Stages of labor and birth: Baby, it's time!
Labor is a unique experience. Sometimes it's over in a matter of hours. In other cases, labor tests a mother's physical and emotional stamina.
You won't know how labor and childbirth will unfold until it happens. However, you can prepare by understanding the typical sequence of events.
Stage 1: Early labor and active labor
The first stage of labor and birth occurs when you begin to feel persistent contractions. These contractions become stronger, more regular and more frequent over time. They cause the cervix to open (dilate) and soften as well as shorten and thin (efface) to allow your baby to move into the birth canal.
The first stage is the longest of the three stages. It's actually divided into two phases — early labor and active labor.
During early labor, your cervix dilates and effaces. You'll likely feel mild, irregular contractions.
As your cervix begins to open, you might notice a clear pink or slightly bloody discharge from your vagina. This is likely the mucus plug that blocks the cervical opening during pregnancy.
How long it lasts: Early labor is unpredictable. For first-time moms, the average length varies from hours to days. It's often shorter for subsequent deliveries.
What you can do: For many women, early labor isn't particularly uncomfortable, but contractions may be more intense for some. Try to stay relaxed.
To promote comfort during early labor:
- Go for a walk
- Take a shower or bath
- Listen to relaxing music
- Try breathing or relaxation techniques taught in childbirth class
- Change positions
If you're having an uncomplicated pregnancy, you may spend most of your early labor at home until your contractions start to increase in frequency and intensity. Your health care provider will instruct you on when to leave for the hospital or birthing center. If your water breaks or you experience significant vaginal bleeding, call your health care provider right away.
During active labor, your cervix will dilate from 6 centimeters (cm) to 10 cm. Your contractions will become stronger, closer together and regular. Your legs might cramp, and you might feel nauseated. You might feel your water break — if it hasn't already — and experience increasing pressure in your back. If you haven't headed to your labor and delivery facility yet, now's the time.
Don't be surprised if your initial excitement wanes as labor progresses and your discomfort intensifies. Ask for pain medication or anesthesia if you want it. Your health care team will partner with you to make the best choice for you and your baby. Remember, you're the only one who can judge your need for pain relief.
How long it lasts: Active labor often lasts 4 to 8 hours or more. On average, your cervix will dilate at approximately 1 cm an hour.
What you can do: Look to your labor partner and health care team for encouragement and support. Try breathing and relaxation techniques to relieve your discomfort. Use what you learned in childbirth class or ask your health care team for suggestions.
Unless you need to be in a specific position to allow for close monitoring of you and your baby, consider these ways to promote comfort during active labor:
- Change positions
- Roll on a large rubber ball (birthing ball)
- Take a warm shower or bath
- Take a walk, stopping to breathe through contractions
- Have a gentle massage between contractions
If you need to have a Cesarean delivery (C-section), having food in your stomach can lead to complications. If your health care provider thinks you might need a C-section, he or she might recommend small amounts of clear liquids, such as water, ice chips, popsicles and juice, instead of solid foods.
The last part of active labor — often referred to as transition — can be particularly intense and painful. Contractions will come close together and can last 60 to 90 seconds. You'll experience pressure in your lower back and rectum. Tell your health care provider if you feel the urge to push.
If you want to push but you're not fully dilated, your health care provider will ask you to hold back. Pushing too soon could make you tired and cause your cervix to swell, which might delay delivery. Pant or blow your way through the contractions. Transition typically lasts 15 to 60 minutes.
Stage 2: The birth of your baby
It's time! You'll deliver your baby during the second stage of labor.
How long it lasts: It can take from a few minutes to a few hours or more to push your baby into the world. It might take longer for first-time moms and women who've had an epidural.
What you can do: Push! Your health care provider will ask you to bear down during each contraction or tell you when to push. Or you might be asked to push when you feel the urge to do so.
When it's time to push, you may experiment with different positions until you find one that feels best. You can push while squatting, sitting, kneeling — even on your hands and knees.
At some point, you might be asked to push more gently — or not at all. Slowing down gives your vaginal tissues time to stretch rather than tear. To stay motivated, you might ask if you could feel the baby's head between your legs or see it in a mirror.
After your baby's head is delivered, the rest of the baby's body will follow shortly. The baby's airway will be cleared if necessary. If you've had an uncomplicated delivery, your health care provider may wait a few seconds to a few minutes before the umbilical cord is cut. Delaying clamping and cutting the umbilical cord after delivery increases the flow of nutrient-rich blood from the cord and the placenta to the baby. This increases the baby's iron stores and reduces the risk of anemia, promoting healthy development and growth.
Stage 3: Delivery of the placenta
After your baby is born, you'll likely feel a great sense of relief. You might hold the baby in your arms or on your abdomen. Cherish the moment. But a lot is still happening. During the third stage of labor, you will deliver the placenta.
How long it lasts: The placenta is typically delivered in 30 minutes, but the process can last as long as an hour.
What you can do: Relax! By now your focus has likely shifted to your baby. You might be oblivious to what's going on around you. If you'd like, try breastfeeding your baby.
You'll continue to have mild, less painful contractions that are close together. The contractions help move the placenta into the birth canal. You'll be asked to push gently one more time to deliver the placenta. You might be given medication before or after the placenta is delivered to encourage uterine contractions and minimize bleeding.
Your health care provider will examine the placenta to make sure it's intact. Any remaining fragments must be removed from the uterus to prevent bleeding and infection. If you're interested, ask to see the placenta.
After you deliver the placenta, your uterus will continue to contract to help it return to its normal size.
A member of your health care team may massage your abdomen. This may help the uterus contract to decrease bleeding.
Your health care provider will also determine whether you need repair of any tears of your vaginal region. If you don't have anesthesia, you'll receive an injection of local anesthetic in the area to be stitched.
Savor this special time with your baby. Your preparation, pain and effort have paid off. Revel in the miracle of birth.
Last Updated Jan 13, 2022