Labor and delivery is the process by which the body prepares for and completes childbirth, moving through a series of stages that open the cervix, move the baby through the birth canal, and expel the placenta. The entire process is divided into three distinct stages, each with its own timeline and physical experience. Whether labor starts on its own or is medically induced, understanding what happens at each phase can help you recognize progress and feel more prepared for what comes next.
The Three Stages of Labor
Labor unfolds in three stages. The first stage covers everything from the earliest contractions to the point when the cervix is fully open at 10 centimeters. The second stage is the pushing phase, from full dilation to the baby’s birth. The third stage begins immediately after delivery and ends when the placenta is expelled, which typically takes 5 to 30 minutes.
Two key changes happen to the cervix during the first stage. It thins out (a process called effacement, measured as a percentage from 0% to 100%) and it opens (dilation, measured in centimeters from 0 to 10). Both need to reach their endpoints before a vaginal delivery can happen. Early in labor, you might be around 1 to 2 centimeters dilated and 60% effaced. By the time dilation reaches 4 to 5 centimeters, the cervix is usually about 90% effaced.
Early Labor vs. Active Labor
The first stage is split into two phases that feel quite different. The latent (early) phase covers dilation from 0 to about 6 centimeters. This is the longer, slower, and less predictable stretch. Contractions may be irregular, and you can often manage them at home with rest, movement, and hydration. For some people, early labor lasts hours; for others, it stretches over a day or more.
Active labor picks up once the cervix reaches around 6 centimeters. Dilation becomes faster and more predictable. About 95% of people in active labor dilate between 1 and 2 centimeters per hour, with those who’ve given birth before progressing faster than first-time parents. Contractions during active labor are stronger, closer together, and longer lasting. This is the phase when most people head to the hospital or birth center.
When to Go to the Hospital
Timing your arrival matters. Going too early can mean hours of waiting in a hospital bed; going too late can mean a stressful rush. For a first baby, a common guideline is to go when contractions come every 3 to 5 minutes over an hour-long period and each one lasts 45 to 60 seconds. If you’ve given birth before, the threshold is a bit more relaxed: contractions every 5 to 7 minutes, lasting 45 to 60 seconds, since labor tends to move faster the second time around.
Other reasons to go in right away include your water breaking, heavy bleeding, a significant decrease in the baby’s movement, or contractions that start well before your due date.
Pushing and Delivery
The second stage begins at full dilation and ends with the birth. For first-time parents, the pushing phase averages about 54 minutes. For those who’ve delivered vaginally before, it averages around 18 minutes. These are averages, though. Pushing can last well over two hours for some first-time parents, particularly with an epidural, which can reduce the urge to push.
During this stage, your care team will guide you on when and how to push with each contraction. You’ll feel intense pressure in the pelvis, and many people describe a burning sensation as the baby’s head crowns. Once the head is delivered, the rest of the body usually follows quickly.
The Placenta and the First Hour
After the baby is born, the third stage focuses on delivering the placenta. Three signs indicate it’s separating from the uterine wall: a gush of blood, the umbilical cord lengthening, and the uterus firming into a rounder shape. Most placentas are delivered within 5 to 30 minutes. Your care team will often give a medication to help the uterus contract, reducing bleeding.
The first hour after birth is sometimes called the “golden hour.” Placing the baby skin to skin on the parent’s chest during this time has well-documented benefits. For the baby, it stabilizes body temperature, reduces stress from the transition to life outside the womb, and promotes earlier, more effective breastfeeding. For the parent, skin-to-skin contact triggers a surge of oxytocin that helps the uterus contract, reduces blood loss, and supports early bonding. The World Health Organization recommends uninterrupted skin-to-skin contact immediately after birth, with the understanding that the newborn will often find the breast and latch on their own. Interrupting this contact during the first two hours has been shown to reduce the chances of a successful early breastfeed.
Pain Management During Labor
Pain relief options fall into two broad categories: methods that reduce pain while keeping you able to feel and move, and methods that block most sensation entirely. What you choose depends on your preferences, how labor is progressing, and what your birth setting offers.
Nitrous oxide (laughing gas) is an option at some hospitals. It doesn’t numb pain but reduces anxiety and increases a sense of well-being, making contractions easier to cope with. You breathe it through a mask and control the timing yourself. An epidural is the most common form of regional pain relief. It delivers continuous medication through a thin tube placed near the spinal cord in the lower back, significantly reducing sensation from the waist down while you remain awake. A spinal block works similarly but is given as a single injection rather than a continuous dose, so its effects are shorter-lived and it’s more commonly used for cesarean births.
Pain-relieving medications given through an IV are another option earlier in labor, though they’re generally not given within the hour before delivery.
Fetal Monitoring
Throughout labor, your care team tracks the baby’s heart rate alongside your contractions. The most common method is external monitoring: two sensors placed on your abdomen, one over the baby’s heart and one near the top of the uterus. This lets the team see how the baby responds to each contraction in real time. If the external reading isn’t clear enough, a small electrode can be placed on the baby’s scalp for a more direct signal. Monitoring patterns help the team identify early signs that the baby may not be tolerating labor well, which can guide decisions about changing positions, adjusting labor pace, or moving to a cesarean delivery.
Cesarean Delivery
Not all deliveries happen vaginally. In 2023, 32.3% of all births in the United States were cesarean deliveries. A cesarean may be planned ahead of time for reasons like the baby’s position (such as breech), placenta placement, or a prior cesarean. It can also become necessary during labor if the baby shows signs of distress, labor stalls despite intervention, or other complications arise. The procedure involves surgical delivery through an incision in the abdomen and uterus, typically under regional anesthesia so the parent is awake.
Why Labor Is Sometimes Induced
Labor induction means starting contractions artificially rather than waiting for them to begin on their own. It’s recommended when continuing the pregnancy poses more risk than delivering. Common reasons include high blood pressure or preeclampsia, gestational or pre-existing diabetes, the baby not growing as expected, low or excessive amniotic fluid levels, water breaking without contractions starting, and pregnancies that extend past 41 weeks.
The timing of induction depends on the specific situation. Well-controlled gestational diabetes managed with diet and exercise, for example, is typically induced between 39 and 40 weeks. Preeclampsia with severe features may prompt induction as early as 34 weeks. In some cases, induction is also offered for practical reasons, such as a history of very fast labors or living far from the hospital. The core principle is straightforward: induction happens when the benefits of delivery outweigh the benefits of waiting.