Is Your Baby Coming Soon? A Complete Guide to the Stages of Labor

You are getting ready to bring your precious little baby into the world. This is a very special time, but it is normal to feel a bit nervous and excited all at once. Understanding how labor works can help you feel much more ready and calm when the big day finally arrives.

Simply put, labor is the natural process where your body moves your baby and the placenta out of your uterus and through your vagina. Doctors usually break this amazing journey down into three main stages.

1. First stage: Labor begins with regular contractions that open up your cervix.

2. Second stage: You push your baby down and birth your child.

3. Third stage: Your body delivers the placenta.

Medical experts often call this a "normal vaginal delivery." However, keep in mind that every birth is unique. You might experience these stages, but your baby could arrive via a scheduled or emergency C-section. Or, if your doctor starts your labor with medicine, your experience will look a bit different. Every mother and baby have their own special birth story.

Not knowing what to expect can cause worry. While your medical team cannot predict every exact detail, they will be right by your side to guide you safely through the process. Both you and your doctors share the exact same goal: a healthy mother and a healthy baby.

First Stage of Labor: Contractions Begin

This first stage begins when you get regular uterine contractions. It ends when your cervix is fully open (dilated) and fully thinned out (effaced).

Your doctor will likely ask you to time your contractions. To measure accurately, count the minutes from the exact start of one contraction to the exact start of the next one.

Regular contractions feel strong and happen in a steady pattern every three to five minutes. These are very different from Braxton Hicks contractions, which are irregular and mild "practice" squeezes. Labor can start on its own, or a doctor can start it using medical methods.

This first stage can last anywhere from 12 to 19 hours. If you have already given birth before, this stage may go by much faster.

There are two main parts to this first stage:

• Early labor: Your cervix opens up to about six centimeters. This phase usually lasts between 6 and 12 hours.
• Active labor: Your cervix opens fully up to 10 centimeters. You may feel a strong urge to push. This phase usually lasts between 4 and 8 hours.

Your doctor will likely suggest that you stay home during early labor. However, you should have your hospital bag ready. Once active labor starts, you must head to the hospital.

How to Make the First Stage Easier

During this first stage, several simple comfort measures can help you manage the early pain:

• Do gentle body stretches to ease muscle tension.
• Practice calming meditation or quiet reflection.
• Walk around the room and change your resting positions often.
• Focus on slow, deep breathing exercises.
• Take a warm shower to soothe your aching back and belly.
• Sit and sway gently on a birthing ball.
• Keep moving safely around your home.

Having a birth partner with you provides incredible emotional and physical support. This person could be your spouse, a family member, a close friend, or a trained labor doula.

If the pain becomes too hard to manage alone, talk with your medical team about available pain relief options.

Can You Sleep Through Early Labor Pain?

Every person handles pain and tiredness differently. If you are able to sleep or rest during early labor, please try to do so. However, strong contractions can sometimes make resting very difficult.

Second Stage of Labor: Pushing and Delivery

This stage begins when your cervix is fully open at 10 centimeters. It ends when your baby is finally born. This part of labor can take anywhere from 30 minutes to several hours.

Even if you do not push right away, your baby slowly moves down through your birth canal. During this second stage:

• Contractions come every two to five minutes and last for 60 to 90 seconds.
• You may feel a strong urge to push when contractions hit, but you can rest between them. Your doctor will tell you when it is time to push.
• The top of your baby's head becomes visible, which doctors call crowning.
• Your doctor helps guide your baby safely out of your birth canal.
• After your baby is born, your medical team cuts the umbilical cord.

Sometimes, instead of a vaginal birth, your doctor may perform a planned or urgent C-section to deliver your baby safely.

Third Stage of Labor: Delivering the Placenta

This stage starts right after your baby is born and ends when your placenta comes out. This is the shortest stage of labor and usually takes less than 30 minutes.

During the third stage of labor:

• Milder contractions return about 5 to 30 minutes after your baby arrives to help detach the placenta from your uterus.
• You may need to push gently, or your doctor may press softly on your belly to help the placenta slide out.
• You might experience a short burst of heavy bleeding as the placenta passes.
• Some mothers feel chilly or get a mild feverish shiver. Always tell your doctor if you experience severe symptoms.

If you had a C-section, your surgeon removes the placenta right after taking your baby out of the uterus.

Your doctor checks the placenta carefully to make sure it came out completely. Leaving any tissue behind can cause serious medical complications. If you needed an episiotomy or had a minor tear, your doctor repairs the skin carefully after the placenta is delivered.

How Does Labor Start and What Causes It?

Medical scientists do not know the exact trigger that starts labor. They believe it happens because of a complex chain of chemical and hormonal changes involving both your body and your growing baby.

