The Three Stages of Labor

Childbirth is the completion of pregnancy, with labor unfolding in three distinct stages, each requiring both physical strength and mental resilience. Maintaining a calm and positive mindset can help manage stress, influence pain perception, and contribute to a smoother labor experience. ^[1]

“Birth is an experience that should be approached with awe, respect, and reverence, for it is one of the greatest miracles of life.” – Inna May Gaskin

What is Labor?

Labor refers to the process of childbirth, where contractions and physical changes are encountered, leading to the delivery of a baby. Preparing for it involves physical, mental, and emotional readiness. A birth plan can help you feel more in control, clarifying your preferences and goals. Understanding the stages of labor also contributes to feeling prepared and less anxious about the journey ahead.

In 2023, the U.S. birth rate was 12.023 births per 1,000 people. ^[2] Whether it’s your first child or another addition to the family, thousands of expecting parents experience the anticipation of labor each year, filled with excitement, joy, and sometimes nerves.

Childbirth can unfold in a variety of ways:

• Vaginal Birth:
  • Natural Birth: No pain relief or medical interventions are used.
  • Medicated Birth: Pain relief methods, such as an epidural, are used to manage discomfort.
  • Assisted Vaginal Delivery: Tools like forceps or a vacuum may assist in delivery.
• Cesarean Section (C-section): A surgical procedure to deliver the baby through an incision in the abdomen and uterus.
• Induced Labor: Labor is medically initiated using medications or mechanical methods.

While the method of delivery may differ, all types of labor follow the same fundamental structure of three stages to ensure the safe arrival of your child.

Wellness Tip: stay flexible in your expectations. While birth plans are great for preparation, things may not always go as planned. Accepting that the different delivery methods are all valid ways to bring your baby into the world can help reduce stress and pressure.

The Three Stages of Labor

Regardless of whether you’re having a vaginal birth, C-section, or induced labor, the childbirth process follows three key stages. ^[3]

1. Stage One: The Build-Up – This stage begins with contractions that help dilate the cervix.
2. Stage Two: The Big Moment – The delivery of your baby into the world.
3. Stage Three: The Finish Line – The delivery of the placenta, completing the birth process.

Stage One: Early Labor, Active Labor, and Transition

The first stage of labor marks the beginning of the childbirth journey. Contractions begin, and the cervix starts dilating to allow the baby to move through the birth canal. Stage One lasts several hours and is divided into three phases. ^[4] 

	Strength of Contractions	Timing of Contractions	Cervix Dilation
Early Labor	Mild and irregular	20 minutes apart to more frequently	0 to 3cm
Active Labor	Strong and regular	3 – 5 minutes lasting around 60 seconds	3 to 6 cm[5]
Transition	Intensify	2 – 3 minutes lasting 60 to 90 seconds	6cm to 10cm[5]

Body Positioning During Stage One

Your body position can significantly affect how you manage labor pains. Understanding the progression of Stage One labor, and knowing your options for different positions, can help you stay in control and manage the physical and emotional challenges as your body prepares for the next stage of childbirth.

• Standing: Using gravity can help alleviate back pain and make contractions more manageable. Although, standing can become tiring as labor progresses.
• Walking: Walking encourages the baby to descend into the birth canal and can also help ease discomfort, though it may not be possible as labor intensifies.
• Sitting: This position can provide some rest and comfort. Sitting cross-legged may help open the pelvic outlet, while also making use of gravity to help lower the baby.
• Hands and Knees: This position helps relieve lower back pain by taking pressure off the spine and redistributing the weight.
• Forearms and Knees: Similar to the hands-and-knees position but with the weight supported by the forearms instead of the hands. This can also ease back discomfort.
• Lying on Your Left Side: Lying on your left side can help reduce blood pressure, which is beneficial during the early stages of labor, and it provides good rest.
• Lying on Your Back: Though this position is not ideal for labor progression, it may be necessary for monitoring the fetus during certain medical procedures.

Wellness Tip: during stage one, your body and mind are working hard to prepare for birth. Trusting the process and focusing on the present moment will help you manage discomfort and create a more positive labor experience.

Stage Two: Delivering Your Baby

Stage Two of labor is often the most emotional and anticipated part of childbirth. It begins when the cervix is fully dilated to 10 cm, and the baby is ready to move through the birth canal. ^[5] This stage typically lasts 20 minutes to two hours, depending on factors like whether it’s your first child or the baby’s position.

As the cervix reaches full dilation, you’ll feel the urge to push during contractions. Your pelvic muscles will help lower the baby down the birth canal, with your doctor or midwife providing guidance on when and how to push. 

