This information is for general guidance only.
It does not replace advice from your midwife or obstetric team. Read more about our approach.
The stages of labour: what to expect from first contraction to birth
Labour is divided into three stages. Knowing what happens at each stage, and roughly how long each lasts, helps you prepare and feel more in control on the day. No two labours are the same, but they all follow the same pattern. Start by recognising the start of labour, think about your pain relief options, and read our guide to tears and episiotomy so you know what to expect.
Not sure whether labour has actually started? Read our guide to the signs of labour first. This page takes over from the moment the pattern is established.
Pre-labour: the latent phase
What is happening
Your cervix softens, shortens and begins to dilate from 0 to 4cm.
How long
Hours to days. This is the longest and most variable phase.
What contractions feel like
Irregular and mild to moderate. They come and go, not yet in a clear pattern.
Length
First baby typically 6 to 36 hours. Shorter for subsequent babies.
What to do at home
- Rest if it starts at night, so you have energy when you need it
- Stay gently active if it is daytime, as walking helps your baby descend
- Eat light snacks and stay hydrated
- Try a warm bath, massage, or TENS machine for comfort
- Time contractions but do not rush to hospital yet
When to call: if you are unsure, worried, or your waters break.
Stage 1: established labour
What is happening
Cervix dilates from 4cm to 10cm (fully dilated).
How long
First baby 8 to 18 hours on average. Second or later 5 to 12 hours.
What contractions feel like
Regular, strong, lasting 45 to 60 seconds. They come every 3 to 5 minutes and steadily get closer and more intense.
Cervical dilation guide
- 4cmBeginning of established labour. Time to head to your place of birth.
- 5-7cmActive phase. Things are progressing well. This is often when pain relief is requested.
- 8-9cmTransition. Often the most intense period, and the shortest.
- 10cmFully dilated. Your body is ready to push.
What happens at the birth unit
- Your midwife will monitor you and your baby's heartbeat
- Vaginal examinations are offered to check how your cervix is opening
- Continuous monitoring (CTG) is offered or used if any concerns arise
- Pain relief options are available — see our guide to pain relief in labour
Transition (8-10cm)
Often the most overwhelming phase, but also the shortest. It is common to feel shaky, nauseous, hot and cold, tearful or certain you cannot go on. Transition usually lasts only 15 to 60 minutes. Your baby is almost here.
Stage 2: the pushing stage
What is happening
Pushing your baby down the birth canal and out into the world.
How long
First baby up to 3 hours. Second and subsequent often under 1 hour.
What it feels like
A strong, often involuntary urge to push, described like needing to poo. Intense pressure in your pelvis and bottom. With an epidural, the urge may be reduced or absent.
Positions for pushing
Upright
Standing, kneeling or squatting uses gravity to help your baby descend.
Side-lying
Helpful if you are tired or have an epidural.
Hands and knees
Eases back labour and gives the pelvis room to open.
Supported squat
Using a birth partner, bar or the side of the bed.
What your midwife will do
- Guide your pushing during each contraction
- Monitor your baby's heartbeat between contractions
- May suggest breathing baby's head out slowly to reduce tearing
When forceps or ventouse may be used
If pushing is not progressing after 2 to 3 hours, if your baby is showing signs of distress, or if you are too exhausted to continue, an assisted delivery with forceps or ventouse (a vacuum cup) can help.
At birth
Your baby's head crowns, then is born, usually followed by the rest of the body with the next one or two contractions. Skin-to-skin contact is recommended immediately. The NHS also recommends delayed cord clamping: waiting at least a minute before clamping and cutting the cord.
Stage 3: delivery of the placenta
After your baby is born, your uterus continues to contract gently to deliver the placenta. These contractions are much milder than labour itself. You have two options, which you can discuss in your birth plan.
Managed third stage
An injection of oxytocin in your thigh speeds up the delivery of the placenta (usually 5 to 30 minutes). The NHS recommends this approach to reduce the risk of heavy bleeding (postpartum haemorrhage).
Physiological third stage
Natural, with no injection. The placenta is delivered in 20 to 60 minutes through your body's own contractions. Only recommended for uncomplicated births with no risk factors for bleeding.
Signs the placenta has delivered
- The umbilical cord lengthens
- A gush of blood
- The uterus rises slightly in the abdomen
Your midwife will check the placenta is complete (a missing piece can cause ongoing bleeding), stitch any tears or episiotomy, and leave you to enjoy extended skin-to-skin time with your baby.
After birth
Golden hour
The first hour after birth is for uninterrupted skin-to-skin and, if breastfeeding, your baby's first feed.
Vitamin K
Offered as an injection or oral drops for your baby, preventing a rare bleeding disorder. Recommended by the NHS.
Your body
Afterpains (your uterus contracting back), perineal care if you have stitches, and your first pass of urine will be checked.
Caesarean birth
Around 1 in 4 births in the UK are by caesarean section. Planned (elective) caesareans are scheduled in advance for medical or personal reasons. Emergency caesareans happen during labour if concerns arise for you or your baby.
A caesarean is major surgery with a longer recovery, but is routinely performed and generally very safe. We will be publishing a dedicated C-section guide soon. In the meantime, see the NHS website or ask your midwife for a copy of the hospital leaflet.
Related guides and tools
A note from our team
This guide reflects NHS UK and NICE guidance on intrapartum care. Every birth is different, and your midwifery and obstetric team will guide you on the day. Read more about us.