You’ve made it through nine(ish) months of pregnancy, and now the big day has arrived: Your baby’s birthday! You might be eager to take on the stages of labor, or you may be nervous about what's to come.

Keep in mind that no matter how you get to the finish line, you will very soon reach the wonderfully rewarding end.

For now, it’s difficult to predict exactly how your birth experience will go down. Just like the baby you’re about to bring into this world, every labor and delivery experience is unique. 

That said, unless things are cut short by a C-section, all women go through three precise stages of labor and childbirth: labor itself (which includes early labor, active labor and transitional labor), pushing and delivering the baby, and delivering the placenta.

Here’s what you can expect — from the first real labor contractions to the moment it’s time to start pushing.

What are the three stages of labor?

From the time you check into the hospital or birthing center, your doctor will periodically give you an internal exam to determine how far you’ve progressed. The three stages of labor and childbirth include the following: 

  • Labor: This includes early, active and transitional labor.
  • Pushing and delivery of the baby: This phase of labor begins with pushing and ends with the delivery and birth of your baby.
  • Delivery of the placenta: Your placenta will either naturally be expelled or need to be removed by your doctor after your baby is born.

What are the three phases of labor?

The first stage of labor and childbirth actually consists of three phases of labor, including:

Keep in mind that there can be slight variations in terms of dilation measurements and timing of contractions. 

What is early labor?

During the first of the three phases of labor, known as early labor, your cervix gradually dilates and effaces to about 4 to 6 centimeters.

It’s usually the longest but thankfully the least intense phase of labor. Contractions become stronger and more frequent, so that they’re spaced at about five-minute intervals as you progress into active labor.

Early labor may entail just two to six hours of very obvious contractions. Or it may progress over several weeks, during which time you may not even notice (or be bothered by) your contractions. 

Signs of early labor

Throughout early labor, you may experience of the following labor signs:

  • Cervical dilation and effacement. Over a span of time of several hours to several weeks, your cervix will dilate to about 4 to 6 centimeters and efface.

  • Moderate and intensifying contractions. Early labor contractions progressively intensify over time rather than ease up, and they aren’t relieved by a change in position. They generally last 30 to 45 seconds and can be regular or irregular. They’ll gradually become more frequent, spaced up to about 20 minutes apart at first to about five minutes apart by the end of early labor.

  • Blood-tinged vaginal discharge. Also known as bloody show, pink- or brown-tinged discharge means the blood vessels in your cervix have ruptured as it begins to efface and dilate. Labor is likely on its way in the next 24 hours, although it may take longer. 

  • Rupture of the amniotic membranes. Before or during early labor, your water might break, either in a stream of warm liquid or a slow but continual trickle of fluid —although it's more likely to happen sometime during active labor. 

What to expect during early labor 

As your baby’s due date nears, you many feel excitement, relief, anticipation, uncertainty, anxiety or even fear. All of these reactions are normal. 

Keep in mind that you may experience some signs of labor weeks before you need to actually head to the hospital or birthing center (if you're not delivering at home). Try to relax as much as you can: You'll need to save your strength for later on.

Here are a few tips to help you feel better prepared during early labor:

  • Alert your birth coach. Put your partner, doula or other birth coach on alert — although that person probably doesn’t have to rush to your side yet, since there’s not much to do this early on.

  • Keep an eye on contractions. You don’t need to time them at this point, but check periodically to see whether they're closer than 10 minutes apart. 

  • Use relaxation techniques. Try meditation, light stretching or deep breathing. But don’t start labor breathing exercises just yet, or you may become exhausted long before you really need them. 

  • Eating a little is likely okay. If you have a low-risk pregnancy and you find yourself hungry in the early phase of labor, most doctors say it’s fine to eat a light, energizing snack, such as toast, plain pasta or rice. In fact, it will give you the energy you need later on. Avoid fatty foods (burgers, potato chips) and anything acidic (orange juice). Sip on water to stay hydrated.

  • Pee often. A full bladder can get in the way of labor.

  • It’s fine to sleep, as long as your water hasn’t broken. If your contractions start at night and your adrenaline isn’t keeping you up, sleep while you still can. 

  • Know when to call your doctor or midwife. Your practitioner most likely gave you instructions about when to call (for example, when contractions are five to seven minutes apart, although you don’t have to experience them in regular intervals). If you think you might be in real labor but aren’t sure, err on the side of caution and call. 

  • Know when to head to the hospital. Follow your practitioner’s instructions. Most women go to the hospital between the first two phases of labor — as the early phase ends and the active phase begins, or when contractions are about five minutes apart. 

Be sure to call your practitioner (or get to the hospital) if:

  • You experience any bleeding. If your discharge becomes bright red, it could indicate placenta previa or another condition that needs to be addressed as soon as possible.

