Labour & birth

Normal delivery: the stages of labour and tips that help

By Nine Moons EditorialMedically reviewed by Professor Dr FarhatUpdated 10 Oct 20269 min read

Quick answer

Labour has three stages: the first, when contractions open the cervix to 10 cm; the second, when you push your baby out; and the third, when the placenta comes out. A first labour often takes 8 to 18 hours once it's established. Nothing guarantees a normal delivery, but continuous support, staying upright and active, a healthy weight, antenatal classes and choosing your hospital carefully all improve your chances.

Key facts

Stage 1	Cervix opens to 10 cm
Established labour	From about 4 to 6 cm
Stage 2	Pushing: up to about 3 hours for a first baby
Stage 3	Placenta: usually within 30 to 60 minutes
First labour	Often 8 to 18 hours once established

The three stages

The cervix opens to 10 cm. Sizes are drawn to scale. Established labour usually starts at about 4 to 6 cm, and a first labour from there often takes 8 to 18 hours.

Early labour at home

Early contractions are irregular and the cervix softens and opens to about 4 cm. This can take many hours. Rest, eat light snacks, drink water, have a warm shower, and time your contractions with our contraction timer. Read when to go to hospital.

Active labour

Contractions become regular, stronger and closer together. Moving around, changing position, rocking on a birth ball and using a bath or shower can help you cope.

Pushing

Once you're fully open, you'll feel a strong urge to push. Upright positions such as kneeling, squatting or on all fours can help, and so can lying on your side. Your midwife will guide you to slow down as the head is born to protect your skin.

The placenta

Most hospitals offer an injection as your baby is born to help the placenta come out quickly and reduce bleeding. Skin-to-skin contact and an early breastfeed help too.

Pain relief options

Option	Good to know
Breathing, movement, massage, water	No side effects; good support makes a big difference
TENS machine	Most useful in early labour
Gas and air (Entonox)	Quick to work and wear off; may make you light-headed
Opioid injections	Can make you and your baby drowsy
Epidural	The most effective. It doesn't increase the chance of a caesarean, but may make an assisted birth (forceps or vacuum) more likely

Evidence-based tips for a normal delivery

Have continuous support from a partner, relative or doula. It's linked to more normal births and less need for pain relief.
Stay upright and mobile in the first stage.
Go to hospital in active labour, not too early, unless advised. Very early admission is linked to more interventions.
Keep active and a healthy weight in pregnancy; see exercise.
Try perineal massage from 34 weeks to reduce the chance of tears needing stitches.
Go to antenatal classes and learn breathing techniques.
Choose your hospital carefully. Ask about its caesarean rate, which varies widely, especially in private hospitals in South Asia.

Myths

Eating desi ghee in late pregnancy, climbing stairs, or drinking castor oil won't make a normal birth happen, and castor oil can cause severe diarrhoea. Dates in the last weeks may help a little, according to small studies.

Frequently asked questions

How long after my waters break will labour start?

Most women go into labour within 24 hours. If not, you'll usually be offered induction.

Can I have a normal delivery after a caesarean?

Often yes. Read about VBAC in our C-section guide.

Will I need an episiotomy?

Not routinely. It's only done if needed, for example to speed up birth.

Sources

NICE NG235: Intrapartum care
WHO: Recommendations on intrapartum care for a positive childbirth experience (2018)
Cochrane: Continuous support for women during childbirth (2017)
Cochrane: Antenatal perineal massage (2013)

General information, not medical advice. Medical disclaimer · How we review content

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