Labor and Delivery

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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Labor and delivery facts

Every woman's experience is unique. Below are typical guidelines that will help you understand what to expect:

  • Normal labor can begin three weeks prior to the anticipated due date up until two weeks afterwards.
  • There is no way to precisely predict when labor will begin.
  • In the first stage of labor the cervix dilates and effaces (thins out). Once contractions begin they will usually increase in strength, duration, and frequency.
  • The second stage of labor begins when the cervix is completely (i.e. 10 centimeters) dilated. It ends when, following expulsive efforts (pushing) by the mother, the infant is delivered.
  • During the third stage of labor the placenta and membranes are delivered.
  • There are a number of methods for monitoring the fetus that may be used during labor.
  • Options for pain control during labor include breathing exercises, imagery, relaxation techniques, medications, and regional anesthesia.

What are the signs of labor and delivery?

Signs and symptoms of impending labor are not uniform among all women.


Lightening is a term used to denote the descent of the fetal head into the pelvis as labor approaches. It can occur up to two weeks prior to the onset of labor, or it may not occur at all. At that time there may be increased pressure on the maternal bladder accompanied by the urge to urinate more frequently. Many women find it easier to breathe after lightening occurs because upward pressure on the diaphragm diminishes.

Mucus plug

Release or passage of the "mucus plug" can be another sign that labor is near. Mucus produced by the cervical glands normally blocks the entrance to the cervix and helps prevent infection. When the fetal head impinges on the cervix, mucus from the cervical glands, along with a small amount of blood, is expelled. This results in a blood-tinged or brownish discharge being expelled from the vagina. Passage of the mucus plug may occur days before or after labor begins. It is also common after a vaginal examination.

Water breaking

Spontaneous rupture of the fetal membranes is referred to as one's "water breaking." This means that the membranes that surround the baby have ruptured, and clear amniotic fluid is often expelled from the vagina at that time. Once this occurs, labor will generally ensue spontaneously. If it does not, induction of labor may be necessary to avoid infection ascending upward through the vagina into the uterus. Most commonly rupture of the membranes does not occur until labor has already begun.


Finally, labor begins with the onset of contractions. At that point the cervix begins to thin out and dilate. When contractions begin to occur less than ten minutes apart, this frequently signals the onset of labor. Irregular contractions, known as Braxton-Hicks contractions or "false labor," occur toward the end of pregnancy during the third trimester, and they do not necessarily signify that labor is imminent. Some women even experience these contractions during the second trimester. Braxton-Hicks contractions are usually milder than those of true labor, and they do not occur at regular intervals.

Medically Reviewed by a Doctor on 6/30/2015
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