Pregnancy can be full of surprises, and labor is no different. You might be eager to take on the stages of labor, or you may be nervous about what’s to come. It’s difficult to predict exactly how your birth experience will go down. Just how long or challenging giving birth may vary significantly from person to person and from pregnancy to pregnancy. Every labor and delivery experience is unique.
However, knowing the three stages of labor can give you the information you and your support system need to feel adequately prepared for what comes next. Keep in mind that no matter how you get to the finish line, you will very soon reach the wonderfully rewarding end.
What are the three stages of labor?
Once you check into the hospital, your doctor will periodically give you an internal exam to determine how far you’ve progressed. All women undergo three precise stages of labor and childbirth unless things are cut short by a C-section:
Stage 1– Labor (which includes early labor, active labor, and transitional labor).
Stage 2– Pushing and delivery of the baby: This phase of labor begins with pushing and ends with the delivery and birth of your baby.
Stage 3– Delivery of the placenta: Your placenta will naturally be expelled or need to be removed by your doctor after your baby is born.
What are the three phases of labor?
The first stage of labor and childbirth consists of three phases, including:
- Early labor: The cervix dilates (opens) and effaces (thins) to 4 to 6 centimeters. Contractions last for approximately 30 to 45 seconds and gradually increase in intensity and frequency, from around 20 minutes to five minutes apart.
- Active labor: The cervix dilates anywhere from 4 to 6 centimeters to 7 to 8 centimeters. Contractions last approximately 40 to 60 seconds and come about three to four minutes apart.
- Transitional labor: The cervix fully dilates to 10 centimeters. Contractions are around 60 to 90 seconds long and occur approximately every two to three minutes.
Keep in mind that there can be slight variations in terms of dilation measurements and timing of contractions.
What is early labor?
During the first of the three phases of labor, known as early labor, your cervix gradually dilates and effaces to about 4 to 6 centimeters.
It is usually the longest but, thankfully, the least intense phase of labor. Contractions become stronger and more frequent. They tend to be spaced at about five-minute intervals as you progress into active labor.
Early labor may entail just two to six hours of very obvious contractions. Or it may progress over several weeks, during which time you may not even notice (or be bothered by) your contractions.
Signs of early labor
Throughout early labor, you may experience any of the following labor signs:
- Cervical dilation and effacement. Over several hours to weeks, your cervix will dilate to about 4 to 6 centimeters and efface.
- Moderate and intensifying contractions. Early labor contractions progressively intensify over time. A change in position usually does not ease or provide very much relief. The contractions can be regular or irregular and generally last 30 to 45 seconds. They will gradually become more frequent, spaced up to about 20 minutes apart at first to about five minutes apart by the end of early labor.
- Blood-tinged vaginal discharge. The appearance of pink- or brown-tinged discharge, also known as the bloody show, means the blood vessels in your cervix have ruptured as it begins to efface and dilate. Labor is likely on its way in the next 24 hours, although it may take longer.
- Rupture of the amniotic membranes. Before or during early labor, your water might break. It may appear in a stream of warm liquid or a slow but continual trickle of fluid and is more likely to happen sometime during active labor.
What you can do:
For many women, early labor is not particularly uncomfortable, but contractions may be more intense for some. 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
What is active labor?
During active labor, your cervix dilates to about 7 to 8 centimeters. Contractions will be more evenly spaced, intense, and frequent, coming about every three to four minutes apart. Active labor usually lasts from two to three-and-a-half hours (with a wide range of what is considered normal).
Signs of active labor
- Intensifying contractions. Contractions will become stronger and longer, typically lasting 40 to 60 seconds, with a distinct peak halfway through. They will also be more frequent, coming every three to four minutes — although the pattern may still not be regular.
- Continued dilation and effacement. Your cervix will dilate from about 4 to 6 centimeters to about 7 to 8 centimeters.
- Increasing pain and discomfort. You may not be able to talk through contractions now. (If you have had an epidural by this point and it has kicked in, you likely will not feel any pain.)
- Other more intense symptoms. As your labor progresses, so will your symptoms. Labor pain medication, such as an epidural, should help to relieve some of them. You may have increasingly intense back pain, leg discomfort or heaviness, fatigue, and bloody show.
- Rupture of the membranes if they have not already. Your membranes might be ruptured artificially now, although the American College of Obstetricians and Gynecologists (ACOG) suggests that it may not be necessary for women with low-risk pregnancies who are progressing normally through labor.
What to expect during active labor?
With contractions coming on more strongly and frequently, you will have less opportunity to rest. Relaxing may be trickier as your labor efforts intensify.
What you can do:
Look to your labor partner and health care team for encouragement and support. Try breathing and relaxation techniques to relieve your 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
What is transitional labor?
During the third and final phase of labor, called transitional labor, your cervix will dilate to 10 centimeters. You will experience strong contractions about every two to three minutes, although it can vary.
This phase of labor is the most intense and the shortest, generally lasting from 15 minutes to an hour. It can sometimes take longer, like up to about three hours.
