Understanding the Stages of Labour and Birth: A Comprehensive Guide

Highlights

• Labour and birth are divided into three main stages.
• The first stage is broken into three phases — latent, active, and transition.
• The second stage is when your cervix is open and ends with your baby’s birth.
• The third stage starts after your baby is born and involves the delivery of the placenta.
• Despite these stages being common to all labours, each pregnancy is unique, and labour experiences vary.

In This Article

• Why is labour separated into stages?
• What happens during the first stage of labour?
• What happens during the second stage of labour?
• What occurs during the third stage of labour?
• What happens during the recovery phase?
• Tools and Assistance

Why is labour separated into stages?

Labour is divided into three stages to help describe the process of childbirth. Understanding these stages allows for better communication with healthcare providers and helps you prepare for what to expect before, during, and after birth.

Some consider the recovery period as a fourth stage. While these stages are common to all labours, each pregnancy is unique, and labour experiences may vary.

What happens during the first stage of labour?

The first stage of labour consists of three phases:

The latent phase

This is the longest phase, lasting for hours or even days. The cervix begins to thin and dilate to about 4 to 6 centimetres. Contractions may be irregular or not noticeable. It is often possible to stay at home during this stage. Rest and relaxation techniques such as gentle stretching, mindfulness, or meditation can help manage discomfort.

The active phase

The cervix dilates further, reaching about 8 centimetres. Contractions become stronger, more regular, and closer together. Contractions may occur every 3 to 4 minutes, lasting 30 to 60 seconds. Those planning to give birth in a medical facility are often advised to go there during this phase.

The transition phase

The cervix fully dilates to 10 centimetres. Contractions intensify, lasting 60 to 90 seconds and occurring every 2 minutes. A sensation of pressure in the lower body may occur, often resembling the need for a bowel movement due to the baby’s position. This phase can last from a few minutes to over an hour.

What happens during the second stage of labour?

The second stage of labour begins when the cervix is fully dilated and ends with the birth of the baby. A vaginal examination may be performed to confirm full dilation.

Phases of the second stage:

• Passive phase: The body prepares for birth, but there may not be an immediate urge to push.
• Active phase: A strong urge to push begins, and this phase continues until the baby is born.

Common sensations during this stage:

• Pressure in the lower body.
• A stretching or burning feeling in the vaginal area.
• Movement of the baby down through the birth canal.

Pain relief options, including medical and non-medical treatments, can be discussed in advance with healthcare providers.

The duration of this stage varies but can last up to 2 hours. Those who have previously given birth often experience a shorter second stage.

What occurs during the third stage of labour?

The third stage of labour begins after birth and involves the delivery of the placenta and membranes that surrounded the baby.

Management options:

• Active management: A synthetic hormone (oxytocin) is administered to help the uterus contract and expel the placenta more quickly.
• Natural management: The placenta is delivered without medical intervention, relying on natural contractions. Pushing gently may be recommended to aid this process.

The third stage typically lasts:

• 5 to 30 minutes with active management.
• Up to one hour with natural management.

Preferences regarding the umbilical cord — such as delayed clamping or allowing a birth partner to cut it — should be discussed in advance with the healthcare team.

What happens during the recovery phase?

After labour, time is needed to rest, bond with the baby, and regain strength.

Common post-labour care includes:

• Monitoring vital signs such as pulse, blood pressure, and temperature.
• Assistance with breastfeeding, if chosen.
• Checking the uterus to ensure it is contracting properly.
• Examining the perineum for tears or excessive bleeding.

Emotional fluctuations are common in the first days or weeks after labour. Support services may be available, particularly if the birth experience was unexpected or if the baby required special care.

Tools and Assistance

• Healthcare Team: It’s important to establish a trusted team of healthcare providers, such as midwives, obstetricians, or doulas, to assist and guide you through the entire process of pregnancy, labour, and postpartum care.
• Birthing Classes: These classes provide information on childbirth, pain management, breathing techniques, and post-labour recovery. They also offer opportunities to ask questions and gain emotional support from others.
• Pain Management Options: Discuss pain relief options in advance with your healthcare provider to understand what is available, including medications, natural therapies, or alternative methods like acupuncture or water birth.
• Postpartum Support Groups: Many communities offer support groups for new parents to help with the transition to parenthood, providing both emotional and practical support.
• Emergency Services: In case of complications or a fast labour, it’s essential to have access to emergency medical services. Ensure you know when and how to contact your healthcare provider or emergency services.
• Mental Health Resources: If you experience any mental health challenges, such as postpartum depression or anxiety, reach out to mental health professionals who specialize in new parent care.