What to Know About the Different Stages of Labor
Going into labor means the finish line is officially in sight. And while the end of your pregnancy is quickly approaching, this grand-finale event may be filled with dramatic twists, surprising turns and—let’s be honest—a fair share of pain and anxiety. Often, there’s a sequence of steps—known as the stages of labor—that take you from those early mild contractions to that incredible moment when you finally meet baby. Of course, every labor and delivery can progress a bit differently. (And, let’s be clear, unplanned or emergency c-sections and other possible hiccups can throw this whole expected progression for a loop.) Still, if you’re planning on trying for a vaginal delivery, you may want to get a better understanding of how things will pace and what to expect throughout.
There are three stages of labor—and within those stages there are additional phases of labor as your body prepares to push baby out. Wondering approximately how long will it last from start to finish, and what to expect throughout? Here’s everything you need to know about the different stages and phases of labor.
The first stage of labor—which includes the latent, active and transition phases of labor—starts with the beginning of regular and consistent contractions and lasts until the moment you start pushing. It may take a few hours. It may even go on for a day or two. Many doctors will tell you that this stage can be prolonged for first-time moms, but that it’s often shorter in subsequent pregnancies. Either way, it’ll definitely test your mental and physical resolve. What’s important is that you find the support you need at each and every point—whether it’s experimenting with different labor positions, relying on help from a partner or loved one or finding effective pain relief.
Latent phase of labor
The movies lie. Rarely does a woman know the second she goes into labor with 100 percent certainty. In real life, it can be hard to determine if you’re actually about to have a baby. (Don’t worry, you’ll figure it out!)
Those initial contractions might feel like lower back pain, or they may ebb and flow somewhat erratically. “False labor will go away with rest and hydration, and Braxton Hicks contractions will ease up after an hour or two,” says Nina Hinting, MD, an ob-gyn at Sinai Hospital in Baltimore. “True labor will continue and continue to worsen.”
As your cervix starts to thin and dilate, the early contractions will hopefully be light enough for you to talk and walk through them, explains Hinting. You may also notice a clump of clear or pinkish discharge from your vagina—that’s your mucus plug, which blocks the cervical opening during pregnancy. Hinting recommends doing what you can to relax and keep your mind off any discomfort you feel during the latent phase of labor. Take a bath or shower, read a book, watch TV or take a stroll. Better yet, sleep if you can; you’ll want to conserve your energy for later.
Active phase of labor
Once the strength of your contractions intensifies and the discomfort makes it hard to talk, walk or find a comfortable position, you’re probably moving into active labor. “When the contractions are three to five minutes apart and they’re lasting a full minute from start to finish, that usually means we’re moving into a more active phase,” says Christina M. Kocis, CNM, director of the Division of Midwifery at Stony Brook Medicine in New York. The active phase of labor typically begins when a mom-to-be is between 4 and 6 centimeters dilated. (FYI, if you haven’t called your doctor or midwife yet, now’s the time to ask about heading to your chosen hospital or birthing center.)
Still not sure if you’ve reached the active phase of labor? Here are some additional signs to watch for, according to Hinting:
You’re having gastrointestinal side effects. As baby drops toward your pelvic wall, you may experience diarrhea or vomiting.
Lots more pelvic pressure. Things may start feeling pretty intense down there.
Bleeding. A bit of bleeding is normal. To be safe, tell your doctor or midwife about any sign of blood.
You have an urge to push. You may want to bear down, but try and resist pushing until you’re advised to do so by your doctor, midwife or nurse.
Another potential sign you’ve entered the active phase of labor? Your water may break. While it’s possible for this to happen in the early stages of labor, it’s more likely to occur as things start heating up. If you’ve ruptured your amniotic sacs, you might feel a sudden gush or a steady trickle. Either way, expect enough fluid to soak your clothes or sheets.