Signs of transitional labor
Throughout transitional labor, you may experience:
- Very strong and painful contractions. You will experience strong contractions that last 60 to 90 seconds long and have intense peaks that last for most of the contraction, no matter whether or not you have been given an epidural. It may seem like you barely get to relax before the next contraction begins because they are spaced only about two or three minutes apart.
- Full dilation. When it is time to deliver your baby, your cervix will dilate from about 7 to 8 centimeters up to the final 10 centimeters. The bloody show will increase as capillaries in the cervix rupture.
- Pressure in your back and abdomen. You will feel intense pressure in the lower back and perineum, along with rectal pressure, with or without an urge to push.
- General discomfort. You may feel sweaty, chilled, shaky, or achy. One or both legs may be completely numb if you’ve had an epidural. Some may have other forms of discomfort, although others may not experience any of these symptoms.
- Fatigue and drowsiness. It’s normal to feel tired by now, or you may also get a second (or fifth!) wind.
What to expect during transitional labor?
This last phase of labor can be physically demanding and draining, but it can also be exhilarating. You may feel impatient — or elated. Hang in there! Here is what you can do in the meantime:
- Resist the urge to push. Pushing before dilation is complete could cause your cervix to swell, which can postpone the delivery. Ask your practitioner or doula for guidance if you feel the urge to push. Panting and blowing air through your mouth can help.
- Breathe. Try to relax between contractions with slow, deep, rhythmic breathing.
- Speak up. Let your birth team know if you don’t want anybody to touch you unnecessarily.
- Ask for an epidural if you want one. It is not too late. You will have to stay still long enough for the needle to be inserted, and it takes some time for it to kick in. Your birth team will tell you when it’s no longer possible to have one.
- Be prepared to wait some more. Even once your cervix has dilated to 10 centimeters, your doctor may still ask you to wait to push until your baby’s head is crowning or you feel an irrepressible urge to push. This “laboring down” allows you to save energy while your uterus naturally pushes your baby further into the birth canal.
- Keep your eye on the prize. By the end of this phase, it will be time to begin pushing the baby out. That bundle of joy will soon be in your arms!
What happens during the other two stages of labor and childbirth?
The three phases of labor are the first part of a larger picture: The three stages of childbirth. Once you have made it through labor, the two other childbirth stages include:
- Pushing and delivering your baby. You will have very intense contractions and a tremendous urge to push (although if you have had an epidural, you will not feel either as much). When instructed by your doctor, push during this stage of childbirth as if you’re having a big bowel movement and rest between contractions. Most women push for 30 minutes to an hour, although the pushing stage may last for a few hours — at which point your doctor will reassess whether other interventions are necessary.
- Delivering the placenta. Once your baby is delivered, your doctor will still need to deliver your placenta, which usually takes about 20 minutes. You will experience gentle contractions as your uterus expels the placenta. Your doctor may help things along by pulling on the umbilical cord or pressing on your abdomen while asking you to push. Your doctor will examine the placenta to ensure it is intact. Any remaining fragments must be removed from the uterus to prevent bleeding and infection. 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 may massage your abdomen. This may help the uterus contract to decrease bleeding. Your doctor will also determine whether you need repair of any tears of your vaginal region. If you do not have anesthesia, you will receive an injection of local anesthetic in the area to be stitched.
What you can do:
Congratulations! Your preparation, pain, and effort have paid off. You have made it through the stages of labor and childbirth — take pride in what you’ve accomplished. And as soon as you can, reward yourself by cuddling with your newborn, breastfeeding (if you choose), and getting some much-deserved rest. Savor this special time with your baby. Revel in the miracle of birth.
How long does labor last?
It’s hard to predict how long your labor and delivery will last, as there’s a wide range of “normal.” However, ACOG says that labor typically lasts a total of around 12 to 18 hours for first births and approximately eight to 10 hours from start to finish for subsequent ones.
Some moms may experience early labor symptoms (such as dilation and effacement) days or weeks before labor starts. In contrast, others may only have noticeable early labor contractions for two to six hours.
Active labor may last anywhere from about two to 24 hours (though the average is two to three-and-a-half hours), while transitional labor can last anywhere from 15 minutes to about three hours.
At a certain point, your doctor may rely on interventions to get things going or speed things up. For example, they may use forceps, vacuum extraction, or even decide to perform a C-section after you have been pushing for at least three hours if you’re a first-time mom or at least two hours if you’ve given birth before.
A few factors that may affect the length of your birth include:
- How many times you have given birth. All phases and stages of labor tend to move along more quickly if this is not the first time you have delivered a baby.
- The position of your baby. If your baby is in a breech position and your doctor has determined it is safe for you to try a vaginal delivery, your cervix may not dilate as quickly, or your baby may not move down the birth canal — slowing down your progress.
- Having certain complications or other issues. If your cervix is not dilating, your baby is in distress, you are exhausted, or you have a prolapsed umbilical cord or uterine rupture, your labor may be cut short by a C-section to keep you and your little one safe.
