The Three Stages of Labor (and How to Know Which You're In)

Understanding the three stages of labor is important so you know what to expect and how to prepare. This blog post explains what you need to know about each stage and how to tell which you’re in at any given point.

women experiencing the three stages of labor

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If you are pregnant and anticipating labor for the first time, you probably have a question in the back of your mind about what labor and giving birth are actually going to be like.

Right up front, if you’re wondering if childbirth is as painful as people say, I recommend you start with my article about that: Is Childbirth Painful? (The Answer Might Surprise You).

Once we’re on the same page about that, we can talk about what you’re going to experience during labor and why it’s all happening. I really do believe that, for most women, the more you know, the better things will go.

So let’s dive in.

Three Stages of Labor

Labor has three stages:

Opening and Thinning
Pushing and Birth
Delivering the Placenta

Each stage has a different purpose, and each feels and looks different than the others.

Labor is also unique for every woman and can vary in many ways. We’ll cover the basics of what you might call the “textbook labor” – a sort of baseline birth that illustrates what happens and in what order and with average time estimates.

Note: Pitocin and epidurals can change the way contractions behave. The timing and descriptions I give in this article are for non-augmented labor (meaning no medication).

Stage 1: Opening and Thinning

The entire purpose of the first stage of labor is to “open the door,” if you will, so your baby can come out. The “door” is your cervix (the little passageway that connects your uterus and your vagina) and it changes in several ways during this stage of labor.

Changes in the Cervix

During the first stage of labor, your cervix changes in three ways: it softens, thins, and opens.

Softness: Your cervix gets softer as labor progresses. The muscles and tissues of the cervix become more flexible, going from the firmness of the tip of your nose to the softness of the inside of your cheek.

Thinning: Your cervix also thins – and shortens – during labor. This thinning is called “effacement.” When you’re not in labor, your cervix is small and tunnel-like, measuring about 1 to 1.5 inches. By the end of this first stage of labor, your cervix is just a ring-like opening, with no height to it at all.

Opening: “Dilation” is the technical word you’ve probably heard for the process of opening that your cervix goes through. During labor, your cervix will go from totally closed to 10 centimeters wide, which is about the distance between your pointer and middle finger if you stretch them out into a wide “V” shape.

The easiest way to understand dilation and effacement is with the analogy of a turtleneck.

Imagine pulling a turtleneck over your head. The material stretches and thins out while the opening widens to make room for your head to come through. That’s exactly what happens to your cervix during labor.

As the contractions push your baby’s head onto your cervix, the tissues get stretched and thinned (effacement). At the same time, the contractions and your baby’s head push the tissues apart, making the opening wider (dilation). And all the while, the tissues are getting softer and more flexible to allow this all to happen.

While all of these changes can be felt by inserting a finger or two into the cervix, you do not have to have cervical checks during labor. Most doctors in the hospital will check every few hours. But most midwives will only check when it’s necessary or when you ask.

Three Parts of the First Stage

The first stage of labor is divided into three parts. It is one continuous process, but for the sake of care providers and mothers who want to know how far labor has progressed, it gets divided into three distinct parts. (Not to be confused with the original 3 stages of labor as a whole.)

These three parts are early labor, active labor, and transition.

Early Labor

Early labor begins when contractions start.

Contractions generally start out about 10 minutes apart, and each one is fairly short, lasting about 30-45 seconds. Early labor can last anywhere from a few hours to more than a day. For most first-time moms, early labor usually lasts somewhere between 6 and 12 hours.

During early labor, your cervix is starting to soften, thin, and open. There isn’t a definite rule of how open you will be before you move to active labor but it will probably be somewhere between 3 and 6 centimeters.

As I said earlier, you don’t have to have cervical checks during labor so you may not know how dilated you are. Labor will still progress and there are other ways of knowing what phase you’re in.

For a lot of women, early labor isn’t too uncomfortable. You’re just starting out so you’ve got lots of energy and it’s exciting that the day is finally here. You know you’re still in early labor if you’re still excited and talking and doing normal things.

