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The Stages of Labor (Labour) Explained

What happens in early labour, active labour, pushing and delivery of the placenta.

Before you use this guide: This is general educational information, not an individual medical assessment. We do not identify a clinician reviewer on this page, so please confirm personal health decisions with your doctor, midwife or paediatrician.

Labour is usually described in three stages. Every labour is different, and times vary a great deal, especially for a first baby. The ranges below are typical, not rules, and your team will judge progress by how you and your baby are doing rather than the clock.

First stage: the cervix opens

The first stage runs from the start of regular contractions until your cervix is fully open at 10 cm. It is the longest stage and has two phases.

• Early (latent) phase: contractions are mild to moderate, 5 to 30 minutes apart, and the cervix thins and opens up to about 4 to 6 cm. This can last many hours, or even a day or two, particularly in a first labour. You can often stay at home.
• Active phase: contractions become stronger, longer and closer together, usually every 3 to 5 minutes, and the cervix opens from about 6 cm to 10 cm. In a first labour this phase often takes around 4 to 8 hours. It is usually quicker in later births.
• Transition, at the end of this phase: contractions are at their most intense and can feel overwhelming. You may feel shaky, hot or cold, sick or irritable, or feel that you cannot go on. This is a sign the baby is close, and it usually does not last long.

What you can do in the first stage

• Stay at home in the early phase if you are well and your pregnancy is low risk. Rest, eat light snacks, drink fluids and keep moving.
• Try a warm shower or bath, a heat pack on the lower back, a birth ball, massage and slow breathing.
• Change positions often. Upright and forward-leaning positions, walking and swaying can help labour progress and ease pain.
• Empty your bladder regularly.
• Ask your birth partner to stay close, offer water and remind you that each contraction ends.
• Call your maternity unit when your contractions follow the pattern you were told, or sooner if something worries you. See our guide on signs of labour and when to go.

Second stage: pushing and birth

The second stage begins when your cervix is fully open and ends when your baby is born. It often takes up to about two to three hours in a first labour, and less in later ones. An epidural can lengthen it. Many women feel a strong urge to push, while others feel pressure or rectal fullness. Contractions often space out, giving you a rest between pushes.

• Your midwife or doctor will guide you on when and how to push. You can follow your body's urges in positions that feel right, such as kneeling, side-lying, squatting or semi-sitting.
• As the head crowns, you may feel stretching and a burning or stinging sensation. Your midwife may ask you to pant or breathe slowly so the skin stretches gently.
• After the head is born, the shoulders and body usually follow quickly with the next contraction.
• Your baby is placed on your chest when possible, for skin-to-skin contact.

If pushing is taking longer than expected, or your baby needs help, your team may suggest assistance with forceps or a vacuum, or sometimes a caesarean. They will explain why and ask for your consent.

Third stage: the placenta

The third stage is the time between your baby's birth and the delivery of the placenta. It typically takes 5 to 30 minutes. You will have mild contractions, and you may be offered an injection of oxytocin into your thigh to help the womb contract and reduce bleeding. This is called active management. Natural (physiological) management is possible for low-risk births, but discuss the options in advance and see our guide on writing a birth plan.

• The cord is clamped and cut, either right away or after a short delay, according to local policy and your wishes.
• You may feel mild cramping as the placenta separates and is delivered.
• Your midwife will check the placenta is complete, check your bleeding and examine you for tears. Our guide to perineal tears explains how they are repaired.

Sometimes called the fourth stage

The first hour or two after birth is sometimes called the fourth stage. Your team will monitor your bleeding, blood pressure, temperature and womb, and check your baby. It is a good time for skin-to-skin contact and a first feed. Read more in our first hours after birth guide.

What can slow labour

• A baby in a position that makes it harder to descend
• Weak or irregular contractions
• Tension, fear or exhaustion
• Pelvic shape, though it is hard to predict before labour

If labour slows, your team may suggest changing position, resting, breaking your waters or using a drip of oxytocin to strengthen contractions.

Tell your midwife straight away if

• Your waters break and the fluid is green, brown or bloodstained
• You have heavy bleeding
• Your baby moves less than usual
• You feel severe constant pain that does not ease between contractions
• You see or feel the umbilical cord in your vagina

Where to check current advice

Practice differs between hospitals and countries, so ask your own team, and check the latest guidance from NICE and the NHS in the UK, the HSE in Ireland, ACOG in the US, the SOGC in Canada and RANZCOG in Australia.

This content is for general information only and is not medical advice. Every pregnancy and every baby is different. Always talk to your doctor, midwife or paediatrician about your own situation, and seek urgent care if you are worried.