him.. I still love him.. I did not get my epideral until 4:00 that afternoon.. I had 100% BACK labor which breathing doesn’t do a frigging thing for by the way.. I felt like my ass was going to explode with each contraction.. So for anyone who wants to glamorize child birth.. there really is nothing glamorous about laying splayed out like a chicken while they stitch you up and your new bundle of joy is passed around the room to all who got to witness.. :) I LOVE my daughter with all my heart.. dont get me wrong but the child birth thing you can keep.. :)

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    • 28

      leela angelina says

      hee hee slayed out like a chicken, got that right.. i didn’t feel my stiches being put in, but right after they were done they walked me naked across the floor to the shower so i could clean up , i felt drunk/ high, but i remember looking at the floor and seeing a ton of blood and i asked out loud ” am i gonna die…lolz its weird not to take drugs yet feel high, and not give a crap that i am naked, bleeding, sweaty and make-up everywhere,, wretched mess, but after that shower,, i felt great, in pain but better than i was minutes before.. :)

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    • 29

      Theresa says

      Tammy, this is exactly how my labour with twins went. I had gone full term and finally the doctor brought me in to be indused. I didn’t want the epidural but there was this one nurse who kept increasing the drip that it was just too much for me. I must have had a student put the epidural in because they had to try twice before they got it in. My friend who came with me was sitting in the corner of the room shocked what was coming out of my mouth. No one told me that with extreme lower back pains that the epidural will not work. The doctors had to keep coming back because it just wasn’t working. After the first twin was born, did they realize that they other one would have to come out breech! Not fun. It would have been way easier to have that C-section. I agree that child birthing is not all glam and happiness. Congrates to those women who did have the best birthing experience.

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  7. 30

    leela angelina says

    poppin out babies is def sucky and it really depends on your pain threshold, mine is on the higher end i found out, my first kid i rushed to the hospital when the contractions were 4 min apart then i had a 7 hour wait till my boy was born ( i know, not really that long, but freaking long enough when your contractions are every 2 minutes, Thank gawd for the hot bath i jump in and out of about 100 times. i didn’t want meds. i like to torture myself, I’m kinky like that,, if i could have had drugs i only wanted ones that would make me forget that i was gonna be completely exposed with 10 strangers my mother and my hubs, that scared me to death so between the pacing , hot baths and the awful ripping and moving of bones and muscles so my kid could get out, they broke my water which set a hell loose, the most immediate feeling of having to poop sweeped over poor husband went so white, the dr, birthing my son, stopped with me and told him to sit down, cause they didn’t have time to pick him off the floor. By this point i didn’t care who saw me naked in the most awkward position, it was the last think on my mind, i was just concentrating on pushing that damn kid out. finally the ring of fire ended, head was out and once they get the shoulders out, i said, THANKGAWD!!!!!!! never so relieved in my life.

    2nd kid came 18 months later, this time i knew what i was in for, which put the fear into me, but this time, when i started having contractions i went to my tub and sat and red a book for 4 hours and relaxed.. then i hollard for my hubs and said,, “time to go”!!!. took us 8 minutes to get to the hospital, rushed me up stairs and the nurses said, “glad you got here when you did or your husband would have delivered the baby on the side of the highway” took me 6 minutes to pop bubbers #2 out. he was super easy. both kids weighted the same to which was weird enough. 7lbs 3oz. but what i learned from it all was, do what you want, you know what you can handle.. i didn’t take any drugs just so i could know what it was really like, because i would love to deliver babies some day and i want to know what it would be like. just so i would know both sides… people have given birth since the dawn of time, so its not gonna be that bad, or the human race would have ended, but hell, if you can get drugs and want drugs… more power to you.. its your body and your baby :) that kid is still gonna come out screaming and looking for you and thats the craziest high i’ve ever been on.

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  8. 31

    Sabrina says

    I had a botched epidural with my first and it only numbed my leg. My water broke so I had to be put on pitocin and I went from 4cm to 9cm just by sitting up. It was AWFUL.

    I figured, what are the chances of my water breaking prematurely with my second? I’ll be able to do a natural birth no problem. 4 in the morning, my water breaks and I’m pissed. I wait 8 hours, am about 2cm dilated and not feeling a thing. The doctor put me on pitocin (to my total upset) and I was fine …until I wasn’t (at 4cm again). Not having an epidural (or at least one that worked) with my first was so awful that I screamed for one this time. By the time the doctor was done numbing me up (the whole process took about 20 minutes) I could feel pressure and was fully dilated. WTF kids?! Thank God I had that epidural.

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    • 32

      leela angelina says

      thats what i kinda feared would happen to me, sorry it happened to you.. at least if your not having epi, you can move and relive some pain but jeeese….

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  9. 33

    samymammy says

    I thought I was going to stick to a birth plan with no epidural- no drugs. After the back labor ripped my back apart and I couldn’t sit, lay or walk. When my doctor said “You sound like your in alot of discomfort, would you like me to have an epidural ready” I practically kissed her.
    When I went into labor with my 2nd child I totally was in denial because she was a few weeks early, I remember thinking WTH was I thinking getting pregnant again, how did I forget this part. I am not going to say it is impossible to go with out drugs or discourage anyone. You have to live through the experience and at the end it is worth all of it when they place that beautiful baby in your arms.
    I will say you will have no shame during it, I remember dropping to a squat position during a contraction while I was in registration and I had a dress on. There was a gentleman infront of me and I could careless. You know what to do, and what you can handle.
    Just my two cents

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