Labor and Delivery is the final part of pregnancy, when contractions, cervical changes, and delivery help bring your baby into the world. Knowing the signs of labor can make the end of pregnancy feel less confusing.
Labor and Delivery: Signs of Labor, Stages, Pain Relief, and What to Expect
This labor and delivery guide explains early labor signs, real contractions, water breaking, the stages of labor, pain relief options, vaginal delivery, cesarean birth, delivery of the placenta, and when to call your doctor or hospital.
What Is Labor and Delivery?
Labor and delivery is the process your body goes through to give birth. Labor usually involves contractions that help the cervix thin and open, baby moving down through the pelvis, delivery of the baby, and delivery of the placenta.
Labor does not look the same for everyone. Some people have a slow start with mild contractions for hours, while others move into active labor more quickly. Some labors begin with contractions, and some begin when the waters break.
ACOG says if you think you are in labor, or if you are not sure, you should call your OB-GYN or other obstetric care provider. ACOG
This page is for general education. It does not replace medical care. Always follow the instructions from your own OB, midwife, hospital, or birth center.
Signs Labor May Be Starting
Labor can start in different ways. Some signs are obvious, like regular contractions or waters breaking. Other signs can be subtle, like backache, cramps, pelvic pressure, loose stools, or more discharge.
The NHS says signs that labor may be starting can include contractions or tightenings, a show, backache, an urge to go to the toilet, and waters breaking. NHS
- Contractions that become stronger, longer, and more regular.
- Period-like cramps or low backache that comes and goes.
- Pelvic pressure or feeling like baby is lower.
- A mucus plug or bloody show.
- Waters breaking as a gush or trickle.
- More vaginal discharge near the end of pregnancy.
- An urge to go to the bathroom.
- Feeling restless, emotional, shaky, or suddenly focused.
Not every sign means active labor has started. It is common to have some signs before true labor begins. When in doubt, call your provider and explain what you are feeling.
Real Labor vs Braxton Hicks
Braxton Hicks contractions are practice contractions. They can feel like your belly tightens and then relaxes. They are often irregular, short, and may ease with rest, fluids, or changing position.
Tommy’s says Braxton Hicks contractions are usually weak, short-lasting, irregular, more uncomfortable than painful, and do not become longer, more painful, or closer together over time. True labor contractions get longer, stronger, more regular, and more intense. Tommy’s
Simple rule: if contractions keep getting stronger, closer together, longer lasting, and harder to talk through, call your provider or hospital for instructions.
Timing Contractions
Timing contractions can help you explain what is happening when you call your doctor, midwife, hospital, or birth center. Count from the start of one contraction to the start of the next contraction.
Track how long each contraction lasts, how far apart they are, and whether they are becoming stronger. Also notice whether they continue even after resting, drinking water, showering, or changing positions.
Tommy’s says to call your midwife, birth center, or labor ward when contractions are regular, strong, lasting at least 60 seconds, and coming every 5 minutes. Your own provider may give different instructions, especially if you are high risk, far from the hospital, or have had a fast labor before. Tommy’s
What Water Breaking Feels Like
Your waters breaking means the amniotic sac has ruptured and fluid is leaking from around baby. It can feel like a sudden gush, a slow trickle, or ongoing wetness that you cannot control like urine.
The NHS says if your waters break before labor starts, call your midwife. The NHS also recommends using a pad, not a tampon, so the color of the waters can be checked. NHS
Tommy’s says waters usually break during the first stage of labor, but they can break before labor starts. Tommy’s also says if waters break before labor, labor often starts within 24 hours. Tommy’s
- Clear or pale fluid can be normal, but still call your provider.
- Green or brown fluid should be reported right away.
- Bad-smelling fluid should be reported right away.
- Fluid with bleeding should be reported right away.
- Leaking fluid with fever, pain, or reduced baby movement needs urgent attention.
When to Call Your Doctor or Hospital
Call your provider any time you think labor may be starting and you are not sure what to do. It is better to call and be told to wait at home than to ignore symptoms that need care.