By this point, things have gotten pretty real. Kocis recommends moving around, sitting on a Pilates ball or taking a shower to see if the warm water helps you cope with the pain of contractions. Meditate or do your breathing exercises if it’s in your plan, and definitely turn to your support person—your partner, doula, nurse or midwife—for encouragement. Sip water to stay hydrated, and if you’re hungry, eat if you’ve gotten the green light. Smaller snacks are best, since “digestion isn’t super-efficient during labor,” says Kocis. (Some doctors may not allow you to eat—or may restrict your diet—during active labor in case a c-section becomes necessary.)
Wondering how long active labor lasts? Eager as you may be to get this show on the road, the frustrating reality is that it’s different for everyone. But you can typically expect that it’ll take anywhere from four to eight hours for your cervix to dilate close to 10 centimeters, according to the MayoClinic.
Transition phase of labor
The pain and pressure in your body intensifies during the last part of the active phase of labor as you transition from being dilated 8 centimeters to a full 10. Contractions will feel like they’re on top of each other and can last anywhere from 60 to 90 seconds.
If you’ve chosen to have a medication-free experience, the transition phase of labor may have you curling your toes, gripping the bed rails and grunting out loud. You’ll likely be exhausted (even with an epidural), and you may feel your confidence slipping. This is “not unusual at this point,” says Kocis. “This is where support is really important; your support person should step up in helping build your confidence and letting you know you can do this.” Hinting agrees, and reminds moms to keep the end goal in sight: “At this point we tell mothers to focus on the baby and on her breathing… We tell them this will be over sooner rather than later.”
Here are a few simple suggestions from Hinting on how to help manage the pain:
- Lower back massage and/or counter pressure applied to your back
- Heating pads applied to your lower back
- Slowing down your breathing, if possible
Once you’re fully dilated, you’ve officially made it through the first stage of labor. Your energy may seem depleted at this moment, but the hard work is just getting started. Welcome to the second stage of labor—aka the birth of baby.
Depending on your circumstance, you might have some extra time to rest before delivery begins. This may be the case if your epidural is preventing you from feeling any pressure down there. To this end, your medical team might “dial back some of the numbness,” says Hinting. This will help you regain some control and feel that urge to push.
How long does the second stage of labor last? There are a host of factors that influence how much time you’ll spend pushing, says Kocis. These include:
- The baby’s size and position
- Your body shape and pelvis size
- Your ability to push
- How tired you are
- The impact of an epidural, if you had one
Suffice to say, it could be minutes or it may be hours. Hinting says that you may feel a burning when baby’s head is crowning; this sensation is often a sign that a few more pushes will do the trick. The head will be delivered first, followed by the rest of baby’s body. Your doctor may wait a few minutes to clamp and cut the cord; delaying this process by a few minutes has been shown to give baby a healthy head start.
If all goes well, you’ll probably be too busy snuggling baby to pay much attention to the third stage of labor, which is delivery of the placenta. “Most of the time it comes out without much maternal effort within the first 10 minutes after birth,” says Hinting. “Some women notice it, some don’t.”
It’s safe to say that delivering your placenta is not as dramatic (or painful) as pushing out a baby. If you have contractions at this point, they’re likely pretty mild. Your doctor or midwife may ask you to push once or twice, and they may gently massage your stomach to examine your uterus, which “doesn’t feel phenomenal,” says Kocis. “But once that placenta is out, moms feel very good and [have] that final sense of relief.” Your doctor or midwife will carefully examine your placenta, and will determine if you need stitches to repair any vaginal tears.
The stages of labor will test your mental and physical fortitude. Remember, it’s okay if things don’t go exactly as expected. Keep your eye on the prize.
About the experts:
Nina Hinting, MD, is an ob-gyn at Sinai Hospital in Baltimore, Maryland. She earned her medical degree at McGill University Faculty of Medicine in Montreal, Canada.
Christina M. Kocis, CNM, DNP, is the director of the Division of Midwifery at Stony Brook Medicine in New York, where she also earned her degrees.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.