What Are the Stages of Labor?
WomensHealth.gov: "Stages of Labor.", Mayo Clinic: "Stages of labor and birth: Baby, it's time!"
Labor happens in three stages. The first stage goes from when you first start having steady contractions to when you’re ready to deliver your baby. It includes an early or latent phase, when contractions are mild and the cervix begins changing to allow the baby to pass through; an active phase, when contractions are strong and most of the work happens to prepare your body for delivery; and a transitional phase when you start feeling the need to push.
The second stage of labor is the actual birth of your baby, and the third stage is the delivery of the placenta.
The First Stage of Labor
The first stage is the longest part of labor and can last up to 20 hours. It begins when your cervix starts to open (dilate) and ends when it is completely open (fully dilated) at 10 centimeters.
Early or latent labor
The early or latent phase is when labor begins. You’ll have mild contractions that are 15 to 20 minutes apart and last 60 to 90 seconds. Your contractions will become more regular until they are less than 5 minutes apart. The contractions cause your cervix to dilate and efface, which means it gets shorter and thinner, and more ready for delivery. During the early phase, your cervix dilates from 0 to 6 centimeters, and contractions get stronger as time goes on. During this phase, you may have discharge from your vagina that’s clear to slightly bloody.
This part of labor could take hours or even days. It’s best to spend it in the comfort of your home. Here are some things you can do to help the process along:
- Take a walk.
- Change positions often.
- Continue practicing breathing and relaxation techniques.
- Soak in a warm tub or take a warm shower. If your water has broken, talk to your doctor before soaking in a tub.
- Rest if you can.
- Drink plenty of liquids and have something light to eat.
- Get yourself packed and ready for the hospital if you aren’t already.
While the cervix dilates from 6 to 8 centimeters (called the Active Phase), contractions get stronger and are about 3 minutes apart, lasting about 45 seconds. You may have a backache and increased bleeding from your vagina (called the "bloody show"). If your amniotic membrane ruptures -- or your "water breaks" at this point -- the contractions may get much stronger.
This part usually lasts about 4 to 8 hours. Your mood may become more serious as you focus on managing the contractions. You’ll depend more on your support person.
It’s usually during the active phase of labor that you’ll go to the hospital or birthing center. Upon arrival, you will be asked to wear a hospital gown. Your pulse, blood pressure, and temperature will be checked. A monitor will be placed on your abdomen for a short time, or continuously, to check for uterine contractions and assess the baby's heart rate. Your health care provider will also examine your cervix during a pelvic exam to determine how far labor has progressed.
An intravenous (IV) line may be placed into a vein in your arm to deliver fluids and medications if necessary. Your doctor may have you limit what you eat and drink at this time if they think it’s possible you’ll need a C-section with general anesthesia.
Some tips to help you through the active phase of labor:
- Try changing your position. You may want to try getting on your hands and knees to ease the discomfort of back labor.
- Keep walking between contractions.
- Empty your bladder often to make more room for the baby’s head in your pelvis.
- Continue practicing breathing and relaxation techniques.
- Ask your birth partner for a gentle massage.
- Listening to soothing music.
- Focus on taking one contraction at a time. Remember that each one brings you closer to holding your baby.
The transition phase is short, but also intense and painful. It usually takes from 15 minutes to an hour for the cervix to dilate from 8 to 10 centimeters. Contractions are 2 to 3 minutes apart and last about 1 minute. You may feel pressure on your rectum and your backache may feel worse. Bleeding from your vagina will be heavier.
You may feel the urge to push, but don’t until your doctor tells you to. Pushing before your cervix is fully dilated may cause it to swell and slow down the process.
The Second Stage of Labor (Delivery)
The second stage of labor begins when your cervix is fully dilated at 10 centimeters. This stage continues until your baby passes through the birth canal, vagina, and is born. This stage may last 2 hours or longer.
Contractions may feel different from the first stage of labor -- they will slow to 2 to 5 minutes apart and last from about 60 to 90 seconds. You’ll feel a strong urge to push with your contractions. Try to rest as much as possible between intervals of pushing, and only push when the health care provider tells you.
Some tips can help you push:
- Try several positions -- squatting, lying on your side with your leg up, or resting on your hands and knees.
- Take deep breaths in and out before and after each contraction.
- Curl into the push as much as possible; this allows all of your muscles to work.
You may get pain-relieving medications or have an episiotomy if necessary while pushing. An episiotomy is a procedure in which a small cut is made between the anus and vagina to enlarge the vaginal opening. An episiotomy may be necessary to get your baby out quicker or to prevent large, irregular tears of your vaginal wall.
The location of your baby's head as it moves through the pelvis (called descent) is reported in a number called a station. If the baby's head hasn’t started its descent, the station is described at minus 3 (-3). When your baby's head is at the zero station, it is at the middle of the birth canal and is engaged in the pelvis. The station of your baby helps indicate the progress of the second stage of labor.
When your baby is born, your health care provider will hold the baby with their head lowered to prevent amniotic fluid, mucus, and blood from getting into the baby's lungs. The baby's mouth and nose will be suctioned with a small bulb syringe to remove any additional fluid. Your health care provider will place the baby on your stomach and shortly after, the umbilical cord will be cut.
The Third Stage of Labor (Delivery of the Placenta)
The third stage of labor begins after the baby is born and ends when the placenta separates from the wall of the uterus and is passed through the vagina. This stage is often called delivery of the "afterbirth" and is the shortest stage of labor. It may last from a few minutes to 20 minutes. You will feel contractions but they will be less painful. If you had an episiotomy or small tear, it will be stitched during this stage of labor.