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Diagram of cervical dilation


Cervix Dilation Chart: Stages of Labor

The cervix, which is the lowest portion of the uterus, opens when a woman has a baby, through a process called cervical dilation. The process of the cervix opening (dilating) is one way that healthcare staff track how a woman’s labor is progressing.

During labor, the cervix opens to accommodate the passage of baby’s head into the vagina, which is around 10 centimeters (cm) dilated for most term babies.

If your cervix is dilated with regular, painful contractions, you’re in active labor and getting closer to delivering your baby.

The first stage of labor is divided into two parts: the latent and active phases.

Latent phase of labor

The latent phase of labor is the first stage of labor. It can be thought of more as the “waiting game” stage of labor. For first-time moms, it can take a while to move through the latent phase of labor.

In this stage, contractions aren’t yet strong or regular. The cervix is essentially “warming up,” softening, and shortening as it prepares for the main event.

You might consider picturing the uterus as a balloon. Think of the cervix as the neck and opening of the balloon. As you fill that balloon up, the neck of the balloon draws up with the pressure of the air behind it, similar to the cervix.

The cervix is simply the bottom opening of the uterus drawing up and opening wider to make room for the baby.

Active stage of labor

A woman is considered to be in the active stage of labor once the cervix dilates to around 5 to 6 cm and contractions begin to get longer, stronger, and closer together.

The active stage of labor is characterized more by the rate of regular cervical dilation per hour. Your doctor will expect to see your cervix opening at a more regular rate during this stage.

How long does stage 1 of labor last?

There’s no scientific hard and fast rule for how long the latent and active phases last in women. The active stage of labor can range from a woman dilating anywhere from 0.5 cm per hour up to 0.7 cm per hour.

How fast your cervix dilates will also depend on if it’s your first baby or not. Mothers who have delivered a baby before tend to move more quickly through labor.

Some women will simply progress more quickly than others. Some women may “stall” at a certain stage, and then dilate very quickly.

In general, once the active stage of labor kicks in, it’s a safe bet to expect a steady cervical dilation every hour. Many women don’t start really dilating more regularly until closer to around 6 cm.

The first stage of labor ends when a woman’s cervix is fully dilated to 10 cm and fully effaced (thinned out).

The second stage of labor begins when a woman’s cervix is fully dilated to 10 centimeters. Even though a woman is fully dilated, it doesn’t mean that the baby is necessarily going to be delivered immediately.

A woman may reach full cervical dilation, but the baby may still need time to move down the birth canal fully to be ready for birth. Once the baby is in prime position, it’s time to push. The second stage ends after the baby is delivered.

How long does stage 2 of labor last?

In this stage, there’s again a wide range for how long it can take for the baby to come out. It can last anywhere from minutes to hours. Women may deliver with only a few hard pushes, or push for an hour or more.

Pushing occurs only with contractions, and the mother is encouraged to rest between them. At this point, the ideal frequency of contractions will be about 2 to 3 minutes apart, lasting 60 to 90 seconds.

In general, pushing takes longer for first-time pregnant people and for women who have had epidurals. Epidurals can reduce the woman’s urge to push and interfere with her ability to push. How long a woman is allowed to push depends on:

  • the hospital’s policy
  • the doctor’s discretion
  • the health of the mom
  • the health of the baby

The mother should be encouraged to change positions, squat with support, and rest between contractions. Forceps, vacuum, or cesarean delivery is considered if the baby isn’t progressing or the mother is becoming exhausted.

Again, every woman and baby is different. There’s no universally accepted “cut-off time” for pushing.

The second stage ends with the birth of the baby.

The third stage of labor is perhaps the most forgotten phase. Even though the “main event” of birth has occurred with the birth of the baby, a woman’s body still has important work to do. In this stage, she’s delivering the placenta.

A woman’s body actually grows an entirely new and separate organ with the placenta. Once the baby is born, the placenta no longer has a function, so her body must expel it.

The placenta is delivered the same way as the baby, through contractions. They may not feel as strong as the contractions that are needed to expel the baby. The doctor directs the mother to push and the delivery of the placenta is typically over with one push.

How long does stage 3 of labor last?

The third stage of labor can last anywhere from 5 to 30 minutes. Putting the baby on the breast for breastfeeding will hasten this process.

Postpartum recovery

Once the baby is born and the placenta has been delivered, the uterus contracts and the body recovers. This is often referred to as the fourth stage of labor.

After the hard work of moving through the stages of labor is finished, a woman’s body will need time to return to its nonpregnant state. On average, it takes about 6 weeks for the uterus to return to its nonpregnant size and for the cervix to return to its prepregnancy state.

Stages of labor and what to expect

During labor, the cervix changes from a tightly closed entrance to a fully open exit for the baby.

Looking at a cervix dilation chart can help people to understand what’s happening at each stage of labor.

Each woman experience labor differently. In this article, we discuss in detail how the cervix is likely to change throughout the stages of labor, and what to expect at each stage.

Most of the time, the cervix is a small, tightly closed hole. It prevents anything from getting into or out of the uterus, which helps to protect the baby.

During labor, intense contractions of the uterus help move the baby down and eventually out of the pelvis, and into the vagina. These contractions put pressure on the cervix and cause it to expand slowly. Contractions tend to get stronger, closer together, and more regular as labor progresses.


