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The four stages of labour and birth

When the day to meet your little one starts approaching, your happiness level rises but so does your anxiety. Labour and birth involve four major stages, each with its own purpose and pace. Once you're aware of all of them, it helps you navigate the situation better and make informed decisions.

Stage 1: Early Labour (Dilation)


Varies but can take 12-24 hours for first-time mothers and 6-12 hours for subsequent deliveries.

What happens:

  • Cervical changes: The cervix, the opening to the uterus, begins to soften (efface) and widen (dilate) to allow your baby's passage.
  • Contractions: Mild to moderate contractions start, initially irregular and spaced far apart, gradually becoming stronger, longer and closer together.
  • Possible signs: Backaches, cramps, watery discharge or a "show" (loss of mucus plug from the cervix).

Tips for stage 1:

  • Rest and relax: You may feel energetic at first but conserve your energy for later stages.
  • Stay hydrated: Drink plenty of fluids to maintain energy and prevent dehydration.
  • Listen to your body: Eat light meals if you feel hungry, move around freely and change positions for comfort.
  • Practice relaxation techniques: Deep breathing, meditation or visualisation can help manage discomfort.
  • Stay connected: Reach out to your birth partner or healthcare provider if you have any questions or concerns.

Stage 2: Active Labour (Delivery)


Usually 2-4 hours but can be longer.

What happens:

  • Stronger contractions: Contractions become more intense and frequent, lasting 30-60 seconds and occurring 2-5 minutes apart.
  • Baby descends: The baby's head moves down the birth canal, putting pressure on your pelvis.
  • Pushing: You may feel an urge to push with each contraction, helping your baby move through the birth canal.

Tips for stage 2:

  • Focus on pushing: Listen to your body and push with each contraction as effectively as possible.
  • Change positions: Experiment with different positions (squatting, kneeling, side-lying) to find one that feels comfortable and facilitates pushing.
  • Stay hydrated and energised: Small sips of water or clear fluids can help maintain energy.
  • Stay positive: Remember the end is near! Encourage yourself and trust your body's ability to deliver your baby.
  • Communicate with your healthcare provider: Follow their instructions and voice any concerns you might have.

Stage 3: Delivery of the placenta (Afterbirth)


Usually within 5-30 minutes after the baby is born.

What happens:

  • Placental separation: The placenta, which nourished the baby during pregnancy, detaches from the uterine wall.
  • Delivering the placenta: You may feel mild contractions as you deliver the placenta.

Tips for stage 3:

  • Continue skin-to-skin contact: Hold your baby close as the placenta delivers, promoting bonding and warmth.
  • Stay relaxed: Breathe deeply and avoid pushing to prevent complications.
  • Delivery of the placenta: Your healthcare team will handle the delivery and examine the placenta for completeness.

Stage 4: Recovery (Bonding and Adjustment)


The first two hours after delivery are crucial for bonding and establishing breastfeeding.

What happens:

  • Skin-to-skin contact: Immediate and uninterrupted skin-to-skin contact promotes bonding, regulates the baby's temperature and stimulates breastfeeding.
  • Breastfeeding: Initiate breastfeeding within the first hour, as colostrum, the first milk, is rich in antibodies and nutrients.
  • Monitoring: Your healthcare team will monitor your vital signs and your baby's well-being.

Tips for stage 4:

  • Focus on your baby: Enjoy this precious time of bonding with your new arrival.
  • Breastfeeding support: Seek help from a lactation consultant if you encounter any challenges with breastfeeding.
  • Rest and recovery: Prioritise sleep and rest to regain your energy after the long journey.
  • Seek support: Don't hesitate to ask for help with feeding, diaper changes or anything else you need.

Medicine Net
Mayo Clinic
Health New Zealand