3 Vital Stages Of Labor: What Happens In Them And What To Do

Jules Brooks Medically reviewed by Jules Brooks (Calmbirth Practitioner, Doula) Written by (MSc)
Childbirth

Image: Shutterstock

Perhaps people might have told you about labor in a vaginal birth. They might have invariably talked about the pain involved and how difficult it could be. Unfortunately, this is what we usually hear while what goes untold or unheard of is the beautiful process of labor and birth.

Have you ever wondered how our body works magically or rather systematically to bring a new life out from the womb? The process of delivering a child is nothing short of a miracle. As a woman enters labor, she passes through three stages.

MomJunction explains all the three stages of labor and gives you tips to cope with it.

Stages Of Labor

Labor progresses in three stages. Let’s see what they are:

  1. The first stage: This is the longest part of labor and can last up to 20 hours. It begins with the onset of the true contractions and lasts until the cervix is dilated to 10cm.
  1. The second stage: It lasts from cervical dilation until the delivery of the baby.
  1. The third stage: The process of childbirth ends with the delivery of the placenta.

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Stage 1 Of Labor

This stage marks the onset of the labor contractions that cause the cervix to soften and dilate.  It involves three phases, namely early labor, active labor, and transition phase.

Stage 1 of labor

Image courtesy: National Women’s Health, Auckland District Health Board

Phases in stage 1 of laborWhat’s happeningWhat you can do
Early labor

  • When you think you are in true labor, start timing your contraction. You can write down the time when each contraction starts and stops.
  • Mild contractions begin 15-20 minutes apart and last 30-40 seconds.
  • Several hormonal and physical changes might indicate the start of your labor.
  • The cervix starts to efface and dilate to 4cm (1). The mucus plug, which has been blocking the cervical passage and protecting the uterus from any infection throughout the pregnancy, is now discharged.
  • The contractions will start in an irregular pattern and last for 30-60 seconds coming every 5-20 minutes (2).
  • Once the gap between two consecutive contractions reaches five minutes, it means the labor is established.
  • As the cervix begins to dilate, you will notice a slight pink or bloody discharge from the vagina.
  • Lower back pain, loose bowel movements, and pressure in the pelvic area are other symptoms during this phase.
  • The amniotic sac can rupture at any time during the first stage.
  • This phase can last for hours or even days.
  • Call the doctor to know what to do.
  • Distract yourself by watching television or playing games.
  • Try to sleep by changing positions.
  • Take a bath or shower if the water has not broken.
  • Have snacks to build your energy reserve.
  • Empty your bowel as often as you can.
  • Get a massage of neck and shoulder done to relieve the tension.
  • Drink enough fluids – a few glasses of water or juice.
  • You may take pain killers such as paracetamol if needed.
Active labor
  • The cervix continues to dilate from 4-7cm (3).
  • The contractions get closer, regular and stronger. They occur every 3-5 minutes and last for about 60 seconds.
  • The water will break with a gush of fluid, and this speeds up contractions.

  • This phase will last for 3-5 hours.

  • It is the time to proceed to the hospital.
  • Seek help from your partner and mother.
  • Get a massage done on the lower back.
  • Practice breathing techniques.
  • Change positions while sleeping.
  • Sit comfortably using pillows.
  • Keep drinking water to hydrate yourself.
  • Walking, standing, and sitting upright can help progress the labor.
Transition
  • The cervix now dilates from 7-10cm.
  • The contractions get longer, stronger, and intense and last for 60-90 seconds, coming in every 2-3 minutes.
  • This is the shortest yet the most challenging phase.
  • You are likely to have hot flashes, chills, vomiting, nausea, and gas during this phase.
  • Continue with breathing exercises.
  • Have your partner by your side to support you during the contractions.

[ Read: Bradley Method Of Childbirth ]

When to call the doctor?

Call your doctor right away if:

  • The water breaks.
  • Abdominal pain gets severe and constant.
  • The baby’s movement slows down or stops.
  • You have bright red vaginal bleeding, which is not normal.

