Stages of Labour: What to Expect at Each Stage

Q: How do I know when the latent phase has ended and established labour has begun?

Established labour begins when your cervix reaches 4cm. You cannot measure that yourself, but the shift often shows up as contractions that feel noticeably stronger and longer, and settle into a more regular pattern, usually around every three to five minutes. If you are unsure, call your midwife or maternity unit. They can check your progress and tell you whether it is time to come in.

Q: What does transition feel like and how long does it last?

Transition is the final part of the first stage, as your cervix finishes opening to 10cm. It is often described as the most intense phase, and you may feel shaky, sick, overwhelmed, or have a strong urge to push. It also tends to be the shortest part of the first stage. Every labour is different, so there is no set length, but that intensity often signals that birth is close. Follow your midwife's guidance before you push, as it is important that full dilation is confirmed first.

Q: Do I have to have the injection to deliver the placenta?

No. You have two options. Active management uses an injection of oxytocin and is the approach routinely offered, because it lowers the risk of heavy bleeding. Physiological management relies on your body's own contractions and uses no medication, though it can take up to an hour and is not suitable in every situation. The choice is yours to talk through with your midwife, ideally before labour, so it can go in your birth plan.

Q: When should I call my midwife or go to the maternity unit?

Call your midwife or maternity unit if your contractions are coming around every five minutes, if your waters break, if you notice heavy bleeding, if you are worried about your baby's movements, or if you feel unwell or have any other worries. You do not need to wait until things feel urgent. Call at any point if something does not feel right.

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Labour is hard to fully picture until you are in it. The tightening of contractions, the deep backache that builds and eases, the slow steady move towards birth. These are the physical markers of a process that tends to follow a broadly predictable path. Knowing the stages of labour, and what to expect at each one, gives you a clearer map of what your body is doing and why.¹

The first stage of labour

The first stage starts when contractions begin and ends once your cervix is fully open. It is the longest stage, and it breaks down into three phases: the latent phase, established labour, and transition.²⁶

The latent phase

The latent phase, sometimes called early labour, is when your cervix softens and opens up to 4cm. You may notice cramp-like pains, much like period pain, a dull backache, a 'show' (a small amount of mucus that has been sealing your cervix), or your waters breaking as a gush or a trickle. Contractions at this point are often irregular, both in how long they last and how far apart they come.⁷

The latent phase can last many hours, and for some it stretches past a day. This is normal. Staying at home during this time is generally advised. You may find it helps to rest, move gently, take a warm bath, or use a TENS machine (transcutaneous electrical nerve stimulation, which sends small pulses through pads on your skin). Paracetamol can ease the discomfort if it suits you. Follow the directions on the packet, and check with your midwife if you are unsure.⁸

Established labour

Established labour starts when your cervix reaches 4cm. By now contractions feel stronger and longer, and they settle into a more regular pattern, often coming every three to five minutes. This is usually the point where your midwife or maternity unit will ask you to come in.³¹⁰

With a first baby, established labour often lasts around eight hours, and it is unlikely to go beyond 18. If you have given birth before, it tends to be shorter, around five hours on average. Every labour is different, so these are typical ranges rather than fixed timelines.¹¹

Transition

Towards the end of the first stage, as your cervix opens from around 8cm to the full 10cm, you reach the phase often called transition. This is usually the most intense part of labour, and also the shortest. You may feel shaky, sick, or overwhelmed, with a strong urge to push. You may feel like you cannot keep going, and that often means birth is close. Let your midwife guide you before you start pushing, especially if full dilation has not yet been confirmed.¹²

The second stage of labour

The second stage begins at full dilation (10cm) and ends with the birth of your baby. It comes in two phases. In the first, the passive phase, your baby moves further down the birth canal on its own, without you needing to push. In the second, the active phase, you work with your contractions to push your baby out.⁴¹³

The active pushing phase can take up to three hours with a first baby, and up to two hours if you have given birth before. These are upper limits for typical births; every labour progresses at its own pace. Your midwife and the wider team keep a close eye on how things are progressing the whole way through.¹⁴

