The experience of labor varies from person to person. Most people go through the same stages, though the length of each stage can differ.
This article looks at what to expect in each of the stages and how a person can tell that labor is starting. It also covers when to go to a hospital, what forms of pain relief are available, and tips for managing each stage.
Each person’s experience of labor is different. Some people do not notice contractions in the earliest stages, and some do not notice their water breaking.
Therefore, people should not be surprised if their experience is different from the one this article describes.
The timeline is approximate, and some stages may overlap.
There are several signs to indicate that labor may start soon. For example, a person may notice the following:
- The baby is sitting lower in the pelvis. This is known as “dropping,” or “lightening.”
- Cervical changes occur that are noticeable during a physical examination.
- In some cases, the mother may have an increased sense of “nesting,” or a desire to tidy and organize the house.
- A bloody mucus discharge may occur, indicating the loss of the mucus plug as labor nears.
- The water breaking is often the first true sign that labor is about to start.
The water is amniotic fluid. When the water breaks, it is time to contact a healthcare professional. That said, not everyone notices when their water breaks. Some people may even confuse it with urine.
Not everyone experiences these signs in the same way. If a person has any concerns about symptoms or other changes, they should ask their healthcare professional for advice.
There are four main stages of labor, and some have substages. The sections below will look at these in more detail.
First stage of labor
This is usually the longest stage of labor. It tends to last for around 12–19 hours, but it varies from person to person. Also, it is usually shorter for a second delivery.
This stage includes three parts:
- early labor
- active labor
- transition to the second stage
During this time, the cervix will dilate (open) fully, to around 4 inches (in) (10 centimeters [cm]). Contractions enable this to happen. When the cervix measures 4 in across, this is the end of the first stage.
The sections below will look at each of the three parts in more detail.
At this stage, which is sometimes called the latent phase, the cervix opens up to nearly 3 in (6 cm).
Contractions enable this to happen. Contractions are usually mild to start with and last for around 60–90 seconds. However, this does vary from person to person.
Between contractions, there may be a break of around 5–15 minutes. As time goes on, the contractions will become stronger.
Lower backache, cramping, and pelvic pressure or tightness may occur, but the person will likely be able to stay at home for most of this stage if they have a healthy, full-term pregnancy.
Some things that may help make this time more comfortable include:
- going for a walk around the block, if possible
- having a light snack
- sleeping, if possible
- drinking fluids, such as water
- tracking the length and frequency of contractions
- taking a bath or shower
- packing a bag for the hospital, if it is not yet ready
- ensuring that the birth plan is finalized
This phase may last for around 6–12 hours, but it can vary widely.
The water may break during this stage or the next. When the water breaks, a person should go to the hospital. For most people, the contractions will start to happen more quickly after this.
During this stage, the cervix dilates around half an inch every hour, starting from just under 3 in (6 cm) to full dilation.
Contractions will intensify, lasting for about 45 seconds and occurring as often as every 3 minutes.
In fact, it may become harder to talk because of the contractions.
Some things that may help include:
- breathing slowly and easily, which will help conserve energy for later
- changing positions, such as standing up and moving around
- listening to relaxing music
- sitting in a warm (but not hot) bath or pool
- urinating often to empty the bladder
- drinking water
If a person has not yet started for the hospital, now is the time to do so.
This phase may last for around 4–8 hours, but it can vary widely.
During this stage, the cervix will open to full dilation. It will expand from 3 in to around 4 in (6 cm–10 cm).
This is often the most challenging stage. Contractions are usually intense, lasting for around 60–90 seconds and happening every 2–3 minutes.
The person may feel:
- sweaty and feverish
This phase usually lasts between 15 minutes and 1 hour.
Second stage of labor
At this stage, the cervix will be fully dilated, and contractions will push the baby through the birth canal. The contractions will be strong, but there may be more time between them.
This stage may feel like an intense need to have a bowel movement. The person may need to push to help the baby along. In time, the baby’s head will show. This is known as crowning. Soon, the healthcare professional will start guiding the baby out.
