Giving birth: Stages of labor

Early labor

Early labor contractions pull on the cervix, which looks a bit like the neck of a turtleneck sweater. Contractions shorten or thin the cervix. This process is called effacement and is measured in percentages.

Your cervix starts out three to four centimeters long. When it is 50 percent effaced, it is about two centimeters long. When it is 100 percent effaced, it is “paper-thin.”

Effacement can happen over days before labor starts. Or, it can happen over hours as labor progresses. With a first labor, it can take quite a while for the cervix to completely efface.

Labor may start slowly because the cervix first thins and then dilates. If you have had a previous labor, your cervix will start opening or dilating while it is effacing. This is why a second labor is often shorter than the first labor.

Dilation is measured in centimeters, one to 10. Dilation to three to four centimeters is considered to be part of early labor. After four centimeters, labor is considered to be active and contractions are more intense.

In early labor, you may only need to use distraction and relaxation techniques. Active labor, however, requires more coping skills. When contractions become longer, stronger, and closer together, the key to coping is to relax between the contractions. During the contractions do whatever technique helps you deal with them.

First stage of labor

The first stage of labor ends when the cervix is fully dilated and your baby’s head slips through the cervix.

The last two to three centimeters of dilation are called transition because it is the transition between the first and second stage of labor. This is the time that contractions are the most intense.

Second stage of labor

Second stage is the work of pushing your baby through your vagina (birth canal). It is more difficult than the distance suggests because your baby must turn to fit through your pelvis. The drawings on the next page show your baby’s journey to birth.

Third stage of labor

The third stage is the shortest and easiest. It is the birth of the placenta.


Cervix thins and dilates during labor. As your baby moves through your pelvis, her head usually rotates to face your spine.		As your uterus pushes your baby through your pelvis, her head begins to show, or "crown."		After most of your baby's head is born, her shoulders move through your pelvis and she begins to rotate again.		After your baby's head and shoulders are born, the rest of her body slips out.

Stage or Phase	What Happens During Labor	How it Feels
First stage Early phase	cervix effaces (thins) and dilates (most effacement, and dilation from 0 to 4 centimeters (cm), occurs lasts 8 to 10 hours or more for first labor contractions last 30 to 40 seconds and begin every five minutes or so	Each phase feels different. Contractions are mild to strong. You may feel comfortable between contractions. You may feel nervous, nauseated, or excited. Try to relax and work with the rhythm of your body.
Active phase	dilation from 4 to 7 cm occurs typically last 2 to 5 hours contractions last about 60 seconds and begin every 3 to 5 minutes	Contractions are stronger. Your attention is focused inward. You may have a dry mouth, chills and nausea, or feel sweaty. Concentrate on staying relaxed between contractions to conserve your energy.
Transition phase	dilation from 7 to 10 cm occurs can last 5 minutes to 2 hours or more contractions last 60 to 90 seconds and begin every 90 seconds to 3 minutes	Contractions are intense and close together. You may have hiccups, nausea, vomiting, shaking and pelvic pressure. You may feel like giving up. Take one contraction at a time.
Second stage (pushing)	uterus pushes baby out typically last 30 minutes to 3 hours contractions last about 60 seconds and begin every 3 to 6 minutes	You may experience a “rest period” before you feel an urge to push. You might get a surge of energy. Pushing can feel like pressure, stinging, burning, or pain. Pushing can take a long or a short time. This depends on the position of your baby, the effects of medicine, and how well you are able to push. Focus on helping your uterus push your baby out.
Third stage	the placenta separates from the uterine wall and is expelled. typically lasts 3 minutes to 30 minutes after your baby's birth.	Contractions are less intense and may even be easy while you expel the placenta. Push gently when your health care provider asks you to do so.