Why is labour defined in stages?

There are 3 stages that can help describe the process of labour and childbirth. Understanding these stages helps you, your midwife and doctor communicate well and prepare for what you and your baby need before, during and after birth.

Some hospitals consider the recovery period to be a fourth stage.

While these stages are common to all labours, remember that labour and birth is experienced differently in each pregnancy.

What is the first stage of labour?

The first stage of labour is broken down into three phases.

The latent phase

• This is the first and longest phase and can last for hours or even days.
• During this phase, your cervix thins and opens to around 4 to 6 centimetres.
• You may have regular or irregular contractions or you might not notice them.
• You can usually stay at home during this stage of labour.
• Try to rest and relax using gentle stretches, mindfulness, meditation or other calming techniques.

The active phase

• Your cervix opens up (dilates) to around 8 centimetres.
• Contractions will become stronger and more regular.
• Your contractions may be around 3 or 4 minutes apart, each lasting 30 to 60 seconds.
• If you are planning to give birth in a hospital or birthing centre, you may be advised to go there during this phase.

The transition phase

• Your cervix fully opens to 10 centimetres.
• Contractions become stronger and longer, happening around 2 minutes apart and lasting for 60 to 90 seconds.
• You may feel pressure in your bottom or feel like you need to have a bowel movement (poo), due to your baby pressing on your rectum.
• This phase can take anywhere from 5 minutes to more than an hour.

What is the second stage of labour?

The second stage of labour begins when your cervix is fully dilated to about 10 centimetres and ends when your baby is born. Your midwife or doctor may recommend a vaginal examination to check how dilated your cervix is.

There are two phases of the second stage of labour:

• a passive phase where you may not feel an urge to push straightaway
• an active phase when you have the urge to push. This stage ends when your baby is born.

You may also feel:

• pressure in your bottom
• a stretching and/or burning feeling in your vagina
• the baby's head moving down

The second stage of labour can be painful. There are several different pain relief options, including medicines and non-medical treatments. Discuss them with your doctor or midwife during pregnancy to help make informed decisions.

The second stage of labour can last up to 2 hours. If you have given birth before, it is often shorter.

What is the third stage?

After your baby is born, the third stage of labour begins with delivery of the placenta and the membranes that surrounded your baby in your uterus.

You have 2 options for this stage:

• Active management, where your midwife will give you an injection of synthetic oxytocin to help the uterus contract and expel placenta.
• Natural (also known as physiological or expectant) management, where you are not given an injection.

Your midwife may ask you to push gently to help with contractions during this stage.

The third stage of labour can take anywhere from 5 to 30 minutes if you opt for active management. It can take up to one hour if you decide to have a natural third stage.

Discuss your preferences with your midwife or doctor during pregnancy and consider including them in your birth plan.

During the third stage of labour the umbilical cord is clamped and cut. If you would like the umbilical cord to be left intact, to be clamped later, or if your birth partner would like to cut the cord, let your midwife know ahead of time so that they can arrange this.

What is the recovery stage?

After labour is complete, you will be able to rest, get to know your baby and begin to recover your strength.

In the recovery stage your midwives will:

• monitor you and your baby, including checking your pulse rate, blood pressure and temperature
• help you with breastfeeding, if you choose to do so
• feel your abdomen to check the top of your uterus and check that it has started to contract back
• check your perineum for tears or bruising and to make sure you are not bleeding excessively

You may feel emotional in the first few days or for up to 2 weeks after labour. Some hospitals or birthing units offer counselling or a birth debriefing service for new parents and their partners to support their emotional wellbeing.

You may especially benefit from this service if your labour did not go as expected, or if your baby needed any special care.

Resources and support

• Speak to your doctor or midwife during a prenatal visit about what to expect during the stages of labour.
• The Royal Australian and New Zealand College of Obstetricians and Gynaecologists provides a pamphlet on labour and birth .
• Health NSW has created a labour and birth booklet outlining the various stages, what to expect at each stage of the birthing process and as well as how you can be supported.
• You can also listen to our podcast on understanding your choices when having a baby.