Updated: Nov 16, 2022
Let's cover the basics you need to know about each stage of labor. The more you know, the more prepared you will be for the changes you feel in your body.
Before discussing the various stages of labor I want to take a moment to review a few key terms and concepts that will come up throughout this post.
Cervix: The cervix is the lower, narrow end of the uterus that forms a canal between the uterus and vagina. Towards the end of pregnancy, your cervix will begin to thin, this is known as effacement. Once the cervix is effaced it can then start to dilate.
Cervical Dilation: The opening of the cervix. The cervix will open (dilate) progressively from 1 to 10 centimeters throughout labor.
Braxton Hick Contractions: In late pregnancy, starting as early as 20 weeks, you may experience a non-painful tightening sensation. These contractions do not dilate the cervix and do not have a progressing pattern. Think of these contractions as your uterus practicing for labor
Contractions: Contractions are when the muscles of your uterus get tight and then relax. Contractions help push your baby out of your uterus. Labor is marked by contractions that are progressively getting stronger, longer, and closer together.
Waves and Surges: Many people associate the word contraction with pain. Many choose to use alternative words like waves or surges. Changing how we refer to contractions can have a significant impact on how we view them and cope with them throughout labor.
A Note About Cervical Checks: Cervical checks, also called vaginal exams are a way that you or your provider can assess how many centimeters dilated you are. These can be very uncomfortable and sometimes triggering. While this is a way to check how dilated you are, it is NOT required. It can give you an indication of where you are in your labor but not necessarily how much longer your labor will last.
Pre-labor is the phase that precedes labor where your body is getting prepared for labor. During this time, you might feel a little anxious as you notice some changes in your body. If you understand what is going on in your body and how to handle it, you'll have a better chance of laboring at home until you are actually ready to go to your birth destination if you are not birthing at home.
A few signs of pre-labor include your bag of water leaking. This presents as a trickle, not a gush of fluid from the vagina. Only 10-20% pe people experience a dramatic breaking of waters as shown in the movies. Breaking of waters typically marks early labor if followed by progressing contractions. You may also have what is called a "bloody show" which is blood-tinged mucus that is released from the vagina before labor. This discharge will continue throughout labor.
If this is your first labor, you may experience regular contractions/waves every 5 to 8 minutes and this can go on for hours without having them get closer together. This is when your body is "tuning up" for labor. Your cervix will start to soften, move forward, thin, and will dilate to around 1 to 2 centimeters. Contractions/waves will likely not be very intense during this time and might feel like menstrual cramping, aches, fullness, or backache. A very small portion of first-time birthers will never experience what I describe and go straight into progressing contractions that I will describe in more detail in "Early Labor".
If this is not your first birth, you may experience progressing contractions at nighttime and which may subside by the morning. They can resume the following night for more hours. This is an on-again-off-again pattern that is normal. An experienced birther will likely be 3 to 4 cm dilated but not yet in labor. Yes, this can be frustrating so it is good to try to do something calming to take your mind off of your contractions/waves.
Pre-labor can last a few hours, many hours, or a few days. You may feel confused, frustrated, eager, or anxious. All of this is normal. You can reach out to your doula who can guide you through this time. You will want to conserve your energy for when labor begins so try to get rest during pre-labor.
The transition from the pre-labor to the dilation phase, also known as early labor, may be gradual but it is typically marked by progressing contractions/waves. This means that contractions/waves are getting stronger, longer, and closer together. During early labor, it is typical that contractions/waves may last from 30 to 40 seconds each and come anywhere from 5 to 30 minutes apart. This means you get a break between each one. As they progress in frequency and length the contractions or waves may become more intense. Typically you can be well distracted between contractions in early labor.
In most cases, early labor makes up anywhere from 2/3 to 3/4 of the duration of labor. This means it could take a few hours or it could take 20 hours to reach 6 centimeters. This timing will depend on the state of the cervix, the position of the baby, and the strength of the contractions/waves. If this is your first birth, it is rare for this to last less than 4 hours.
If your contractions are very long and very close together right off the bat you may be experiencing quick labor also known as precipitous labor. Precipitous labors are relatively uncommon. Quick labors are likely a sign that things are going really well; your baby is in a great position and your body is going smoothly through the motions of labor.
