The stages of labour: from the first contraction to the placenta
What happens at each stage of labour, how long it usually lasts, when to set off for the maternity unit and when to call straight away.
4 min read
In this article
Labour is not a single moment but a journey in three stages. Knowing what is happening makes it easier to decide when to stay home, when to set off and when to ask for help.
Early labour
The cervix softens, shortens and starts to open, up to about 4 cm. Contractions are irregular, coming and going, and this stage can last many hours, sometimes days, especially with a first baby. It is usually the longest stage.
Most women can spend this stage at home, where they feel more comfortable:
- eat something light and drink, as you will need energy later
- if it starts at night, try to rest; if it starts in the day, move gently and stay upright
- a warm shower, a back massage and slow breathing help with the pain
In Albania, many women set off for the maternity unit at the first contraction, especially when they live far away. If the journey is long, agree with your gynaecologist in advance when you should leave.
Active labour
Active labour starts when the cervix is about 4 cm open and contractions become stronger, longer and regular. The cervix opens to about 10 cm. With a first baby this usually takes 8 to 18 hours; with later babies, around 5 to 12 hours.
When to call the maternity unit or your gynaecologist
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1
Regular contractions
When they come every 5 minutes or more often, or when you think labour has started.
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2
Your waters
If your waters break, call straight away, even without contractions. Note the colour of the fluid.
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3
Bleeding
Any bleeding from your vagina needs a call straight away.
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4
Your baby’s movements
If your baby is moving less than usual, do not wait.
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5
Before 37 weeks
If you think labour has started early, call straight away.
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6
Very frequent contractions
A contraction lasting more than 2 minutes, or 6 or more contractions in 10 minutes, needs a call straight away.
If you cannot reach the maternity unit and feel your baby is coming, with a strong urge to push, call 127.
Pushing and birth
When the cervix is fully open, the second stage begins. You will feel a strong urge to push with each contraction. Your midwife guides you on when to push and when to breathe slowly, so your baby’s head comes out gently. With a first baby, pushing usually should not last more than 3 hours; with later babies, no more than 2 hours. If it takes longer, a doctor can help.
The placenta
After your baby comes the placenta. You are usually offered an injection in your thigh as your baby is born, so the womb contracts and the placenta comes out within about 30 minutes. The injection lowers the risk of heavy bleeding, but can make you feel sick. Without it, the placenta can take up to an hour. The cord is usually cut after 1 to 5 minutes, not straight away.
Then comes skin-to-skin and the first feed. Read breastfeeding: the first days and, for packing, the hospital bag checklist.
Common questions
How long does a first labour last?
When should I set off for the maternity unit?
Can I eat during labour?
Sources we consulted
Written by the mam.al editors as general information. It does not replace advice from your doctor or midwife. Contains public sector information licensed under the Open Government Licence v3.0.