From contractions to crowning to meeting your baby: everything that happens during labour

In a vaginal birth, labour happens in three stages, from those first subtle signs (which you might miss entirely) to the final push when you meet your baby for the very first time. Every labour looks different but knowing what to expect can help you feel more prepared and confident ahead of the big day.

So, we’ve put together a guide to all the stages of labour and birth to help with just that.

Early signs: how labour begins

Labour rarely starts with a dramatic rush to hospital. Instead, there are often smaller signs that things are beginning:

• A ‘show’: This is a jelly-like plug of mucus that seals up your cervix during pregnancy and comes away in preparation for labour. It may be yellow or streaked with blood and can come undone hours or days before labour begins.
• Contractions: These start as irregular, period-like pains or feelings of tightening. They gradually become stronger, longer, and closer together.
• Waters breaking: The amniotic sac surrounding your baby can rupture before labour, releasing fluid. Unlike in the films, this tends to be a trickle rather than a gush, and it often happens after contractions have started. The liquid should be clear — the NHS says you should contact your midwife or doctor if it is coloured or smelly.
• Back pain: As your baby’s head presses into your spine, it can be uncomfortable as they position themselves for birth.
• Needing the toilet/weeing or pooing yourself: Your baby’s head also presses into your bladder and bowels, which can lead to you losing control of them — this is nothing to be embarrassed about and is quite common.

The latent phase

The first stage of labour, known as the ‘latent’ stage (latent means something is not yet fully developed, or is lying dormant), can last for hours or days.

It begins with the cervix softening and thinning (sometimes known as effacement) and opening (known as dilation) from 0 to 10 centimetres.

Contractions help to soften and shorten the cervix — at this stage, they might be irregular and can range from causing slight discomfort to more pain.

Tips for the latent phase:

• Have something to eat and drink in this phase — you might not be able to later, and can build up your strength for when labour starts
• If it starts during the day, try to keep yourself active and upright to help the baby move into the pelvis and the cervix to dilate
• If it starts at night, sleep if you can. If not, try to stay relaxed and keep yourself comfortable.
• Warm baths or showers can help, as can massages and breathing exercises.

The first stage: established/active labour

Once contractions become regular, longer, and stronger, you enter active labour. During this stage, the cervix dilates from around 3-4cm to the full 10cm. The rate of dilation varies but if you are having your first baby, it’s often about 1cm per hour.

This is when you’ll likely go to hospital or call your midwife if you’re having a home birth.

You might feel contractions building in intensity, peaking and then easing off, with short periods of rest in between, as well as pressure in your lower back or pelvis.

This stage of labour usually lasts between eight and 18 hours for first-time mums but is often quicker (five to 12 hours) for mums who have given birth before.

You will be monitored by a midwife during this time. They will offer vaginal examinations to see how the labour is progressing (which you don’t have to have if you don’t want), as well as listening to the baby’s heart every 15 minutes. Midwives may also electronically monitor your contractions and your baby’s heartbeat, especially if you have an epidural or there are any concerns about you or the baby.

Doctors or midwives can also speed this stage up by breaking your waters or using an oxytocin drip.

At the end of this stage, you might feel an uncontrollable urge to push during each contraction or feel like you can’t go on — these are signs that you’re getting closer to birth.

The second stage: birth

Once the cervix is fully dilated to 10cm, the second stage of labour begins. This is when you push your baby down the birth canal and out into the world.

You may feel a powerful, uncontrollable urge to push with each contraction. The sensation is often compared to needing a large poo, as your baby’s head presses on your back passage. If you’ve had an epidural, you might not feel this urge, however.

You will need to find a comfortable position to give birth in — you may have decided this in your birth plan or your midwife can help. This could be sitting, lying on your side, standing up, kneeling, squatting, or going on all fours.

As your baby moves down the birth canal, you might feel your baby’s head move forward during a contraction and slip back a little between contractions.

The pushing stage shouldn’t last longer than three hours, or two hours if you have given birth before.

As the baby’s head crowns (meaning it becomes visible at the vaginal opening), you may feel a stretching or burning sensation. Some people call this the ‘ring of fire’ as the tissues are stretched, but it doesn’t tend to last long. You will be asked to stop pushing and do some breathing exercises to give the skin and muscles around your vagina and anus time to stretch as the baby’s head passes.

At this point, you may be given an episiotomy, or a small cut made to your perineum, to avoid tearing or speed things up. You’ll get an anaesthetic injection before this is done, and medical staff will stitch it back up once the baby is born.

Once the baby’s head passes through the vagina — the hardest bit — the rest of their body follows within the next few contractions. This stage can be as quick as a few minutes or as long as a few hours.

If you are having twins, the second baby should be born quickly after the first. If your contractions stop, medical staff can give you hormones to restart them.

And whether it’s a single or multiple birth, forceps or a suction cup can be used to help with delivery.

Once they are born, your baby will be placed on your chest for skin-to-skin contact if all is well, and you can breastfeed them when you like (ideally within the first hour of birth).

The third stage: delivering the placenta

After your baby is born, there’s one last thing to do: deliver the placenta. In this stage, the womb contracts, and the placenta separates from the wall of the uterus before coming out of your vagina. This can take up to an hour. You may have mild contractions to help push out the placenta.

You can choose between active management or physiological management for this stage.

Active management involves an injection of oxytocin which makes your womb contract to speed up the delivery of the placenta. Meanwhile, physiological management means letting this happen naturally.

Active management lowers your risk of complications like heavy bleeding after birth, but increases the chances of you being sick and can make afterpains worse.

Delivering the placenta is not usually painful, more like passing a large clot, and some mums barely even notice it coming out.

The umbilical cord is also cut during this stage. Midwives will either wait until the cord stops pulsing — meaning that all the blood from the placenta has passed to the baby — or until around five minutes have passed. Unless, of course, there are concerns or the cord is wrapped around your baby’s neck.

Once the placenta is out, your uterus will contract down, helping to stop bleeding.

Labour is unpredictable—each woman’s experience is unique, and the length and sensations of each stage can vary widely. However, knowing what to expect at each stage can help you feel more in control and ready for the journey ahead. Remember, your midwife or doctor will be there to support you every step of the way.