Labour has three stages: the first stage, when the cervix opens to 10 cm; the second stage, when the baby is pushed out and born; and the third stage, when the placenta is delivered. Many midwives also talk about a “fourth stage”, the first hours after birth, when mother and baby are closely watched. A first labour often lasts 12 to 18 hours or more; later labours are usually shorter.
Early signs that labour is starting
- Regular, painful contractions that get longer, stronger and closer together
- A “show”: a plug of mucus, sometimes streaked with blood
- Waters breaking: a gush or trickle of fluid from the vagina
- Backache, cramping, or needing the toilet often
Braxton Hicks (“practice”) contractions are irregular and usually ease with rest or a change of position. True labour contractions don’t.
First stage of labour
Latent phase
The cervix softens, shortens and opens to about 4 to 5 cm. Contractions may be irregular. This phase can last many hours, especially in a first labour. Women are often encouraged to rest, eat lightly, drink and stay mobile at home if all is well.
Active phase
From about 5 cm to full dilatation (10 cm). Contractions become regular and strong, typically every 2 to 5 minutes. WHO’s Labour Care Guide uses 5 cm as the start of active labour and recognises that progress can be slower than the old “1 cm per hour” rule while still being normal.
What midwives monitor: baby’s heart rate, mother’s pulse, blood pressure and temperature, contractions, cervical dilatation, fluid and urine, pain and emotional wellbeing.
Second stage: pushing and birth
From full dilatation to the birth of the baby. Women feel a strong urge to push. It may last a few minutes to around three hours in a first labour, and is usually shorter in later births. Upright positions, kneeling or side-lying can help. The midwife guides the birth of the head slowly to reduce tearing.
Third stage: delivery of the placenta
After the baby is born, the womb contracts and the placenta separates. With active management (an injection of oxytocin given straight after birth, and controlled cord traction by a skilled attendant), this usually takes up to 30 minutes and reduces the risk of postpartum haemorrhage. Delayed cord clamping, for at least one minute, benefits the baby.
Fourth stage: the first hours after birth
- Skin-to-skin contact and breastfeeding within the first hour
- Checking bleeding, the womb (it should feel firm), blood pressure and pulse
- Checking for tears and repairing them
- Monitoring the baby’s breathing, colour and temperature
When to go to hospital
Follow the advice of your midwife or antenatal clinic. Go in, or call, if:
- Contractions are regular, about every 5 minutes, and strong (sooner if this is not your first baby, you live far away, or you were told to come early)
- Your waters break, especially if the fluid is green, brown or smelly
- You have any vaginal bleeding
- Your baby is moving less than usual
- You have severe headache, blurred vision, fever, or constant severe tummy pain
- You are less than 37 weeks pregnant and think labour has started
What to pack
Antenatal card and test results, ID, sanitary pads, baby clothes and wrappers, a warm hat for the baby, nappies, a change of clothes, toiletries, snacks and water, a phone charger, and any items your hospital asks for.
Frequently asked questions
How long does labour last for a first baby?
Often 12 to 18 hours or more from the start of regular contractions, but it varies widely.
What does a contraction feel like?
Many women describe a tightening across the bump with period-like pain or back pain that builds, peaks and fades.
Can I eat during labour?
In low-risk labour, light food and drinks are usually encouraged. Follow your midwife’s advice.
Related reading: Partograph and WHO Labour Care Guide · 12 danger signs in pregnancy · Postnatal danger signs
Updated 5 November 2026. Based on WHO intrapartum care recommendations. This guide is for education and does not replace advice from your midwife or healthcare provider.
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