Stages of Childbirth

Going through the birth of your child is a wonderful and unique experience. No two deliveries are alike and there is no way to tell how your delivery is going to be. What we can tell you is the stages you will go through during this process and what you can generally expect.

Each phase is full of different emotions and physical challenges. It is one big adventure you are about to take and we would like to give you a guide for it.

Childbirth can be broken into three stages:

  • First stage: Begins from the onset of true labor and lasts until the cervix is completely dilated to 10 cm.
  • Second stage: Continues after the cervix is dilated to 10 cm until the delivery of your baby.
  • Third stage: Delivery of your placenta.

First Stage

The first stage is the longest and is broken down into three phases:

  1. Early labor phase: Starts from the onset of labor until the cervix is dilated to 3 cm.
  2. Active labor phase: Continues until the cervix is dilated to 7 cm.
  3. Transition phase: Continues until the cervix is fully dilated to 10 cm.

Early Labor Phase

What to do:

During this phase you should just relax. It is not necessary for you to rush to the hospital. It might be nicer for you to spend this time at home, in familiar territory. If it is during the day you should do daily simple routines around the house. Keep yourself occupied but still conserve some of your energy. Drink plenty of water and eat small snacks. Keep track of the time of your contractions.

If it is during the night it is a good idea to try and get some sleep. If you can't fall asleep, do things that will distract you like cleaning out your closet, packing your bag, or making sack lunches for the next day.

What to expect:

  • Duration will last about 8-12 hours
  • Your cervix will efface and dilate to 3 cm
  • Contractions will last about 30-45 seconds, giving you 5-30 minutes of rest in between contractions
  • Contractions are typically mild, somewhat irregular, but progressively stronger and closer together
  • Contractions may feel like aching in your lower back, menstrual cramps, and pressure or tightening in the pelvis area
  • Your water will break; also known as amniotic sac rupture (this can happen any time within the first stage)

When monitoring contractions observe the following:

  • Growing more intense
  • Following a regular pattern
  • Lasting longer
  • Becoming closer together

If/when your water breaks (amniotic sac ruptures) note the following:

  • Color of fluid
  • Odor of fluid
  • Time rupture occurred

Tips for the support person:

  • Practice timing contractions
  • Be a calming influence
  • Offer comfort, reassurance, and support
  • Suggest activities that will distract her
  • Keep up your own strength, you will need it!
  • If you can not be with her during this early phase, simply do these things on the phone.
  • Don't feel bad if you are not there. If the contractions are fairly far apart then you have plenty of time.

Active Labor Phase

What to do:
It is about time for you to head to the hospital. Your contractions will be stronger, longer and closer together. It is very important that you have all the support you can get. Now is also a good time for you to start your breathing techniques and try some relaxation exercises for you to use in between contractions. You should switch positions often during this time. You may want to try walking or taking a nice bath. Continue to drink water if your doctor allows you to. If you feel like you need some pain relief such as an epidural or analgesic, just ask. Remember to urinate periodically.

What to expect:

  • Duration will last about 3-5 hours
  • Your cervix will dilate from 3cm to 7cm
  • Contractions during this phase will last about 45-60 seconds with 3-5 minutes rest in between
  • Contractions will feel stronger and longer
  • This is usually the time that you head to the hospital

Tips for the support person:

  • Give your undivided attention
  • Offer verbal reassurance and encouragement
  • Massage her abdomen and lower back
  • Keep track of contractions (if she is hooked up to a monitor ask how it works)
  • Go through the breathing techniques with her
  • Help make her comfortable (prop pillows, get her water, apply touch)
  • Remind her to change positions frequently (take her for a walk or offer her a bath)
  • Continue with distractions (music, reading a book, playing a simple card game)
  • Don't feel bad if she is not responding to you

Transition Phase

What to do:
During this phase you will rely heavily on your support person. This is the hardest phase to go through but you are almost to the end. Think "one contraction at a time." This may be hard to do if the contractions are running together, but just think about how far you have come. When you feel an urge to push, wait until you are instructed to. Forget that this is the hardest phase and remember that it is the shortest.

