Stages of labor

Stages of labor

First stage of labor

The first stage of labor is divided into three phases: early, active and transition. The first stage of labor is when the cervix dilates (opens) to 10 centimeters.

Early labor

Early labor contractions pull on the cervix, which looks a bit like the neck of a turtleneck sweater. Contractions shorten or thin the cervix. This process is called effacement and is measured in percentages.

Your cervix starts out three to four centimeters long. When it is 50 percent effaced, it is about two centimeters long. When it is 100 percent effaced, it is "paper-thin."

Effacement can happen over days before labor starts. Or, it can happen over hours as labor progresses. With a first labor, it can take quite a while for the cervix to completely efface. Labor may start slowly because the cervix first thins and then dilates.

Dilation is measured in centimeters, one to 10. In general, early labor moves to active labor by about six centimeters (cm).

In early labor, you may only need to use distraction and relaxation techniques to help cope with any discomfort.

Active labor

During active labor, contractions are more regular and intense, and cervical change is more regular. Active labor, however, requires more coping skills. When contractions become longer, stronger, and closer together, the key to coping is to relax between the contractions. During the contractions do whatever technique helps you deal with them.

active labor

First stage active labor

Transition labor

The last two centimeters of dilation are called transition because it is the transition between the first and second stage of labor. This is the time that contractions are the most intense. The first stage of labor ends when the cervix is fully dilated and your baby's head slips through your cervix.
First stage transition

First stage transition

Second stage of labor

Second stage is the work of pushing your baby through your vagina (birth canal). It is more difficult than the distance suggests because your baby must turn to fit through your pelvis. 

Cervix thins and dilates during labor. As your baby moves through your pelvis, her head usually rotates to face down.

purple arrow

As your uterus pushes your baby through your pelvis, her head begins to show, or purple arrow Most of your baby's head is born. As her shoulders move through your pelvis, she begins to rotate again.

purple arrow

Your baby's head and shoulders are born, and the rest of her body slips out.

 

    

Third stage of labor

The third stage is the shortest and easiest. It is the delivery of the placenta.

Stages of labor: What happens, how it feels

Stage or phase What happens during labor How it feels

First stage

Early phase

  • cervix effaces (thins) and dilates (opens)
  • may occur gradually over several hours or days
  • most effacement, and dilation from one to about four to six cm
  • may last 14 to 20 hours or more for first labor
  • contractions last 30 to 45 seconds and come every five to 30 minutes

Each phase feels different. Contractions are mild to strong. You may feel comfortable between contractions. You may feel nervous, nauseated or excited.

Try to relax and work with the rhythm of your body.

Active phase

  • dilation from about four to six cm through 8 cm
  • typically last three to five hours
  • contractions last 45 to 60 seconds and begin every three to five minutes

Contractions are stronger. Your attention is focused inward. You may have a dry mouth, chills and nausea, or feel sweaty.

Concentrate on staying relaxed between contractions to conserve your energy. It is important to move and switch positions throughout labor to help your baby descend and get in a good position for delivery.

Transition phase

  • dilation from eight to 10 cm
  • can last 30 minutes to 2 hours
  • contractions last 60 to 90 seconds; there are 30 seconds to 3 minutes rest in between contractions

Contractions are intense and close together. You may have hiccups, nausea, vomiting, shaking and pelvic pressure. You may feel like giving up.

Take one contraction at a time.

Second stage (pushing)

  • uterus pushes baby out
  • typically lasts 20 minutes to two hours or longer
  • contractions last 45 to 60 seconds and begin every three to five minutes
  • Your health care team may recommend waiting to push until the baby is lower, in a better position, or until you feel the urge
    to push.

You may experience a "rest period" before you feel an urge to push. You might get a surge of energy. Pushing can feel like pressure, stinging, burning or pain. Pushing can take a long or a short time. This depends on the position of your baby, the effects of medicine, and how well you are able to push.

Focus on using your abdominal muscles to push down, out and away. Your health care team will help suggest positions and techniques to aid you in your pushing efforts.

Third stage (after birth)

  • the placenta separates from the uterine wall and is expelled
  • typically lasts three minutes to 30 minutes after your baby's birth.

Contractions are less intense and may even be easy while you expel the placenta.

Push gently when your health care provider asks you to do so.

Source: Allina Health Patient Education, Beginnings: Pregnancy, Birth and Beyond, eighth edition, ob-ah-90026
First Published: 10/04/2002
Last Reviewed: 12/06/2021