  • In certain situations, if your membranes rupture. If the amniotic fluid is green or brown, your baby may have had his first bowel movement. Also let your doctor know right away if your water breaks before week 37 of pregnancy (you could be in preterm labor) or if you feel something slipping from your cervix into your vagina (which rarely could be a sign of umbilical cord prolapse).

  • You feel no fetal activity. It may be hard to notice because you’re distracted by contractions. If so, have a snack or some juice, walk a bit, then lie down, relax and try counting your kicks again. You should feel 10 movements within two hours.

What is active labor?

During active labor, your cervix dilates to about 7 to 8 centimeters. Contractions will be more evenly spaced, intense, and frequent, coming about every three to four minutes apart. Active labor usually lasts from two to three-and-a-half hours (with a wide range of what's considered normal). 

Signs of active labor

During the active phase of labor, you can expect the following symptoms:

  • Intensifying contractions. Contractions will become stronger and longer, typically lasting 40 to 60 seconds, with a distinct peak halfway through. They’ll also be more frequent, coming every three to four minutes — although the pattern may still not be regular. 

  • Continued dilation and effacement. Your cervix will dilate from about 4 to 6 centimeters to about 7 to 8 centimeters.

  • Increasing pain and discomfort. You may not be able to talk through contractions now. (If you’ve had an epidural by this point and it's kicked in, you likely won’t feel any pain.)

  • Other more intense symptoms. As your labor progresses, so will your symptoms, though labor pain medication like an epidural should help to relieve some of them. You may have increasingly strong back pain, leg discomfort or heaviness, fatigue, and bloody show.

  • Rupture of the membranes, if they haven’t already. Your membranes might be ruptured artificially now, although the American College of Obstetricians and Gynecologists (ACOG) suggests that it may not be necessary in women with low-risk pregnancies who are progressing normally through labor.

What to expect during active labor 

With contractions coming on more strongly and frequently, you’ll have less opportunity to rest. As your labor efforts intensify, it may be trickier to relax.

Here’s what you can do during active labor:

  • Check into the hospital, if you haven’t already. Your practitioner will likely encourage you to get to the hospital or birthing center when active labor starts, or when your contractions are about five minutes apart. When you arrive, you’ll be asked to change into a hospital gown and will either be brought to your room, or to a triage (assessment) room if the staff thinks you may not be in active labor. A nurse will ask you a few questions about your pregnancy and labor so far, give you routine consent forms to sign, and do an internal exam. If you haven’t yet reached 4 to 6 centimeters dilation, you may be sent home to allow labor to progress more.

  • Ask for help, if you need it. As long as everything is progressing safely, the hospital staff will leave you alone with your coach for now (or stay out of your way but in your room). They’ll monitor your blood pressure, contractions and bloody show as needed. Don't hesitate to ask your coach for whatever you need to stay as comfortable as possible, whether it's a back rub, ice chips to munch on or a cool washcloth for your forehead. 

  • Breathe and try to relax. If you're planning on using breathing exercises, start as soon as the contractions become too strong to talk through. Didn’t plan ahead and practice? Ask the nurse or doula for suggestions. You may also want to try any relaxation techniques that help, walk around a bit if you haven’t yet had an epidural, or change positions. Do whatever makes you feel more comfortable (and if something isn't working, stop).

  • Drink and eat, as recommended. You might be offered light, clear beverages or ice chips to replace fluid and keep your mouth moist. If you’re hungry and have your practitioner’s okay, have a light snack (a Popsicle, for example).

  • Request an epidural, if you want one. An epidural can be given as soon as you feel you need it (and you'll probably want to ask for it before things get too intense since the procedure takes some time and it can take about 30 minutes after it's inserted before it starts to work). Your practitioner may suggest other tactics to ease your discomfort first, like sitting in water before you start pushing, getting a massage, or changing positions. If you do want an epidural, your anesthesiologist will get an IV going.

  • Be prepared for other interventions as necessary. ACOG guidelines call for fewer or delayed labor interventions in low-risk women who are progressing normally through labor. Your practitioner or hospital staff will intermittently monitor your baby with a Doppler or fetal monitor; you’ll get more frequent monitoring if your delivery is higher-risk. Your practitioner may also augment your labor if it’s progressing very slowly by using Pitocin or by artificially rupturing the membranes (if they’re still intact). 

  • Use the toilet periodically. Continue to urinate regularly: A full bladder can slow down your progress. If you’ve been given an epidural, you’ll already be hooked up to a catheter. Try to move your bowels if you haven’t in the last 24 hours.

What is transitional labor?

During the third and final phase of labor, called transitional labor, your cervix will dilate to 10 centimeters as you experience strong contractions about every two to three minutes, though it can vary.

While this phase of labor is the most intense, it’s also the shortest, generally lasting from 15 minutes to an hour (though it can sometimes take longer, like up to about three hours).

