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Labour has three main stages. In the first stage the cervix opens, in the second stage your baby is born, and in the third stage the placenta comes out. Each stage feels different, and each can take a different amount of time for every woman.
Knowing what is happening in your body makes labour less frightening. Below is a plain guide to each stage, how long it may take, and what helps.
Labour at a glance
- First stage: the cervix thins and opens from 0 to 10 cm. It is the longest stage.
- Second stage: from full dilation (10 cm) to the birth of your baby.
- Third stage: from the birth of your baby to delivery of the placenta.
Timings below come from the NHS, Cleveland Clinic and the US National Institute of Child Health and Human Development (NICHD). They are averages. Your own labour may be shorter or longer and still be healthy.
First stage: the cervix opens
This stage starts with contractions that tighten and release your womb. The NHS describes it in two parts, a latent phase and established labour. Cleveland Clinic and NICHD call them early and active labour.
Early (latent) labour
The cervix softens and slowly opens. Contractions are often mild and irregular, and you may notice a clear or slightly bloody mucus discharge called a show. NICHD says contractions at this point last 30 to 60 seconds and come every 5 to 20 minutes. Early labour can last many hours and in a first pregnancy up to around 20 hours. Cleveland Clinic gives 6 to 12 hours as a typical range for early labour.
Most women can stay at home during this phase. Eat light snacks, drink fluids, rest if it is night, and stay upright and moving if it is daytime. A warm shower, gentle massage and slow breathing can ease the discomfort.
Established (active) labour
The NHS says labour is established when the cervix has opened to about 4 cm and contractions are stronger and regular. Cleveland Clinic counts active labour from about 6 cm to 10 cm and says it usually lasts 4 to 8 hours. Sources differ on the exact start, which is one reason guidelines vary. Contractions become longer, stronger and closer together, and you may feel pressure in your lower back.
The NHS gives 8 to 18 hours as a typical range for the whole first stage in a first baby, and 5 to 12 hours in later births. Your care team listens to your baby's heartbeat at regular intervals and checks your progress.
When to be cautious: go to the hospital without delay if your waters break, you have vaginal bleeding, your baby moves less than usual, contractions are very frequent and strong, or you are before 37 weeks. Our guide to the signs of labour explains what to look for.
Second stage: pushing and birth
This stage begins when the cervix is fully open at 10 cm. You may feel a strong urge to push, often compared to the need to pass stools. Cleveland Clinic says contractions come every 2 to 5 minutes and last about 60 to 90 seconds. You push with contractions and rest in between, guided by your midwife or doctor.
Your baby's head moves down and becomes visible at the vaginal opening. This is called crowning. The NHS explains that the midwife or doctor may ask you to stop pushing and take short breaths so the skin can stretch slowly. The rest of the body usually follows within a contraction or two.
The second stage can last from about 20 minutes to a few hours. The NHS notes that pushing should usually last no more than 3 hours for a first baby and 2 hours for later babies. It often takes longer in a first labour or when an epidural is used. If progress slows, your doctor will discuss options such as assisted birth or a caesarean.
Tip: try different positions such as kneeling, squatting, side-lying or standing with support. The NHS says to choose what feels comfortable, and kneeling on all fours can relieve backache.
Third stage: delivery of the placenta
After the birth your baby can usually be placed on your chest for skin-to-skin contact. The womb then contracts again, and the placenta separates. This stage is usually the shortest, often under 30 minutes. The NHS describes two approaches:
- Active management: you are given an injection to help the womb contract, and the cord is cut after a few minutes. This lowers the risk of heavy bleeding.
- Physiological management: no injection is given and the placenta comes out naturally, sometimes taking up to an hour.
Your care team will explain the options before or early in labour. If the placenta does not come out or you bleed heavily, they may advise switching to active management. You may feel shaky or have chills after birth, and this is common. Any tear or cut is repaired once the placenta is out.
The hours after birth
Some experts call the two to three hours after the placenta is delivered a fourth stage. Staff watch your bleeding, blood pressure and womb, and you begin feeding and bonding with your baby. Ideally the first breastfeed happens within the first hour, according to the NHS.
Coping with pain through labour
- Have a support person with you, such as your partner, a family member or a trained birth companion.
- Change positions often and use a birthing ball if available.
- Practise slow, deep breathing, and use a warm bath or shower in early labour.
- Ask about pain relief early. Read about pain relief options in labour before your due date.
When labour may need help
Cleveland Clinic lists situations that doctors treat as slower than usual, such as early labour lasting over 20 hours in a first birth, or the placenta staying in the womb more than 30 minutes after birth. Doctors may then suggest medicines to strengthen contractions, breaking the waters, or other steps. Our page on normal and C-section deliveries explains birth choices in more detail.
When to see a doctor
Contact your doctor or reach the hospital promptly if you have:
- Waters breaking, especially if the fluid is green, brown or smells bad
- Heavy vaginal bleeding
- Reduced baby movements
- Regular strong contractions before 37 weeks
- Severe constant pain, or contractions that are very close with little rest
- A feeling that the baby is coming now
Use the emergency page if you need urgent help.
Talk to a doctor
If you have questions about your own situation, you are welcome to book an appointment or call us on +91 944 103 0587. Chaitanya Hospital in Kadapa offers 24/7 delivery and emergency care, and teleconsultation is available. This article is for general awareness and is not a substitute for a doctor's advice.
References
This article was written in our own words from the following public health sources.
Educational content
Please note. This article is for general awareness and is not a substitute for a doctor’s advice, diagnosis or treatment. If you are worried about your health, or in an emergency, call +91 944 103 0587 or visit the hospital.
