The Three Stages Of Labor
Labor is described in three stages. Together these stages complete the delivery and the passage of the placenta.
During the first stage, the woman reaches full cervical dilatation. This begins when contractions start, and it is the longest stage of labor. The first stage is divided into three phases: latent, active, and transition.
- In the latent phase, contractions occur more often, become stronger, and become more regular. During this phase the cervix thins. This is called effacement. The latent phase varies from woman to woman and from labor to labor. It may take a few days or be as short as a few hours. The latent phase tends to be 10 to 12 hours for a woman who has had children. For first pregnancies, it may last closer to 20 hours. Many women confuse the latent phase of labor with Braxton Hicks contractions. Membranes may rupture in the early- to mid-portion of the first stage of labor. If they rupture, the labor process often speeds up.
- The next portion of the first stage of labor is the active phase. During this phase, the cervix dilates rapidly. For most women, dilation goes from 3 to 4 centimeters to 8 to 9 centimeters. The active phase is the most predictable, lasting an average of 5 hours in first-time mothers and 2 hours in mothers who have given birth before.
- Finally, there is the transition phase. During this phase, the cervix dilation continues to dilate, but at a slower pace, until fully dilated. In some women, the transition phase is not really noticeable, blending into the active phase. This is also a phase of more rapid descent, when the baby is passing lower into the pelvis and deeper into the birth canal. In mothers with no anesthesia, nausea, vomiting and uncontrollable shaking may occur. These symptoms can be frightening to watch and experience, but they're a part of normal birth. They signal that the first stage is almost completed.
The second stage is the delivery of the infant. During the second stage, mom actively pushes out the baby. For first-time mothers, this can take 2 to 3 hours, so it's important to save your energy and pace yourself. For second babies and beyond, the second stage often lasts less than an hour -- and sometimes, only a few minutes. If you have an epidural anesthetic, the second stage may require more time.
The third stage of labor is the passage of the placenta. This may occur right away, or take up to 30 minutes. The process may be sped up naturally by breastfeeding (which releases oxytocin), or medically by administering a drug called pitocin.
Reviewed By: John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.