What to Do During Early Labor

During early labor, you’ll want to keep yourself busy. Don’t do anything that takes too much energy, but try not to focus too much on labor.

You could be in labor for a long time, so you’ll want to save your physical and mental energy for later on. For now, do simple housework, play a game, watch a movie, go on a walk – do anything except focus on contractions.

This would be a good time to check your bags if you’re going to the hospital or a birth center or to set up your birth pool if you’ll be doing a home water birth.

At this stage of labor you’ll still be at home, regardless of where you’ll give birth, so feel free to eat and drink. Now is a good time to eat a meal (or whatever you want, really) so you can have the energy you need for what’s to come.

Active Labor

Active labor is when things get a little more intense. Contractions will get closer together – maybe as close as 3 minutes apart – and will get longer, too, probably around 60 seconds. Active labor typically lasts 4-8 hours.

During active labor your cervix will continue to soften, thin, and open. Typically, active labor is defined as ending when you reach 6 or 7 centimeters.

Your amniotic sac (or “water”) may break during active labor, if it hasn’t already. It may be a big gush or just a few drops – both are normal. It’s also possible that your water won’t break until later, or even until after your baby is born, but that’s not very common.

You know you’re in active labor when you start to get serious. You’ll start to really focus during contractions and you’ll no longer feel talkative. It’s normal to not feel very excited anymore at this point, too. You’ll know labor is progressing if that’s the case.

What to Do During Active Labor

From active labor on, you’ll want to try different positions often. During this stage, try lying down with lots of pillows supporting all your limbs and your belly. If that’s uncomfortable, try sitting on a birthing ball or walking around slowly. Whatever your position, try to stay as relaxed as possible.

Warm water can also feel really good at this point. Try taking a bath or standing in the shower.

Now that you’re really working hard and focusing, you may prefer to dim the lights (if you have that option). Make sure phones are silenced and other distractions are removed.

Unless you’re at the hospital, you may still want to eat and drink. (Most hospitals don’t allow you to eat and drink anything except ice chips or water once labor really gets going.) Even if you can’t get much down, try to eat a spoonful of honey to give you a boost and continue drinking water with electrolytes.

When Should I Go to the Hospital?

If you plan to give birth in the hospital, plan to drive there during active labor. How will you know when it’s time? Many people talk about the “4-1-1” rule.

This rule says that when your contractions are about 4 minutes apart, lasting about 1 minute each, and that’s been going on for 1 hour, it’s time to go to the hospital or birth center. Following this rule will usually get you to your birth place in time to give birth in the right room.

If you have given birth before or have progressed very quickly through labor, you may want to leave your house earlier.

Transition

Transition immediately follows active labor. For a lot of women, it is the hardest part of labor. Other women (like me) don’t even realize they’ve reached transition.

At this point, contractions may feel like they’re coming one on top of another. Contractions will typically last 60-90 seconds with about 2 minutes in between. So it doesn’t just feel like you don’t get a break; you really aren’t getting much of one.

Transition typically lasts anywhere from 15 minutes to an hour.

During transition, your cervix will finish softening, thinning, and opening. Once you get to 10 centimeters, you are considered “complete,” meaning your cervix is completely open, and the first stage of labor is over.

It is almost a given that when a woman reaches transition, she’ll feel like giving up. When you get to transition, you’ll probably feel like you can’t do it anymore, like you’re too tired and it’s too much and you’re just done. The thing is, that very feeling tells you that you are almost done!

What to Do During Transition

You may or may not realize you’ve reached transition, so just keep doing what worked during active labor. For me, lying down made contractions feel way worse, so I was either standing or sitting on my birthing ball or couch the entire time, even during transition.

The Resting Phase

For some women, transition is followed by a period of rest. Contractions may get farther apart or completely stop for a while. If you experience this, take advantage of it! Relax, drink something, and go to the bathroom.

Most of the time nothing is wrong and your body simply knows it needs a rest before going on.

