Stages of Labor
Labor is divided into three stages, which include the thinning and dilation of the cervix, the descent of the baby through the pelvis and out of the birth canal, and finally, the delivery of the placenta.
FIRST STAGE: EARLY LABOR
In this stage, contractions become more regular, strengthen over time, and do not go away with a change of position or activity. During this stage the birthing person is often happy, excited and/or nervous, present and social, and still able to talk through contractions. The cervix has begun to efface and dilate from 0 to 4 centimeters.
Early labor is a time to rest, eat, hydrate, and stay comfortable. Oftentimes a birthing person will decide to spend as much of early labor as possible in their own home (if they plan to deliver in a birth center or hospital).
FIRST STAGE
FIRST STAGE: ACTIVE LABOR
Contractions are now closer together, longer, and stronger. They are regularly 2-5 minutes apart, lasting for a full minute or more. The incredibly powerful muscles of the uterus are working to open the cervix from 4 to 8 centimeters. In active labor the birthing person and their birth team will relocate to the place where they plan on giving birth.
The birthing person will be more serious and focused, needing various coping strategies to manage. The birth partner(s) and doula will suggest comfort techniques, encourage relaxation and rest between contractions, offer nourishment and hydration, and help assist with an hourly trip to the bathroom.
FIRST STAGE: TRANSITION
This is the final, most intense stretch of the first stage of labor. The cervix dilates from 8 to 10 centimeters and contractions last between 90 seconds to 2 minutes, and are 2-3 minutes apart. Rectal pressure and the urge to push during contractions may be felt as the baby’s head engages in the pelvis.
The intense sensations surging through the birthing person’s body may make them feel discouraged, disoriented, or out of control. The birth partner(s) and doula will help them stay present, relax between contractions to build up energy for pushing, and stay hydrated.
SECOND STAGE
PUSHING
The cervix is now fully dilated and the baby can now pass through the pelvis, twisting out of the birth canal and into the world! Contractions last for 60-90 seconds.
The birthing person will feel an overwhelming sensation of “needing to poop.” They may need help with coping techniques and want direction from their care provider or they may prefer quiet, perhaps dozing in between contractions. The birth team and doula will offer comfort techniques and water.
The second stage is complete when the baby is born!
THIRD STAGE
DELIVERY OF PLACENTA
With the hard work of labor over, the care provider will attend to the birthing person and the baby. Between five to thirty minutes after the birth of the baby, contractions will pick up again to deliver the placenta. They are mild to uncomfortable and occur irregularly.
The placenta is birthed in a few gentle pushes (no bones!). The care provider will perform any necessary repairs. Finally, the uterus contracts down to the size of a fist within minutes after the delivery of the placenta.
The birth partner and doula will help the birthing person follow the care provider’s instructions, if needed. They will also ease the transition to immediate postpartum, nurture bonding, and assist with initial latch support.