Signs of transitional labor

Throughout transitional labor you may experience:

  • Very strong and painful contractions. Whether or not you’ve been given an epidural, you’ll experience strong contractions that last 60 to 90 seconds long and have intense peaks that last for most of the contraction. Because they're spaced only about two or three minutes apart, it may seem like you barely get to relax before the next contraction begins. 

  • Full dilation. Your cervix will dilate from about 7 to 8 centimeters up to the final 10 centimeters — when it will be time to deliver your baby. Bloody show will increase, as capillaries in the cervix rupture.

  • Pressure in your back and abdomen. You’ll feel strong pressure in the lower back and/or perineum along with rectal pressure, with or without an urge to push.

  • General discomfort. You may feel sweaty, chilled, shaky or achy. One or both legs may be completely numb if you've had an epidural. And you may have other forms of discomfort too, though you may not experience any of these symptoms.

  • Fatigue and drowsiness. It’s normal to feel tired by now, or you may also get a second (or fifth!) wind. 

What to expect during transitional labor  

This last phase of labor can be physically demanding and draining, but it can also be exhilarating. You may feel impatient — or elated. Hang in there! Here’s what you can do in the meantime:

  • Resist the urge to push. Pushing before dilation is complete could cause your cervix to swell, which can postpone delivery. If you feel the urge to push, ask your practitioner or doula for guidance. Panting and/or blowing air through your mouth can help.

  • Breathe. Try to relax between contractions with slow, deep, rhythmic breathing.

  • Speak up. Let your birth team know if you don’t want anybody to touch you unnecessarily.

  • Ask for an epidural, if you want one. It’s not too late, although you’ll have to stay still long enough for the needle to be inserted and it takes some time for it to kick in. Your birth team will tell you when it's no longer possible to have one.

  • Be prepared to wait some more. Even once your cervix has dilated to 10 centimeters, your practitioner may still ask you to wait to push until your baby’s head is crowning or you feel an irrepressible urge to push. This “laboring down” allows you to save energy while your uterus naturally pushes your baby farther down into the birth canal.

  • Keep your eye on the prize. By the end of this phase, it’ll be time to begin pushing baby out. That bundle of joy will soon be in your arms!

Once you’ve reached the end of transitional labor, you’ll be moved to the delivery room, if you aren’t already there. Or if you’re in a birthing bed, the foot of the bed will simply be removed to prepare for delivery.

How long does labor last?

It’s hard to predict how long your labor and delivery will last, as there’s a wide range of "normal." ACOG says that labor typically lasts a total of around 12 to 18 hours for first births and around eight to 10 hours from start to finish for subsequent ones.

Some moms may begin to experience early labor symptoms (such as dilation and effacement) days or even weeks before labor starts in earnest, while others may only have noticeable early labor contractions for two to six hours.

Active labor may last anywhere from about two to 24 hours (though the average is two to three-and-a-half hours), while transitional labor can last anywhere from 15 minutes to about three hours.

At a certain point, your practitioner may rely on interventions to get things going or speed things up. They may possibly use forceps, vacuum extraction or even decide to perform a C-section after you’ve been pushing for at least three hours if you’re a first-time mom or at least two hours if you’ve given birth before.

A few factors that may affect the length of your birth include:

  • How many times you've given birth. All phases and stages of labor tend to move along more quickly if this isn’t the first time you’ve delivered a baby.

  • The position of your baby. If your baby is in breech position and your doctor has determined it’s safe for you to try a vaginal delivery, your cervix may not dilate as quickly or your baby may not move down the birth canal — slowing down your progress.

  • Having certain complications or other issues. If your cervix isn’t dilating, your baby is in distress or you’re exhausted, or you have a prolapsed umbilical cord or uterine rupture, your labor may be cut short by a C-section to keep you and your little one safe.

What happens during the other two stages of labor and childbirth?

The three phases of labor are the first part of a larger picture: The three stages of childbirth. Once you’ve made it through labor, the two other childbirth stages include:

  • Pushing and delivering your baby. You’ll have very intense contractions and a tremendous urge to push (although you won’t feel either as much if you’ve had an epidural). Push during this stage of childbirth as if you’re having a big bowel movement when instructed by your practitioner, and rest between contractions. Most women push for 30 minutes to an hour, although the pushing stage may last for a few hours — at which point your practitioner will reassess whether other interventions are necessary. 

  • Delivering the placenta. Once your baby is delivered, your practitioner will still need to deliver your placenta, a process that usually takes about 20 minutes. You’ll experience gentle contractions as your uterus expels the placenta. Your doctor may help things along by pulling on the umbilical cord or pressing on your abdomen while asking you to push. 

Congratulations! You’ve made it through the stages of labor and childbirth — take pride in what you’ve accomplished since labor (and pregnancy) began. And as soon as you can, reward yourself by cuddling with your newborn, breastfeeding (if you choose), and getting some much-deserved rest.