It may be that your baby’s head has entered your vagina, leaving extra room in the uterus. If this is the case, this calmer period may be your uterus shrinking to fit your baby’s body so it can continue pushing.

Stage 2: Pushing and Birth

You did it! You made it through the longest part of the labor process. The “door” of your cervix is open and now your little bundle of joy can be born.

The point of the second stage of labor is to get your baby out.

Your baby has to make his or her way through your open cervix and your vagina (often called “the birth canal”). That means your baby also has to navigate their way through your pelvis.

Your baby has to make a series of what are called “cardinal movements.” They have to rotate a few different ways because of the shape and size of the human pelvis. This video explains it well.

What Pushing Contractions Are Like

During this second stage, your contractions change. They’re different from the contractions you’ve experienced up to this point. They’ll be more spaced out than they were during transition, probably anywhere from 2 to 5 minutes apart. And they’ll likely last longer than any before – around 90 seconds.

Pushing contractions also have a different purpose. Rather than your uterus putting pressure on your cervix to help it soften, thin, and open, now your uterus is trying to push your baby out.

During the first stage of labor, it’s best to relax through contractions and let your body do the work. But during the pushing stage, a lot of women find that working with their body and pushing during contractions makes the contractions much more bearable.

That was definitely true for me.

For some women, pushing is a relief and seems easier than the first stage of labor. For others, pushing is the hardest part.

Some women push for only a few minutes. Others push for hours. And some women prefer to relax and let their body do the pushing, as is taught in HypnoBirthing (though that doesn’t work for everyone).

The pushing stage is usually characterized by a calm determination and a strong desire to finish what you’ve started. Many women experience a second wind and feel they have more energy once they realize they’re so close to meeting their new baby.

What to Do During the Pushing Stage

During the pushing stage of labor, you will be pushing but there is still an element of relaxation. While you may be actively pushing during contractions, you’ll need to allow your body to fully rest in between contractions so you don’t get exhausted.

In this stage, you may want to continue changing positions often. Try squatting, being on your hands and knees, lunging with one leg up, or lying on your side with one leg elevated.

Remember, your baby has to make his or her way through your pelvis; changing positions and utilizing gravity will help with that.

If you’ve enjoyed being in water prior to the pushing stage, you may want to stay in the water for pushing and for birth. (In the hospital, however, you will likely be asked to get out of the water before your baby is born. If you’re at a birth center or at home, that choice will be entirely up to you.)

As your baby’s head reaches your perineum (the tissue and muscle between your vagina and anus), push more gently or not at all. Letting your baby’s head move through your vaginal opening slowly may reduce the risk of tearing.

You may not be able to stomach anything during the pushing phase, but continue drinking water to avoid dehydration.

Other Things to Know About the Second Stage of Labor

While the second stage of labor is fairly straightforward, lots can happen as your baby descends through your pelvis and is born. Let’s talk about some of those things.

Crowning or the “Ring of Fire”

At the end of the second stage of labor, you will almost certainly experience what some people call “the ring of fire.” The technical term is “crowning” and it happens when your baby’s head reaches the vaginal opening and stretches the tissues there. It can feel like a burning, tingling, stretching sensation.

Learn more about crowning in The Ring of Fire During Birth (and What You Can Do About It).

Perineal Tears

It’s possible that as your baby is born, your perineum – the muscles and tissue in between your vagina and anus – will tear. It sounds painful, but you’re actually numbed to the sensation because of the pressure your baby’s head puts on those tissues as they are born.

To learn more about perineal tearing, go to Perineal Tearing During Birth: What It Is and How to Avoid It.

Episiotomies

While perineal tearing can happen naturally, some care providers may also cut that tissue to make the vaginal opening bigger. This is called an episiotomy (eh-pee-zee-awh-tuh-mee). Episiotomies are rarely necessary and usually do more harm than good.

You can learn more in The Cascade of Interventions [Explained].

Directed or Delayed Pushing

In a hospital setting, doctors and nurses often “coach” moms on when and how to push. Occasionally, there’s a medical reason to wait to push (like a lip of the cervix that still needs to move out of the way).

