Stages of Labour in Pregnancy: What You Need to Know

If this is your first time giving birth, labour can feel like stepping into the unknown. So it's completely natural to feel anxious about what lies ahead. To help you prepare for the big day, let's take a closer look at what you can expect during the stages of labour, so you feel more prepared to welcome your little one.

What are the stages of labour?

Labour happens in three different stages. During the first stage, your contractions start up and the cervix (the lower part of the womb that connects to the vagina) slowly stretches. This creates the opening that your baby needs to pass through. 

The second stage begins once your cervix has opened completely (fully dilated), and this is when you'll be pushing to help deliver your baby. Finally, there's a third stage where your placenta comes away from the wall of your uterus (womb) and gets delivered. This usually happens within half an hour after your baby arrives.

However, you may experience these stages differently to other women, in terms of both how they feel and how long they take.

When should you head to the hospital?

If you’re expecting to go into labour soon, it’s recommended that you head to the hospital when your contractions have become strong, regular, and are coming every five minutes for at least an hour. If this is your first pregnancy, this timing becomes even more important.

However, you should come to the hospital immediately, regardless of your contraction pattern, if you experience any of the following:

• Your waters bag break (rupture of membranes)

• You experience a heavy vaginal bleeding

• Your baby's movements have decreased significantly

• Labour seems to be progressing very quickly

These situations need immediate medical attention to keep both you and your baby safe and healthy.

Stage 1: The first signs your baby is on the way

Understanding what happens during the first stage of labour can help you feel more in control when the time comes.

Early labour (latent phase)

Early labour marks the start of your birthing experience. During this phase, your contractions will feel mild and irregular at first, but they'll gradually become stronger. Your cervix begins to soften and open, going from completely closed to about 4 centimetres..

You might notice a backache, cramps similar to period pain, and possibly a "bloody show" – a small amount of mucus mixed with a little blood. Don't worry if this phase lasts several hours or even a couple of days, especially if this is your first baby. Every woman's experience is different.

During early labour, you'll be most comfortable staying at home to rest and save your energy for what's ahead. Gentle walking, staying well-hydrated, and practising the breathing exercises you learnt in your antenatal classes can help you manage any discomfort.

Active labour

Active labour begins when your cervix reaches about 4 centimetres. Your contractions will become longer, stronger, and closer together as your cervix continues opening from 4 to 10 centimetres. If you are finding the pain during active labour challenging, there are several options to help you feel more comfortable, including epidural anaesthesia or guided breathing techniques.

If you feel that the active labour is being more intense, it means that you're getting closer to meeting your little one.

Stage 2: Delivery of the baby

The moment you've been waiting for is almost here. Let's walk through what happens during the delivery of your baby.

Transition to pushing

Your contractions will be strong and frequent, lasting up to 90 seconds each. You will probably feel intense pressure in your lower back and rectum, as well as a strong urge to push. This is your body's way of telling you that it is ready for the second stage of labour and that it is time to bring your baby into the world. 

It's natural to feel anxious during this phase, but knowing that this level of intensity is normal can help you to stay calm and focused.

Giving birth

During the second stage, your body works with each contraction to guide your baby through the birth canal. Your baby's head will appear first, followed by their shoulders and the rest of their body.

The pushing stage can take anywhere from a few minutes to several hours depending on your condition, your baby's position, and whether this is your first birth. While this stage is physically demanding, it's also the most rewarding part of your pregnancy journey, as you will finally be able to hold your baby in your arms.

Stage 3: Delivering the placenta

The third stage of labour starts after your baby is born. Your uterus will continue contracting to deliver the placenta, which usually takes between 5 and 30 minutes.

Your doctor may gently massage your abdomen or give you medication to help your uterus contract and reduce any bleeding. You may experience mild cramping during this stage, known as “afterpains”, which actually help your uterus to return to its normal size.

Your healthcare provider will manage the delivery of the placenta in one of two ways:

• Active management:

  • You’ll be given an injection to help your uterus contract. The umbilical cord is then clamped and cut, and the placenta is gently guided out. This approach reduces the risk of heavy bleeding and other complications.

• Expectant management:

  • The placenta is left to come out naturally with little or no intervention. With this approach, the umbilical cord usually remains attached until it stops pulsating.

If your birth is straightforward and without complications, your medical team may also delay clamping the cord for a few minutes after your baby is born. This delayed cord clamping lets extra nutrient-rich blood flow from the placenta to your baby, which can provide important health benefits.

Coping with pain and discomfort during labour

Every woman experiences labour pain differently, but there are many ways to help you feel more comfortable throughout the process.

Pain relief options

There are a range of ways to manage pain during labour, from non-medical to medical treatments. Non-medical treatments include gentle massage, warm showers, or water immersion. Medical treatments include gas and air (nitrous oxide), pain-relieving injections and epidural anaesthesia.

