Stages of Labour: What Happens from Start to Finish

First stage: cervix dilating

The first stage is the longest and is itself divided into two phases.

Latent phase (early labour). Your cervix softens, shortens, and begins to open (dilate) from 0 to about 4 centimetres. Contractions during this phase are often irregular, mild to moderate, and may come and go. This phase can last anywhere from a few hours to a couple of days, particularly with a first baby. Most people spend this phase at home, resting, eating lightly, and using comfort measures like warm baths, a TENS machine, and breathing techniques.

Active phase. Your cervix dilates from about 4 to 10 centimetres (fully dilated). Contractions become stronger, longer, and closer together, typically lasting 45 to 60 seconds and coming every 3 to 5 minutes. This is when you should be at your birth location. The active phase usually lasts around 8 hours for a first baby, though it can be significantly shorter for subsequent births.

During the active phase, your midwife will monitor your progress and the baby's heart rate. You can use any pain relief options available to you. Moving around, changing positions, and using a birth ball can all help with comfort and may help labour progress.

Transition. The very end of the first stage, from about 8 to 10 centimetres, is sometimes called the transition phase. This is often the most intense part of labour. Contractions are very close together, lasting 60 to 90 seconds with short breaks between them. You may feel shaky, nauseous, or overwhelmed. Some people feel a strong urge to push. Your midwife will guide you on when to start pushing.

The transition phase is usually short, lasting around 30 minutes to 2 hours, but it can feel endless while you are in it. Knowing that this intensity means you are very close to meeting your baby can help you get through it.

Second stage: birth

The second stage begins when your cervix is fully dilated at 10 centimetres and ends when your baby is born. This is the pushing stage.

For first-time parents, the second stage typically lasts between 1 and 3 hours. For those who have given birth before, it is usually shorter, often under an hour. An epidural may extend the second stage because the pushing sensation is reduced.

Your midwife will encourage you to follow your body's natural urge to push (known as spontaneous pushing) rather than sustained, directed pushing unless there is a clinical reason to speed things up. Pushing is hard work and can feel productive and empowering for some people, and exhausting for others. Both experiences are completely normal.

Your baby's head will gradually become visible (crowning), and your midwife will guide you through the final pushes. Once the head is delivered, the body usually follows quickly with the next contraction.

Your baby will likely be placed directly onto your chest for skin-to-skin contact, which helps regulate their temperature, heart rate, and breathing, and supports early bonding and breastfeeding.

Third stage: delivering the placenta

The third stage is the delivery of the placenta (afterbirth) and membranes. This happens after the baby is born and is the shortest stage.

You will be offered a choice of two approaches.

Active management (managed third stage). An injection of oxytocin is given into your thigh as the baby is born or shortly after. This helps the uterus contract and the placenta detach. Your midwife then gently delivers the placenta by controlled cord traction. This usually takes 5 to 15 minutes and reduces the risk of heavy bleeding (postpartum haemorrhage). Most UK hospitals recommend active management as standard.

Physiological (natural) third stage. No injection is given. The placenta detaches and is delivered naturally with the help of gravity, a change of position (such as sitting upright or squatting), and breastfeeding, which stimulates natural oxytocin release. This can take up to an hour. Your midwife will monitor you for signs of excessive bleeding.

Discuss your preference with your midwife beforehand and include it in your birth plan. If you opt for a physiological third stage and there are any concerns about bleeding, your midwife may recommend switching to active management.

Delayed cord clamping

Regardless of which third stage approach you choose, delayed cord clamping (waiting at least 1 to 3 minutes before cutting the umbilical cord) is now standard NHS practice. This allows additional blood to flow from the placenta to the baby, increasing iron stores and reducing the risk of anaemia in early infancy.

How long does labour take overall?

There is no single answer. A typical first labour from the start of active contractions to delivery might last 12 to 18 hours in total, but this varies enormously. Subsequent labours tend to be shorter, often 6 to 8 hours. Some labours are much shorter (precipitous labour), and some are much longer.

The latent phase accounts for most of the total time. Once active labour is established, things usually progress more predictably.