Guide to Labor: All You Need to Know About Stages of Labor

Every woman’s labor is different. Some women are in labor for many hours, even a day or more, while others deliver their baby within a few hours. Whether a woman has had a child before can impact the duration of labor—a woman’s first baby often takes longer to deliver than subsequent babies.

It’s impossible to know how your labor will unfold until it begins. But knowing what to expect will help you prepare mentally, emotionally, and physically for labor. Let’s take a look at the stages of labor as they typically unfold for vaginal deliveries.

The first stage of labor has three phases—early labor, active labor, and transitional (advanced) labor.

Early labor involves the dilation and thinning (effacing) of the cervix, which allows the baby to move into the birth canal. This is the longest (but least painful) of the three stages of labor. For some women, dilation and effacement is a very gradual process that takes weeks or even as long as a month.

As the cervix dilates, the mucus plug that blocks the cervical opening will become dislodged, which you may or may not notice. This can happen anywhere from a couple of hours to a few weeks before labor begins. Then, a few days to 24 hours before delivery, you might notice a brown or bloody discharge from your vagina, called “bloody show.”

During early labor you’ll feel mild contractions that come at regular intervals and, generally, last between 30 and 90 seconds. Near the end of early labor, contractions will likely occur less than five minutes apart.

Early labor often lasts six to 12 hours, especially for first-time moms. Soothing activities, such as a warm shower or massage can help ease pain or discomfort. Many women choose to take a walk, watch a movie, or even do light household chores during this phase. There’s no right or wrong, as long as it’s safe for you and your baby.

Active labor is the second phase of early labor, and this is where the real work begins. During this stage your cervix should dilate to 10 centimeters (cm), and your contractions will become stronger, closer together, more regular, and longer. This is the stage where you might feel your water break, if it hasn’t already. You might experience nausea, cramping in the legs, and pressure in your lower back. Now is the time to head to your delivery center, or call your midwife if you’re planning to deliver at home.

Active labor can last up to eight hours, and even longer for some women, especially first-time moms. For women who have had one or more previous vaginal deliveries, labor can take as little as a couple of hours.

The transitional or advanced stage of labor occurs before delivery. This stage can be especially painful, and you may feel the urge to push. But pushing when your cervix isn’t fully dilated can cause swelling, so your healthcare provider/midwife may ask you to resist until your body is ready.

Transitional labor can be physically demanding, with strong contractions lasting 60-90 seconds. You may feel frustrated, exhausted, and overwhelmed, and this is normal. Using the techniques you learned during your childbirth classes, including breathing and panting, and looking to your labor coach for support, should help you during this stage.

It’s impossible to know how long this stage of labor will be or how it will unfold until it begins. But knowing what to expect will help you prepare mentally, emotionally, and physically for labor.

Now that dilation is complete, it’s time to help the baby through the birth canal by pushing.

Delivery generally takes 30 minutes to an hour, but it can last as little as a few minutes or as long as several hours. Your contractions should last for 60 to 90 seconds, but will likely be more regularly spaced—typically two to five minutes apart.

At this stage, you’ll move into the position that’s most comfortable for you to start pushing and follow instructions from your practitioner/midwife. Women usually give three big pushes per contraction, but how much you push will depend on how much energy you have. You’ll want to recover between contractions to conserve as much energy as possible.

It’s important not to push with your upper body, or strain your face, which can leave you with black or bloodshot eyes. Keep your chin to your chest to help you focus on pushing with your lower body as if you’re having a bowel movement. Don’t worry about emptying your bowels or passing urine while you’re pushing—this happens to most, if not all, women during delivery and is no cause for embarrassment.

Your birthing team should provide you with a mirror to see your baby’s head crown. Don’t become frustrated if you see the head crown . . . and disappear again—your efforts will soon be rewarded when your little one emerges into the world.

Once your baby’s head has fully emerged, your practitioner will suction any mucus from the baby’s nose and mouth, and help guide the baby’s shoulders, torso, and legs out. Once out, the birthing team will give your baby a wipe down and swath him or her in a blanket. Soon after, you’ll relish that first cry and hold your baby in your arms.

The third and final stage is delivering the placenta (also known as afterbirth) that filtered nutrients for your baby while he or she was in the womb. This last stage can last anywhere from five to 20 minutes, or more, during which you may feel mild contractions that help separate the placenta from the uterine wall, and which move it into the birth canal so you can push it out.

If you’ve decided to preserve your baby’s cord blood, cord tissue, and/or placental tissue, the medical team will carefully preserve the placenta and umbilical cord for later harvesting of the stem cells contained within the blood and tissue.

Your practitioner will stitch up any vaginal tears that may have occurred during delivery. After delivery you can expect to have bleeding (called lochia), similar to a heavy period—this is perfectly normal.

Congratulations—you’ve brought your baby into the world!

During your pregnancy, you should consider preserving your baby’s umbilical cord blood, cord tissue, and placental tissue, which could provide substantial medical benefits in the future.

Cord blood is a rich source of stem cells that are easily accessible and only available when your baby is born. These stem cells are genetically unique to your baby and your family, and can be used to treat your baby, the baby’s siblings, and other family members for various medical conditions. Cord blood stems cells are hematopoietic stem cells (HSCs), which can become any of the blood cells and cellular blood components in our bodies (such as white blood cells, red blood cells, and platelets). Transplants of stem cells from cord blood are an effective therapy for certain blood-borne and genetic conditions, including various types of leukemia and lymphoma.

Cord tissue and placental tissue both contain special multipotent stem cells called mesenchymal stem cells, which means they can differentiate into many different types of cells, including cartilage cells (chondrocytes), bone cells (osteoblasts), and fat cells (adipocytes). These cells can potentially be used to treat a wider range of conditions than cord blood alone can treat and are currently the subject of over 300 clinical trials worldwide!

Storing cord blood, cord tissue, and placental tissue can be invaluable for future medical treatment. Learn more about cord blood and tissue storage here.

Sources:

•  Labor and delivery, postpartum care. (2023, October 26). Mayo Clinic.
•  Midwifery Today: Article
•  Miles, K. (2023, August 17). Labor positions. BabyCenter.
• Americord. (2023, October 16). Cord Blood 2.0® - Cord Blood Banking & Storage | Americord®. Americord Registry.
• Lerch, M. (2023, August 31). Our innovative approach to cord blood banking | Americord. Americord Registry.
•  Midwifery Today: Article
• Miles, K. (2023b, August 17). Labor positions. BabyCenter.

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