Understanding the stages of labor is crucial to empower and provide autonomy to women during childbirth. Discover how labor unfolds, phase by phase!
Talking about “stages of labor” may sound unfamiliar to many women. Unfortunately, much of our lives are spent uninformed about childbirth, even for those who have experienced it or have connections with women who have undergone various types of delivery.
As a doula, I often remind expectant mothers that the fear of childbirth isn’t exactly fear of childbirth itself. It’s the fear of what we imagine childbirth to be. In most cases, our fear is merely a projection of things we’ve heard or seen (let’s be honest, childbirth in movies and TV shows is rarely depicted as beautiful!). In essence, fear is everything we don’t know about childbirth.
Below, discover the four stages of labor and how to recognize them!
First Stage of Labor: Dilation
The first stage of labor is typically the longest. For first-time mothers, it’s normal for the dilation phase to last around 12 hours on average, possibly extending much longer (for example, my first labor lasted 20 hours from the moment my water broke to the beginning of the pushing phase). During this stage, contractions will cause the cervix to dilate, divided into three moments:
Latent Stage
You’ll likely spend the latent phase of labor wondering if you’re really in labor or just experiencing an upset stomach. This is because contractions (also known as training contractions or prodromal labor) are generally very mild and irregular.
You might feel a contraction every 20 minutes or more initially, sometimes approaching intervals as close as every five minutes. However, there’s no consistency, and the timing between contractions can vary.
The best thing to do during this phase is to continue with your normal routine. If you find yourself in the latent phase in the middle of the night, go back to bed and try to sleep if you can. Most women don’t feel uncomfortable at this stage, and many may not even realize they’re having contractions.
It’s too early to head to the hospital, so relax, eat, drink, shop, and take the opportunity to pack your maternity bag, notify your doula, or decorate your home if you’re having a home birth.
Active Labor
The active phase of labor is when contractions start becoming consistent and rhythmic.
Contractions usually occur every five minutes and last, on average, up to 60 seconds. They will also become more uncomfortable, feeling more like annoying menstrual cramps than the urge to go to the bathroom (as in the latent phase).
The difference from the active phase to the latent phase is that the active phase is progressive. Once contractions gain rhythm and consistency, the intervals between contractions tend to decrease over time, and contractions gradually intensify. Therefore, the latent phase is often (incorrectly) referred to as “false labor.”
However, even as they become more intense and regular, you still have intervals between contractions. Take the opportunity to relax, snack, drink water, and inform your birthing team about the situation.
If you aim for a natural hospital birth without medication, wait for contractions to become closer together (every 3 minutes or less) before heading to the hospital. While there are exceptions, it usually takes a few hours for contractions to transition from “every 5 minutes” to “every 2 minutes.”
Moving and relaxing are key to a successful active labor! Use a hot shower when contractions become more painful or change positions, squatting whenever a contraction comes. It’s time to call your doula to assist with pain relief techniques!
Transition Stage
This is one of the shortest but certainly one of the most challenging parts of labor. Contractions may be two or three minutes apart, lasting up to a minute and a half. This is when contractions are most intense, and some women may even experience vomiting (don’t be alarmed; it’s common!).
If the active phase has been lengthy, you might feel the urge to give up, request pain relief, or opt for a cesarean. However, remember that this stage usually lasts no more than an hour or two, and you’re already very close to your goal!
Support from your partner and your birth doula is crucial here. They should encourage you, remind you that you’re doing well, help you find a comfortable position, use cool cloths to wipe and cool your face, and offer water to keep you hydrated between contractions.
The transition phase is when you understand why it’s called labor and not a stroll. It’s hard work, ladies and gentlemen! At the end of the transition phase, you’ll be fully dilated!
It’s common for some women to have a brief pause without contractions after reaching full dilation, and they won’t immediately feel the urge to push. Consider it a well-deserved break after the hard work!
Second Stage of Labor: Expulsion
The expulsion phase is when the body begins pushing out the baby, hence the name. You’ll feel your body exerting force even without your command, involuntarily. This phase can last three or more hours, but for many women, it will conclude within an hour.
The birthing position can significantly influence the duration of the expulsion phase. Generally, upright positions are more favorable and contribute to a quicker expulsion, as gravity works in your favor. Examples of upright positions include sitting on a birthing stool, squatting, kneeling, or even standing.
Other factors that may influence the duration of expulsion include the baby’s position, the use of medications, and especially whether the woman feels well and comfortable or not.
“Should I push to help the baby come out?” is undoubtedly the most common question here. The answer is: no. As a rule, you should not actively push. Your body will do it on its own. If you exert too much force, the risk of tearing will be higher.
Third Stage of Labor: Placental Abruption
Congratulations, you’ve gone through the first part, and your baby has been born! Now comes the second part: the delivery of the placenta. Sounds weird? Believe it or not. But even after holding your baby, you may feel the urge to push again. It’s the placenta wanting to come out!
The good news is that the placenta doesn’t have bones (can I get an amen?), making it much easier to deliver compared to the baby. Breastfeeding your baby in the first hour after birth (the so-called “golden hour“) will help the uterus contract and expel the placenta. In most cases, the expulsion of the placenta occurs within an hour after birth, usually within a few minutes.
Fourth Stage of Labor: Recovery & Postpartum
Postpartum can be more challenging than a week of active labor contractions, and yes, it is considered a part of labor. This is because your body will still undergo many changes after the baby’s birth: organs will return to their place, the uterus will shrink back to its usual size, breasts will need to produce colostrum and eventually milk. The hormone surge from childbirth also plays a role here.
Slowly, your body will become more like your pre-pregnancy self, but not exactly the same. Don’t feel pressured or expect to be identical to the woman you were before having a child; you truly are not the same. And that’s not a bad thing. You’ve given birth to a child, a human being! Like butterflies, you’ve transformed on this journey.
Don’t hesitate to ask for help in the postpartum period; we need and deserve it. We don’t have to do everything on our own, especially when our bodies are still recovering. Ask someone to hold the baby while you take a shower or to look after them so you can eat or even get some more sleep.
Here, we don’t subscribe to the “Who gives birth, deals with it alone” philosophy. We are more of the “It takes a village to raise a child” approach. Embrace your childbirth experience, live through postpartum with all its joys and contradictions, and keep an open mind to the new woman you’ve become!
