How long is the first stage of labor

Labor is the body’s natural process of childbirth. It lasts on average 12 to 24 hours for a first birth. Usually, labor is shorter for births after that.

Labor happens in three stages. The first stage goes from when you first start having steady contractions to when you’re ready to deliver your baby. It includes an early or latent phase, when contractions are mild and the cervix begins changing to allow the baby to pass through; an active phase, when contractions are strong and most of the work happens to prepare your body for delivery; and a transitional phase when you start feeling the need to push.

The second stage of labor is the actual birth of your baby, and the third stage is the delivery of the placenta.

The first stage is the longest part of labor and can last up to 20 hours. It begins when your cervix starts to open (dilate) and ends when it is completely open (fully dilated) at 10 centimeters.

Early or latent labor

The early or latent phase is when labor begins. You’ll have mild contractions that are 15 to 20 minutes apart and last 60 to 90 seconds. Your contractions will become more regular until they are less than 5 minutes apart. The contractions cause your cervix to dilate and efface, which means it gets shorter and thinner, and more ready for delivery. During the early phase, your cervix dilates from 0 to 6 centimeters, and contractions get stronger as time goes on. During this phase, you may have discharge from your vagina that’s clear to slightly bloody.

This part of labor could take hours or even days. It’s best to spend it in the comfort of your home. Here are some things you can do to help the process along:

  • Take a walk.
  • Change positions often.
  • Continue practicing breathing and relaxation techniques.
  • Soak in a warm tub or take a warm shower. If your water has broken, talk to your doctor before soaking in a tub.
  • Rest if you can.
  • Drink plenty of liquids and have something light to eat.
  • Get yourself packed and ready for the hospital if you aren’t already.

Active phase

While the cervix dilates from 6 to 8 centimeters (called the Active Phase), contractions get stronger and are about 3 minutes apart, lasting about 45 seconds. You may have a backache and increased bleeding from your vagina (called the "bloody show"). If your amniotic membrane ruptures -- or your "water breaks" at this point -- the contractions may get much stronger.

This part usually lasts about 4 to 8 hours. Your mood may become more serious as you focus on managing the contractions. You’ll depend more on your support person.

It’s usually during the active phase of labor that you’ll go to the hospital or birthing center. Upon arrival, you will be asked to wear a hospital gown. Your pulse, blood pressure, and temperature  will be checked. A monitor will be placed on your abdomen for a short time, or continuously, to check for uterine contractions and assess the baby's heart rate. Your health care provider will also examine your cervix during a pelvic exam to determine how far labor has progressed.

An intravenous (IV) line may be placed into a vein in your arm to deliver fluids and medications if necessary. Your doctor may have you limit what you eat and drink at this time if they think it’s possible you’ll need a C-section with general anesthesia.

Some tips to help you through the active phase of labor:

  • Try changing your position. You may want to try getting on your hands and knees to ease the discomfort of back labor.
  • Keep walking between contractions.
  • Empty your bladder often to make more room for the baby’s head in your pelvis.
  • Continue practicing breathing and relaxation techniques.
  • Ask your birth partner for a gentle massage.
  • Listening to soothing music.
  • Focus on taking one contraction at a time. Remember that each one brings you closer to holding your baby.

Transition phase

The transition phase is short, but also intense and painful. It usually takes from 15 minutes to an hour for the cervix to dilate from 8 to 10 centimeters. Contractions are 2 to 3 minutes apart and last about 1 minute. You may feel pressure on your rectum and your backache may feel worse. Bleeding from your vagina will be heavier.

You may feel the urge to push, but don’t until your doctor tells you to. Pushing before your cervix is fully dilated may cause it to swell and slow down the process.

The second stage of labor begins when your cervix is fully dilated at 10 centimeters. This stage continues until your baby passes through the birth canal, vagina, and is born. This stage may last 2 hours or longer.

Contractions may feel different from the first stage of labor -- they will slow to 2 to 5 minutes apart and last from about 60 to 90 seconds. You’ll feel a strong urge to push with your contractions. Try to rest as much as possible between intervals of pushing, and only push when the health care provider tells you.

Some tips can help you push:

  • Try several positions -- squatting, lying on your side with your leg up, or resting on your hands and knees.
  • Take deep breaths in and out before and after each contraction.
  • Curl into the push as much as possible; this allows all of your muscles to work.

You may get pain-relieving medications or have an episiotomy if necessary while pushing. An episiotomy is a procedure in which a small cut is made between the anus and vagina to enlarge the vaginal opening. An episiotomy may be necessary to get your baby out quicker or to prevent large, irregular tears of your vaginal wall.