Throughout pregnancy, your cervix stays closed and firm. When labor starts, your cervix must thin out and open up while your uterus starts squeezing.

Experts believe that when your baby is fully ready, their body sends tiny signals that stimulate your hormones to kick off labor. This natural event usually happens between 37 and 42 weeks of pregnancy. Sometimes, a doctor needs to induce labor with medicine.

Two main components help start and keep labor going:

• Prostaglandins: These are hormone-like substances made by your uterine cells. They help soften your cervix and trigger uterine contractions.
• Oxytocin: As your baby presses against your cervix, it stimulates your pituitary gland to release oxytocin. This powerful hormone travels to your uterus and causes strong contractions.

A few early signs hint that labor is starting soon:

• A dull, persistent ache in your lower back .
• A bloody show, which is the loss of your mucus plug tinged with pink or red blood .
• Loose stools or mild diarrhea .
• A strong nesting instinct to clean and organize your home .

Are You Really in Labor? Early Signs to Watch

It can be very hard to know if real labor has started. If this is your first baby, you might easily confuse irregular Braxton Hicks contractions with real labor. Real labor follows a steady pattern that gets stronger over time.

If you think you are in real labor, pay close attention to these three factors:

• Frequency: How far apart are your contractions? Keep track in a notebook or use a phone app to see if they follow a regular schedule.
• Duration: How long does each contraction last? As labor moves forward, contractions usually last longer. Keep a timer handy to measure each one.
• Intensity: Do your contractions feel progressively stronger? Labor pain naturally increases as you move through the stages. Make notes on how the pain changes over time.

What Is Abnormal Labor?

To keep both you and your baby safe, doctors follow specific guidelines to define abnormal labor. These rules help them know when to step in and prevent complications. Your medical team will always explain their concerns and treatment choices before doing any medical procedure.

First Stage Abnormalities

Doctors consider early labor prolonged if:

• You are having your first baby and early labor lasts longer than 20 hours.
• You have given birth before and early labor lasts longer than 14 hours.

Doctors consider active labor prolonged if:

• Your water breaks and you have had contractions for four hours, but your cervix has not opened past six centimeters.
• Your water breaks, you receive Pitocin, and you have had contractions for six hours without opening past six centimeters.

Second Stage Abnormalities

Doctors consider the second stage prolonged if:

• You are having your first baby and this stage lasts longer than three hours without an epidural, or four hours with an epidural.
• You have given birth before and this stage lasts longer than two hours without an epidural, or three hours with an epidural.

Third Stage Abnormalities

Doctors consider the third stage abnormal if your placenta stays inside your uterus for more than 30 minutes after your baby is born.

When Should You Go to the Hospital?

The best time to head to the hospital is when you enter active labor.

Call your doctor or hospital labor ward when your contractions come every five minutes and last for at least an hour. If your water breaks, call your doctor right away whether you feel contractions or not. If you are unsure whether you are in early labor or having Braxton Hicks contractions, call your care team for guidance.

What Happens When You Reach the Hospital?

When you arrive at the hospital, check in at the main admission desk. Nurses will likely take you to a triage room first as part of the admission process. Most hospitals allow only one support person to join you in this room.

After triage, staff moves you to your labor, delivery, and recovery room:

• You change into a comfortable hospital gown.
• A nurse checks your pulse, blood pressure, and temperature.
• Monitors wrap around your belly to track your contractions and your baby's heartbeat.
• Your doctor performs a gentle cervical exam to check your dilation.
• A nurse may place an IV line in your arm to give you fluids and medicines if needed.

How Long Will You Stay in the Hospital?

Your hospital stay depends on the hospital guidelines and how you give birth. If you have a C-section, you need a longer recovery stay because it is major surgery. Any health complications or medical issues for you or your baby can also extend your hospital stay.

Is There a Fourth Stage of Labor?

Some medical experts describe the two to three hours after your placenta is delivered as the fourth stage of labor. During this time, you begin bonding with your newborn baby. Your uterus starts to shrink down, and doctors monitor you closely to watch for any heavy bleeding.

How Long Does Labor Usually Take?

For a first-time mother, labor typically lasts between 12 and 24 hours. For later births, labor usually goes much faster, taking about 8 to 10 hours. The first stage of labor takes up the majority of this total time.

References & Further Reading:

• World Health Organization (WHO). WHO recommendations: intrapartum care for a positive childbirth experience.
• National Health Service (NHS UK). Stages of labour and birth.
• Mayo Clinic. Labor and delivery: What to expect.
• Centers for Disease Control and Prevention (CDC). Pregnancy Complications and Labor Signs.
• National Institutes of Health (NIH / MedlinePlus). Childbirth and Labor Stages.