Active labor starts around 6 centimeters of dilation. Previously it was thought that active labor began around 4 centimeters but most recent research has shown that 6 centimeters are a more accurate indication of active labor. Contractions/waves in the active phase of labor last about 60 seconds each and are typically 3-4 minutes apart. During active labor, your cervix will continue to dilate to 8 centimeters.
Active labor typically shows a slow and steady progression from one centimeter to the next. For some, this can be a relatively quick progression, especially if this is not your birth labor.
Once you reach 8 centimeters you are considered to be in transition. The reason it is called "transition" is that this is when your body transitions from having a baby on the inside to having a baby on the outside of your body. As you progress from 8 to 10 centimeters of dilation contractions will last from 1-1.5 minutes and they may occur as frequently as 2 minutes apart.
At this point, your body is releasing a host of hormones to prepare for the birth of your baby. This increase in hormones can make you feel hot or cold, shaky, and nauseous. You may start to feel a sense of doubt at this stage because there are new sensations happening in your body. At this point, there tends to be more pressure on your perineum as your baby descends down the pelvis. These are all signs that you are getting closer to meeting your baby.
Many see the transition as the most challenging part of labor. It typically lasts between 30 minutes to two hours. You might begin feeling an urge to push but it is too early to start pushing. If you start pushing before your a fully dilated (10 centimeters) this can lead to swelling of your perineum. Your doula or care provider can help you manage these urges.
You have reached 10 centimeters of dilation and your baby has descended down your pelvis. This stage can be as short as 1 minute for an experienced birther and 2-5 hours for a first-time parent with an epidural. During this stage contractions/waves will be more spaced out which gives you a well-deserved break in between each one.
During the contractions/waves, you will be actively pushing and once the contractions subside you can rest. You and your baby are working together. Your baby will make instinctual movements to optimize their position. Their head will work to stretch your perineum to make space for them to be birthed. At the end of this phase, your baby's head will emerge, then one shoulder at a time. Once the shoulders have emerged your baby should slide right out. At this point, they should be put immediately on your chest.
The Golder Hour
The golden hour, or the third stage, begins once your baby is born and concludes with the birth of the placenta. This typically takes between 5-30 minutes. The placenta is the organ that has been attached to your uterine wall and has supported the nutrient transfer to your baby throughout pregnancy. Your baby is still attached to the placenta by the umbilical cord.
At this time, about 1/3 of your baby's blood supply is still in the placenta and is transferred to your baby through the umbilical cord. It is important to allow the umbilical cord to remain attached to your baby until it has stopped pulsing and turned white. This means the optimal amount of blood has been transferred to your baby. (Yeah, I know, our bodies are incredible!) This can take 3-5+ minutes. Some hospitals use an outdated technique of chord clamping where they immediately cut the cord. This is against what research shows is best for our baby so make sure you specify you want delayed cord clamping in your birth plan. Check out my FREE Visual Birth Plan Template that you can customize to share your preferences with your care team.
While it is common for contractions to slow down, contractions will continue as they facilitate the birth of your placenta. Birthing your placenta will likely be quite easy to birth because it does not have any bones. Throughout this time it is best to practice skin-to-skin contact with your baby and initiate breastfeeding. This will optimize bonding, connection, breastfeeding, and the continued contraction of your uterus which helps prevent hemorrhage. Try to ensure that your baby has skin-to- ski contact with you or your partner for the first hour after they are born.
Disclaimer: This information does not substitute for a care provider-patient relationship and should not be relied on as personal medical advice.
a free gift for you!
Ease your labor pains naturally without asking for an epidural.
Meet the Author
Clara O'Rourke (she hers),
Holistic Doula & Childbirth Educator.
I am a researcher turned total birth nerd with a passion for supporting people birth in their full power! I guide people through their pregnancy, labor, and postpartum journey by helping them overcome fear or anxiety about birth, providing evidence-based information so they can make informed decisions, and making sure they have everything they need to birth with confidence. Birth is sacred and it should be treated that way. I am committed to providing support for birth and beyond, regardless of a person's background, sexual orientation, gender identity or expression, or relationship status. También ofrezco mis servicios en español. I wish you and your growing family the brightest of beginnings!