What to expect:

  • Duration will last about 30 min-2 hrs
  • Your cervix will dilate from 7cm to 10cm
  • Contractions during this phase will last about 60-90 seconds with a 30 second-2 minute rest in between
  • Contractions are long, strong, intense, and may overlap
  • This is the hardest phase but thankfully the shortest
  • You may experience hot flashes, chills, shaking, nausea, vomiting, or gas

Tips for the support person:

  • Offer lots of encouragement and praise
  • Cut out the small talk
  • Continue breathing with her
  • Help guide her through her contractions with encouragement
  • Encourage her to relax in between contractions
  • Don't feel hurt if she seems to have really strong anger toward you, it's just a phase she is going through!

Second Stage

The second stage of childbirth is pushing and delivery of your baby. Up until this point your body has been doing all the work for you. Now that your cervix has fully dilated to 10 cm it is time for your help. Time to PUSH!

Pushing and what to expect:

  • The entire process of the second stage lasts anywhere from 20 minutes to 2 hours
  • Contractions will last about 45-90 seconds with a 3-5 minute rest in between
  • You will have a strong natural urge to push
  • You will feel strong pressure at your rectum
  • Most likely you will have a slight bowel or urination accident but don't be embarrassed
  • Your baby's head will eventually crown (become visible)
  • You will feel a burning, stinging sensation during crowning
  • During crowning you will be instructed by your healthcare provider not push

Pushing and what to do:

  • Get into a pushing position (one that uses gravity to your advantage)
  • Push when you feel the urge, unless told otherwise
  • Relax your pelvic floor and anal area (Kegel exercises can help)
  • Rest between contractions so you can regain your strength
  • Use a mirror so you can see your progress (this can be very encouraging!)
  • Use all your energy to push
  • Do not feel discouraged if your baby's head poked out and then goes back in (this process can take two steps forward and then one step back)

Tips for the support person:

  • Help her to be relaxed and comfortable (give her ice chips if you can and support her in her position)
  • Encourage, encourage, encourage
  • Be her guide through her contractions
  • Affirm what a great job she has done and is doing
  • Don't feel bad if she tells you to shut up or some other unexpected remark

What your baby is doing:
While you are in labor your baby is taking steps to enter this world

1. Your baby's head will turn to one side and the chin will automatically rest on the chest so the back of the head can lead the way. Once you are fully dilated

2. Once you are fully dilated, your baby's head leads the way and the head and torso begin to turn to face your back as they enter your vagina.

3. Next you will begin to see your baby's head, this is known as crowning.

4. Once your baby's head is out, the head and shoulders again turn to face your side. This position allows your baby to easily slip out.

Delivery and what to expect

When your baby is delivered he/she is not going to come out looking like the Gerber Baby. Keep in mind your baby has been soaking in a sac full of amniotic fluid for nine months. He/she has been through contractions, and your very narrow birth canal. The results of this journey include:

  • Cone-shaped head
  • Vernix coating (cheesy substance that coats the fetus in the uterus)
  • Puffy eyes
  • Lanugo (fine downy hair that cover the shoulders, back, forehead, and temple that will shed by the end of the first week)
  • Enlarged genitals

Third Stage

The third stage is the delivery of the placenta and is the shortest stage. The time it takes to deliver your placenta is anywhere from 5 to 30 minutes.

What to expect & what to do:
After the delivery of your baby, your healthcare provider will be waiting for small contractions to begin again. This is the signal that your placenta is separating from the uterine wall and ready to be delivered. Pressure will be applied by massage to your uterus; and the umbilical cord will be gently pulled on. The result will be the delivery of your placenta, also known as afterbirth. You may experience some severe shaking and shivering after your placenta is delivered. This is common and nothing to be alarmed about.

You have now completed all the stages of childbirth and will be monitored for the next few hours to make sure that the uterus continues to contract and bleeding is not excessive.

Now you can relax and enjoy your little bundle of joy!


Reprinted with permission from American Pregnancy Association