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Stage 2 Of Labor

The second stage involves pushing the baby into the birthing canal and eventually delivering. This stage progresses as follows:

  • The cervix is fully dilated (10cm) by this time.
  • This stage lasts for one to two hours in the first-time mothers or longer than two hours if the mother and baby are coping with the contractions (4). Epidural can also prolong the length of the second stage of labor.
  • Contractions get longer and stronger.

The pushing phase:

During this phase, the natural urge to push gets stronger. Along with that, you may also experience:

  • Increased pressure in the perineum, rectum, and lower back.
  • A strong bowel pressure.
  • A burning or stretching feeling in the vagina due to crowning (the baby’s head moving down). At this stage, the woman is asked to stop pushing so that the perineum stretches gradually.
  • Usually, there is a wait for the next contraction, then the baby is born.
  • The baby comes out, usually with the head first.

What you can do:

  • Try different positions — squatting, lying on your side with your leg up or resting on your hands and knees.
  • Take deep breaths before and after each contraction.
  • Curl into push as much as possible, this allows all of your muscles to work.
  • Concentrate on the contractions and take a break in between.
  • Try different positions while sitting, standing, or walking.
  • If you get hot flashes, use cold face washer.
  • Keep yourself hydrated by taking fluids.

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[ Read: Baby Crowning ]

Stage 3 Of Labor

After the baby is born, the placenta is delivered in the third stage.

  • The average time of the third stage of labor is six minutes (5).
  • Labor stimulation, analgesia during labor, and cord drainage could prolong the phase.
  • The contractions begin 5-10 minutes after childbirth and are mild and less painful.
  • The vagina feels fuller as the placenta passes through.
  • Chills and shivering are common while you are delivering the placenta.

What you can do:

  • Stay relaxed.
  • Ask the doctor, if you wish to see the placenta.
  • Begin breastfeeding your baby after the delivery.

What Happens After The Labor?

After the placenta is delivered, the uterus will start to contract to regain its original size. Otherwise, the doctor injects an ecbolic (contracting drug) into your leg as soon as the baby’s shoulder is out. This injection speeds up placental separation from the uterus and helps the uterus to contract faster to reduce the blood loss.

In case of any tears in the vaginal area, the doctor will place the stitches by giving local anesthesia. This anesthesia will be given only if you did not get one during labor.

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Frequently Asked Questions:

1. At what stage of labor is epidural given?

Epidural is given when you are 4-5cm dilated and have regular contractions. However, an epidural can slow down the contractions. In this case, Picotin will be given to speed up the labor.

2. What does it feel like when I start to dilate?

As the cervix dilates, it becomes softer. You can insert a finger into the vaginal opening that feels like soft lips. While doing this, you may probably feel the head of your baby.

3. Which stage of labor is the longest and how long does it last for?

The duration of labor varies from woman to woman. The first stage of labor is usually the longest and for the first time moms, it may last from 6-20 hours. However, in those who have had babies earlier, this stage could be quite shorter lasting for 2-10 hours. Moreover, if the cervix is not dilated properly or the fetus is not in the optimal position, then it is certain that the labor will get prolonged.

Isn’t it amazing to know that your body works with precision to bring the baby out into this world? When you are in labor, you wouldn’t know in which stage of labor you are. In fact, a study has found that most women, especially first-timers, didn’t know that there are several stages of labor (6). Ultimately, what matters is your well-being and your baby’s.

4. Do I have to get a cut or episiotomy?

You may experience a perineal tear, which could be sutured by your midwife or doctor. You might also have an episiotomy, if necessary, while pushing. An episiotomy is a procedure in which a small incision made in the second stage of labor to quickly enlarge the opening for the baby to pass through. It should only done in an urgent situation to make the opening wider for the baby. The incision is done at a 90 degree angle of the posterior perineum and sutured after. This will help in the delivery of your baby and prevent large irregular tears of vaginal walls.

[ Read: Lamaze Method Of Childbirth ]

Do you have an experience to share? Let us know about it in the comments section below.

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