The location of your baby's head as it moves through the pelvis (called descent) is reported in a number called a station. If the baby's head hasn’t started its descent, the station is described at minus 3 (-3). When your baby's head is at the zero station, it is at the middle of the birth canal and is engaged in the pelvis. The station of your baby helps indicate the progress of the second stage of labor.

When your baby is born, your health care provider will hold the baby with their head lowered to prevent amniotic fluid, mucus, and blood from getting into the baby's lungs. The baby's mouth and nose will be suctioned with a small bulb syringe to remove any additional fluid. Your health care provider will place the baby on your stomach and shortly after, the umbilical cord will be cut.

The third stage of labor begins after the baby is born and ends when the placenta separates from the wall of the uterus and is passed through the vagina. This stage is often called delivery of the "afterbirth" and is the shortest stage of labor. It may last from a few minutes to 20 minutes. You will feel contractions but they will be less painful. If you had an episiotomy or small tear, it will be stitched during this stage of labor.

The second stage starts when your cervix is fully open (dilated) and the muscles of your womb are tightening and loosening to push the baby down and out. 

You may not feel an urge to push straightaway, which is called the passive second stage. It becomes the active second stage when you have the urge to push. It ends when your baby is born.

Your midwife will monitor you and the baby closely at this stage, as well as support you as you push. They’ll also help you to find a comfortable position.

Every labour is different. But, on average, once you start actively pushing you’ll probably deliver within 3 hours if it’s your first baby, and within 2 if you’ve had a baby before.

The second stage if you're having twins

If you have your babies vaginally, it will take the same time to push out the first baby as it would if you were just having one baby. After your first baby has been born, doctors will check on the position of the second baby.

If your second baby is in a good position, he or she will usually arrive much more quickly than the first. If the second baby is in a trickier position, you may need extra help for the birth.

The third stage of labour

You’re in the third stage of labour when you’ve had your baby but need to deliver the placenta. Your midwife will speak to you during your pregnancy about the 2 options for delivering the placenta and the pros and cons of each.

You can have active management, which means you’ll have an injection that helps you deliver the placenta or you can try physiological management. This means that you will deliver the placenta without any injection.

It’s a good idea to write your choice in your birth plan. If you want to try to deliver the placenta without the injection, you can change your mind and have the injection at any time if you want to.

NICE guidance recommends that the umbilical cord, which links your placenta to the baby, is not clamped and cut until at least 1–5 minutes after you give birth. This allows the blood from the placenta to continue being transferred to the baby even after they are born, which helps with their growth and development.

You may want to find out if the place where you want to give birth practices delayed cord clamping and include a request for this to happen in your birth plan.

If there is a delay in labour

You and your baby will be monitored throughout your labour to make sure everything is okay. Sometimes, things don't go according to plan and labour slows right down or there may be problems. You might need help because you’ve been in labour for a long time and you are exhausted. Or your baby’s heart rate might drop and the doctors might want them to be born quickly.

When this happens, there are a few different ways that your baby can be delivered the baby safely.

Delays during the first stage

If the first stage of labour is slow, your midwife or doctor may suggest breaking your waters (also known as artificial rupture of the membranes) if they haven’t broken already.

Having your waters broken doesn't hurt your baby, but there are risks as with any intervention.

Having your waters broken may make your contractions stronger and more painful. It may be worth talking to your midwife about pain relief before your waters are broken. Find out more about what to expect when your waters break.

You may also be offered a drip with oxytocin (a drug that makes your contractions stronger), which will help labour to progress. If you have oxytocin, you should be offered an epidural. You will also be encouraged to have electronic monitoring, which involves being attached to a monitor that continuously monitors your baby's heartbeat and your contractions. You may also have regular vaginal examinations at this point.

Delays during the second stage

If you are having your first baby and your contractions are weak, you may be offered an oxytocin drip. You should be offered an epidural at the same time.

If the second stage of labour is slower than normal, you should be offered a vaginal examination. You may also have (with your agreement):

  • your waters broken (if they haven’t already)
  • an oxytocin drip to help your labour progress (and an epidural)
  • more pain relief.

If the second stage of labour goes on for longer than expected, you may be offered an assisted birth. If a vaginal birth is not possible, you will be advised to have a caesarean section.

If your baby needs to be born quickly

Your baby may need to be born quickly if there are any concerns about their health or yours. This might mean an assisted birth or a caesarean section, depending on how quickly your baby needs to be born. Your midwife and obstetrician should explain why the birth needs to happen soon and what the options are.

You may need your birth partner to help you understand what’s happening and what your options are, especially if you are not feeling well or are very tired. They can also take control and make any decisions for you if you need them to.