Stages of labour and birth

Labour is the normal physiological process during which the cervix softens, shortens, and dilates to allow the birth of the baby, followed by the delivery of the placenta.

Labour is divided into three stages, each associated with specific physical and emotional changes as the body prepares for and progresses through birth.

First stage of labour

The first stage begins with the onset of regular contractions and ends when the cervix is fully dilated (10 cm).

Latent phase

During the latent phase, the cervix softens, effaces (thins out), and begins to dilate. Contractions are often irregular at first and gradually become stronger and more frequent.

Women may experience:

Period-like pains or lower backache.
A “show” (clear or blood-stained mucus discharge).
Irregular contractions that become more regular over time.
Rupture of membranes (waters breaking).

This phase can last several hours or days. Women are encouraged to rest, stay hydrated, eat lightly, and use comfort measures such as movement, relaxation, hypnobirthing, and water immersion.

Active phase

The active phase begins when labour is established and continues until the cervix is fully dilated.

During this phase:

Contractions become stronger, longer, and more frequent.
The cervix progressively opens to allow the baby to pass through the birth canal.
Women may use a variety of pain relief and coping strategies.

The active phase usually progresses more rapidly than the latent phase.

Second stage of labour

The second stage begins when the cervix is fully dilated and ends with the birth of the baby.

During this stage:

The baby moves down through the birth canal.
Many women experience an overwhelming urge to push as the baby’s head descends.
The perineum stretches to allow the baby’s head and body to be born.

Third stage of labour

The third stage begins after the birth of the baby and ends with the birth of the placenta and membranes.

There are two approaches:

Physiological third stage

The placenta is delivered naturally through maternal effort and uterine contractions.
No routine medication is given.
The umbilical cord is usually clamped and cut after pulsation has ceased.

Active management of the third stage

An injection of oxytocic medication is given following the birth of the baby.
Controlled cord traction is used to assist delivery of the placenta.
This approach reduces the risk of postpartum haemorrhage.

After delivery of the placenta, the uterus contracts to reduce bleeding and the midwife will assess maternal wellbeing, blood loss, and any need for perineal repair.

Find out more about the third stage of labour.