It's Time! Understanding the Stages of Labor and Delivery

*Updated: 11 Dec 2024

Labor and delivery, also known as childbirth, is the process by which the baby leaves the uterus (womb). Sometimes labor progresses quickly over only a few hours. Other times, it is a physical and emotional endurance marathon. Childbirth is different for every woman and for every pregnancy. That said, there is a pattern of characteristics common to most labor experiences. Understanding those patterns, also known as the stages of labor and delivery, can help you prepare for what to expect once the process begins. It also helps to learn some of the various techniques and treatments used to manage each stage.

What Is the 1st, 2nd, 3rd, and 4th Stage of Labor?

Labor is divided into three stages:

• Labor
• Pushing and birth
• Delivery of the placenta
• Recovery
  

Signs Your Body Is Getting Ready for Labor

As your due date approaches, your body begins to prepare for labor, signaling that your baby’s arrival is just around the corner. These signs often occur within 24 to 48 hours before labor begins, giving you time to get ready both physically and emotionally. Here are the key indicators to watch for:

• Contractions: True labor contractions are stronger, more regular, and last longer than Braxton Hicks (false labor) contractions. If contractions occur every 4 to 5 minutes, labor is typically 1 to 2 days away.
• Bloody Show: This refers to a small amount of blood-tinged discharge from the cervix as it thins and the mucus plug is released. The discharge may appear brown, pink, or slightly red and has a thick, mucus-like texture.
• Water Breaking: A gush or steady trickle of fluid signals the rupture of the amniotic sac. If this happens before contractions begin, contact your midwife and use a pad to note the fluid’s color.
• Nesting Instinct: A sudden burst of energy and an urge to clean, organize, or prepare for labor.
• Weight Loss: Shedding 1 to 3 pounds in the days before labor due to increased urination or a decrease in water retention.
• Backache: Persistent low back pain, which can indicate that labor is imminent.

Additional signs that labor may soon follow include diarrhea and nausea. These symptoms occur as your body prepares for the significant changes ahead. Recognizing these signs can help you feel more prepared and confident as you enter the final stage of pregnancy.

First Stage of Labor: Early Labor and Active Labor

The early stages of labor may take between 12 to 19 hours. For second and subsequent pregnancies, this stage may move along at an ever faster pace, from 4 to 12 hours. During this stage, you’ll feel your uterine muscles begin to regularly tighten and relax (contractions). This helps begin the process of moving your baby further down into the birth canal. Your cervix gradually becomes wider (dilates) and thins (effaces). This stage of labor has two phases: early labor and active labor.

Phase 1: Early Labor (Latent Phase)

Early labor, called the latent phase, typically happens at home. This is when contractions are becoming more frequent (usually 5 to 20 minutes apart) and last for about a minute each. The cervix dilates about 3 to 6 cm. You may notice a pink, clear, or bloody vaginal discharge (heavy bleeding warrants a trip to the hospital).

How Long Does Early Labor Last?

The latent phase is the longest and, for most people, least painful phase of labor. In fact, some people may not even recognize that they are in labor if their contractions are not very painful or regular. This is the time most people head to the hospital.

Labor Pain Symptoms and When to Go to Hospital: What Is the 5-1-1 Rule for Contractions?

You may want help to decide when to go to the birthing center. Lamaze International says that, traditionally, the 5-1-1 rule is used`; that is, when contractions come every 5 minutes, each lasting a full minute, and have been that way for an hour. More recent recommendations are 4-1-1 (four minutes apart) or even 3-1-1 (three minutes apart). No matter what, listen to your body an follow your instincts.

Phase 2: Active Labor

You should already be at your hospital or birthing center for the active phase of labor. During this phase, contractions become longer, more frequent, and more intense (typically 3 to 4 minutes apart).

What Does the First Stage of Active Labor Feel Like?

You may begin to feel the need to push as your baby progresses down the birth canal. Pain, cramping, and pressure in the legs and lower back are common. The amniotic sac around your baby may also rupture (known as your water breaking).

