Understanding the Stages of Labor

Bringing a new life into the world is both a euphoric and arduous journey, with significant changes happening in your body through each stage. As you prepare your body and mind for birth, understanding the stages of labor is foundational to your fully informed experience. In this simple guide, we'll introduce each stage with a brief overview to start you on your journey of discovery.

Here’s a brief overview of what happens during the three stages of labor.

Stage 1: Labor

The first stage of labor is the longest stage. For first-time moms, it can last from 12 to 19 hours. It may be shorter (about 14 hours) for moms who’ve already had children. It’s when contractions become strong and regular enough to cause your cervix to dilate (open) and thin out (efface). This lets your baby move lower into your pelvis and into your birth canal (vagina). This stage of labor ends when you are 10 centimeters dilated. The first stage is divided into three parts: early labor, active labor and transition to stage 2 of labor.

Early labor

If you’re going through childbirth for the first time, early labor may last anywhere from six to 12 hours. Many experts recommend staying at home in early labor to reduce the chances of medical intervention. This is a time to stay relaxed, move around, and make sure you have everything you need when active labor comes (including your birth plan).

What’s happening:

• Mild contractions every 5-15 minutes with each one lasting 60-90 seconds
• Pink, red, or blood discharge (”bloody show”)*

*If you experience heavy bleeding, reach out to your prenatal care provider right away.

Dilation and Effacement, what are they?

Effacement is the thinning and shortening of the cervix during childbirth. It is expressed as a percentage, indicating the reduction in length. When you are not in labor, the cervix is usually around 3 to 4 cm long. When you are told you are 50% effaced during labor, this means that the cervix has thinned by half of its original length and is now approximately 2 cm thick.

‍Dilation is the opening of the cervix to allow the passage of the baby through the cervix and into the vaginal canal. Dilation is measured in centimeters, indicating the width of the cervical opening. As labor progresses, the cervix dilates from its closed state, with complete dilation typically considered to be 10 cm.

Active labor

Active labor is when you need to go to your birthing location. You may be in active labor for 4-8 hours, beginning with regular contractions and six centimeters of cervical dilation.

What’s happening:

• Longer and more painful contractions that come as quickly as every three minutes and last about 45 seconds
• Pressure in the lower back and leg cramping
• Urge to push
• Dilated cervix from 6-10 centimeters
• Your water may break
• You may feel very sick

Transition

The transition to the second stage of labor, which can last from 15 minutes to an hour, is often the toughest part.

What’s happening:

• 60-90 second contractions that are very close together
• You may feel like you need to bear down
• Pressure in your lower back and rectum
• If you feel the urge to push, tell your prenatal care provider.

Stage 2: Pushing and childbirth

The second stage is when you’re fully dilated and ready to bring your baby into the world. Stage 2 can last anywhere from 20 minutes to a few hours. If you’ve had an epidural or this is your first childbirth, it can take longer. The stage ends with the birth of your baby.

Did you know? Oxytocin, often referred to as the "love hormone," plays a key role in triggering contractions and intensifying the ejection reflex.

What’s happening:

• 60-90 second contractions about 2-5 minutes apart
• Some people may need a small cut at the opening of their vagina to get the baby out. This is called an episiotomy.
• Your baby’s head starts to show (crowning)
• Your prenatal care provider helps your baby pass through the birth canal. If needed, they may assist the delivery with forceps or suction.
• Your baby is born! The umbilical cord gets cut afterward. You can identify who you want to do that in your birth plan.

Stage 3: Afterbirth

Now it’s time for the placenta to be delivered. The placenta is an organ that nourishes your baby through pregnancy. It’s attached to the umbilical cord. Waiting for the placenta to pass typically lasts 20 minutes.

What’s happening:

• Less painful contractions 5-30 minutes after birth that help the placenta pass
• Possibly some contractions after the placenta passes (medication can help)
• Your prenatal care provider will make sure your uterus feels right after the delivery of the baby and the placenta.
• If you had to have an episiotomy, you’ll have that repaired.
• Possible chills or shakiness (your provider can help with this)

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Sources:

• https://www.ajog.org/article/S0002-9378(17)32057-4/fulltext
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984379/
• https://www.marchofdimes.org/find-support/topics/birth/stages-labor