Understanding what happens during labor helps you feel prepared and empowered.
How Long Does Labor Last?
Every labor is different.
First-time mothers:
- Average 12-18 hours (from start of active labor)
- Can be shorter or much longer
Subsequent babies:
- Average 6-10 hours
- Often faster than first
Remember: These are averages. Your experience may differ completely.
The Three Stages of Labor
Stage 1: Cervical Dilation (Longest Stage)
Cervix opens from 0 to 10 cm
Divided into three phases:
Early Labor (Latent Phase)
Cervix dilates 0-3 cm
What you’ll feel:
- Mild, irregular contractions
- 5-30 minutes apart
- Each lasting 30-45 seconds
- Like strong menstrual cramps
- Can talk through them
How long:
- Can last hours to days
- Or happen so gradually you don’t notice
What to do:
- Stay home (usually)
- Rest if at night, stay active if during day
- Eat light meals
- Drink plenty of water
- Time contractions when they become regular
- Take shower or bath
- Watch movie, play games
- Try to relax
Don’t rush to hospital yet – you’ll be more comfortable at home.
Active Labor
Cervix dilates 4-7 cm
What you’ll feel:
- Regular, strong contractions
- 3-5 minutes apart
- Lasting 45-60 seconds
- Intense – need to focus through them
- Can’t talk during contractions
- Pressure building
How long:
- Usually 4-8 hours (first baby)
- Faster for subsequent babies
What’s happening:
- Cervix opening more quickly
- Baby moving down
- This is when you go to hospital (if not already there)
Coping strategies:
- Change positions frequently
- Walk around
- Use birth ball
- Shower or bath
- Breathing techniques
- Massage and counter-pressure
- Focus and visualization
- Pain medication if desired
This is hard work! Stay focused on one contraction at a time.
Transition Phase
Cervix dilates 8-10 cm (fully dilated)
The hardest part, but shortest!
What you’ll feel:
- Very intense, strong contractions
- 2-3 minutes apart
- Lasting 60-90 seconds
- May feel overwhelming
- Pressure in pelvis and rectum
- Nausea or vomiting
- Shaking or trembling
- Hot and cold flashes
- Strong emotions
How long:
- 15 minutes to 2 hours
- Often 30-60 minutes
Common thoughts:
- “I can’t do this anymore”
- “I want to go home”
- “Get this baby out now!”
If you feel this way, you’re probably in transition – almost there!
Coping:
- Take one contraction at a time
- Breathe through each one
- Remember: this means you’re almost done
- Partner’s support crucial here
- Don’t push yet (until told cervix fully dilated)
Stage 2: Pushing and Delivery
From fully dilated to baby born
What you’ll feel:
- Intense pressure low in pelvis
- Urge to push (like needing to poop)
- “Ring of fire” as baby crowns (intense stretching)
- Relief and power when pushing
How long:
- First baby: 20 minutes to 2-3 hours
- Subsequent babies: Often quicker (minutes to 1 hour)
- Longer with epidural (less urge to push)
What you’ll do:
- Push with contractions (unless told to wait)
- Rest between contractions
- Follow your body’s urge or provider’s guidance
- Multiple pushes per contraction
Positions for pushing:
- Semi-reclined (common in hospital)
- Squatting (gravity helps)
- On hands and knees
- Side-lying
- Standing or kneeling
Try different positions – find what feels right.
What’s happening:
- Baby moves down birth canal
- Baby rotates to fit through pelvis
- Crowning: baby’s head visible
- Head born first (usually)
- Body follows quickly (next push or two)
Provider may:
- Guide you when to push or pant
- Support perineum
- Check for umbilical cord around neck (common, usually fine)
- Suction baby’s nose and mouth
Then: Your baby is born!
Stage 3: Delivery of Placenta
Often forgotten but important!
What happens:
- More contractions (much milder)
- Placenta separates from uterus
- You push placenta out (easier than baby!)
- Provider examines placenta (ensure it’s complete)
How long:
- 5-30 minutes after baby born
While this happens:
- Baby usually on your chest
- Cord may still be attached (delayed clamping)
- You may not even notice placenta delivering
- Focused on your baby!
Provider may:
- Massage your abdomen (helps uterus contract)
- Give medication (Pitocin) to prevent heavy bleeding
- Repair any tears or episiotomy
Pain Management Options
Natural/Non-Medical Options
Position changes:
- Upright positions (standing, swaying)
- Hands and knees
- Squatting
- Birth ball
- Walking
Hydrotherapy:
- Shower (water on back)
- Bath or birthing tub
- Warm, soothing
Massage and counter-pressure:
- Lower back massage
- Hip squeezes
- Pressure on sacrum
Breathing techniques:
- Slow, deep breaths
- Focusing on exhale
- Rhythmic breathing
Visualization and meditation:
- Imagining cervix opening
- Picturing baby moving down
- Focus object
Movement and rocking:
- Swaying hips
- Rocking in chair
- Dancing with partner
Vocalization:
- Moaning or humming (low sounds)
- Releases tension
These work best in early and active labor.
Medical Pain Relief Options
Epidural (Most Common)
Regional anesthesia – numbs from waist down
How it works:
- Catheter placed in lower back
- Numbing medicine continuously delivered
- Takes 10-20 minutes to work
- Reduces pain 90-95%
Benefits:
- Excellent pain relief
- You’re awake and alert
- Can still feel pressure (helps with pushing)
- Can rest during long labor
Considerations:
- Limits mobility (often can’t walk)
- Continuous monitoring required
- IV fluids needed
- Catheter in bladder (can’t feel when need to pee)
- May lengthen pushing stage slightly
- Rare complications (headache, nerve damage)
- Doesn’t always work perfectly (one-sided, missed spots)
When you can’t get it:
- Too early (cervix should be 4-5 cm)
- Too late (baby coming soon)
- Certain medical conditions
- Shortage of anesthesiologists
You can still change your mind and get epidural even if planning natural birth.
