What to Expect During Each Stage of Labor

Labor and delivery can feel overwhelming, especially if you don’t know what to expect. Although every pregnancy and birth experience is unique, vaginal childbirth generally happens in three stages.

Dr. Rachael Counts, an OB/GYN with University Health, explains the stages of labor to help pregnant patients feel more prepared for delivery, understand their pain management options and know when it’s time to go to the hospital.

The Facts About Childbirth

Let’s start with the basics: “Childbirth is the process of giving birth to a baby,” said Dr. Counts. “During labor and delivery, you’ll push out both the baby and the placenta, which is the “temporary” organ that gives the baby nutrients, removes waste and helps with the overall development during pregnancy.”

You may have always heard that pregnancy is a nine-month journey, but a full-term pregnancy lasts 37-40 weeks.

When you near the end of that time period, your body will often “go into labor.” This means it starts the process of contractions that will help you deliver your baby.

What are Contractions?

Dr. Counts explains that contractions occur when the uterus's muscles tighten and relax.

When this happens, you may experience several different symptoms, including:

• Abdominal cramps
• Contractions that gradually become closer together
• Dull pain in the lower back
• Leaking fluid or bleeding from the vagina

False Contractions

When you enter your second trimester, you may experience false contractions, also known as Braxton Hicks.

“Compared to labor contractions, false contractions feel less intense and are irregular,” said Dr. Counts. “For example, when your body is going into labor, real contractions will feel like they are occurring in a pattern and typically last longer than a minute.” Dr. Counts further explained that false contractions will last a shorter amount of time and often do not worsen over time.

When it comes to other signs of false labor, you will feel pain in the abdominal area. “If you are in true labor, the pain will often come from the back of your body then move to the front,” said Dr. Counts.

When To Call Your Doctor About Labor

Signs of labor can look different for everyone, but contractions that become stronger, more frequent, and closer together are often an indication that labor is beginning.

Dr. Counts advises that you should contact your women’s health provider if you experience leaking fluid, vaginal bleeding or persistent lower back pain.

“Your provider may recommend staying home and monitoring your symptoms for a while or they may ask you to come in for an evaluation to determine the next steps,” Dr. Counts said.

When it’s time, your provider will let you know when to go to the hospital.

The 3 Stages of Labor

When you are given the green light to go to the hospital, that means the baby is on their way. When you have officially entered labor, there are three stages:

Stage 1: Cervical Dilation

Cervical dilation is the longest stage of labor and consists of three “sub-stages” of the labor process.

During the actual labor of the labor process, you’ll have uterine contractions that cause the cervix to dilate (open up) and efface (thin out). “These changes allow your baby to move into the birth canal,” said Dr. Counts. “The labor stage ends when you are 10 centimeters dilated and ready to begin pushing.”

Latent Labor

Latent labor, also called early or prodromal labor, is the first phase of labor. It may last up to 18-24 hours, during which you may experience contractions every 5 to 15 minutes, lasting up to 90 seconds each. You will be in latent labor until 6 centimeters of dilation.

Dr. Counts said during this phase, “do what you can to relax and conserve your energy.”

It may be helpful to walk around, take a shower or practice deep breathing. Some people choose to get an epidural or request alternative pain medication during this time.”

Active Labor

“After you reach 6cm of dilation and your contractions get closer together and are more painful, you’ve entered active labor,” said Dr. Counts. Many will dilate more quickly during this phase of labor, so most medical providers recommend you head to the hospital when you are having regular, painful contractions after 6 centimeters.

As you go through active labor, which typically lasts between four and eight hours, your cervix will continue to dilate. Your water may break, if it hasn’t already. You may feel queasy, experience lower back pain or feel shaky.

During the active labor phase, you can receive medication to relieve labor pain, including an epidural. Many patients include preferences like pain management and labor support in a birth plan to help prepare for delivery, which can help reduce stress during the labor process.

Transition Phase

The transition phase of labor can be the most painful, as your body prepares for the pushing stage. Contractions will be close together and you may feel pressure in your lower back and pelvis.

If you feel the urge to push, let your medical providers know. They’ll check your progress to see if you’re fully dilated.

This time of transition into the pushing stage of labor is usually quick.

Stage 2: Pushing & Birth

The second stage of labor begins when you’re fully dilated and effaced. This stage is when you begin pushing your baby out, a process that can be very rapid, but can also take up to 4 hours.

Dr. Counts explained: “Four different things will happen during this stage of labor: You’ll begin to push, your baby will descend (move further down) in the birth canal, you’ll experience crowning (where the baby’s head is visible at the vaginal opening), and your baby will be born. You can ask for a mirror to help watch these steps occur.”

Sometimes, special tools are needed to help your baby be born. These include vacuum or forceps. Vacuums are suction cups that attach to the back of the baby’s head and forceps are like salad tongs that go along baby’s head and face.

These tools are used if you are too tired to continue pushing or if the baby is in distress. While there are risks associated with these procedures, your delivery provider will only recommend them if they feel they are in your and your baby’s best interest.

Stage 3: Placental Delivery

The final stage of labor is delivering the placenta. During this stage, you’ll continue to have contractions, which will expel the placenta from the uterus and down the birth canal. Your delivery provider will also pull gently on your umbilical cord in order to help the placenta deliver.

This stage of labor takes less than 30 minutes. Your recovery process also begins during this stage. If you experienced any tears during labor, your provider would repair them and you may receive medications to prevent heavy bleeding.

Stages of Labor During a C-section

Above, Dr. Counts described the stages of labor that happen during a vaginal delivery. What happens if you have a C-section?

“It depends on the nature of the C-section,” said Dr. Counts. “If it’s a planned C-section, meaning it’s scheduled on a specific date, you may not have any stages of labor.”

At most, you may have experienced early labor, where contractions can begin days ahead of time.

Your provider may suggest a C-section if you’ve been laboring without progress after a certain period of time, meaning you either aren’t dilating or the baby isn’t descending into the birth canal. When that happens, you’ll go through part of the first two stages of labor before the surgical procedure.

If you have an urgent or emergent C-section, however, where you or the baby is endangered during the birthing process, you may progress through the first two stages of labor before the surgical procedure.

Depending on the baby’s health needs, they may be taken to the neonatal intensive care unit (NICU) for additional medical support.

The placenta is also removed during a C-section, completing the third stage of labor.

Labor & Delivery at University Health

If you’re preparing for childbirth, having the right care team can make all the difference. At University Health, our specialists are here to support you through every stage of pregnancy, labor and delivery with personalized, compassionate care. From routine prenatal visits to high-risk pregnancy services and labor support, the Women’s & Children’s Hospital offers expert care for both mom and baby.

Learn more about why we’ve been recognized as a Best Maternity Hospital by Newsweek.