If you’ve watched any television shows about birth, labor is generally shown as having one stage: ouch! The truth is that labor is not that simple. In fact, labor is divided into three stages. Here's what to expect during each one.
The first stage of labor
The first stage of labor is the one people typically associate with birth. It is a period of contractions that dilate the cervix and help the baby move into the birth canal. This stage is actually broken up into three phases.
The first phase of the first stage is known as early labor. Typically, early labor is the longest and easiest part of labor. The contractions are generally about five to 20 minutes apart and last about 30 to 45 seconds. You will typically find that the contractions are fairly manageable and require little to no support. The rest period is much longer than the contraction itself, with enough time to relax before another contraction starts.
The second phase of the first stage is known as active labor. This is when contractions pick up in intensity, frequency, and duration. The contractions usually come every three to five minutes and last about a minute. You will need to actively work toward pain relief during the contractions, though the break period is still longer than the contraction. This phase officially starts when you are six centimeters dilated.
The third phase of the first stage is called transition. The last few centimeters of dilation occur in this phase. The contractions usually are two to three minutes apart and last about a minute and a half each. The resting period is cut dramatically, making this one of the most intense parts of labor. The good news is that it is also typically the shortest part of labor. You'll likely need focused one-on-one coaching during this phase of labor. This phase technically ends when you reach 10 centimeters of dilation.
The second stage of labor
The second stage of labor is commonly known as pushing. The pushing phase can begin once the cervix is out of the way. The contractions generally last about one minute and come about every three to four minutes. These contractions have a different feel to them. You can actively work with the contractions to push the baby down and out.
There are two kinds of pushing: spontaneous and directed (coached). Spontaneous pushing is pushing when you feel your body's natural urge to do so, and it is considered best for the majority of women. It can help decrease pain and fatigue. Directed pushing (bearing down, even when you may not feel the natural urge) is helpful if the woman can’t feel when it’s time to push or isn’t clear on how to push, most commonly because of epidural anesthesia. However, studies show there is no evidence to support the routine use of directed pushing.
The second stage of labor can take anywhere from a few minutes to a few hours. This stage ends with the birth of the baby.
The third stage of labor
This stage starts as soon as the baby is born and ends with the birth of the placenta. Typically, the parents are cuddling with the baby during this time. This stage usually takes no more than 30 minutes, during which the doctor or midwife is assessing the perineum (the area between the anus and the vulva) and waiting for the cord to lengthen to show that the placenta is separating. Then, the placenta is born, completing this stage.
How long will labor last?
While it would be great if we had a specific timeframe to rely on, it is difficult to estimate because of all of the different factors, including:
- How many previous babies you’ve had
- How those babies were born
- Your age at the time of delivery
- Your race and ethnicity
- Your epidural use
However, there are some general guidelines. If you are having your first baby, it will usually take a bit longer to give birth than it would for someone who has had a baby before. However, as you age, a first-time birth goes a bit faster — at least until you reach the age of 40. It takes longer to go from four centimeters to six centimeters than previously thought.
Another reason that it is a bit difficult to estimate the average length of labor is that doctors have long had trouble clearly defining labor and its stages. The best evidence available is the active labor definition above. However, it’s safe to say that labor takes longer now than it did 50 years ago, for a variety of reasons.
Knowing the stages of labor will help you become familiar with the process. This can also help you and those supporting you decide how to plan for comfort measures and pain relief, which can be very empowering as you make decisions during labor.