For Those Who Need a Cesarean Section (C-Section)

In some cases, Stage Two may not unfold as expected, and a C-section may be necessary for the safe delivery of your baby. A C-section may be planned ahead of time if there are concerns about the baby’s position, maternal health conditions, or previous C-sections. However, it can also be an emergency procedure if complications arise during labor.

Although a C-section skips the pushing phase of labor, it still requires strong mental preparation, especially if it becomes necessary unexpectedly. Mental preparation helps you stay calm and focused in the face of uncertainty.

Wellness Tip: be adaptable and practice self-compassion. Whether planned or unexpected, a C-section is a safe and important way to bring your baby into the world. Remind yourself that your birth experience matters, and allow space for all emotions; relief, disappointment, gratitude, or uncertainty.

Body Positioning During Stage Two

The second stage of labor is often the most physically demanding, requiring strength, endurance, and focus. Beyond the physical aspect, mental health plays a role in managing this stage effectively. The positions you choose during this stage can significantly impact both your comfort and the efficiency of the delivery process. A calm and focused mindset will reduce tension, improve breath control, and enable you to work with your body.

• Lithotomy: Lying on your back with legs in stirrups, common in hospitals, especially for assisted deliveries (forceps, vacuum).
• Semi-Lithotomy: Similar to lithotomy but with an elevated head and shoulders for added comfort.
• Squatting: Uses gravity to aid descent, opens the pelvis, and may make pushing more effective.
• Hands and Knees: Helps with back pain, fetal rotation, and provides a break from other positions.
• Side-Lying: A restful option that conserves energy, eases back pain, and aids posterior-positioned babies.
• Kneeling: Supports gravity-assisted birth while allowing stability on a ball or bed.

Stage Three: Delivering the Placenta

Stage Three begins immediately after your baby is born and involves the delivery of the placenta, which supports your baby during pregnancy. For vaginal births, small contractions will help detach the placenta from the uterine wall. You may be asked to push gently and the process usually takes 5 to 30 minutes.

For C-sections, the placenta is removed during the surgery, with no need for pushing. The doctor ensures it’s fully detached to avoid complications. After the placenta is delivered, your doctor will check for any issues and then the birth process is complete. 

Preparing for Labor

Labor can be an intense and unpredictable experience, but feeling mentally prepared will make a significant difference. Using techniques that promote relaxation and focus can enhance your overall sense of control. Here are a few options to support both your body and mind during labor:

1. Hypnobirthing: Hypnobirthing promotes deep relaxation, self-hypnosis, and visualization, helping to reduce fear and anxiety surrounding childbirth. ^[6] By reinforcing positive affirmations and a calm mindset, it encourages a sense of control, lowers stress hormones, and enables an empowered birth experience.
2. Prenatal Yoga: Prenatal yoga strengthens both the body and mind, teaching breathing techniques and mindfulness to manage labor-related stress. It improves emotional well-being, reduces anxiety, and promotes mental clarity, helping you stay calm and centered as labor approaches.
3. Birthing Classes: Education is key to reducing fear and uncertainty. Birthing classes provide knowledge on labor, pain management, and coping strategies, boosting confidence. Feeling informed will assist you to make decisions, whatever you encounter.
4. Massage and Acupressure: Gentle touch and pressure-point stimulation can help reduce pain, lower cortisol, and increase endorphins, the body’s natural painkillers. This promotes relaxation, relieves tension, and supports emotional well-being throughout labor.
5. Breathing Techniques: Controlled breathing keeps the nervous system regulated, preventing panic and helping you stay focused during contractions. You can practice these techniques ahead of time and use them during labor to stay grounded.
6. Water Birth: The soothing effect of warm water can help relax both the body and mind, easing muscle tension and reducing anxiety. Many women find water immersion during stage one of labor calming, as it creates a peaceful, spa-like environment that supports emotional well-being during labor. ^[7]

Talk with your healthcare provider to ensure your choices align with your birth plan. Feeling heard and supported by your team is key to maintaining emotional well-being throughout the process.

Wellness Tip: find a relaxation technique that resonates with you and practice it beforehand. Labor can feel overwhelming, but having a go-to method can help you stay calm and centered.

Your Birth Journey

No matter how labor unfolds, it remains a powerful and transformative experience. Understanding its stages and preparing both your mind and body can help you feel more capable and confident. Ultimately, your birth journey is unique; what matters most is that you feel supported, informed, and ready for the adventure of bringing your baby into the world.