As the due date gets closer, soon-to-be moms may wonder what actually happens once labour begins. Knowing when the cervix opens, when pushing starts, how the placenta is delivered and why you are monitored after birth can help you understand how labour and delivery progress. Labour begins with regular uterine contractions that soften, thin and open the cervix. It then progresses to the birth of the baby, delivery of the placenta and the immediate recovery period. The 4 stages of labour describe these milestones, but the pace can differ between women, particularly between a first birth and subsequent births.
The first stage includes the latent and active phases. The phases of labour describe changes in contractions and cervical dilation, while the second stage starts only after complete dilation.
The first stage starts with regular painful contractions and ends when the cervix is fully dilated to 10 cm.
The cervix begins to soften, efface and dilate. Contractions may initially be less intense and can feel like period cramps, abdominal tightening or lower backache. This phase can last several hours.
Contractions become stronger and closer together as cervical dilation progresses. The active phase of labour usually begins when the cervix is dilated to about 5 cm. It usually does not extend beyond 12 hours in a woman having her first baby or 10 hours in a woman who has given birth before.
Your maternity team checks cervical change, contractions, maternal vital signs and the baby's heart rate. As full dilation approaches, pelvic or rectal pressure may become stronger.
The second stage starts when the cervix is fully dilated and ends with the baby's birth. Strong contractions move the baby through the pelvis and birth canal. You may feel increasing pelvic pressure and an urge to push.
This stage includes a passive period after full dilation and an active period when the baby descends with maternal pushing. The active second stage may last up to 3 hours in a first birth and up to 2 hours in subsequent births.
The baby's heart rate, position and descent are monitored along with your condition. If labour is not progressing safely or the baby needs to be delivered sooner, the obstetric team may discuss assisted vaginal birth or caesarean birth.
The third stage begins after the baby is born and ends when the placenta and membranes are delivered. The uterus continues contracting, helping the placenta separate from the uterine wall.
Active management is important in this stage to reduce postpartum haemorrhage. This may include a uterotonic such as oxytocin, with controlled cord traction by a trained provider when appropriate.
After delivery, the placenta and membranes are checked for completeness and the mother is observed for bleeding. Poor uterine contraction, retained placental tissue and tears in the birth canal can cause postpartum haemorrhage and need prompt treatment.
The fourth stage refers to the first one to two hours after the placenta is delivered. It is a period of close observation because significant bleeding can develop soon after birth.
The maternity team monitors your:
When mother and baby are stable, skin-to-skin contact is encouraged. It is recommended to start breastfeeding as early as possible, preferably within the first hour after birth.
Labour cannot be placed on one fixed timetable. A common timeline is as follows:
Common sensations include:
Breathing and relaxation techniques, position changes, movement, massage and medical pain-relief options can help. Your obstetrician can explain which options are available and suitable for you.
During antenatal appointments, discuss your birth preferences, pain-relief choices, previous caesarean or other medical conditions, and when your doctor wants you to reach the hospital.
Childbirth classes can help you practise breathing, relaxation and positions for labour. Keep your hospital bag, medical records, identification documents, prescribed medicines and baby's essentials ready before your due date.
Contact your maternity team when contractions become regular and progressively stronger or when your obstetrician has given you specific instructions.
Seek urgent assessment for:
If you have a high-risk pregnancy, a previous caesarean or are below 37 weeks, medical evaluation is necessary.
Cloudnine brings obstetric, anaesthesia, newborn and emergency support together for childbirth. Its antenatal education also covers labour stages, breathing, pain relief and birth preparation, helping mothers understand what to expect and discuss their concerns with the clinical team.
Knowing the 4 stages of labour can make the sequence of childbirth easier to understand: the cervix opens, the baby is born, the placenta follows and the mother is closely monitored afterwards. The milestones remain the same, but the pace can differ considerably. Your maternity team uses cervical progress, contractions, vital signs and the baby's condition to decide when additional support is needed. Understanding these stages can help you prepare for labour without expecting your birth to follow someone else's timeline
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The latent phase can last several hours and may be longer in a first pregnancy. Your doctor looks at cervical change and the pattern of contractions rather than using a fixed number of hours to decide whether labour is progressing.
Active first-stage labour averages about 8 hours in women having their first baby and about 5 hours in subsequent pregnancies. The upper duration noted is about 12 hours for a first birth and 10 hours for subsequent births. These figures refer to active labour, not the entire latent phase.
Breathing and relaxation techniques, position changes, walking when appropriate, massage and support from a companion can help. Medicines and epidural analgesia may also be used when clinically suitable.
Postpartum haemorrhage is the major concern. It may occur when the uterus does not contract adequately, placental tissue remains inside the uterus or there is a tear in the birth canal. The team therefore manages the third stage actively when appropriate, checks the placenta and monitors bleeding closely.
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