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Labor and Delivery - Stages of Labor

The process of having a baby occurs in several stages over many hours or even a few days—from early labor through delivering the baby and the placenta. During labor, contractions in your uterus open your cervix and move the baby into position to be born.

Stage one: Early, active, and transition

Early labor

Early labor is often the longest part of the birthing process, sometimes lasting 2 to 3 days. Uterine contractions:

  • Are mild to moderate (you can talk while they are happening) and last about 30 to 45 seconds.
  • May be irregular (5 to 20 minutes apart) and may even stop for a while.
  • Open (dilate) the cervix to about 3 cm (1 in.). First-time mothers can have many hours of early labor without the cervix dilating.

It's common for women to go to the hospital during early labor and be sent home again until they are in active labor or until their "water" breaks (rupture of the membranes). This phase of labor can be long and uncomfortable.

Active labor

The active stage of labor starts when the cervix is about 3 cm (1.2 in.) to 4 cm (1.6 in.) dilated. This stage is complete when the cervix is fully effaced and dilated and the baby is ready to be pushed out.

Compared with early labor, the contractions during active labor are more intense and more frequent (every 2 to 3 minutes) and longer-lasting (50 to 70 seconds). Now is the time to be at or go to the hospital or birthing center. If your amniotic sac hasn't broken before this, it may now.

As your contractions get stronger, you may:

  • Feel restless or excited.
  • Find it hard to stand up.
  • Not be allowed to eat or drink. Some hospitals let you drink clear liquids. Others may only allow you to suck on ice chips or hard candy.
  • Want to start using breathing techniques or other ways to control pain and anxiety.
  • Feel the need to shift positions often. This is good for you, because it improves your circulation.
  • Want pain medicine, such as epidural anesthesia.
  • Be given intravenous (IV) fluids.

To learn more about pain medicine, see Managing Pain.


The end of active labor is called the transition phase. As the baby moves down, your contractions become more intense and longer and come even closer together.

When you reach transition, your delivery isn't far off. During transition, you will be self-absorbed, concentrating on what your body is doing. You may be annoyed or distracted by others' attempts to help you but still feel you need them nearby as a support. You may feel increasingly anxious, nauseated, exhausted, irritable, or frightened.

A mother in first-time labor will take up to 3 hours in transition, and a mother who has vaginally delivered before will usually take no more than an hour. Some women have a very short, if intense, transition phase.

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