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Stages of Labor

Logo of the Eunice Kennedy Shriver National Institute of Child Health and Human Development
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Stage 1 Early Phase

Computer-generated diagram of a fetus in the womb. The vagina and uterus are labeled with text, followed by a label pointing to the cervix reading “Cervix softens and thins.”
Narrator: Labor has three stages. In the first stage of labor, the body prepares to give birth. There are two phases: early and active.

Early labor can last from hours to days. First-time moms may spend more time in this phase.

The cervix, or the opening to the uterus, begins to soften; efface, or thin out; and dilate, or open. The cervical changes are necessary so the baby can pass through. Usually a woman’s water breaks during the first stage of labor. Contractions—or tightening of the uterus—become strong and regular. Typically, the woman will have a 30- to 70-second long contraction every 5 to 20 minutes.

There may also be a stringy, bloody discharge from the vagina, called “bloody show.” This is considered normal.
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Stage 1 Active Phase

A similar diagram as in the previous slide, but with the fetus turned slightly and pressed against the dilating cervix. The vagina and uterus are labeled with text, followed by a label pointing to the cervix reading “Dilated cervix.”
Narrator: Active labor occurs when the cervix starts to dilate more quickly. Contractions get stronger, last longer, and occur more often. The cervix continues to open wider, to about 10 centimeters. Then, pushing can start.
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Stage 2

A similar diagram as in the previous slide, but with the baby’s head past the cervix and crowning. The vagina, uterus, and umbilical cord are labeled with text, followed by a label pointing to the baby’s head reading “Infant’s head crowning.”
Narrator: In the second stage of labor, the child is born. A health care provider usually encourages the woman to “push” to help the baby move down the vagina. She might push for minutes or hours.

Once the baby’s head starts to come out—called crowning—a provider guides the rest of the baby out. Childbirth is finished when the baby is completely out of the vagina.

The provider then cuts and clamps the umbilical cord, which connected mom and baby during pregnancy.
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Stage 3

A similar diagram as in the previous slide, but without the fetus. The cut umbilical cord sticks out of the vagina and is still connected to the placenta inside of the uterus.

The vagina and cervix are labeled with text, followed by the placenta and umbilical cord.
Narrator: The last stage of labor involves delivery of the placenta, or afterbirth. During pregnancy, the placenta supplies food and oxygen to the fetus. Once the umbilical cord is cut, the placenta has to come out.

Contractions typically begin 5 to 10 minutes after the baby’s birth. During this time, the placenta detaches from the uterus. A provider may encourage the woman to “push” just as she did to deliver the baby.

After 5 to 30 minutes, the placenta comes completely out of the vagina. Then, the process is complete.
BOND National Institues of Health Home Home Division of Intramural Population Health Research