What are the Stages of Labour?
The experience of childbirth is one that is both unique and commonplace. Emotionally and physically, women can have very different experiences. For example, the amount of time involved in each step is different for each woman and for each pregnancy.
The first stage of labour can last anywhere from hours to days. During pregnancy, the cervix (the lower, narrower part of the uterus) remains closed and plugged with mucous to protect against infection. During the first stage of labour, the cervix will start to open and the mucous plug will come out (referred to as show). The muscles tighten and relax to thin and open (dilate) the cervix to allow the baby to pass through the birth canal. Within the first stage of labour, there are sub-stages:
- Early labour is the beginning of the process of dilatation of the cervix. Contractions gradually open and widen the cervix. It generally starts with mild, irregular uterine contractions. Early labour continues until the cervix is approximately 3-4cm dilated. It can progress continuously into active labour, or it can stop and start.
- Active labour usually begins when the cervix is 3-4cm dilated. Contractions become stronger and more regular. Unlike the contractions of early labour, which most women can talk through, the strength of these contractions requires most women to breathe through them. The cervix dilates more rapidly and the baby’s head starts to descend down the birth canal.
- The transitional phase is the transition from the first stage of labour to the second stage of labour. It involves the completion of the process of the cervical opening. Contractions are stronger and last longer, leading to full cervical dilatation of 10cm. This stage can last many hours. In a first time mom, the cervix usually dilates at about 1cm per hour in active labour. Sometimes a drug called “Oxytocin” is used if the labour is proceeding too slowly. Oxytocin helps to increase the frequency and intensity of contractions.
The second stage of labour starts when the cervix is fully dilated at 10cm and the woman feels the urge to push. The baby is pushed down the birth canal and born. The baby will move a little down the birth canal with each contraction and each push. At the beginning of the second stage of labour, the baby will often slip back again; but with continued pushing, the baby will keep moving further down the birth canal and eventually stop slipping back. The second stage of labour can take minutes or hours. For women who have given birth before, the process usually goes faster.
The third stage of labour occurs after the baby has been born and is when the placenta is delivered. Weaker contractions will occur after birth. The contractions cause the placenta to peel away from the uterine wall and continue until the placenta is delivered. This usually happens within 5-10 minutes after delivery of the baby, but a normal third stage of labour can continue for up to 30 minutes.
The delivery of the placenta is the final stage of childbirth. Labour is complete and the mother can focus on bonding with her new baby.
Susanne Raab is a lawyer at Pacific Medical Law, and an advocate for people living with disabilities. She has been selected for inclusion by her peers in Best Lawyers in Canada in the area of Medical Negligence and is recognized as a leading practitioner in the Canadian Legal Lexpert® Directory in medical malpractice. Susanne is also a Fellow of the Litigation Counsel of America, an honorary trial lawyer society whose membership is limited to less than one-half of one percent of North American lawyers, judges and scholars.