More often, though, mothers are asked to wait because the doctor is with another patient.

If you feel the urge to push, not doing so is very uncomfortable. Not only that, but it can cause real problems! Those problems include higher risk of hemorrhage, intrauterine infection, severe perineal tears, and a higher likelihood of your baby being admitted to the NICU.

Instrumental (or Assisted) Delivery

Occasionally, an OBGYN may decide to use forceps or a suction device to help guide your baby out of the birth canal. Usually this assisted delivery only happens when there are signs of fetal distress or when labor seems to not be progressing.

Instrumental delivery is less risky than a c-section, but it’s still a good idea to avoid it if you can.

Learn more in The Cascade of Interventions [Explained].

C-section

Sometimes a planned vaginal birth will end in a cesarean section (or c-section). Occasionally, c-sections are necessary for the health and safety of mom or baby or both.

The World Health Organization (WHO) has long held that the ideal rate of c-sections – meaning the rate at which fewest mothers and babies die – is 10%. The average c-section rate in hospitals across America in 2021 was 32.1%, three times the “ideal” amount.

If that’s the case, there’s no denying that most c-sections that happen in America aren’t medically necessary. (Some become medically necessary as labor progresses because of the use of other interventions, which you can read about in The Cascade of Interventions [Explained].)

If you plan to give birth in a hospital, be sure to ask about your hospital’s c-section rate and have a discussion about it with your OB. If the rate is high, find a different hospital!

Learn more in C-sections: Why and How to Avoid Having One.

Stage 3: Delivering the Placenta

Stage three is the shortest and usually the easiest. Within 30-60 minutes (maybe even sooner) you’ll feel a few more contractions. You’ll likely hardly notice them because you’ll be holding your new baby.

These contractions help to detach the placenta from the wall of your uterus and push it out through your vagina. The hormone oxytocin helps to expel your placenta, especially if you breastfeed immediately after birth.

Some doctors will pull on the cord and massage your abdomen to encourage the placenta to come out. They may also give you Pitocin to encourage the uterus to contract. This is called “active management” and is common but is not without danger.

Women who experience active management of the third stage of labor have almost 3 times the risk of dangerous blood loss than women who experience expectant management (letting the placenta come out on its own).

As is almost always the case with birth, if left alone, things will proceed safely and effectively. The placenta will come out wholly and within an hour most of the time.

After your placenta has come out, you are done with labor and birth! Congratulations! Yes, you’ll be tired and you’ll need time to heal, but cherish these moments with your newborn. The miracle of birth and the days that follow are like nothing else you’ll ever experience.

The Emotional Signposts of Labor

In the explanations above, you may have noticed some emotion-based descriptions of the stages of labor:

“You know you’re still in early labor if you’re still excited and talking and doing normal things.”
“You know you’re in active labor when you start to get serious.”
“When a woman reaches transition, she’ll feel like giving up.”
“The pushing stage is usually characterized by a calm determination and a strong desire to finish what you’ve started.”

These are the emotional signposts of labor. I learned about them in my Bradley Childbirth class.

For me and my husband, they were a much clearer way to understand which stage I was in as I progressed through labor than the somewhat-arbitrary timing of contractions. (And I didn’t have a cervical check until I was fully dilated, after 14 hours of labor, so we didn’t have that for reference either.)

These signposts can be an invaluable tool for you and your birth team, especially if you plan to give birth unmedicated. To learn more about these signposts and how they can help you, check out Emotional Signposts: Your New Labor Roadmap.

Conclusion: Keeping Learning, Keep Preparing

Now that you know what the three stages of labor are like, physically and emotionally, I hope you feel much more prepared for what’s to come at the end of your pregnancy.

But don’t stop here – keep learning and keep preparing. The more you and your husband know, the more you’ll be able to enjoy birth and trust the process, and that’s how it should be.

Until next time,

Allison

The Three Stages of Labor (and How to Know Which You’re In)

Three Stages of Labor