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Beginnings: Pregnancy, Birth & Beyond

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Preparing for labor: What happens during labor

The childbirth process

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When it is time for your baby to be born, the muscular wall of your uterus will start a pattern of tightening then relaxing (known as contractions). This action pulls on your cervix, the opening of your uterus to the vagina. That makes the cervix begin to thin out or efface.

The contractions also push your baby down against the cervix. That makes your cervix open or dilate. Effacement and dilation are the work of the first stage of labor.

When the cervix is fully open so that your baby can pass through, contractions push your baby down your vagina and into the world. Your baby must turn in order to fit through your pelvis. This is the work of the second stage of labor.

After your baby is born, the placenta separates from the wall of your uterus. It only takes a few pushes to push out the placenta. This is the third stage of labor.

Getting ready to cope with labor

There are things you can do during your pregnancy that will help you feel ready to cope with labor. Taking childbirth classes, understanding the labor process, and knowing how to work with your body will make you feel more confident about the birth process.

Many couples find childbirth classes a special time to be together. They can prepare for their new baby and focus on learning what to do during labor and birth.

The stages of labor

Think of labor as being divided into stages and phases.

Stage or phase What happens How it feels

First stage
Early phase

Cervix effaces (thins) and dilates (opens).

May occur gradually over several hours or days.

Most effacement, and dilation from 0 to 4 centimeters, occurs.

Lasts 8 to 12 hours or more for first labor.

Contractions last 30 to 45 seconds and come every 5 to 30 minutes.

Each phase feels different. Contractions are mild to strong.

You may feel comfortable between contractions. You may feel nervous, nauseated, or excited.

Try to relax and work with the rhythm of your body.

Active phase

Dilation from 4 to 7 centimeters occurs.

Typically lasts 3 to 5 hours.

Contractions last 45 to 60 seconds and begin every 3 to 5 minutes.

Contractions are stronger.

Your attention is focused inward. You may have a dry mouth, chills, and nausea, or feel sweaty.

Concentrate on staying relaxed between contractions to conserve your energy.

Transition phase

Dilation from 7 to 10 centimeters occurs.

Can last 30 minutes to 2 hours.

Contractions last 60 to 90 seconds; there are 30 seconds to 3 minutes rest in between contractions.

Contractions are intense and close together.

You may have hiccups, nausea, vomiting, shaking, and pelvic pressure. You may feel like giving up.

Take one contraction at a time.

Second stage (pushing)

Uterus pushes baby out.

Typically lasts 20 minutes to 2 hours or longer.

Contractions last 45 to 60 seconds and begin every 3 to 5 minutes.

You may experience a "rest period" before you feel an urge to push. You might get a surge of energy.

Pushing can feel like pressure, stinging, burning or pain. Pushing can take a long or a short time. This depends on the position of your baby, the effects of medicine, and how well you are able to push.

Focus on using your abdominal muscles to push down, out and away. This is what you do when you are trying to urinate faster. (Or, the opposite of a kegel exercise.)

Third stage (after birth)

The placenta separates from the uterine wall and is expelled.

Typically lasts 3 to 30 minutes after your baby's birth.

Contractions are less intense and may even be easy while you expel the placenta.

Push gently when your health care provider asks you to do so.


Source: Allina Health's Patient Education Department, Beginnings: Pregnancy, Birth and Beyond, sixth edition, preg-ahc-90026, ISBN 1-931876-25-8

First published: 10/04/2002
Last updated: 08/22/2011

Reviewed by: Allina Health's Patient Education Department experts