The Stages of Labor

No one’s birth is like yours

Every body and every birth is unique, with its own journey through labor and delivery. While you’re pregnant, your relatives or friends will probably tell you all their birth stories. But no one actually knows how your labor will go, and there’s no exact roadmap for what to expect. However, the physical process of vaginal delivery is broken down into four stages. Understanding these can be very useful in order to explore your birth options, choose your preferences, and stay in tune with your body during labor. 

Stage I – Effacement and Dilation (thinning and opening) of the Cervix

Part 1: Early Labor – Your cervix opens from 0–4 centimeters

What you might feel: 

  • Irregular contractions that become stronger and more frequent over time 
  • Unsure if you are in labor or not
  • Able to do your normal daily activities
  • Bloody show or loss of mucous plug
  • Leaking or breaking of waters

What you can do:

  • Rest and relax
  • Your normal daily activities
  • Eat and drink
  • Take a shower or bath
  • Take a walk
  • Keep track of your contractions
  • Call your provider if your waters leak or break

Part 2: Active Labor – Your cervix opens from 4–8 centimeters

What you might feel:

  • Contractions every 3-5 minutes lasting around 60 seconds
  • Unable to talk during a contraction
  • Unable to continue normal activities
  • Bloody show or loss of mucous plug
  • Leaking or breaking of waters
  • Need for support

What you can do:

  • Go to your hospital or birth center, or contact your homebirth provider
  • Change positions, including walking or standing
  • Get support from your doula and birth team
  • Take a shower or bath
  • Eat and drink
  • Use pain management strategies
  • Receive pain relief medication
  • Decline pelvic exams if you wish
  • Decline artificial breaking of waters if you wish

Part 3: Transition – Your cervix opens to 10 centimeters

What you might feel:

  • Intense contractions every 2-3 minutes lasting around 60–90 seconds
  • Increased pain and pressure
  • Exhausted, frustrated, or overwhelmed
  • Hot, cold, shaky, or nauseous 

What you can do:

  • Change positions 
  • Get support from your doula and birth team
  • Use pain management strategies
  • Receive pain relief medication

Stage II – Descent, Pushing, and Birth: Your baby moves through the birth canal

    What you might feel:

  • Contractions every 2-5 minutes, lasting around 60 seconds
  • The baby’s head moving down
  • An urge to push
  • Increased pressure
  • Stretching or burning

    What you can do:

  • Change positions
  • Get support from your doula and birth team
  • Push when you feel the urge, not when given instructions
  • Allow your baby to “labor down” (move lower in the pelvis) before pushing 
  • Use pain management strategies
  • Receive pain relief medication
  • Decline episiotomy 

Stage III – The Placenta: Your uterus detaches and expels the placenta 

    What you might feel:

  • Contractions

    What you can do:

  • Have skin-to-skin contact with your baby
  • Request delayed cutting of the umbilical cord
  • Breastfeed
  • Push when you need to

Stage IV – Recovery: The first 1-2 hours after delivery

    What you might feel:

  • Joy, relief, exhaustion, strong emotions
  • Cramping as your uterus contracts
  • Cold or shaky 
  • Swelling, soreness, or pain in the perineum 

    What you can do:

  • Stay skin-to-skin with your baby
  • Breastfeed
  • Eat and drink
  • Request ice packs for swelling and pain
  • Place your baby skin-to-skin with your partner if you need to get up

Remember: No one knows how long each stage of your labor will take. It’s normal for Stage I to last anywhere from a few hours to a whole day, or more. Stage II can be less than an hour or over 3 hours. Ask your obstetrician or midwife how they approach longer labors, and avoid providers or birth settings with strict rules about when to intervene. 

Have more questions about labor and delivery? Schedule your free 15-minute consultation on Mae.