ACOG says to go to the hospital if your water has broken and you are not having contractions, you are bleeding heavily from the vagina, you have constant severe pain with no relief between contractions, or you notice the fetus is moving less often. ACOG
Call right away for heavy bleeding, waters breaking, green or brown fluid, fever, severe headache, vision changes, sudden swelling, chest pain, severe shortness of breath, severe belly pain, constant pain between contractions, or baby moving less than usual.
The First Stage of Labor
The first stage of labor is when the cervix thins and opens. This stage often includes early labor, active labor, and transition. It is usually the longest stage.
Mayo Clinic explains that during the first stage of labor, the cervix opens and the contractions become stronger, closer together, and more regular. Mayo Clinic
Early Labor
Early labor can feel like mild or moderate contractions, period-like cramps, low backache, pelvic pressure, or tightening that comes and goes. You may still be able to talk, move around, shower, eat lightly if allowed, and rest between contractions.
Some people stay home during early labor if their provider says it is safe. Others may need to go in sooner because of medical history, distance from the hospital, broken waters, bleeding, reduced movement, or provider instructions.
Active Labor
Active labor usually means contractions are stronger, closer together, and harder to ignore. You may need to focus through contractions, breathe through them, change positions, use pain relief, or go to the hospital or birth center if you are not already there.
Cleveland Clinic explains that active labor is when contractions are longer, stronger, and more painful, and the cervix continues to dilate. Cleveland Clinic
Transition
Transition is often the most intense part of the first stage of labor. Contractions may be very strong and close together. Some people feel shaky, nauseated, sweaty, emotional, overwhelmed, or like they cannot do it anymore.
Those feelings can happen as your body gets close to full dilation. Your labor team can help you breathe, change positions, use coping tools, and know when it is safe to push.
The Second Stage of Labor: Pushing and Birth
The second stage of labor begins when the cervix is fully dilated and ends with the birth of the baby. This is the stage where pushing may happen.
Some people feel strong pressure, burning, stretching, or an urge to bear down. Others may feel less urge to push if they have an epidural. Your provider or labor nurse can guide pushing based on baby’s position, your body, your pain relief, and baby’s heart rate.
Positions may include lying on your side, sitting upright, squatting with support, hands and knees, or using a birth bar. What is safe depends on your labor, your hospital, your provider, baby’s monitoring, and any medical concerns.
The Third Stage of Labor: Delivering the Placenta
The third stage of labor begins after baby is born and ends when the placenta is delivered. You may still have contractions, but they are usually less intense than labor contractions.
Mayo Clinic says the placenta is delivered after the baby, and medication may be given after delivery to encourage uterine contractions and reduce bleeding. Mayo Clinic
Your provider will check that the placenta is complete, watch bleeding, and examine whether any tears need repair.
Pain Relief During Labor and Delivery
Labor pain can come from uterine contractions, cervical dilation, pressure from baby moving down, stretching, and delivery. Pain relief choices can be different depending on your hospital, birth center, medical history, and labor progress.
Cleveland Clinic explains that labor pain happens because the uterus contracts to move baby down the birth canal and because pressure and stretching happen during birth. Cleveland Clinic
- Breathing techniques and relaxation.
- Changing positions or walking if allowed.
- Warm shower or bath if approved by your provider.
- Massage, counter-pressure, or support person help.
- Birth ball or peanut ball if available.
- IV pain medicine if offered and appropriate.
- Nitrous oxide if offered at your facility.
- Epidural or spinal anesthesia if appropriate.
Ask your provider what options are available where you plan to deliver. Not every hospital or birth center offers the same choices.
Epidural During Labor
An epidural is a common pain relief option during labor. It places medicine near the nerves in the lower back to reduce labor pain. Some people still feel pressure, but pain may be much lower.
An epidural may affect movement, bladder function, blood pressure, and pushing. Your care team will monitor you and baby. Ask your provider about benefits, risks, timing, and what to expect at your hospital.
You do not have to decide everything before labor starts, but it helps to know your options before contractions become intense.
