Going through childbirth is a lot like life: Despite the many surprises or hurdles thrown your way, you can feel confident, empowered, and capable of creating a positive experience if you’re flexible with all the things you can’t control and stay present to the moment—and have a killer community.
And if you’re like me—that is, someone who didn’t understand this before birth and parenthood—well, you’re in for a glorious journey.
Still…as a first-time parent preparing for birth, you might have a few practical questions about what the stages of labor and delivery are like.
Here’s the secret: Ask any repeat parent and they’ll tell you, “No one ever told me that ‘when you know, you know’ describes active labor just as much as finding true love.”
While you’re waiting for labor to begin, attempting to differentiate between Braxton Hicks, a growing baby, and contractions, let this be your takeaway: If you’re questioning what is going on in your body (how strong is this contraction? Is this it?! How many contractions have I had?), it’s likely not active labor. But if you can't tell what's going on, because let's be real, it's hard to know the difference the first time around, it's always best to reach out to your provider!
If you’re looking to learn more about the stages of labor, how to find the best childbirth classes online, tips for a natural birth (scratch that, no form of birth is unnatural. But I will share tips to have an unmedicated birth), or stories of women giving birth, you’ve come to the right place!
Here are top questions from first-time women giving birth about what to expect from the stages of labor:
What are the early signs of labor?
Here are a few “soft” signs that might mean you’re *closer* to going into labor:
● Your baby drops (known as lightening): this doesn’t necessarily mean you’re going to go into labor, but it is very exciting to be able to breathe again and realize that your baby is even closer to the exit door!
● You experience increased vaginal discharge: As labor approaches, you’ll notice that your vaginal discharge thickens and changes color. Your body produces more vaginal discharge to protect your baby from infection. The more discharge present, the more likely it is to wash away a pathogen. Near the end of pregnancy, as your body prepares for labor, some women experience more vaginal discharge in preparation for birth.
● You lose your mucus plug: The name leaves nothing to the imagination. Your mucus plug is exactly what it sounds like. This plug prevents pathogens from entering the uterus during pregnancy, but can fall out as your cervix dilates. If it falls out, it could mean your cervix is changing, but it doesn’t mean you’ll go into labor right away.
● You experience low back pain and cramping: As your joints loosen and expand thanks to the hormone relaxin, and as your baby moves lower into your pelvis, you can experience cramps and aches in your groin and lower back.
You might be curious about the stages of labor and how long each stage lasts.
Stage 1:
Early Labor: 0 to 4 cm
● Early labor lasts around 8 to 12 hours.
● Contractions last about 30 to 45 seconds and occur every 5 to 30 minutes.
● Contractions are typically mild and somewhat irregular, but become progressively stronger and more frequent.
Active Labor: 5 to 10 cm
● Active labor lasts about 3-5 hours.
● This is usually the time to head to the hospital or birth center.
● Contractions during this phase will last about 45 to 60 seconds and occur every 3 to 5 minutes.
● Contractions will feel stronger and longer.
● Around 8 to 10 cm, you might experience something called “transitioning,” which is when your body is preparing to push. You might experience nausea, hot flashes, chills, or vomiting.
Stage 2: 10 cm to the birth of your baby
● Pushing can take minutes to a few hours.
● You can push using open glottis or closed glottis technique (although we recommend open glottis!)
Stage 3: The delivery of your placenta
● Takes 5 to 30 minutes.
Here’s how to know if you’re (truly) in labor and how to cope if you’re going for an unmedicated birth:
Myth: If my water breaks, it means my baby is coming right now!
Heads up
The big water gush is more movie moment than reality. The truth is, breaking this could be a slow trickle or a big gush. You might not even know if the fluid is water, pee, or vaginal discharge—it’s hard to tell what’s what during the third trimester! Let your OB provider know what’s going on so they can help you figure it out!
Takeaway
If your water breaks, even if you’re not contracting, the countdown to delivery is on! The amniotic sac provides a layer of protection to your baby, and once removed, the rate of infection increases around 24 hours after your first experienced fluid leak.
Pro Tip
While waiting to hear back from your OB/Midwife, walk around the house in a skirt without underwear to see if you continue to leak fluid. If you continue to leak, it’s likely amniotic fluid!
Midwife Tip
You can give your OB/Midwife [KD1] [MM2] a better picture of what’s going on if you look and smell the fluid. Sound gross? It’s not. Here’s how it helps guide our decision-making process when we talk to you on the phone:
1. The color of the fluid can be clear, pasty/creamy, or green-tinged. If it’s green-tinged, we recommend you come to the hospital because it could mean your baby pooped in utero and we’d like to monitor you and baby a little more closely.
