Labor and delivery (11)
- Signs of labor: Know what to expect
- Episiotomy: Can you deliver a baby without one?
- Inducing labor: When to wait, when to induce
- see all in Labor and delivery
Postpartum care (7)
- Exercise after pregnancy: How to get started
- Maternity leave: Tips for returning to work
- Weight loss after pregnancy: Reclaiming your body
- see all in Postpartum care
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Stages of labor: Baby, it's time!
Labor is a natural process. Here's what to expect during the three stages of labor — and how to promote comfort as labor progresses.
By Mayo Clinic staffEvery woman's labor is unique, even from one pregnancy to the next. In some cases, labor is over in a matter of hours — or less. In other cases, labor tests a mother's physical and emotional stamina.
When everything goes smoothly, the stages of labor unfold in three distinct parts.
Stage 1: Early labor and active labor
The first stage of labor occurs when the cervix opens (dilates) and thins out (effaces) to allow the baby to move into the birth canal. This is the longest of the three stages of labor. It's actually divided into two phases of its own — early labor and active labor.
Early labor
During early labor, your cervix will begin to dilate. You may feel mild to moderately strong contractions during early labor. They may last 30 to 60 seconds and come every five to 20 minutes. As your cervix begins to open, you may notice a thick, stringy, blood-tinged discharge from your vagina. This is known as bloody show.
How long it lasts: You may need to be patient. Early labor is unpredictable. It may last for hours or even days, especially for first-time moms. It's often much shorter for subsequent deliveries.
What you can do: Until your contractions increase in frequency and intensity, it's up to you. For many women, early labor isn't particularly uncomfortable. You may feel like doing household chores, taking a walk or watching a movie. Or you might simply continue your daily activities.
It may also help to:
- Take a shower or bath.
- Listen to relaxing music.
- Have a gentle massage.
- Try slow, deep breathing.
- Change positions.
- Drink water, juice or other clear liquids.
- Eat light, healthy snacks.
- Apply ice packs or heat to your lower back.
Active labor
Now it's time for the real work to begin. During active labor, your cervix will dilate to 10 centimeters. Your contractions will become stronger and progressively longer. Near the end of active labor, it may feel as though the contractions never completely disappear. You may feel increasing pressure in your back as well. If you haven't headed to your labor and delivery facility yet, now's the time.
Your initial excitement may wane as your labor progresses and the pain intensifies. Don't feel that you're giving up if you ask for pain medication or anesthesia. Your health care team will help you make the best choice for you and your baby. Remember, you're the only one who can judge your need for pain relief.
How long it lasts: On average, active labor lasts up to eight hours. For some women, active labor lasts hours longer. For others — especially those who've had a previous vaginal delivery — active labor is much shorter.
What you can do: Look to your labor coach and health care team for encouragement and support. Try breathing and relaxation techniques to combat your growing discomfort. Use what you learned in childbirth class or ask your health care team for suggestions.
It may also help to:
- Change positions.
- Rock in a rocking chair.
- Roll on a birthing ball.
- Take a warm shower or bath.
- Place a cool, damp cloth on your forehead.
- Take a walk, stopping to breathe through contractions.
- Have a massage between contractions.
If you feel the urge to push, try to hold back until you've been told you're fully dilated and it's time to push. It may help to pant or blow. Pushing too soon may cause your cervix to tear or swell, which can delay delivery or cause troublesome bleeding.
Stage 2: The birth of your baby
It's time! You'll deliver your baby during the second stage of labor.
How long it lasts: It can take from a few minutes up to several hours or more to push your baby into the world. It often takes longer for first-time moms and women who've had an epidural.
What you can do: Push! You may be encouraged to push with each contraction to speed the process. Or you might take it more slowly, letting nature do the work until you feel the urge to push.
Many women choose to push while lying in a birthing bed. Squatting or sitting works well for others. Some women prefer to get on their hands and knees or kneel while a labor coach supports their upper body. Try different positions until you find one that feels best. When you push, don't hold tension in your face. Bear down and concentrate on pushing where it counts.
At some point, you may be asked to push more gently — or not at all. Slowing down gives your vaginal tissues time to stretch rather than tear. Feeling the baby's head between your legs or seeing it in a mirror can help you stay motivated.
After your baby's head is delivered, his or her airway will be cleared and your health care provider will make sure the umbilical cord is free. The rest of your baby's body will follow shortly.
Next page(1 of 2)
- Labor and birth. The National Women's Health Information Center. http://womenshealth.gov/Pregnancy/childbirthandbeyond/laborandbirth.cfm. Accessed Jan. 9, 2009.
- Normal progress of labor. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, PA: Churchill Livingston/Elsevier; 2007. http://www.mdconsult.com/das/book/body/116077551-3/790123043/1528/125.html#4-u1.0-B978-0-443-06930-7..50014-1--cesec17_621. Accessed Jan. 9, 2009.
- Delivery of the placenta and fetal membranes. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, PA: Churchill Livingston/Elsevier; 2007. http://www.mdconsult.com/das/book/body/116077551-4/0/1528/127.html. Accessed Jan. 9, 2009.
- Funai EF, et al. Mechanism of normal labor and delivery. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Silverman F, et al. Management of the third stage of labor. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Simkin P, et al. Nonpharmacological approaches to management of labor pain. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- Funai EF, et al. Management of normal labor and delivery. http://www.uptodate.com/home/index.html. Accessed Jan. 9, 2009.
- You and your baby: Prenatal care, labor and delivery, and postpartum care. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/ab005.cfm. Accessed Jan. 9, 2009.
- Management of normal labor. The Merck Manuals Online Medical Library for Healthcare Professionals. http://www.merck.com/mmpe/sec18/ch260/ch260d.html. Accessed Jan. 9, 2009.