How to Manage the First Stage of Labor

Try to remain calm and relaxed during this stage. Many people find deep breathing, taking a walk, massage, or gentle stretching helpful. You may even want to soak in a warm (not hot ) bath if your water hasn’t broken. Once you arrive at the hospital, move around or switch positions to get more comfortable, go to the bathroom as much as you want, and drink plenty of water. Ask for pain relief medicine or epidural anesthesia if you need it.

Second Stage of Labor: Pushing and Birth

Once your cervix has opened or dilated to 10 cm, the first stage of labor is over and the second stage of labor begins. This is the part where you actually start trying to push the baby out of your body. For many people, this is the most intense and challenging phase and lasts from 30 minutes to several hours. 

Contractions begin to slow a bit, coming every 2 to 5 minutes, and last for about a minute to a minute and a half. Your doctor or midwife will instruct you when to push, giving you a moment to rest in between contractions. During this stage, your baby’s head will show (crowning), and your healthcare provider will help guide the baby out. After the baby is out, they will cut the umbilical cord.

How to Manage the Second Stage of Labor

If you’re having difficulty pushing or feel uncomfortable, try kneeling, squatting, or sitting instead. Your healthcare provider may also make a small incision at the opening of your vagina (an episiotomy) to help the baby exit your body more easily.

Third Stage of Labor: Delivery of the Placenta

This is the shortest stage of labor, typically lasting less than 20 minutes. Within half an hour after delivery, you’ll begin to experience mild contractions as your body expels the placenta (afterbirth). Your doctor or midwife may have to gently push on your abdomen to move the placenta and may ask you to push. Heavy vaginal bleeding during or after this stage is common. If you feel feverish or have chills, notify your healthcare provider immediately.

How to Manage the Third Stage of Labor

Your doctor or midwife will ensure that all of the placenta is completely removed from your body, as retained products of conception can cause severe health issues. If needed, you’ll receive treatment for excessive vaginal bleeding. You’ll also get stitched up if an episiotomy was performed.

Fourth Stage of Labor: Recovery

Recovery begins within the first 2-3 hours after giving birth. During this period, the uterus contracts intermittently to expel any remaining material and regain its muscle tone. Breastfeeding accelerates these contractions because it stimulates the release of oxytocin, a hormone that supports uterine contraction. During this phase, you might experience:

• Tremors and chills
• Discomfort due to pain, episiotomy, tears, or hemorrhoids
• Weakness and dizziness, especially when standing
• Difficulty urinating caused by swelling in the genital area

When you feel ready, you can take a warm shower to relax and then rest to recover from the physical demands of labor and childbirth. Begin breastfeeding as needed, as skin-to-skin contact with your baby helps them learn to nurse while also keeping them warm and calm.

If you’re unable to do skin-to-skin contact, your partner can step in to provide warmth and comfort for the baby. During this time, your baby will also be monitored or cared for by a neonatologist.

When to Contact a Doctor

Contact your healthcare provider or birthing center when your contractions are five minutes apart for at least one hour or immediately after your water breaks (regardless of contractions). Even if you’re unsure or think you may be experiencing Braxton-Hicks contractions (false labor), it’s a good idea to let your delivery team know what’s happening. Seek medical assistance immediately if you experience any of the following:

• heavy bleeding
• shortness of breath
• chest pain
• fainting or dizziness
• swelling in the arms, legs, or face
• extreme vomiting and nausea
• a marked decrease in fetal movement

The Bottom Line on the Stages of Labor and Delivery

The stages of labor and delivery are a unique experience for every person and every pregnancy. Understanding what to anticipate with each stage can help you stay relaxed and focused. Creating a thorough birth plan with your doctor or midwife is a great way to prepare and make your preferences known. It also helps to have a designated birthing partner, like a spouse, doula, family member, or friend, with you to help motivate and encourage you during the process.