The third stage of labour

Once your baby is born, the third stage is the delivery of the placenta. There are two ways to manage this stage, and it is worth talking both through with your midwife before labour begins, so your preference can be noted down.⁵¹⁵

Active management involves an injection of oxytocin (a hormone that makes the womb contract) given soon after the birth. It prompts your uterus to tighten and push the placenta out, usually within 30 minutes. This is the approach routinely offered, because it lowers the risk of heavy bleeding after birth.¹⁶

Physiological management uses no medication, relying on your body's own contractions to deliver the placenta. This can take up to an hour. It is not suitable in every situation, as for some it carries a higher risk of heavy bleeding. Your midwife can help you weigh this up and talk through what fits your situation.¹⁷

What support looks like throughout

During the latent phase at home, your main support comes from rest, familiar comfort measures, and being able to call your midwife or maternity unit whenever something concerns you. Once you are in established labour, your midwife stays with you, keeping an eye on you and your baby and guiding you through each phase. In the second stage, you are supported to push at a pace that feels right for you. Through the third stage, your midwife manages the delivery of the placenta and checks that you are well.

If you have questions about your labour, or want to go through your options in more detail, raise them at your next antenatal appointment or contact your midwifery team directly.

Frequently Asked Questions

How do I know when the latent phase has ended and established labour has begun?

What does transition feel like and how long does it last?

Do I have to have the injection to deliver the placenta?

When should I call my midwife or go to the maternity unit?

Sources

[1] The stages of labour and birth

Knowing the stages of labour, and what to expect at each one, gives you a clearer map of what your body is doing and why
[2] The stages of labour and birth

The first stage starts when contractions begin and ends once your cervix is fully open... It breaks down into three phases..
[3] The stages of labour and birth

Established labour starts when your cervix reaches 4cm... In a first pregnancy, established labour often lasts around 8 to 18 hours..
[4] The stages of labour and birth

The second stage begins at full dilation (10cm) and ends with the birth of your baby.
[5] The stages of labour and birth

Once your baby is born, the third stage is the delivery of the placenta
[6] The stages of labour

The first stage of labour begins with contractions, ends when the cervix is fully dilated, and is divided into the latent, active, and transition phases.
[7] Signs that labour has begun

Physical signs of early labour can include cramp-like pains, backache, a 'show' (the mucus plug), and waters breaking as a gush or trickle.
[8] Coping with the early stages of labour

It is recommended to stay at home during the latent phase, managing discomfort with rest, gentle activity, warm baths, paracetamol (if suitable), or a TENS machine.
[9] Signs that labour has begun

You should contact your midwife or maternity unit when contractions become regular (around every 5 minutes), if your waters break, if you notice heavy bleeding, if you have concerns about your baby's movements, or if you have any other concerns.
[10] The stages of labour

Established labour begins when the cervix reaches 4cm dilation and contractions become stronger and more regular, typically every 3-5 minutes.
[11] The stages of labour

For a first baby, active labour often lasts around 8 hours but is unlikely to exceed 18 hours. For subsequent babies, it averages 5 hours.
[12] The stages of labour

During transition, it is common to feel overwhelmed, shaky, nauseous, or feel an urge to push; feeling you cannot continue is often a sign that birth is close.
[13] Giving birth to your baby

The second stage of labour starts at full dilation (10cm) and ends with the baby's birth, involving both a passive phase of descent and an active phase of pushing.
[14] The stages of labour

The active pushing part of the second stage typically lasts up to 3 hours for a first baby and up to 2 hours for subsequent babies.
[15] The third stage of labour

The third stage of labour is the delivery of the placenta, which can be managed either actively with an injection or physiologically without medication.
[16] Do I need an injection to deliver the placenta?

Active management of the third stage is recommended to reduce bleeding risk and involves an oxytocin injection to deliver the placenta, usually within 30 minutes.
[17] The third stage of labour

Physiological management involves no medication, relying on natural contractions to deliver the placenta, which can take up to an hour.