Stages of Labor: Early Labor, Active Labor & Transition

Stage
The birth of your child is a special and unique experience. No two deliveries are identical, and
there is no way to predict how your specific delivery is going to go. However, you can know the
stages of the birth process and what to generally expect.
Childbirth usually occurs in three stages:
First stage: The time of the onset of true labor until the cervix is completely dilated to 10 cm.
Second stage: The period after the cervix is dilated to 10 cm until the baby is delivered.
Third stage: Delivery of the placenta.

First Stage of Labor

The first stage of labor is the longest and involves three phases:

Early Labor Phase The time of the onset of labor until the cervix is dilated to 3 cm.

Active Labor Phase Continues from 3 cm. until the cervix is dilated to 7 cm.

Transition Phase Continues from 7 cm. until the cervix is fully dilated to 10 cm.

Each phase is characterized by different emotions and physical challenges. Think of it as a big
adventure with some important guidelines.

Early Labor Phase

What to do:
During this phase you should just try to relax. It is not necessary to rush to the hospital or birth
center. Try to enjoy the comfort of the familiar surroundings at home. If early labor occurs
during the day, do some simple routines around the house.
Keep yourself occupied while conserving your energy. Drink plenty of water and eat small
snacks. Keep track of the time of your contractions. If early labor begins during the night, it is a
good idea to try to get some sleep. If you are unable to fall asleep, focus on doing some light
activities like cleaning out your closet, packing your bag, or making sack lunches for the next
day.
What to expect:

Early labor will last approximately 8-12 hours

Your cervix will efface and dilate to 3 cm

Contractions will last about 30-45 seconds, giving you 5-30 minutes of rest between
contractions

Contractions are typically mild and somewhat irregular, but become progressively
stronger and more frequent

Contractions can feel like aching in your lower back, menstrual cramps, and
pressure/tightening in the pelvic area

Your water might break this is known as amniotic sac rupture and can happen any time
within the first stage of labor

When experiencing contractions, notice if they are:

Growing more intense

Following a regular pattern

Lasting longer

Becoming closer together

When your water breaks (amniotic sac rupture), note the following:

Color of fluid

Odor of fluid

Time rupture occurred

Tips for the support person:

Practice timing contractions

Be a calming influence

Offer comfort, reassurance, and support

Suggest simple activities to draw her focus from the labor

Keep up your own strength. You will need it!

Active Labor Phase

What to do:
Now is time for you to head to the hospital or birth center. Your contractions will be stronger,
longer and closer together. It is very important that you have plenty of support. It is also a good
time to start your breathing techniques and try a few relaxation exercises between contractions.
You should switch positions often during this time. You might want to try walking or taking a
warm bath. Continue to drink plenty of water and urinate periodically.
What to expect:

Active labor will last about 3-5 hours

Your cervix will dilate from 4cm to 7cm

Contractions during this phase will last about 45-60 seconds with 3-5 minutes rest in
between

Contractions will feel stronger and longer

This is usually the time to head to the hospital or birth center

Tips for the support person:

Give the mother your undivided attention

Offer her verbal reassurance and encouragement

Massage her abdomen and lower back

Keep track of the contractions (if she is being monitored, find out how the machine
works)

Go through the breathing techniques with her

Help make her comfortable (prop pillows, get her water, apply touch)

Remind her to change positions frequently (go with her on a walk or offer her a bath)

Provide distractions from labor such as music, reading a book, or playing a simple card
game

Dont think that there is something wrong if she is not responding to you

Transition Phase
What to do:
During this phase the mother will rely heavily on her support person. This is the most
challenging phase, but it is also the shortest. Try to think one contraction at a time (this may be
hard to do if the contractions are very close together). Remember how far you have already
come, and when you feel an urge to push, tell your health care provider.
What to expect:

Transition will last about 30 min-2 hrs

Your cervix will dilate from 8cm to 10cm

Contractions during this phase will last about 60-90 seconds with a 30 second-2 minute
rest in between

Contractions are long, strong, intense, and can overlap

This is the hardest phase but also the shortest

You might experience hot flashes, chills, nausea, vomiting, or gas

Tips for the support person:

Offer lots of encouragement and praise

Avoid small talk

Continue breathing with her

Help guide her through her contractions with encouragement

Encourage her to relax between contractions

Dont think that there is something wrong if she seems to be angry it is a normal part of
transition

Last Updated: 08/2015

Compiled using information from the following sources:
Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 17.
Pregnancy, Childbirth and the Newborn: The Complete Guide. Simkin, Penny, P.T., et al, Ch. 9.