Labor & Delivery: What to Expect

As you near your due date, you’re likely to feel both excited and a bit scared. Learning about what to expect can help you focus on the joy.

Signs and Stages

Labor is a series of contractions, or muscle spasms, of the uterus that help the cervix open (dilate) and thin. This in turn allows the baby to move through the birth canal. Labor often starts 2 weeks before or after an estimated delivery date. It lasts about 12 to 14 hours for a first-time mom. If you’ve given birth in the past, labor may be shorter this time.

Signs of labor vary from woman to woman. Just days before going into labor, you may notice a “bloody show.” This is when a small amount of mucus, slightly mixed with blood, passes from the vagina.

Referred to as “water breaking,” fluid may gush or leak from the vagina when the fluid-filled sac protecting your baby in the womb breaks. You should contact your doctor as soon as this happens. Many women go into labor within 24 hours.

3 Stages of Labor



First Stage

Latent Phase

  • Typically the longest phase, during which you’re admitted to the hospital
  • Contractions occur 5 to 20 minutes apart; pain usually starts in the back and moves to the front
  • Cervix opens up to 3 or 4 centimeters
Active Phase
  • Contractions are more severe, last longer, and occur 3 to 4 minutes apart
  • Cervix opens 4 to 7 centimeters
Transition Phase
  • Contractions are very strong, last 60 to 90 seconds, and occur every few minutes
  • Cervix opens 8 to 10 centimeters
Second (Pushing Stage)
  • Begins when the cervix is completely open and ends with the delivery of the baby
  • May take between 30 minutes and 2 hours for a first pregnancy
Third Stage
  • Delivery of the placenta takes place after the baby is delivered and usually lasts a few minutes

What is False Labor?

With a few weeks to go before your due date, you may have cramps called false labor or Braxton Hicks contractions. Unlike true labor, the time between each muscle spasm does not get shorter or stronger over time. Pain is limited to the front of your body, instead of starting in the back and moving to the front. These cramps may go away if you walk or rest.

Ways to reduce Discomfort

As a mom-to-be, you have a lot of choices to make, from names to nursery colors. One decision that’s even more important is how to manage labor pains during the big event. You may find meditation, massage, or rhythmic breathing helpful at the start of labor.

You may also choose to use pain medicine to help soothe strong contractions. Depending
on your health history, epidural anesthesia, delivered near the spinal cord, may be an option. This eases pain in the lower part of the body. Talk with your doctor about the risks, side effects, and benefits of each pain-relief option. You may also want to take a Prepared Childbirth class to help ease your mind as you get closer to your delivery date.

Delivery Options

In deciding whether to have a cesarean or vaginal birth, talk with your doctor about your current health and health history. For the majority of women, a vaginal birth is typically considered safer and healthier. A cesarean may be better if:

  • You’re expecting multiples—twins, triplets, or more
  • The bottom part of your baby’s body is closest to the birth canal (breech position)
  • You have had a previous cesarean with
    a vertical incision
  • You have a medical condition that may make vaginal birth unsafe, such as diabetes, high blood pressure, or an infection such as active herpes
  • The placenta, which supplies oxygen and
    nutrients to the baby, blocks the opening
    of the uterus

After labor has started, other situations may
also make it necessary to have a cesarean in order to protect your baby.

layout graphic