Stages of Labor and Birth
Stage 1: Early and Active Labor
Labor begins when the cervix softens and opens up because of regular and increasing contractions. This allows the baby to move down into the birth canal. The first stage of labor is usually the longest and includes early labor and active labor.
Early Labor (Latent Phase)
During early labor, contractions are mild and not always regular. The cervix opens to less than 6 centimeters. Some people notice a bloody or pinkish discharge, which is often the mucus plug coming out.
Most people can stay at home during this stage. The length of early labor varies and may last hours or even days. Those who have given birth before often move through this stage more quickly. Ways to stay comfortable during early labor:
- Walking
- Taking a warm shower or bath
- Listening to soft music
- Practicing slow, deep breathing
- Changing body positions
If the water breaks or there is heavy bleeding, contact a healthcare provider right away.
Active Labor
Active labor begins as the cervix opens from 6 to 10 centimeters. Contractions become longer, stronger, and closer together. This phase is more intense and is often when people go to the hospital or birthing center. The water may break during this time if it hasn’t already. Some people feel leg cramps, nausea, upset stomach, or pressure in the lower back and rectum.
Active labor usually lasts 4 to 8 hours, but every labor is different. The cervix often opens about 1 cm per hour, but this can be slower, especially with a first baby. Pain management options include breathing techniques, massages, moving around, and, if desired, pain medication or an epidural. Eating solids may not be allowed, especially if a C-section might be needed; usually, only clear liquids are allowed.
| Phase | Main Feature | Average Duration | What Helps |
|---|---|---|---|
| Early Labor | Mild, irregular contractions; cervix ≤ 6 cm | Hours to days | Relaxation, walking, warm bath, music, support |
| Active Labor | Strong, close contractions; cervix 6–10 cm | 4–8 hours + | Breathing, massage, birthing ball, movement |
As labor reaches the end of this stage (sometimes called the transitional phase), contractions become strongest and can last 60–90 seconds, coming every few minutes. The urge to push may start, but it’s important to wait until the cervix is fully open.
Stage 2: Pushing and the Arrival of the Baby
The second stage begins when the cervix is fully open (10 cm) and ends when the baby is born.
- How Long It Lasts: This stage can take just a few minutes or a few hours. First-time mothers and those with an epidural often push for longer.
- What Happens: The urge to push usually matches up with contractions, but sometimes the provider guides when to push or slow down. Changing positions—such as squatting, sitting, kneeling, or being on hands and knees—can help.
Support teams encourage pushing with each contraction. It can be motivating to feel the baby’s head or see it with a mirror as it crowns. As the head comes out, the provider may ask for gentler pushes to help tissues stretch and lower the chance of a tear.
After the baby’s head appears, the shoulders and the rest of the body follow. The provider may clear the baby’s mouth and nose to help with breathing. The umbilical cord is usually cut shortly after birth. Sometimes, the provider waits a bit before cutting the cord to allow extra blood from the placenta to reach the baby, which can help increase iron levels. Key features in the second stage:
- Full cervical dilation (10 cm).
- Strong urge to push.
- Baby moving down the birth canal.
- Various pushing positions possible.
- Support from care team.
- Cord clamping may be delayed for extra benefits.
| Step | What Happens | Timeframe | Who Helps |
|---|---|---|---|
| First urges to push | Feel the pressure, start pushing | Minutes-Hours | Medical team, partner |
| Crowning | Baby’s head stretches vaginal opening | Minutes | Doctor/Midwife |
| Birth of shoulders/body | Rest of baby delivered | Moments | Doctor/Midwife |
| Cord clamping | Cord cut, blood transfer to baby (delay possible) | 30 sec–few min | Doctor/Midwife |
Sometimes tearing, swelling, or a small cut to help deliver the baby can happen. Most tears heal well with stitches. Providers can help prevent major tears by slowing pushing at the right time.
Stage 3: Delivering the Placenta
The third part of labor begins after the baby is born and ends with the delivery of the placenta. The placenta has given the baby nutrients during pregnancy, and now it needs to come out to prevent infection and heavy bleeding.
- How Long It Lasts: This stage usually takes less than 30 minutes.
- What Happens: Mild, less painful contractions help separate the placenta from the uterus and move it into the birth canal. One more gentle push delivers it. Providers may give medicine by mouth or injection before or after the placenta comes out to help the uterus keep contracting and reduce heavy bleeding.
The care team checks the placenta to make sure every piece has come out. If any fragments remain inside, they must be removed right away to avoid infection or bleeding. Some new mothers like to see the placenta for curiosity or cultural reasons. Other things that happen in this stage:
- Continued mild contractions.
- The care team may massage the uterus to help it shrink.
- Monitoring for heavy bleeding or other concerns.
- Encouragement to try breastfeeding, which helps the uterus contract.
| What’s Happening | Purpose | Who’s Involved |
|---|---|---|
| Uterine contractions | Moves placenta out, prevents bleeding | Mother, providers |
| Medicine may be given | Helps with uterine contractions | Providers |
| Placenta delivery | Completes the birth process | Mother, providers |
| Examination of placenta | Ensures all parts removed | Providers |
| Breastfeeding encouraged | Supports bonding and uterine shrinking | Mother, baby |
If there is extra bleeding or if the placenta does not come out on its own, extra care or minor procedures may be needed.
The First Moments After Birth
Once the placenta is delivered, the body continues to adjust. The uterus keeps contracting to return to its normal size. Healthcare teams watch for any heavy bleeding, especially if the uterus doesn’t contract well. Common things that happen after birth:
- The care team checks for vaginal tears or possible stitches.
- Blood pressure, heart rate, and temperature are watched closely.
- Nurses check for numbness or ability to move legs if pain medication was used.
- Skin-to-skin contact is encouraged as soon as possible, even while small medical checks happen.
Breastfeeding in the first hour after birth (if possible) supports bonding and helps the uterus contract. Babies usually have their first checkup, often called the APGAR score, to make sure breathing, heart rate, and responses are healthy.
What Recovery Looks Like
- Bleeding (called lochia) is normal and like a heavy period at first.
- Cramps or “after pains” are common as the uterus keeps shrinking.
- Swelling, soreness, or stinging in the vaginal area can happen, especially if there was a tear or stitches.
- For those with a C-section, a different set of care steps are needed, such as caring for the incision.
- Fatigue is normal, and rest is important.
The next hours and days are called the postpartum period. This time is for recovery, feeding the baby, and getting to know the newborn. Physical changes, emotional ups and downs, and care needs for both baby and parent are all normal parts of this period. Monitoring for concerns like heavy bleeding, fever, or severe pain is important.
Support During Postpartum
- Nurses and doctors provide advice for breastfeeding or formula feeding.
- Instructions about caring for stitches or the incision (if a C-section) are given.
- Watching for signs of postpartum depression or strong emotional changes.
Most people stay in the hospital or birthing center for one to three days after vaginal delivery and a little longer after a C-section. Before going home, the healthcare team makes sure parent and baby are healthy, feeding well, and ready for the first days together. Common questions new parents often have:
- How to care for stitches or swelling
- What’s normal bleeding versus too much
- Signs of infection
- Basics of baby care (feeding, bathing, diapering)
- When to follow up with the doctor
Checklist for After Birth
- Monitor bleeding.
- Take care of stitches or incision.
- Begin feeding the baby.
- Ask for emotional support if needed.
- Schedule newborn and follow-up appointments.
Hospitals, birthing centers, and home birth attendants all have protocols to help guide families through these first hours and days. Every birth experience is unique, but knowing what to expect helps make the process clearer for everyone involved.
