Step-by-step Guide to Labor: All You Need to Know About Stages of Labor

Every woman’s labor is different. Some women are in labor for many hours, even a day or more, while others deliver their baby within a matter a few hours. Whether a woman has had a child before can impact the duration of labor—a woman’s first baby often takes longer to deliver than subsequent babies.

It’s impossible to know how your labor will unfold until it begins. But knowing what to expect will help you prepare mentally, emotionally, and physically for labor. Let’s take a look at the stages of labor as they typically unfold for vaginal deliveries.

First Stage: Early Labor

The first stage of labor has three phases—early labor, active labor, and transitional (advanced) labor.

Phase 1: Early labor involves the dilation and thinning (effacing) of the cervix, which allows the baby to move into the birth canal. This is the longest (but least painful) of the three stages of labor. For some women, dilation and effacement is a very gradual process that takes weeks or even as long as a month.

As the cervix dilates, the mucus plug that blocks the cervical opening will become dislodged, which you may or may not notice. This can happen anywhere from a couple of hours to a few weeks before labor begins. Then, a few days to 24 hours before delivery, you might notice a brown or bloody discharge from your vagina, called “bloody show.”

During early labor you’ll feel mild contractions that come at regular intervals and, generally, last between 30 and 90 seconds. Near the end of early labor, contractions will likely occur less than five minutes apart.

How long it lasts: Early labor often lasts six to 12 hours, especially for first-time moms. Soothing activities, such as a warm shower or massage can help ease pain or discomfort. Many women choose to take a walk, watch a movie, or even do light household chores during this phase. There’s no right or wrong, as long as it’s safe for you and your baby.

Phase 2: Active labor is the second phase of early labor, and this is where the real work begins. During this stage your cervix should dilate to 10 centimeters (cm), and your contractions will become stronger, closer together, more regular, and longer. This is the stage where you might feel your water break, if it hasn’t already. You might experience nausea, cramping in the legs, and pressure in your lower back. Now is the time to head to your delivery center, or call your midwife if you’re planning to deliver at home.

How long it lasts: Active labor can last up to eight hours, and even longer for some women, especially first-time moms. For women who have had one or more previous vaginal deliveries, labor can take as little as a couple of hours.

Phase 3: The transitional or advanced stage of labor occurs before delivery. This stage can be especially painful, and you may feel the urge to push. But pushing when your cervix isn’t fully dilated can cause swelling, so your healthcare provider/midwife may ask you to resist until your body is ready.

Transitional labor can be physically demanding, with strong contractions lasting 60-90 seconds. You may feel frustrated, exhausted, and overwhelmed, and this is normal. Using the techniques you learned during your childbirth classes, including breathing and panting, and looking to your labor coach for support, should help you during this stage.

It’s impossible to know how your labor will unfold until it begins. But knowing what to expect will help you prepare mentally, emotionally, and physically for labor.

Second Stage: Pushing the Baby Out

Now that dilation is complete, it’s time to help the baby through the birth canal by pushing.

Delivery generally takes 30 minutes to an hour, but it can last as little as a few minutes or as long as several hours. Your contractions should last for 60 to 90 seconds, but will likely be more regularly spaced—typically two to five minutes apart.

At this stage you’ll move into the position that’s most comfortable for you to start pushing, and follow instructions from your practitioner/midwife. Women usually give three big pushes per contraction, but how much you push will depend on how much energy you have. You’ll want to recover between contractions to conserve as much energy as possible.

It’s important not to push with your upper body, or strain your face, which can leave you with black or bloodshot eyes. Keep your chin to your chest to help you focus on pushing with your lower body, as if you’re having a bowel movement. Don’t worry about emptying your bowels or passing urine while you’re pushing—this happens to most, if not all, women during delivery and there is nothing to be embarrassed about.

Your birthing team should provide you with a mirror to see your baby’s head crown. Don’t become frustrated if you see the head crown . . . and disappear again—your efforts will soon be rewarded when your little one emerges into the world.

Once your baby’s head has fully emerged, your practitioner will suction any mucus from the baby’s nose and mouth, and help guide the baby’s shoulders, torso, and legs out. Once out, the birthing team will give your baby a wipe down and swath him or her in a blanket. Soon after, you’ll relish that first cry and hold your baby in your arms.

Third Stage: Delivering the Placenta

The third and final stage is delivering the placenta (also known as afterbirth) that filtered nutrients for your baby while he or she was in the womb. This last stage can last anywhere from five to 20 minutes, or more, during which you may feel mild contractions that help separate the placenta from the uterine wall, and which move it into the birth canal so you can push it out.

Don’t shy away from looking at the placenta once it’s delivered—this amazing creation provided sustenance for your baby all those months!

If you’ve decided to preserve your baby’s cord blood, cord tissue, and/or placenta tissue, the medical team will carefully preserve the placenta and umbilical cord for later harvesting of the stem cells contained within the blood and tissue.

Your practitioner will stitch up any vaginal tears that may have occurred during delivery. After delivery you can expect to have bleeding (called lochia), similar to a heavy period—this is perfectly normal.

Congratulations—you’ve brought your baby into the world!

the stages of labor

About Cord Blood, Cord Tissue, and Placental Tissue Storage

During your pregnancy you should consider preserving your baby’s umbilical cord blood, cord tissue, and placenta tissue, which could be lifesaving in the future.

Cord blood is a rich source of stem cells that is easily accessible and only available when your baby is born. These stem cells are genetically unique to your baby and your family, and can be used to treat your baby, the baby’s siblings, and other family members for various diseases and illnesses. Cord blood stems cells are hematopoietic stem cells (HSCs), which can become any of the blood cells and cellular blood components in our bodies (such as white blood cells, red blood cells, platelets, etc.). Transplants of stem cells from cord blood are an effective therapy for certain blood borne and genetic diseases, including various types of leukemia and lymphoma.

Cord tissue and placenta tissue both contain special multipotent stem cells called mesenchymal stem cells, which means they can differentiate into many different types of cells, including cartilage cells (chondrocytes), bone cells (osteoblasts), and fat cells (adipocytes). These cells can potentially be used to treat a wider range of diseases than cord blood alone can treat.

Storing cord blood, cord tissue, and placenta tissue can be invaluable for future medical treatment. Learn more about cord blood and tissue storage here.