stages of labour
Labour & birth

The three stages of labour

Find out about the changes that will take place in the three stages of labour.

The onset of labour differs for most women. Some women experience mild, short, regular contractions that have a long interval between them, e.g. 20 minutes. As labour establishes, the contractions become longer and more painful and have a shorter interval, e.g. every five to 10 minutes. Some women start labour with contractions that are of long duration, feel painful and occur frequently, e.g. every five minutes.

The complete process of labour and delivery is divided into three stages.

1. The first stage, when the cervix gradually opens up (dilates).

2. The second stage, when the baby is pushed down the vagina and is born (this is sometimes separated into two phases – the passive or descent phase with no pushing, and the active or pushing phase).

3. The third stage, when the placenta comes away from the wall of the womb and is also pushed out of the vagina.

First stages of labour

During pregnancy, your cervix is closed and plugged with mucus, to keep out infection. Your cervix is long and firm, giving a strong base to your uterus (womb). It’s also in a position that points slightly towards your back (posterior position). In the first stage of labour, your cervix has to move forward (anterior position), ripen and open, so your baby can be born. By the end of this stage your cervix will be fully dilated, and open to about 10cm in diameter.

Second stage of labour

During the second stage of labour, you will push your baby down your vagina (the birth canal) and meet him or her for the first time. You’ll feel the pressure of your baby’s head low down in your pelvis, and with each contraction, you may have two or three strong urges to bear down. Listen to your body, and let it push in response to the urges. Take a few breaths between pushes. With every bout of bearing down, your baby will move through your pelvis a little, but at the end of the contraction, he’ll probably slip back a little again.

Don’t worry, as long as your baby keeps gradually moving down, you’re doing okay. When your baby’s head is very far down in your pelvis, you’ll probably feel a hot, stinging sensation. This will happen as the opening of your vagina starts to stretch around your baby’s head. Your midwife will tell you when she can see your baby’s head, and may ask you to stop pushing and to take short, panting breaths. This helps you to resist the urge to bear down for two or three contractions, so that your baby is born gently and slowly. Taking this approach also helps you to avoid a tear or an episiotomy. Your midwife may use warm compresses to support your perineum as your baby is born for the same reason.

Third stage of labour

The third stage of labour begins once your baby is born, and ends when you deliver the placenta and the empty bag of waters that are attached to the placenta (membranes). These come away as your uterus contracts down after the birth. Your contractions will be noticeable but weaker when they begin again, as your uterus contracts down. The placenta gradually peels away from the wall of your uterus, and you may get the urge to push again. The placenta, with the membranes attached, will drop to the bottom of your uterus, and out through your vagina.

Some hospitals adopt a different procedure in relation to a managed third labour. If you are not bleeding and wish to have a natural third stage, please talk with your midwife. This is when you deliver the placenta without the help of drugs, unless they are needed. A natural third stage can take longer – upright positions, skin-to- skin contact with your baby, and starting to breastfeed your baby, may all help to stimulate contractions. When the third stage is complete, you can get to know your new baby.

The difference between early and established labour:

  • Early Labour Stage – The time of the onset of labour until the cervix is dilated to 3-4 cm.
  • Active Labour Stage – Continues from 4 cm until the cervix is dilated to 10 cm.
  • Transition Phase Stage – Continues from 7 cm until the cervix is fully dilated to 10 cm. During the transition stage, the woman can become withdrawn and sometimes feel nauseated or have low blood pressure.

More like this:

The first 72 hours
Everything you need to know about labour positions
Home birth in Ireland

Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.


Eating for two

Our expert dietitian gives us the lowdown on your prenatal diet necessities.



Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….