Stages of labour
The three stages of labour are:
- Dilation of the cervix
- Birth of your baby
- Delivery of the placenta
First stage of labour
During the first stage of labour, your cervix will begin to thin out and dilate to about 10cm. Your labour will be closely monitored to ensure everything progresses normally, and you and your baby remain healthy.
This stage is divided into three phases:
- Early phase: Longest and least painful as your cervix dilates to 3cm, with mild contractions that can start irregularly and become more regular as time passes.
- Active phase: Strong, painful contractions about two minutes apart as your cervix dilates to 7-8cm.
- Transitional phase: Contractions will be intense, painful and feel as if they are constant. You may also feel as though you need to use the bathroom as your baby moves down the birth canal and puts pressure on your bowel.
Second stage of labour
Once your cervix is fully dilated, it’s time for your baby to be born. You will be experiencing regular, intense contractions and you may feel the urge to push. Your doctor and midwife will provide guidance during this stage as they help ensure a safe, smooth delivery of your baby.
Once your baby crowns, your doctor or midwife will guide your baby’s shoulders to come out, which is followed by the body.
The length of the second stage of your labour differs with each pregnancy. If this is your first baby, it can take a little longer (between an hour and two hours). Though you will be closely monitored to ensure your labour is progressing as it should. If not, any issues that could be causing a delay will be investigated and handled.
Third stage of labour
This stage is the delivery of the placenta. Once your baby is born, your uterus begins to contract to loosen your placenta. You may not feel these contractions.
This stage can be handled in two different ways:
- Active management: With your consent, your doctor will give you an injection of the hormone oxytocin into your arm or thigh. Once the umbilical cord is cut, the obstetrician or midwife will gently pull the cord while applying counter pressure to the uterus to speed up the delivery of the placenta.
This process is called controlled cord traction (CCT) and it helps to reduce the risk of blood loss and other complications. This is considered best practice. Speak to your obstetrician if you do not wish to have active management. The oxytocin injection will not interfere with delayed cord clamping.
- Expectant management: This is when you decide to let the placenta deliver naturally. The umbilical cord will remain attached to the baby until it stops pulsating.
The length of this stage varies and depends on your management preference and your risks.
When to ring the hospital
If this is your first baby, knowing when to go to the hospital can be a nervous time. You may be thinking it’s too early, but secretly wondering if you’ve waited too long. Don’t worry; this is normal for all first-time parents.
You should call the hospital on 07 5430 3320 if:
- Your waters break: This is your membranes rupturing. You may feel a sudden gush or a trickle of fluid – put a pad on and call the hospital. The midwife will ask you what colour the fluid is and how much. It is normal for the colour to be pink or clear.
- You have regular contractions: The time between contractions is consistent (eg two minutes), and the contractions last a similar amount of time (eg one minute).
- You notice blood loss: If you notice any vaginal blood loss, put on a pad and phone the hospital.
- You want reassurance: Call the hospital and speak to a midwife.
Also call the hospital on 07 5430 3320 if you experience any of the following concerns:
- Change in the pattern of your baby’s movements: Your obstetrician will discuss the relevance of foetal movements with you and any changes to look out for. If you have any concerns or there are changes in the pattern of your baby’s movements, you can ring the hospital or your obstetrician at any time.
- Signs of high blood pressure: blurred vision, upper abdominal pain, headaches, significant and sudden swelling of your face and hands.
- Early labour: If you notice any labour signs before you are 38 weeks pregnant.
If you’re just experiencing the early symptoms of labour, you should try to relax and get comfortable at home. Call your birthing partner to let them know that you’re in the early stages of labour.
As your contractions start to get more regular, and they are around seven to 10 minutes apart, you should start timing them. Note how many minutes pass between the start of one and the start of the next.
Once your contractions are around five minutes apart, or if you no longer feel comfortable and safe at home, or if you need some help with pain management -- it’s time to go to the hospital. It’s a good idea to phone ahead to let us know you’re on your way.
If at any time during this period, you aren’t sure what you should do, you can call our midwives. They will ask you a few questions to assess your situation and provide helpful advice on what you should do.
For more information on early labour please visit the Pregnancy, Birth & Baby website (Australian Government, Department of Health).