Vaginal Delivery
A vaginal delivery means baby is born through the vagina. During vaginal birth, the cervix opens, baby moves down through the pelvis, and you push or breathe baby down when your provider says it is time.
Some vaginal births need extra help, such as vacuum or forceps, depending on baby’s position, your pushing, baby’s heart rate, and provider judgment. Your provider should explain what is happening and why help may be needed.
After baby is born, the umbilical cord is clamped and cut, the placenta is delivered, bleeding is watched, and any tearing may be repaired.
Cesarean Delivery
A cesarean delivery, also called a C-section, is surgery to deliver baby through an incision in the abdomen and uterus. Some C-sections are planned ahead of time, and some happen during labor for medical reasons.
A C-section may be recommended for reasons such as placenta concerns, breech position, certain medical conditions, previous uterine surgery, baby distress, labor not progressing, or other safety concerns.
If a C-section becomes necessary, your team should explain why, what will happen, what pain control will be used, and what recovery may look like.
What to Pack for Labor and Delivery
A simple hospital bag can make labor and delivery feel less stressful. You do not need to pack the whole house. Focus on the things you will actually use.
- ID, insurance card, and hospital paperwork if needed.
- Phone charger with a long cord.
- Comfortable clothes for after birth.
- Going-home outfit for baby.
- Car seat already installed or ready to install.
- Hair ties, lip balm, toothbrush, and basic toiletries.
- Glasses or contacts if you use them.
- Snacks for your support person if allowed.
- Birth preferences or notes if you have them.
What Happens Right After Delivery?
Right after delivery, baby may be placed on your chest if you and baby are stable. Your team may dry baby, check breathing, check color and tone, and keep watching both of you.
The cord may be clamped and cut, the placenta will be delivered, and your provider will check for bleeding or tears. Baby may be weighed, measured, checked, and given newborn care based on hospital policy and your preferences.
If baby needs extra help breathing or adjusting, the newborn team may move quickly. This can feel scary, but the goal is to help baby safely transition after birth.
Birth Plan vs Real Life
A birth plan can be helpful, but labor and delivery can change quickly. A good birth plan is flexible and lets your team know what matters most to you.
You can include preferences about support people, pain relief, movement, pushing positions, delayed cord clamping, skin-to-skin, feeding, newborn medications, visitors, and photography.
Try to think of it as birth preferences, not a script. The most important goal is a safe mom and baby.
Labor and Delivery Tips for First-Time Moms
If this is your first labor and delivery, it can feel hard to know what is normal. Calling your provider is not bothering them. That is what they are there for.
- Keep your phone charged near the end of pregnancy.
- Know the number for your hospital, birth center, or provider.
- Know when your provider wants you to come in.
- Practice timing contractions before labor starts.
- Keep your hospital bag and car seat ready.
- Do not ignore reduced baby movement.
- Use a pad if you think your waters broke.
- Ask questions if you do not understand what is happening.
When Labor and Delivery Needs Urgent Care
Some symptoms during labor and delivery need urgent attention. Do not wait at home if you are worried about heavy bleeding, severe pain, reduced movement, or fluid that looks green, brown, bloody, or smells bad.
Call your doctor, hospital, birth center, or emergency services right away for heavy bleeding, baby moving less, waters breaking before you know what to do, green or brown fluid, fever, severe headache, vision changes, sudden swelling, chest pain, severe shortness of breath, constant severe abdominal pain, seizures, fainting, or anything that feels seriously wrong. This page is general education and does not replace medical care.
Labor and Delivery Summary
Labor and delivery can begin with contractions, waters breaking, a bloody show, backache, pelvic pressure, or a mix of symptoms. Real labor contractions usually become stronger, longer, and more regular over time.
The main stages of labor include the cervix opening, baby being born, and the placenta being delivered. Pain relief can include breathing, movement, support, IV medicine, nitrous oxide, epidural, or other options depending on your hospital and medical needs.
The most important thing to remember is this: call your provider if you think labor is starting, your waters break, bleeding happens, pain feels severe, or baby is moving less than usual.