This stage can be a short as 20 minutes, but it usually lasts for up to 2 hours. It can last for up to 3 hours for a first delivery. Other factors that may change the time frame for this stage include the size and position of the baby.
If necessary, the healthcare professional may need to cut the vaginal opening or use forceps or suction to help the baby out.
At the end of this stage, the baby will be born, and somebody will cut the umbilical cord.
Third stage of labor
During the third stage of labor, contractions will continue until the placenta (afterbirth) is delivered.
Fourth stage of labor: Recovery
This stage is the recovery time. During this time, the person’s healthcare team will:
- clean and weigh the baby
- measure the baby, assess their health, and record the Apgar score
- provide any stitches or medication that is necessary
- present the baby to the mother for the first nursing, if possible
Nursing soon after delivery will:
- help the uterus contract
- help stop any bleeding
- initiate the bond between the mother and the baby
If a cesarean delivery is necessary, the recovery stage will be a little different. Learn more about what to expect from a cesarean delivery here.
The recovery process will also be different if the baby is stillborn. If this is the case, the person’s healthcare team will offer support and guidance.
The duration of labor varies from person to person, but sometimes, it can be much longer or much shorter than usual.
During rapid labor, someone may only notice signs of active labor, birth, and the delivery of the placenta. This can take 3–5 hours or under.
If labor is prolonged or does not progress, it can last for up to 20 hours or more. Depending on the reason, a healthcare professional may recommend certain measures to speed up labor, such as:
- breaking the water, if necessary
- administering an oxytocin drip
- using a monitoring device to track progress
In some cases, a cesarean delivery may be necessary.
If labor does not start by 41–42 weeks, a healthcare professional may induce labor. Learn more about that here.
A healthcare professional will provide a person with specific instructions about when to go to the hospital.
However, the person should check with their provider whenever they have concerns about labor progress or symptoms.
It is important to go to the hospital if:
- Contractions are strong, regular, and occurring at shorter and shorter intervals.
- Lower back pain or cramping develops and does not resolve.
- The water breaks, either as a gush or a trickle.
- There is a bloody-brown vaginal mucus or discharge.
- There is bleeding.
- Other concerns arise.
- Fetal movements decrease or stop.
A person should be sure to take their overnight bag with them, as well as their medical records and birth plan, if necessary.
Healthcare professionals advise a hospital delivery for most people, as is it easier to respond if complications occur. Learn more about the possible complications here.
Sometimes, contractions will start well before labor. These are called Braxton-Hicks contractions, or practice contractions. Although they are similar to labor contractions, these early contractions are not usually a sign that labor is starting.
- are irregular
- go away in time
- may resolve with walking, lying down, or other changes in activity
True contractions will persist and increase in intensity. Learn more about how to tell the difference here.
Labor almost always involves pain, but this will affect people differently. Ways of managing pain during labor include both natural and medicinal methods.
The following sections will look at these options in more detail.
Some natural methods of pain management during labor include:
- trying breathing and relaxation techniques
- sitting in warm water
- receiving a massage
- applying hot or cold compresses
- receiving support from a companion or doula
- changing position
- trying visualization and guided imagery
- trying aromatherapy
- listening to music
- using a labor ball
Many people prefer to avoid medicinal methods of pain management, if possible. However, this may not always be possible.
Some medicinal methods of pain management include:
- Opioids: A healthcare professional may inject medications into a vein or muscle.
- Epidural: This is a catheter in the lower back that delivers a combination of medications, including narcotics and local anesthetics.
- Spinal block: This usually involves a single injection of pain relief medication into the spinal fluid.
- Pudendal block: The healthcare professional may inject medication such as lidocaine or chloroprocaine into the vagina and pudendal nerve.
- General anesthetics: Healthcare professionals rarely use these, as they lead to a total loss of consciousness. They involve a muscle relaxant and nitrous oxide.
A person can speak with a healthcare professional about the risks and benefits of each form of pain relief to see which option is best for them and their baby.