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Onset of labor, the first stage, is heralded by contractions of the uterus felt as cramplike pains in the abdomen or lower back that recur at intervals of 10 to 30 minutes and last about 40 seconds; they increase in frequency until they occur at about 2-minute intervals. With each contraction the cervix, or neck of the uterus, dilates until it becomes wide enough, about 4 in. (10 cm), to permit emergence of the baby.
In the second stage of labor the baby passes through the birth canal, most commonly head first, and is born. The effectiveness of uterine contractions in this stage is enhanced by the bearing-down abdominal contractions of the mother.
The third stage of labor, which occurs about 15 to 30 minutes after the child is born, is characterized by the separation of the placenta from the uterine wall and its expulsion. The total time of labor averages 13 to 14 hours in women pregnant for the first time and 8 to 9 hours in women who have previously borne children.
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