The best option for you will depend on your preferences, medical recommendations and how your labour progresses.

Breathing and relaxation

The breathing and relaxation techniques you practise during pregnancy will be invaluable during labour. Slow, deep breathing helps to reduce muscle tension, while rhythmic breathing patterns provide a positive focus during contractions.

Relaxation techniques such as visualisation, guided meditation or listening to calming music can help you to maintain focus and reduce stress. The more you practise these techniques beforehand, the more naturally you will be able to use them when your contractions intensify.

The presence of a support person often helps enormously during labour, providing emotional encouragement and practical assistance throughout your birthing experience.

Warning signs during labour

While most labours progress smoothly, it's important to recognize when you need immediate medical attention. Keep an eye out for these signs:

• Heavy vaginal bleeding

• Severe abdominal pain that's different from contraction pain

• A sudden decrease in your baby's movements

• Green or brown-coloured amniotic fluid

• High fever

• Any seizures

Recognising these warning signs helps to ensure that you and your baby receive the right care at the right time. Our medical team is always available to support you and address any concerns that arise.

Tips for parents in preparing for labour

Getting ready for labour involves both practical preparation and emotional readiness. Attending antenatal classes helps you understand what to expect, practice breathing techniques, and learn about your options during labour.

Pack your hospital bag several weeks before your due date and discuss your birth preferences with your healthcare provider. Creating a birth plan during your pregnancy consultations helps ensure your medical team understands your priorities and preferences for labour and delivery.

Staying active throughout your pregnancy, eating well, and continuing to practice relaxation techniques all contribute to a more positive birth experience.

Labour can feel less overwhelming when you know what to expect. If you have questions about your birth plan or preparation, schedule an appointment with Thomson Women’s Clinic. Our obstetrician and gynaecologist (O&G) specialists will guide you through your options, ensuring you feel supported, informed, and confident in your birth journey.

The cost of childbirth in Singapore

The cost of childbirth in Singapore varies significantly depending on the hospital type, ward class, and delivery method. For a normal vaginal delivery in public hospitals, subsidised wards (Class C or B2) typically cost between SGD 1,000-1,800. 

However, if mother prefer more privacy and comfort, private wards in public hospitals are available, with Class B1 wards ranging from SGD 4,500-5,200 and Class A wards costing between SGD 5,300-6,900. Private hospitals charge higher fees for normal deliveries, typically between SGD 9,000 and 13,000.

Caesarean sections are considerably more expensive. In public hospitals' subsidised wards, C-sections range from SGD 2,000-4,700 depending on the ward class and complexity of the procedure. Private wards in public hospitals cost between SGD 7,400-9,700 for Class B1, and SGD 8,700-11,500 for Class A wards. Private hospitals charge significantly more for C-sections, with costs ranging from SGD 13,700-23,300.

Insurance or Medisave (for Singaporean and Permanent Resident) may help cover some costs. Knowing the potential cost in advance allows you to plan and avoid financial stress.

FAQ

Which part of labour hurts the most?

How long will each stage of my labour last?

Every woman's labour is different, but here are some general timeframes. The first stage of labour can last 6-18 hours if this is your first baby, but it's often shorter for subsequent births. The pushing stage may last 30 minutes to 3 hours for first pregnancies and less than an hour if you've given birth before. The third stage is the shortest, lasting 5-30 minutes.

What's considered a normal length for labour?

Labour length varies significantly between women. If this is your first baby, expect 12-18 hours on average, while subsequent births often take 6-10 hours. How long your labour lasts depends on factors like how quickly your cervix dilates, the strength of your contractions, and your baby's position.

At what point should I come to the hospital?

Most hospitals recommend coming in when your contractions are strong, regular, and five minutes apart for at least an hour. This corresponds to about 4-5 centimeters dilation. If you have a high-risk pregnancy, we may recommend coming in earlier.

How painful is labour?

Pain levels are different for every woman. Some experience strong period-like cramps, while others feel intense pressure in their pelvis and lower back. Pain often peaks during the transition and pushing phases. The combination of breathing techniques, movement, massage, and medical pain relief options we offer can help you manage discomfort effectively.

How will I know labour has actually started?

Labour begins with regular, increasingly painful contractions, bloody show, your waters breaking, and growing pelvic pressure. Some women also experience persistent backache, loose bowel movements, or sometimes a sudden burst of energy in the hours before labour begins.

Is it normal to have pain after delivering the placenta?

Yes, some discomfort after delivery is completely normal. Your uterus continues contracting to control bleeding, which causes cramping we call "afterpains." If you need stitches, you might experience additional tenderness. This pain typically decreases over several days with adequate rest and appropriate pain relief.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.