Labor is typically divided into multiple stages. Like pregnancy, dividing labor into separate stages allows healthcare professionals and laboring women to know what is happening in the body at any given time, and helps provide a general idea of how soon the baby will arrive.
There are three stages of labor, with each being defined by variables like cervical dilation, thickness of the cervix (effacement), and where the baby’s head is in relation to certain pelvic bones (station). The cervical position and consistency may also be assessed in the earliest stage of labor. There is a wide variation of how these different phases present for each birthing person – for example, certain stages may last longer or be less intense for some women – but specific aspects of each phase occur in most peoples’ experiences of labor.
Stage 1
- Phase 1: Early (latent) labor: This phase is marked by irregular contractions that help to soften the cervix, bring it forward, and begin to dilate. As contractions aren’t quite regular, early labor may last a while and may come and go. If you notice bright red bleeding or fluid leakage at this time, it’s best to go to the hospital. If this phase continues for days and you are exhausted, speak with your provider, as there may be pain relief measures such as therapeutic rest that they may be able to offer.
- Phase 2: Active labor: The second phase, active labor, begins once contractions are regular and stronger. The dilation may be 4-6 centimeters and contractions become roughly 60-90 seconds long, occurring every 2-3 minutes. The time between 8cm to 10cm is called ‘transition’, where some may experience vomiting, shaking, and chills. In a normal labor course, the cervix continues to dilate until it reaches the maximum 10 cm.
Stage 2
In this phase, women may begin to experience increased rectal pressure and the sensation of needing to push, as the cervix is fully dilated and the baby is low in the pelvis. The length of stage 2 varies based on the position and station of the baby, whether pain medication was used, and other factors. Phase 2 of the childbirth process ends when the baby has completely exited the vagina and the doctor, midwife, or loved one cuts the umbilical cord.
Stage 3
Stage 3 solely involves the expulsion of the placenta, which may take up to 30 minutes. Although the baby is born at this point, this phase is crucial because the afterbirth cannot stay in the body. The uterus continues to contract even after the baby has exited, causing the birthing person to feel contractions, and also possibly shake or feel chills. The healthcare provider may or may not ask the woman to push, depending on the need. If there is difficulty in removing the placenta, your healthcare provider may need to perform additional procedures to help remove it, as a retained placenta can increase the risk of infection and hemorrhage.
Recovery
After delivering the placenta, there may be lacerations in the perineum, vagina, labia or other areas that may need to be repaired. Medication will be used during the repair. After this is complete, the birthing person can now rest and recover from giving birth. Blood pressure, pulse, and temperature are monitored. Pitocin may be administered either through the IV or through an injection to help prevent excess bleeding or hemorrhage. The baby may be examined on the birthing person’s chest, as long as the baby is doing well. If there are any problems, the baby may be taken to a nursery specifically for newborns to be examined and then returned to the parent.
Signs to look for
It’s important for people who are at risk for premature labor to be on the lookout for signs of early labor. Some of these include pressure or pain in the lower back and pelvis, increased vaginal discharge or persistent leakage of fluid (especially with coughing or sneezing), vaginal bleeding, and five or more contractions occurring over the course of an hour. Any of these signs could indicate preterm labor, so it is crucial to call a healthcare provider if you notice anything.
Reviewed by the Ovia Health Clinical Team
Sources
- “Stages of labor.” BIDMC. Beth Israel Deaconess Medical Center, 2016. Web.
- “Stages of labor.” MarchofDimes. March of Dimes Foundation, May 2014. Web.
- “Stages of labor.” SutterHealth. Sutter Health, 2008. Web.
