Labor & Delivery

The Three Stages of Delivery

As you grow closer to the end of your pregnancy, hopefully you’ve had regular visits with your doctor or healthcare provider; taken prenatal vitamins throughout your pregnancy; eaten the right foods; and exercised.  You may have read different pregnancy books or taken a prenatal class to better prepare yourself for the last phases of your pregnancy.


For most women, a normal vaginal birth follows the stages below:

First Stage: Dilation and Effacement (thinning of the cervix) 2,3

As you enter the first stage of labor, your cervix begins to dilate or open.  At the same time, your cervix begins to efface or thin and grow shorter. Your cervix will dilate from 0 to nearly 10 cm and efface from 0% to 100%. For some women it may takes days and for others only hours. There are three phases during the first stage of labor:

  • Early labor — During the first stage, the cervix will dilate to about 3 cm. You will begin to feel pressure and may experience false labor contractions, similar to Braxton-Hicks contractions, and/or other early signs that the process has begun.  Real labor normally is marked by regular contractions and lasts longer as the contractions grow stronger as you get closer to delivery.
     
  • Active labor — During the active labor phase, you will experience stronger contractions and the process will be faster as the cervix dilates from 4 to 7 cm.  Contractions may be as close as a few minutes apart and last for as long as 45 seconds.  This may be the time to contact your doctor and go to the hospital (don’t forget your bag).  There, the medical team will monitor your baby’s heart rate and your contractions. Every labor is different. If this is your first baby, this phase may last several hours; if you’ve had a baby before, labor may go quickly.
     
  • Transition — As you progress from the first stage to the second stage, your cervix will have dilated from 7 cm to 10 cm. At 10 cm you are considered fully dilated and are in the transition phase. Your contractions will be very close together and may seem like they never disappear.

Second Stage: Delivery2,3

The second stage begins when you are fully dilated.  This is when your doctor or medical team will tell you when to push to help move the baby down the birth canal. Pushing is timed to coincide with each contraction, which lasts approximately one minute. The delivery of your baby can take a few minutes or a few hours.


Third Stage 1,2

You will most likely get to hold your newborn immediately after delivery. You also will deliver the placenta during the third stage of labor, and your doctor will make sure that your bleeding is controlled.

All deliveries are different and if your delivery doesn’t go exactly as you expected, it’s not unusual.  You will be calmer and better informed if you have discussed in advance what procedures your doctor would follow if there should be any unexpected problems.


Recovery

You may be very excited after your baby is born and may not realize that your body needs lots of rest. While you are focusing your attention on your newborn, you must also remember to take care of yourself.  

Recovery time varies greatly and often depends on how the delivery progressed. If you had a normal vaginal birth, your recovery will normally be faster than if you had a caesarian section, which often requires a longer stay in the hospital.  Your doctor may prescribe medication for pain management if he feels it is required, and will tell you how long it will be before you can begin your normal activities.

If you are breastfeeding your newborn, be aware that there will be additional demands made on your body during this time.  You and your baby need and will benefit from continued supplementation of prenatal vitamins. Be sure to talk to your doctor about continuing your prenatal vitamins throughout the breastfeeding period.

Over the next few weeks, you and your baby will develop a routine together.  You’ll have much to learn about being a parent, just like you did about being pregnant. Be sure that you continue eating right and that regular rest is part of your recovery plans.


  1. Bukowski R Malone FD, Porter FT, Nyberg DA, Comstock CH, Hankins GD, Eddleman K, Gross SJ, Dugoff L, Craigo SD, Timor-Tritsch IE, Carr SR, Wolfe HM, D’Alton ME. Preconceptional folate supplementation and the risk of spontaneous preterm birth: a cohort study. PLoS Med. 2009 May 5,6(5):e1000061. Epub 2009 May 12.
  2. Mayo Clinic: http://.mayoclinic.com/health/signs-of-labor/PR00083.
  3. Taber’s Cyclopedic Medical Dictionary. 20th ed. in: Venes D, editor. Philadelphia: F.A. Davis company; c2005