Stages of labor and birth: Baby, it's time!
Medically reviewed on June 22, 2018
Every woman's labor is unique, even from one pregnancy to the next. Sometimes labor is over in a matter of hours. In other cases, labor tests a mother's physical and emotional stamina.
You won't know how labor and childbirth will unfold until it happens. You can prepare, however, by understanding the typical sequence of events.
Stage 1: Early labor and active labor
The first stage of labor and birth occurs when you begin to feel regular contractions, which cause the cervix to open (dilate) and soften, shorten and thin (effacement). This allows the baby to move into the birth canal. The first stage is the longest of the three stages. It's actually divided into two phases of its own — early labor (latent phase) and active labor.
During early labor, your cervix dilates and effaces. You'll feel mild, irregular contractions.
As your cervix begins to open, you might notice a clear, pink or slightly bloody discharge from your vagina. This is likely the mucus plug that blocks the cervical opening during pregnancy.
How long it lasts: Early labor is unpredictable. For first-time moms, the average length varies from hours to days. It's often shorter for subsequent deliveries.
What you can do: Until your contractions increase in frequency and intensity, it's up to you. For many women, early labor isn't particularly uncomfortable. Try to stay relaxed.
To promote comfort during early labor:
- Go for a walk
- Take a shower or bath
- Listen to relaxing music
- Try breathing or relaxation techniques taught in childbirth class
- Change positions
Your health care provider will instruct you on when to leave for the hospital or birthing center. If your water breaks or you experience significant vaginal bleeding, call your health care provider right away.
Now it's time for the real work to begin. During active labor, your cervix will dilate from 6 centimeters (cm) to 10 cm. Your contractions will become stronger, closer together and regular. Your legs might cramp, and you might feel nauseated. You might feel your water break — if it hasn't already — and experience increasing pressure in your back. If you haven't headed to your labor and delivery facility yet, now's the time.
Don't be surprised if your initial excitement wanes as labor progresses and the pain intensifies. Ask for pain medication or anesthesia if you want it. Your health care team will partner with you to make the best choice for you and your baby. Remember, you're the only one who can judge your need for pain relief.
How long it lasts: Active labor often lasts four to eight hours or more. On average, your cervix will dilate at approximately one centimeter per hour.
What you can do: Look to your labor coach and health care team for encouragement and support. Try breathing and relaxation techniques to combat your growing discomfort. Use what you learned in childbirth class or ask your health care team for suggestions.
Unless you need to be in a specific position to allow for close monitoring of you and your baby, consider these ways to promote comfort during active labor:
- Change positions
- Roll on a large rubber ball (birthing ball)
- Take a warm shower or bath
- Take a walk, stopping to breathe through contractions
- Have a gentle massage between contractions
If you need to have a C-section, having food in your stomach can lead to complications. If your health care provider thinks you might need a C-section, he or she might recommend small amounts of clear liquids, such as water, ice chips, popsicles and juice, instead of a large, solid meal.
The last part of active labor — often referred to as transition — can be particularly intense and painful. Contractions will come close together and can last 60 to 90 seconds. You'll experience pressure in your lower back and rectum. Tell your health care provider if you feel the urge to push.
If you want to push but you're not fully dilated, your health care provider might ask you to hold back. Pushing too soon could make you tired and cause your cervix to swell, which might delay delivery. Pant or blow your way through the contractions. Transition usually lasts 15 to 60 minutes.
During the first stage of labor, the cervix opens (dilates) and thins out (effaces) to allow the baby to move into the birth canal. In figures A and B, the cervix is tightly closed. In figure C, the cervix is 60 percent effaced and 1 to 2 cm dilated. In figure D, the cervix is 90 percent effaced and 4 to 5 cm dilated. The cervix must be 100 percent effaced and 10 centimeters dilated before a vaginal delivery.
Stage 2: The birth of your baby
It's time! You'll deliver your baby during the second stage of labor.
How long it lasts: It can take from a few minutes up to a few hours or more to push your baby into the world. It might take longer for first-time moms and women who've had an epidural.
What you can do: Push! Your health care provider will ask you to bear down during each contraction or tell you when to push. Or you might be asked to push when you feel the need.
When you push, don't hold tension in your face. Bear down and concentrate on pushing where it counts. If possible, experiment with different positions until you find one that feels best. You can push while squatting, sitting, kneeling — even on your hands and knees.
At some point, you might be asked to push more gently — or not at all. Slowing down gives your vaginal tissues time to stretch rather than tear. To stay motivated, you might ask to feel the baby's head between your legs or see it in a mirror.
After your baby's head is delivered, the rest of the baby's body will follow shortly. His or her airway will be cleared if necessary. Your health care provider or labor coach will then cut the umbilical cord.
Stage 3: Delivery of the placenta
After your baby is born, you'll likely feel a great sense of relief. You might hold the baby in your arms or on your abdomen. Cherish the moment. But a lot is still happening. During the third stage of labor, you will deliver the placenta.
How long it lasts: The placenta is typically delivered in five to 30 minutes, but the process can last as long as an hour.
What you can do: Relax! By now your focus has likely shifted to your baby. You might be oblivious to what's going on around you. If you'd like, try breast-feeding your baby.
You'll continue to have mild contractions. They'll be close together and less painful. You'll be asked to push one more time to deliver the placenta. You might be given medication before or after the placenta is delivered to encourage uterine contractions and minimize bleeding.
Your health care provider will examine the placenta to make sure it's intact. Any remaining fragments must be removed from the uterus to prevent bleeding and infection. If you're interested, ask to see the placenta.
After you deliver the placenta, your uterus will continue to contract to help it return to its normal size. A member of your health care team will massage your abdomen to make sure the uterus feels firm.
Your health care provider will also determine whether you need stitches or repair of any tears of your vaginal region. If you don't have anesthesia, you'll receive an injection of local anesthetic in the area to be stitched.
Savor this special time with your baby. Your preparation, pain and effort have paid off. Revel in the miracle of birth.