After the first stage when the cervix starts dilating, which is typically quite long drawn-out, the contractions become more powerful and frequent and you feel an urge to push, which results in the baby being expelled. In the third and final stage, the placenta is expelled.
First-time births usually take slightly longer.
The best thing you can do for your body during the hours of contractions and labour pains is to relax as much as you possibly can. You can try having a warm bath, massage or acupuncture. It can help to have prepared in advance for dealing with the labour pains. Later on, you may need medical pain relief of some sort. You can also try different birthing positions.
1. Dilation and opening of the cervix
You are likely to feel both nervous and excited when the first contractions occur; nine months of waiting will soon be over.
To begin with, the contractions are weak and irregular. Initially, they might happen once an hour and last about a minute. For first births, this stage, which is the longest stage of labour, takes nine to fifteen hours. It is usually shorter for subsequent births.
The contractions become progressively stronger and more frequent. The muscles of the uterus work at full capacity as the cervix expands. The first 5 centimetres of dilation usually take the longest. The ligaments holding your pelvic bones together become stretched and taut.
Towards the end of this stage, the cervix continues opening and the mucus plug gradually dislodges. If your waters haven't already broken, it will probably happen now, or relatively soon.
At the culmination of this stage, the contractions occur at two-minute intervals and last a minute and a half. Use the time between the contractions to relax and recuperate. Use the techniques you have read about or learned on your birth preparation course.
2. Bearing down and expulsion
When the cervix has dilated approximately 10 centimetres, the next stage starts. The mother feels the urge to bear down with the contractions (if the baby is far enough down the birth canal). This stage usually takes between one and two hours, although this is highly individual.
During stage one, the baby moved down through the birth canal. In stage two, its head presses against the pelvic floor, causing the contractions to become stronger. When the baby's head reaches the pelvic floor and presses against your rectum, you feel a strong urge to push.
It feels like a strong backwards pressure, as if you urgently needed to defecate.
The duration of stage two depends on many factors, such as your strength and stamina and how relaxed you are. The midwife will support you and ask you to push harder when the baby's head is about to come out. After one or two more contractions, the rest of baby's body is expelled. This stage ends with a miracle: your baby is born and you finally meet it for the first time.
Almost all your pain disappears the moment the baby comes out. Most mothers are surprised and relieved over this.
Now the third and final stage begins.
3. Expulsion of the placenta
Shortly after the baby comes out, it is time to expel the placenta. The womb contracts and it feels like labour is starting again. You will probably be asked to push out the placenta and the membranes that surrounded the baby. But don't worry - this is nothing compared to the labour you've just been through.
There will be bleeding at this stage, and then the midwife will feel your belly to check that the womb has contracted properly. This is important to prevent you from bleeding too much.
The midwife examines that placenta to check that it has been expelled in its entirety. If any residue is left inside the womb, it can cause infections and bleeding later.
When the labour is over, the midwife checks your pelvic area and stitches up any tears. This is always done with some form of anaesthetic. Any larger tears are stitched by an obstetrician. After this you are given clean clothing and left for a while with your baby to enjoy the miracle that has just occurred: your new little family.
Read more about labour in our app, The Pregnancy Book.