The stages of labour

While every woman has a completely different experience of childbirth she’ll still go through the three stages of labor, unless she has a cesarean either before her labor begins or partway through it. 

It can be helpful to view each stage as a separate event so that once you reach the end of one stage, you know you’ve achieved a lot and are getting closer to meeting your baby.

Stage 1

This is the time when your cervix (the neck of the uterus) thins and dilates (opens up) to allow your baby to pass through. During this stage, your uterus contracts in order to dilate your cervix to 10 centimeters. Typically the first stage lasts around eight to 10 hours with a first baby and your contractions will build in intensity as time passes, becoming stronger and closer together. Even though this stage is the longest, don’t be disheartened. One misconception about labor is that you spend hours and hours in pain, but during the first few hours of stage 1 you’ll probably be able to read a magazine or chat happily to your birth partner even if you’re not using strong pain relief.

Stage 1 includes two phases:

Latent phase This is early labor, when your cervix changes very slowly – you might also hear it called pre-labor. If you’re timing your contractions during this phase and they’re lasting 30-40 seconds with enough time in between to have a cup of herbal tea, there’s no need to panic. Stay relaxed and get as much rest as you can for when the pace steps up.

Active phase At this point, your contractions will be stronger and more frequent, coming every five minutes or less and lasting 45-60 seconds. You’re now in established labor and you may need pain relief (see our pain relief article for more details on your options)??. This phase lasts five to six hours (it’ll be quicker if you’re given Pitocin but will take longer if you have an epidural) – you’ll enter it at around 3-4 centimeters dilated and end it fully dilated.

At the end of this phase comes what’s referred to as ‘transition’. It’s effectively a bridge between the first and second stages of labor, and some women find their contractions ease while their body prepares to push out their baby. Others find it makes them feel sad and weepy and they lose heart. With encouragement, these feelings will pass and your baby will be born very soon. You may feel a very strong urge to bear down or push, but if your cervix hasn’t fully dilated pushing too soon could cause it to swell. If there’s any risk of this, you’ll be encouraged to pant through your contractions until you reach 10 centimeters.

Stage 2

This is the time from when you start pushing until your baby is born. The contractions you feel now cause an overwhelming urge to bear down and push out your baby. At this stage most women don’t need to be guided, and go with what their body is telling them to do. Listen to your caregivers and if they ask you to pant instead of push, try your best to do so. You may worry about the sounds you might make during this stage, but if grunting and groaning (or screaming at your partner) help you to deal with each contraction, they’re helping to make the birth easier – and again you should go with them.

Pushing If you can, try to keep your pushing smooth and steady, to avoid putting pressure on your perineum. Most women prefer to be in a more upright position at this stage, as gravity helps the baby move downwards and you don’t have to do as much work. It is also helpful to relax your pelvic floor muscle and anal muscles as much as possible as you’re pushing. This may make you urinate or pass a stool, but it’s nothing to be embarrassed about. It happens to lots of women and your caregivers will have seen it plenty of times (in fact, you probably won’t even notice).

Crowning This is the point where the top of your baby’s head becomes visible – your anal area and perineum (the area between your vagina and anus) may bulge a little as it starts to happen. Your baby's head may slip back up the birth canal between contractions. Your OB-GYN will likely tell you to pant through contractions so she can guide your baby’s head out without it causing a tear in your perineum. It can take a couple of contractions after it has crowned for your baby’s head to fully emerge, usually pointing downwards, and your baby will then twist so that her shoulders are in a better position to come out. The rest of her body should slip out easily.

Assisted delivery If you’re unable to push out your baby, your OB-GYN may help him out with forceps or a vacuum extraction cup. An episiotomy (a surgical cut in the perineum) may be necessary to widen your vaginal opening.

Once your baby is born Your baby will be delivered onto your chest and will be covered in blood and vernix, a creamy substance that protected her skin while she was inside you. After you’ve given her a kiss she’ll be wrapped, any mucus will be suctioned from her nose and mouth, and her airways will be checked. If everything is straightforward and your baby is doing well, you can relax, cuddle and introduce yourself to your newborn. If you’re planning to breastfeed, now is a good time to try – your newborn will have a rooting reflex that will help her seek out your nipple and latch on.

Stage 3

Stage 3 is the time from the birth of your baby to the delivery of the placenta, which is expelled by the uterus once your baby has been delivered. Your OB-GYN will watch for signs that your uterus has contracted to detach the placenta and gently pull on the umbilical cord to assist as you push it out. Latching your baby on to breastfeed can help stimulate these final contractions, or your OB-GYN may give you a shot of Pitocin (some OB-GYNs give this routinely and it may also be recommended if you had an assisted delivery). Alternately, you may be given the option to deliver the placenta naturally, which can take anything up to half an hour. The contractions won’t be as strong and painful as the ones you experienced while giving birth.

Your OB-GYN will examine the placenta to make sure it’s all there – if any is retained it can prevent your uterus from contracting to seal the blood vessels where the placenta was attached, and this can result in heavy bleeding.

What do contractions feel like?

Labor pains, or contractions, feel different from women to women, but are mostly described as a tightening sensation that spreads around your lower abdomen. You might also feel a hardening of the uterine muscle at the peak of the contraction, and they can be accompanied by backache. Most women describe contractions as being like very intense period pains. If you imagine them to be a bit like walking up a very steep set of hills, which are hardest to climb at the very top, but when you reach the peak you can walk back down the other side easily (till you reach the next hill).

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.