Stages of Labor: One...Two...Three...Breathe!

As an expectant mother, it’s normal to feel anxious about giving birth. But with a better understanding of the stages of labor and delivery, you can regain a sense of control over the process. Now, let’s take a look at what happens during the three stages of labor.

5 min read

Updated December 30, 2019

Reviewed by Olga Adereyko, MD, Primary Care Physician, General Practitioner, Medical Consultant

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Overview of labor

Every woman experiences labor differently. As much as you prepare for childbirth, there will always be a few things you simply can’t predict. However, knowing how labor usually progresses, and what to expect at each stage, should offer a little peace of mind.

Stage 1: Early and active labor

The first of the three stages of labor begins when you start to feel regular contractions. These contractions will make your cervix dilate (or open up), while also becoming shorter and thinner (i.e., cervical effacement). Note that they’re different from Braxton-Hicks contractions, which do not trigger cervical dilation. The first stage is the longest of all three stages of labor, and is composed of early and active labor.

Early labor or latent phase

Your contractions will be mild, less frequent, and irregular. You could notice a small amount of clear or blood-tinged discharge. This is the mucus plug that was covering the entrance to your cervix during pregnancy.

Early labor tends to be longer for first-time moms, and it typically gets shorter with subsequent deliveries. The latent phase might last for hours or even days when you’re having your first child.

Here are several activities to consider trying during early labor:

Going for a walk
Listening to music
Practicing breathing exercises
Trying relaxation techniques
Changing your position
Taking a shower or bath
Eating or drinking something light

For many women, this stage isn’t particularly uncomfortable. Your health care provider will tell you when to leave for the hospital or birthing center. But don’t hesitate to call them if you experience heavy bleeding, your water breaks, or you have any major concerns.

Active labor

Your cervix will dilate from 6 to 10 centimeters. Contractions become longer, more frequent, and regular. Again, unlike Braxton-Hicks contractions, real contractions do not remain short and irregular until they pass.

Active labor may be accompanied by other symptoms, such as:

Leg cramps
Nausea
A feeling of pressure on your back
Your water breaking (if it hasn’t already)

You should now make your way to the hospital or birthing center. Pain intensifies as this stage of labor unfolds. Discuss the use of pain medications or anesthesia with your doctor if necessary.

During active labor phase contractions become longer, more frequent, and regular.

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Active labor lasts roughly four to eight hours, or occasionally longer. On average, your cervix dilates about one centimeter per hour of active labor.

Here are several activities to consider trying during active labor:

Changing positions
Getting support from your partner, loved one, or health care team
Trying controlled breathing and relaxation techniques
Rolling on a birthing ball
Taking a warm shower
Getting a gentle massage between contractions

If your doctor believes you might need a C-section, they’ll ask you to avoid consuming large amounts of liquid or heavy meals.

The final phase of active labor is also known as transition. Contractions come even closer together, and last for up to 90 seconds. Although you’ll likely feel the urge to push, your doctor will probably ask you to hold back until you’re fully dilated.

Stage 2: Pushing your baby into the world

Delivery occurs in the second stage of labor, which takes anywhere from a few minutes to a couple of hours.

You’ll be told to bear down during each contraction. (Note, the urge to push feels similar to the urge to have a bowel movement.) If you’ve received an epidural, your doctor may need to tell you exactly when to push.

Delivery occurs in the second stage of labor, which takes anywhere from a few minutes to a couple of hours.

In certain cases, you might consider changing positions until you find the one that works for you. Some women prefer to squat, kneel, or get on all fours.

Your doctor usually asks you to stop pushing when your baby’s head is about to come out. This decreases your chances of sustaining vaginal tears. Once their head is through, the rest of their body will follow. The delivery team will cut your child’s umbilical cord and clear their airways, if necessary.

Stage 3: Placenta delivery

If everything has gone according to plan, you’ll probably be able to hold your baby afterwards. However, you still need to deliver the placenta in the final stage of labor.

This occurs roughly 5 to 30 minutes after childbirth, but could take up to an hour. You’ll feel milder, frequent contractions, and you could even try breastfeeding while you wait.

You still need to deliver the placenta in the final stage of labor.

Once it’s time, you’ll be asked to push again. Your doctor should then examine the expelled placenta to make sure it’s complete. Any pieces of placenta remaining inside your uterus must be removed, since they could lead to bleeding and infection.

It’s possible that you’ll be provided with medications to minimize bleeding. Your uterus continues to contract to stop any bleeding and return to its regular size. Lastly, your health care provider examines your abdomen to feel whether your uterus is firm, and see if you require vaginal stitches.

What to expect after labor

Following delivery, a nurse, midwife, or pediatrician will examine your baby. They’ll be weighed and measured, and receive a tag with your name on it for easy identification.

Expect continued bleeding and discharge, known as lochia, for the next few weeks. However, it should gradually lighten as time passes. Be sure to seek medical help if you experience heavy bleeding after childbirth.

Following delivery, a nurse, midwife, or pediatrician will examine your baby. For example, they’ll be weighed and measured.

Your doctor is going to provide instructions on how to care for a C-section wound or vaginal stitches, if needed. Ask them any questions you have regarding you and your baby’s care.

Once you’re home, it’s natural to want to give your bundle of joy your undivided attention, and research shows that skin-to-skin contact stimulates bonding. However, it’s also important to focus on your own recovery and well-being. Be aware that certain hormonal changes lead to uncomfortable postpartum symptoms, including:

Sore breasts
Leaking milk
Hair loss
Mood swings
Irritability
Sadness
Anxiety

Takeaway

Developing a thorough understanding of the three stages of labor will hopefully help you stay cool, calm, and relaxed on the big day. Remember to make your wishes and personal preferences known to your doctor beforehand so that they’re better equipped to support you during labor.

Although childbirth is an exhausting and physically demanding process, you’ll be rewarded with an indescribable joy only your baby can bring!

References

https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/stages-of-labor/art-20046545 https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/basics/postpartum-care/hlv-20049465 https://www.nhs.uk/conditions/pregnancy-and-baby/what-happens-straight-after-the-birth/ https://www.nhs.uk/conditions/pregnancy-and-baby/what-happens-during-labour-and-birth/

History of updates

Current version (30 December 2019)