Labour and birth

Stages of labour

7 min read

Find out what to expect during the three stages of labour – from how long it can take to be fully dilated to your choices for delivering the placenta after your baby’s been born.

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16Your body goes through an incredible process when you’re in labour, starting with the dilation of your cervix through to the birth of your baby and delivery of the placenta. We take you through the stages of an uncomplicated vaginal birth.

Early labour: up to 4 cm dilated

The latent phase of labour (also known as pre-labour or early labour) is the time when your cervix softens, thins and reaches a dilation of four centimetres. At this point you’ll most likely notice the first signs of labour.

It’s not unusual for early labour to last for several days, or for contractions to start and stop again a few times before you go into active labour, which can be both frustrating and tiring.

If you find yourself in a long early labour, get in touch with your midwife. They can make sure everything is going as expected and give you advice on how to cope with the pain or the options you have to help bring on labour.

The first stage of labour: 4-10 cm dilated

The first stage of labour, also known as active labour, starts when you’re four centimetres dilated and are having regular, painful contractions. It’s at this point that you’re encouraged to travel to the hospital or birth centre, or to call your home birth midwife.

It’s very individual how long this stage lasts, but it’s usually the longest of the stages and can take from five to 18 hours. If you’ve had a baby before, you’ll probably get to the stage of being fully dilated faster this time around compared to your last birth, although it does also depend on which position your baby’s in.

Because the first stage can last quite a while, it’s important to try to eat and drink regularly to keep your energy levels up, so remember to pack some snacks in your hospital bag.

It’s also good to keep active, and it can help to adopt different upright or kneeling positions to use gravity to push the baby down on your cervix. Labour wards and birth centres have a range of equipment that can help you with this, for example:

Use our Birth Choice tool to find out what’s available at the birth unit where you’re planning to have your baby.

If you want to have a home birth, your midwife can show you different ways you can use this environment in the first stage to keep active and upright, for example:

  • walking up and down stairs
  • leaning on chairs
  • kneeling in front of a sofa or bed.

Use our home birth checklist for more tips on things to have ready before you go into labour to help you in the first stage.

The first stage of labour is also when you’ll have the most need for, and the greatest choice of, pain relief methods. Make sure you’ve talked your preferences through with your midwife in advance and have noted these down in your birth plan, so you both have an idea of what you may like to use on the day.

Your birth partner can be a great help and support in this stage of labour, they can:

  • help you change positions
  • massage your back
  • get you drinks and snacks
  • talk to you about pain relief options.

Transition: the last part of the first stage

When you’re around 7-8 centimetres dilated, you’re entering the transitional phase which lasts until you’re fully dilated. This is the very end part of the first stage of labour and many women find it the most difficult part of the birth.

It can be very intense and painful, and a lot of women report feeling fearful and experiencing a loss of control at this point. It’s not unusual for women who have previously handled contractions well without medical pain relief to suddenly feel like they need more help.

For birth partnersit can also be a difficult time as women may find it more difficult to communicate at this point as they focus on coping with the contractions.

However difficult you’re finding this stage, it’s a sign that the long first stage of labour is coming to an end, and you’re very close to meeting your baby.

The second stage of labour: birth of the baby

The second stage of labour is when your baby is born and it starts when you’re fully dilated and need to push. If you’ve had an epidural, the medical team may turn it down at this point, so you’ll be able to feel the urges to push.

The part of birth when you’re pushing your baby out can last from a few minutes to a couple of hours. Just like with the first stage of labour, the second stage usually takes longer if you’re a first-time mum.

If you’re in a birth pool for pain relief, you may choose to stay in it to have a water birth. Out of water, you can stand, kneel, lean, sit on a birth stool or lie down – there are many different positions to give birth in and it’s all about finding which one is right for you.

Your midwife will help you find the best position while also keeping an eye on your baby’s heart rate to make sure you’re both coping well through the contractions.

CQC stats on women's position during birth: legs in stirrups; standing/squatting/kneeling; sitting; lying flat or on side

Every time you have a contraction and push, your baby’s head gets pushed down through your pelvis further into the birth canal. When the contraction ends, the head will move up again. This is completely normal and not a sign that your pushes are ineffective, the gradual descent through the birth canal allows your tissue to stretch to let the baby out.

Just before your baby’s born, their head is visible at the entrance of your vagina. It’s called crowning and your midwife could encourage you to stop pushing at this point to allow the baby’s head to be born slowly.

You’ll feel an intense stinging pain as your baby’s head comes through your vagina and your midwife may put their hand against your perineum to prevent tearing.

Once your baby’s head is born, the rest of the body follows swiftly, and suddenly, your baby’s here and you get to see them for the first time. Depending on how you feel, your baby can be placed straight on your chest or be dried quickly with a towel first.

The umbilical cord is usually left attached for one to three minutes to allow all the blood from the placenta to reach the baby (delayed cord clamping) while they’re skin-to-skin with you.

If you have specific thoughts about birth positions you’d like to try when giving birth, how you want your baby’s cord clamped and whether you’d like them skin-to-skin immediately, it’s a good idea to write it down in your birth plan in advance, so your midwives are aware of your preferences and wishes.

The third stage of labour: delivery of the placenta

After your baby’s been born, the placenta and the remaining parts of the umbilical cord need to be delivered. This is the third and final stage of labour and can happen within a few minutes to an hour after your baby is born.

You’ll have two choices for how you want to deliver the placenta:

  • Physiological third stage: You wait for the placenta to be delivered naturally, either through you pushing it out or from it sliding out when you stand up.
  • Active/managed third stage: You’ll get a hormone injection in your thigh that helps your uterus contract and detach the placenta from your uterus.

Hospitals often recommend a managed delivery as there is some evidence to suggest you’re a bit more likely to suffer from heavy blood loss with a physiological third stage. However, the choice is yours and many midwives are very supportive of a natural delivery of the placenta as long as you’ve had an uncomplicated birth without interventions.

When the placenta’s been delivered, your midwife will look it over to make sure that it has come out whole – retained placenta pieces in your womb can cause bleeding or infection.

After the birth

For the first couple of hours after the birth your midwife will be at hand making sure both you and your baby are doing well. Among other things, they will check your perineum for tears and make sure your baby has their first feed.

After an uncomplicated birth, you can expect to be able to leave the hospital or birth centre a few hours after the birth, although many women do stay at least one night in a postnatal ward or room. After you’ve come home, or the day after you’ve had a home birth, you’ll be seen by your community midwife team for your first postnatal appointment.

If things don’t go to plan

On this page we’ve outlined what you can expect in a uncomplicated vaginal birth. There are many things that can happen during labour to make it less straightforward, so you may find it useful to also read our advice on inductions, assisted births and c-sections to feel prepared for all eventualities.

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