Chart — Maternal-Newborn

Stages of Labor Comparison

A comprehensive side-by-side comparison of all four stages of labor — including latent and active phases within Stage 1 — with key events, cervical changes, contraction patterns, typical duration, and nursing focus for each stage.

Educational use only. Duration of labor varies by parity, analgesia, and individual patient factors. Values reflect general guidelines from ACOG/AWHONN. Always apply clinical judgment and follow provider orders. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.

Stages and Phases of Labor

Stage / Phase	Key Events	Cervical Changes	Nursing Focus
Stage 1 — Latent Nullip: up to 20 hrs Multip: up to 14 hrs	Mild irregular contractions become regular Bloody show may appear Patient ambulatory, talkative Membranes may be intact or rupture	0 → 6 cm dilation Effacement progresses Contractions q5–20 min, 30–45 sec	Establish baseline assessment IV access; baseline FHR Encourage ambulation Support comfort measures VS q4h
Stage 1 — Active ≥1 cm/hr; median ~6 hrs (nullip)	Contractions stronger and more frequent Fetal descent progresses SROM or AROM may occur Patient focused; may request analgesia	6 → 10 cm dilation Full effacement Contractions q2–5 min, 45–60 sec	Continuous FHR monitoring VS q1–2h Assess amniotomy fluid color Pain management support Encourage position changes
Stage 1 — Transition 30 min – 2 hrs	Most intense phase Nausea, vomiting, shaking Urge to push may occur Irritability; minimal rest between contractions	8 → 10 cm dilation Full effacement Contractions q2–3 min, 60–90 sec	Do not leave patient Coach breathing through contractions Discourage pushing until complete Continuous support and coaching
Stage 2 Nullip: up to 3 hrs Multip: up to 2 hrs (+1 hr each with epidural)	Complete dilation to delivery Cardinal movements of labor Crowning; perineal stretching Birth of infant	10 cm (complete) Fetal station descends Contractions q2–3 min, pushing effort	Continuous FHR monitoring Coach pushing efforts Prepare delivery field and warmer VS q5–15 min Call APGAR at 1 and 5 min
Stage 3 5–30 min	Placental separation signs Gush of blood; cord lengthening Uterus rises; becomes globular Placental delivery	Cervix fully dilated Uterus contracts post-delivery Oxytocin administered (AMTSL)	Monitor blood loss Administer oxytocin per order Inspect placenta for completeness No fundal pressure before separation Alert if >30 min without delivery
Stage 4 (Recovery) First 1–2 hours postpartum	Hemostasis achieved Uterus contracts and descends Lochia rubra begins Bonding and breastfeeding initiation	Fundus firm, midline, at umbilicus Lochia: rubra, moderate flow Cervix closing	BUBBLE-LE q15 min × 4 Assess for PPH signs Encourage voiding Support skin-to-skin; breastfeeding Emotional assessment

NCLEX Pearls

Active labor begins at 6 cm (2014 ACOG redefinition) — not 4 cm as in older guidelines
Normal active phase progress: ≥1 cm/hour dilation
Placenta retained >30 minutes after delivery = obstetric emergency
Fourth stage is highest-risk time for PPH — assess every 15 minutes × 4
A boggy uterus in Stage 4 = uterine atony → massage until firm, administer oxytocin
Transition phase is the most intense — urge to push may occur before complete dilation

Related Resources

Labor and Delivery OverviewFull guide with contraction assessment, FHR monitoring, and stage-by-stage nursing priorities

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Stages of Labor ReferenceDetailed reference with maternal changes, duration, and nursing considerations

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Standards & sources

Fact-checked Jun 20, 2026

This page is written to align with ACOG / AWHONN Labor Standards. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →