Labor Flow Chart

Prelabor/warm-up
Contractions may be regular and strong
Contractions do not progress, feel flat, or even stop (on-again & off-again)
May last several hours or come and go over several days
Cervix softens, moves forward, and thins with no dilation
Birthing parents may feel confused, anxious, frustrated, concerned, or excited in this stage
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Early/Prodromal Labor
Contractions are intense, duration, and closer together
Contractions every 15-30 minutes apart at 15-40 in duration & can take up to 20 hours
The cervix moves forward, is very soft, and thin until 4-5 cm
Birthing parents may feel hope, disbelief, eagerness, and tired in this stage.
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Active Labor
Contractions are closer and stronger
Contractions every 3-4 minutes lasting over 1 minute in duration; 3-7 hours for primiparas
The cervix is thin, soft, and dilating faster to 7-8 cm
Birthing parents feel tired, more serious, and increased pelvic pressure.
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Hard Labor
Contractions are back-to-back, lasting for at least a minute in a regular pattern
Cervix is very thin and dilation continues to 8-9 cm
Birthing parents may get hot, tremble, and more vocal with intense pelvic pressure
Birthing parents are serious and focused on contractions or may feel overwhelmed
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Transition
Contractions have reached their maximum intensity and are closer together
Usually last 15 minutes to a couple of hours
Cervix is fully effaced and dilates to 10 cm with the urge to push or grunt through contractions
Birthing parents may feel nauseated, weepy, easily irritated, and withdraw into herself
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Pushing & Birth
The uterus is most dense at the fundus and helps push the baby down into the pelvis
May take a few minutes to a few hours
Cervical dilation complete and contractions may space out to give the birthing parent some rest
Birthing parents feel a lot of pressure to their bottom, the “urge to poop”, and involuntary pushes
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Placental Birth
Contractions may stop for some time allowing for bonding with baby
The adrenaline from the birth may make the birthing parent tremble
Contractions restarts and the birthing parent feels cramping
The placenta (afterbirth) is born usually within an hour after birth
First nursing sessions usually start soon after the placenta is born

Giselle Rackley giselle.rackley@midwifery.edu (210) 860-71119 Geeky Gal Birth Advocate