Stages of labor
Labor is the work of the women's body to bring forth a baby (and placenta) into the
world. Every women's labor progresses at its own pace and is never exactly the same, even
in the same woman.
During labor, involuntary contractions of the upper uterus (the fundus) causes the
lower part of the uterus (the cervix) to become effaced (shortened and thinned) and
dilated (opened). These contractions gradually increase to size of the cervical opening
until it is approximately four inches. When you are 100% effaced and fully dilated (10
cm), the baby is able to pass through the cervix to the vagina, the birth canal and to the
waiting outside world.
Prelabor is a period prior to "the real thing" during which mom
feels contractions, yet the cervix is not dilating. Contractions may be regular and
strong, lasting for hours, however, they do not become longer, stronger and closer
together. Prelabor may come and go over several hours, days, or even weeks. During
prelabor, mom may feel excitement and anticipation thinking this is "the real
thing" or she may be confused, wondering if she is in labor. Fear may be the
prevailing emotion if mom is not prepared or feels the contractions are more painful than
As prelabor contractions become longer, stronger and closer together in a regular
pattern and the cervix begins to dilate, mom is said to be in labor. Labor is usually
divided into three stages. Early labor is the first stage, and it typically is the longest
phase. During this period, mom should continue to drink fluids, eat foods that appeal to
her (food that is easy to digest such as soups or jello) and do light activity. Walking is
good during this period. Remember to rest as this is just the beginning, energy will be
needed for the remainder of the labor.
Coaching during the early phase consists of helping mom relax, timing her
contractions and finishing any final preparations for time spent in the hospital (clearing
schedule at work, sitters for other children, pets, etc.). Mom will always benefit from
positive encouragement. As the contractions become stronger and closer together, other
relaxation techniques may be started.
During the active stage of labor when the cervix dilates from three to eight
centimeters, mom often feels the need to go to the hospital. Typically she is less
talkative, less excited and may even begin to doubt her ability to cope. It takes more
energy to stay on top of the contractions, and coaches will notice mom becoming more
introverted. Contractions are lasting 45-60 seconds and coming every three to five
minutes. Slow paced breathing may be useful during this stage. Mom may also request
Coaches will get a good workout during this phase. Try all of the "tools in your
bag," some may work for short periods and others not at all. Massage, a cool cloth to
the face, walking, position changes every half hour, breathing, fluids as ordered,
showering, up to the bathroom regularly and positive encouragement with eye-to-eye contact
are some of the tools at your disposal.
Transition is the final phase of the first stage of labor. The cervix dilates
from seven to ten centimeters. It is the most intense phase, yet the shortest phase.
Contractions last 60-90 seconds and come every two to three minutes. They may even have
double peaks. Physically mom may experience nausea and vomiting, shaking of her arms and
legs, sweating in her upper body and her feet may be cold. There may be pressure on the
rectum and bladder and premature urge to push. During this phase mom may feel like giving
up. It is difficult for her to rest between contractions, and she may be very irritable.
Because of the intense feelings, the coach's encouragement during this phase is vital.
Remind mom to take the contractions one at a time; she does not have to deal with them all
at once. When one is done it will never be repeated; she is coming closer to her goal of
birthing a baby. Breathe with her, and talk to her in a quiet, firm voice. Don't take
offense to anything she may say or do, and above all, do not leave her.
These phases complete the opening of the cervix. You may be able to visualize this
process by thinking about putting on a tight turtleneck sweater. You pull and stretch the
neck until you have it opened far enough for you to push your head through. Just like
that, the uterus has to pull on the cervix, stretching it with each contraction until it
is opened to the wildest diameter of the baby's head. Then you will be able to push the
The second stage is pushing the baby out into the world. Contractions
continue to come but last 60-75 seconds and have decreased in frequency to three to five
minutes. Mom may feel an irresistible urge to push, or she may have little urge to push.
Pushing often feels good if the perineum is relaxed and the urge to push is present.
Although mom may be tired, there usually is a burst of energy and determination as this
stage progresses. Facial distortion and grunting sounds or moaning are normal. As birth
draws near, excitement increases.
During the pushing stage, the coach may be physically supporting mom in her efforts to
maintain a good position for pushing. Encourage her to work with her body and push when
she has the urge. Position a mirror so she can see the baby's head. Praise, comfort and
The final stage is the birth of the placenta. Following the birth of the
baby, the mom may be unaware of the birth of the placenta or the repair of the episiotomy.
The joy and euphoria following the baby's birth is the prevailing emotion. Mom may be
hungry and/or tired, but does not notice. As the coach, rejoice with mom in the new baby
and her accomplishment (and yours) of successfully bringing the baby into the world. Help
her to breastfeed, if desired. A warm blanket and something to drink may be appreciated by
mom. Enjoy your time together.
Back to Labor Information Page