2. Because leaking a little bit of urine is fairly common near the end of pregnancy, smelling the fluid can help us determine if it’s urine or amniotic fluid. [KD3] Amniotic fluid tends to smell slightly sweet and urine smells like, well, you know.
Unmedicated Birth Tip
If your water broke and your goal is to go unmedicated, it’s time to rock that body! Literally. Go for a walk, bounce on a birth ball, squat (and then squat some more). Gravity puts pressure on your cervix, movement helps your baby get into an optimal position, and all of this can work together to spark contractions if you’re not already having them. If you’re not in active labor by 12 to 24 hours, MEDICAL PROVIDERS/OB PROVIDERS/ETC recommend induction to prevent infection.
Birth Story
My water broke at 41 weeks at midnight, which I barely noticed through tired eyes and my swollen belly obscuring my view. I called my midwife and she confirmed it was my bag of water that broke. She recommended I go back to sleep and to expect her at my house around 6 a.m. At 6 a.m., she told me I had until 12 p.m. to get into active labor, otherwise I’d need to transfer to the hospital. She gave me some lemon verbena and recommended I walk and squat as much as possible. I ended up doing 200 squats that morning! I was in active labor by 11 a.m. and had my baby by 5 p.m. that day. —Heather
Labor Contractions
Myth: Timeable contractions = active labor!
Heads up
The rule of thumb with determining whether someone is in active labor is typically called 3-1-1. Every 3 minutes you have a contraction (frequency), the contraction lasts 1 minute (duration), and the pattern lasts 1 hour (trend).
But you can tell active labor has arrived when the contractions are strong, intense, and require focus! When you’re in active labor, you can’t do or think about much else.
During a contraction, your belly will be as firm as your forehead, and you might feel pressure in your pelvis or a dull ache in your back.
Other signs contractions are the real deal:
· Contractions continue with movement and rest—even in the shower or bath!
· You can’t stand having clothes on your body.
· You might experience a trance-like state and don’t hear anything anyone says.
· You might poop, throw up, or get very sweaty.
Contractions can start and stop, increase and decrease in intensity before settling into a regular pattern. If you can talk and move during a contraction, it’s probably not active labor.
Pro tip
You can keep a contraction log in your phone or use a contraction timer app, such as Bloomlife. Start the clock when your contraction begins and tap it again when it ends. That’s how long your contraction is! Is it 3-1-1?
Midwife tip
A watched pot never boils—find ways to be present during the early stages of labor to take the mental and emotional pressure off your contraction pattern. There are four things [KD4] you need to focus on: relax, breathe, feel the earth beneath you, and then do nothing extra.
Unmedicated tip
If you’re wondering what hens have to do with having an unmedicated birth, I’m about to tell you. What does a hen have to do to ensure the birth of her chicks? Only four things: relax, breathe, feel the earth beneath her, and then do nothing extra. It's doing nothing extra that becomes hard when you're excited to get the show on the road, tired from nine months of growing and caring for a human, and physically very uncomfortable.
You got this!
Myth: I’ve never done this before so I don’t know what I’m doing!
Heads up
If you feel like labor is moving too quickly or not quickly enough, if you are concerned at any point about your health or your baby’s health, or if you have a gut instinct you need to head to the hospital, trust yourself and check in with your OB provider!
Pro tip
A pregnant mama knows her body and baby better than anyone!
Midwife tip
If during your pregnancy you find your OB or midwife dismisses you, brushes past your concerns, or speeds through appointments, it might be time to find a new provider. If your OB or midwife doesn’t trust and listen to you now, they won’t trust you in labor. Find someone who makes you feel supported, empowered, and heard.
Birth Story
I had my first baby with an OB. The birth was fine (speaking of your birth as “not great, not terrible!” is a pretty low bar to hold for one of the most important moments of your life[KD5] ), but ultimately I chose this provider because they were in-network, easy to get to, and I had seen them for well-women visits. With my second pregnancy, I went back to the same OB who delivered my first baby, saw me through my miscarriages, and still couldn’t remember my name. I was 32 weeks pregnant before I made the decision to transfer to a midwife practice. After my first visit, everyone knew my name and my daughter’s name. I had the most amazing birth. I don’t want to go through pregnancy again, but I’d have more kids just to have a midwife at my birth. —Katie