The stages of labor vary considerably from woman to woman. Some women’s labors are short, others are long, some women experience a long early labor and short pushing stage, other women have the opposite.
While each woman experiences birth differently, there are three key stages of labor that every woman generally goes through—the stages may not last the same amount of time for every woman. This post will answer the following questions, so you know what’s important during each stage:
- What are each of the three stages of labor—what do some healthcare practitioners consider to be the fourth stage?
- At which stage do I need to go to the hospital?
- How do I know for sure if I’m really in labor?
How many stages of labor are there?
The process of giving birth is categorized into three stages (some would say four):
- Early labor
- Active labor
- Some medical professionals also consider the postpartum period to be a fourth stage of labor.
What happens during the first stage of labor?
Here are the key happenings during the early stage of labor, aka the first stage:
|Cervix||Dilates to three centimeters|
|Contraction Length||30 – 45 seconds|
|Contraction Frequency||5 – 30 min apart, might be irregular|
|Contraction Strength||Begins mild and becomes progressively stronger|
|Contraction Feels Like||Lower back pain, menstrual cramps, and/or pressure in pelvis|
|Length of Stage||Highly variable, can last anywhere from several hours to days|
What happens during the second stage of labor?
Here are the key happenings during the active stage of labor, aka the second stage:
|Cervix||Dilates from four to seven centimeters|
|Contraction Length||45 – 60 seconds|
|Contraction Frequency||3 – 5 min apart|
|Contraction Strength||Stronger than the first stage|
|Contraction Feels Like||Stronger, longer, and more intense than early labor|
|Length of Stage||Lasts approximately 3 – 5 hours|
What happens during the third stage of labor?
Here are the key happenings during the transition stage of labor, aka the third stage:
|Cervix||Dilates from seven to 10 centimeters|
|Contraction Length||60 – 90 seconds|
|Contraction Frequency||30 seconds – two minutes apart|
|Contraction Strength||Very strong and intense|
|Contraction Feels Like||Highly intense, can also experience hot flashes, chills, nausea, and vomiting with contractions. Also, at this point, you may also feel pressure on your rectum, releasing your bowels|
|Length of Stage||Lasts approximately 30 min to two hours|
During which of stages of labor do I start pushing?
Once your cervix is full dilated to 10 centimeters, and the vaginal canal is clear for the baby to be delivered, so you can begin pushing at this stage to deliver the baby. Pushing times can be variable with some women pushing for less than an hour and some pushing for over three hours.
What is the fourth stage of labor?
The postpartum is sometimes considered a fourth and final stage of labor. After the baby is delivered and during the postpartum stage, contractions can resume—with lower intensity than during transition—to deliver the placenta. Although there isn’t a medical benefit to consuming or keeping it, some women may be interested in preserving the placenta for a lotus birth, which you can talk to your doctor about before the stages of labor begin.
In the immediate postpartum period, you may experience chills or shakiness. Some women also experience intense mood changes, also known as “baby blues,” likely because of the precipitous drop in hormones like estrogen and progesterone post-delivery.
Also, some women may begin breastfeeding within hours of giving birth, but for others, lactation can take a few days or even months to become regular. If you want to breastfeed and need support, contact your midwife or a lactation specialist.
During which of the stages of labor will my water break?
Despite what you may have seen in the movies, it’s rare for water to break before you are in early labor or even during early labor. Although the exact number is still debated, water breaking consistently seems to appear for a fraction of women, and it’s more likely that the stronger contractions of active labor will cause the amniotic sac to rupture.
Also, be aware that if your water breaks before you are in labor or during early labor, it’s not necessarily a sign that active labor is imminent. Some women experience strong contractions soon after water breaking, and some experience a delay.
The bottom line? Water breaking can be a sign of labor, but the most reliable indicators that you can monitor are contraction strength and frequency, so don’t wait for water breaking to be the tell-tale sign. If your water does break in early labor, note the time when this happens and contact your doctor immediately. A potential complication of water breaking in early labor is infection, so it’s best to consult with a medical professional as soon as possible. Also, amniotic fluid is usually clear and odorless, so if you observe any color or odor, let your doctor know immediately so they can assess for complications.
During which of the stages of labor should I go to the hospital or birth center?
It’s best to head to the hospital or birth center during the active labor stage, when the contractions are strong and about five minutes apart. You may hear about the “5-1-1” rule, which recommends that women go to the hospital when contractions are five minutes apart, last for one minute, and have been that patternfor one hour.
You should know that while stronger and more frequent contractions typically correlate with increased cervical dilation, that’s not always true, which is problematic because hospitals typically use cervical dilation (not contractions strength) to determine whether or not you should be admitted. So, if you’re experiencing strong contractions but your cervix hasn’t dilated more than three centimeters yet, then you may not be admitted. And, even more problematic, every hospital sets its own rule about that exact measurement of cervical dilation.
If your contractions are manageable, and your cervix hasn’t dilated more than three centimeters yet, then you will be advised to return home. You will also be given guidance about how long to wait until returning to the hospital and what to note in the pattern of your contractions. If you’re struggling with the pain, you may also be prescribed medication to help you manage it until you can be admitted.
How do I know if I’m really going into labor?
Depending on how many weeks pregnant you are, there comes a point when analyzing every cramp and bit of pregnancy discharge seems like a potential sign of labor. And if you’ve been having Braxton Hicks contractions, it can be particularly tricky to tell the difference between these “practice” contractions and true labor.
Contractions are really the key feature to help distinguish whether you’re really going into labor or not. Here’s what to look for to be sure that you’re truly going into labor:
- Contractions will consistently increase in intensity
- Contractions will become closer together over time
- Contractions will not subside with changing position or activity
- Contractions will usually be felt throughout the lower back and pelvic region (not localized higher up in the abdomen, as Braxton Hicks contractions tend to be)