Stages of labor

Recognizing the signs of labor can help you know when it's time to call your health provider and head to the hospital. Learning about the stages of labor can help you know what to expect during labor and delivery.
Labor occurs in three stages. When regular contractions begin, the baby moves down into the pelvis as the cervix both effaces (thins) and dilates (opens). How long labor lasts and how it progresses is different for every woman. But each stage features some milestones that are true for every woman.

Stage 1: Early labor and active labor
The first stage of labor takes place in two phases: early labor and active labor.

During early labor:

  • Your cervix will start to dilate.
  • You may feel strong and regular contractions that last 30-60 seconds and come every 5 to 20 minutes.
  • You may notice a bloody show.
  • You may be in early labor for a few hours or days, especially for first-time moms.
  • You may want to spend this phase at home or wherever you are most comfortable.

During active labor:

  • Your contractions will become stronger, longer and more painful.
  • There may be very little time to relax in between contractions.
  • You may feel pressure in your lower back.
  • Your provider may tell you to get ready and head to the hospital.
  • Your cervix will dilate fully to 10 centimeters so the baby can be born.

What you can do:

  • Rest and relax.
  • Take a shower or bath (so long as your water hasn't broken).
  • Watch TV or listen to music.
  • Change positions.
  • Take a walk around the house or room.
  • With your provider's okay, drink or eat healthy snacks during the early part of labor.
  • Place ice packs on your lower back.
  • Place a cold washcloth on your forehead.
  • Have your partner rub your lower back.
  • Suck on ice chips.
  • Go to the bathroom often to empty your bladder.

Stage 2: Baby is born
During the second stage of labor, your cervix is fully dilated and ready for childbirth. Your health provider will want you to begin pushing to allow your baby to be born.

During stage 2 of labor:

  • It can last as short as 20 minutes or as long as several hours (especially for first-time moms).
  • You may feel pressure on your rectum from your baby's head moving down the birth canal.
  • You may feel the urge to push.
  • Your provider may give you an episiotomy, a small cut to enlarge the vaginal opening. (Most women don't need an episiotomy.)
  • Your baby's head begins to crown (show).
  • Your provider will guide the baby out of the birth canal.
  • Your provider may use special tools to help you in delivery.
  • Your baby is born and the umbilical cord, which connected mother and baby, is cut.

What you can do:

  • Find a position that is most comfortable for you to push.
  • Push when you feel the urge or when your health provider tells you.
  • If you're uncomfortable or pushing has stopped, try a new position.
  • Rest in between contractions.

Stage 3: Delivery of placenta
During the third stage of labor, the placenta, which gave your baby food and oxygen through the umbilical cord, is delivered. While you are bonding with your new baby during the first minutes of her life, your provider will get you ready for this final stage.

During stage 3 of labor:

  • Contractions will begin 5 to 10 minutes after birth.
  • You may have chills or shakiness.
  • It may take 5 to 30 minutes to deliver the placenta.

What you can do:

  • Relax.
  • Push when your health provider tells you.
  • If you'd like, ask to see the placenta.
  • Begin breastfeeding to provide your baby with important nutrients to help her stay health and grow.

Once you're done, give yourself a big pat on the back for all your hard work. You've made it through childbirth! Now, enjoy these first special moments with your new baby as you and your partner welcome him to the world.

Coping with labor pain
Some women prefer to deal with the pain of childbirth naturally, using breathing and relaxation techniques learned in childbirth education classes. Other women decide to use pain medication to help manage labor pain.

You may want to have a natural childbirth. But during labor, you may decide to use some pain medication, such as epidural or a spinal, to cope with the pain. It's okay to change your mind. Don't feel like you gave up or let your baby down. Only you know how strong the pain feels. It's okay to talk with your provider and do what you think is best.

September 2009

Most common questions

What is an epidural?

An epidural is the most popular and effective kind of pain relief for labor. You get a needle with a small tube attached placed in your lower back. Medicine goes through the tube while you're in labor. It numbs your lower body so you can't feel the pain from your contractions. The medicine doesn't make you go to sleep, so you can be wide awake when your baby is born!

What is fetal-scalp blood sampling?

Fetal-scalp blood sampling is a quick test your health care provider can use to check if your baby is getting enough oxygen during labor.

During labor, your cervix dilates (opens) to let your baby out. Your cervix is the opening to the uterus that sits at the top of the vagina. In order to have fetal-scalp blood sampling, your cervix must be dilated enough that your provider can reach your baby’s head.

The test may remind you of a pelvic exam. It takes about 5 minutes. You lie on your back with your feet in stirrups. Your provider places a plastic cone in the vagina that fits up against the baby’s head. Your provider pricks your baby’s scalp and takes a small amount of blood. The blood is tested, and results are ready in a few minutes.

You may feel some pressure during the test, but it shouldn’t hurt. Your baby may have some bruising or bleeding at the spot where he’s pricked.

If you have an infection, like HIV or hepatitis C, your provider may not recommend fetal blood sampling. This is because you can pass these infections to your baby through the spot where he’s pricked.

What is oxytocin?

Oxytocin is a hormone your body makes to help start labor contractions. Contractions are when the muscles of your uterus get tight and then relax. They help push your baby out of your uterus (womb).

Your body also makes oxytocin during breastfeeding. Oxytocin helps your uterus shrink back to its original size after giving birth.

If labor is slow to start or your contractions stall, your health care provider may give you a medicine called Pitocin. Pitocin acts like oxytocin and can help start contractions or make them stronger.

What is Pitocin?

Pitocin is a medicine that acts like oxytocin, a hormone your body makes to help start labor contractions. Contractions are when the muscles of your uterus get tight and then relax. They help push your baby out of your uterus (womb). Health care providers often use Pitocin to:

  • Help induce labor
  • Help labor move along if your contractions slow down, or if they aren’t strong enough

You may start having labor contractions shortly after you get Pitocin. It can make your contractions very strong and lower your baby's heart rate. Your provider carefully monitors your baby's heart rate for changes and adjusts the amount of Pitocin you get, if needed.

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