Spinal Block
Similar to epidural but single dose:
- Used for cesarean delivery
- Faster acting than epidural
- Complete numbness
- Wears off after few hours
Nitrous Oxide (Laughing Gas)
Inhaled pain relief:
- Breathe through mask during contractions
- Reduces pain perception
- Mild sedation
- Doesn’t eliminate pain completely
Benefits:
- Quick onset
- Short-acting (breathe, it works; stop breathing, it stops)
- You control it
- Can still move around
- Doesn’t affect baby
Not available everywhere.
IV Pain Medications (Opioids)
Drugs like fentanyl or morphine through IV:
- Takes edge off pain
- Doesn’t eliminate it
- Makes you sleepy/drowsy
- Effects last 2-4 hours
Considerations:
- Makes you feel “out of it”
- Can affect baby (breathing, alertness)
- Not given close to delivery
- Less effective than epidural
Less commonly used now that epidurals are widely available.
Making Your Choice
No “right” choice:
- Natural birth is not superior
- Epidural doesn’t make you “weak”
- Listen to your body
- Pain management is personal decision
You don’t get a medal for going without pain relief.
Your experience, your choice.
Vaginal Birth vs. Cesarean Delivery
Vaginal Birth (Goal)
Safest for most mothers and babies
Recovery:
- Shorter hospital stay (24-48 hours)
- Faster recovery overall
- Can move immediately after
- Minimal restrictions
Possible tears or episiotomy:
- First degree (skin only) – heals quickly
- Second degree (muscle involved) – most common, heals in few weeks
- Third/fourth degree (rare) – involves deeper tissues
Cesarean Delivery (C-Section)
Major abdominal surgery
Reasons for planned C-section:
- Breech baby (feet or bottom first)
- Placenta previa (placenta over cervix)
- Previous classical C-section
- Multiple babies
- Certain medical conditions
Reasons for emergency C-section during labor:
- Labor not progressing (failure to dilate)
- Baby in distress (heart rate problems)
- Cord prolapse (cord comes first)
- Placental abruption
- Maternal exhaustion
What happens:
- Spinal or epidural anesthesia (awake during)
- Curtain blocks view (unless you request mirror)
- Incision in lower abdomen
- Baby born in 5-10 minutes
- Closing takes 30-45 minutes
- Partner usually allowed in operating room
Recovery:
- Hospital stay 3-4 days
- Major surgery recovery (6-8 weeks)
- Pain managed with medication
- Restrictions on lifting and activities
- Abdominal scar
C-section is safe but recovery is harder than vaginal delivery.
Sometimes necessary for safety of mother or baby.
Assisted Delivery
Sometimes baby needs help getting out:
Vacuum Extraction
Suction cup on baby’s head:
- Gentle pulling during contractions
- Helps guide baby out
- Can cause temporary cone-shaped head (resolves in days)
Forceps
Metal instruments shaped like large spoons:
- Guide baby’s head
- Gentle pulling during pushing
- Less common than vacuum
- May cause bruising on baby’s face (temporary)
Used when:
- Baby is stuck
- Mother too exhausted to push
- Baby showing signs of distress
- Faster than C-section
What If Things Don’t Go As Planned?
Birth rarely goes exactly as envisioned.
Common changes:
- Needing pain relief when planned natural
- Labor longer than expected
- Needing Pitocin to strengthen contractions
- Needing C-section
- Medical interventions you didn’t want
This is not failure.
Healthy mother and baby is the goal – however that happens.
Let go of expectations. Stay flexible. Trust your medical team.
Immediately After Birth
Your baby is here!
First moments:
- Baby placed on your chest (skin-to-skin)
- Crying (clearing lungs)
- Vernix (white coating) and blood
- Umbilical cord still attached initially
Delayed cord clamping:
- Wait 1-3 minutes before clamping and cutting
- Allows blood transfer from placenta to baby
- Increases baby’s iron stores
- Recommended by WHO
Apgar scores:
- Assessed at 1 and 5 minutes
- Rates: color, heart rate, reflexes, muscle tone, breathing
- Score of 7-10 is normal
- Low score doesn’t predict long-term health
First hour (“golden hour”):
- Skin-to-skin contact
- Baby may latch and feed
- Bonding time
- Most measurements and exams can wait
You may feel:
- Overwhelming love
- Relief
- Exhaustion
- Shaking (from hormones and adrenaline)
- Thirsty and hungry
- Euphoria
Or you may feel nothing yet – that’s okay too! Bonding takes time.
Your Support Team
Who’s in the room:
Obstetrician or midwife:
- Delivers baby
- Manages labor
- Handles complications
Labor nurse:
- Monitors you and baby
- Helps with positioning
- Provides support and guidance
- Often with you more than doctor
Anesthesiologist:
- Provides epidural or spinal
- Manages pain medication
Pediatrician or neonatal team:
- Present for delivery (especially if concerns)
- Examines baby
- Handles newborn complications
Plus your chosen support people.
Remember
Your body was designed to do this. Women have been giving birth since the beginning of time.
Labor is hard, but you’re stronger than you know.
Every contraction brings you closer to meeting your baby.
Trust your body. Trust your support team. Trust the process.
Soon you’ll hold your baby in your arms. All of this will be worth it.
You can do this.