Most medical guides divide labor into three stages:

  • Stage one: early, active, and transition labor. Contractions begin, the cervix dilates, and the baby moves down in the pelvis. Stage one is complete when the cervix has dilated to 10 centimeters (cm).
  • Stage two: The body begins pushing out the baby. During this stage, women often feel a strong urge to push. This stage ends with the birth of the baby.
  • Stage three: Contractions push out the placenta. This stage ends with the delivery of the placenta, usually within a few minutes after the birth of the baby.

However, many women in labor may feel that they are experiencing many more stages than this.

Stage one: early labor

In the early stages of labor, the cervix dilates to the following sizes:

  • 1 cm, about the size of a cheerio
  • 2 cm, the size of a small to medium-sized grape
  • 3 cm, the size of a quarter

Late in pregnancy, the cervix may have already dilated several centimeters before a woman experiences any symptoms of labor.

Some women, particularly those who are giving birth for the first time, have difficulty telling whether labor has begun. This is because contractions in early labor are often mild and irregular, growing steadily more intense as the labor progresses and the cervix dilates.

This increase in intensity may take just a few hours or can take many days. Knowing whether this is actual labor can help people to prepare.

During true labor, a person’s contractions:

  • are not just on one side of the body
  • begin at the top of the uterus, and feel like they are pushing down
  • get more intense and regular with time
  • do not stop with rest or taking a warm shower

Some women may benefit from resting or eating a snack at this stage to ensure they have enough energy for the more tiring stages ahead.

Stage one: active labor

During the active stage of labor, the cervix dilates to the following sizes:

  • 4 cm, the size of a small cookie, such as an Oreo
  • 5 cm, the size of a mandarin orange
  • 6 cm, the size of a small avocado or the top of a soda can
  • 7 cm, the size of a tomato

Labor contractions become more intense and regular during active labor. Many women find that the main characteristic of active labor is that the contractions are extremely painful rather than uncomfortable.

At this stage of labor, some women may choose medication, such as an epidural to cope with the pain. Others prefer to manage the pain naturally. Changing positions, moving, and remaining hydrated can help with the pain of active labor.

Stage one: transition phase

During the transition phase of labor, the cervix dilates to the following sizes:

  • 8 cm, the size of an apple
  • 9 cm, the size of a donut
  • 10 cm, the size of a large bagel

For many women, transition is the most challenging stage. However, it is also the shortest. Some people begin feeling an urge to push during the transition stage. It is also common to feel overwhelmed, hopeless, or unable to cope with the pain. Some women vomit.

Some women find that the coping strategies that worked well in the earlier stages of labor are no longer useful. Transition tends to be short and is a sign that the baby will soon arrive. Moving, changing positions, and visualization exercises can help.

The cervix continues dilating during transition, and transition ends when the cervix has fully dilated.

Stage two: full dilation and pushing

Once the cervix has reached 10 cm, it is time to push the baby out. Contractions continue but also produce a strong urge to push. This urge might feel like an intense need to have a bowel movement.

This stage can last anywhere from a few minutes to a few hours. It is often longer for those giving birth for the first time.

Historically, doctors told women to push according to a schedule, to count to 10, and to remain on their backs. Today, the advice is very different, and research says it is safe for women to push according to their body’s cues and for as long as feels comfortable.

Pushing from a standing or squatting position may also help speed things along. Allowing people to push from a range of positions gives the medical staff better access to the woman and baby should they need to assist with the delivery for any reason.

As a woman delivers the baby, she may feel an intense burning and stretching as her vagina and perineum stretch to accommodate the baby. This sensation typically lasts just a few minutes, though some women tear during this process.

Stage three: after the birth

Share on PinterestAfter delivery, the cervix will start to contract to its previous size.

A few minutes after the birth, a woman may experience weaker contractions. After a contraction or two, the body should expel the placenta.

If the body does not entirely expel the placenta, a doctor or midwife may have to help deliver it. Sometimes, they will give a woman an injection of synthetic oxytocin to speed up delivery and prevent excessive bleeding.

Shortly after delivery, the cervix begins contracting back down to its previous size. This process can take several days to several weeks.

As the uterus and cervix shrink, many women will feel some contractions. Most women bleed for several weeks after giving birth.

Labor is different for each woman. It typically lasts longer with a first birth, but the length and type of labor vary greatly between individuals.

Some people experience labor that consists of a weaker type of contraction for days or weeks before giving birth. Others give birth in a matter of minutes, while some labors take days. Most fall somewhere in the middle.

Labor often starts slowly, becoming progressively more intense. It may also start and stop, or slow during moments of stress or intrusion.

Visualizing the cervix expanding might help some people understand the source of labor pain, offering a sense of control and deeper insight into the processes of labor.

Important to know - Health of a Petersburger

The total duration of childbirth and their course


The total duration of childbirth depends on many factors: age, physique and physical condition of the woman, her psychological mood, the speed of cervical dilatation, first pregnancy or repeated, the size of the child, the type of presentation and a number of other points.

Labor activity proceeds differently for all women, but the main periods of childbirth are clearly distinguished: 1st period - the period of contractions, the longest and most intense, 2nd period - the direct birth of a baby, 3rd period - the birth of the afterbirth (placenta). nine0008

First stage of labor (opening period)

As the name implies, during this period there is a gradual opening of the cervix as a result of regular contractions of the uterine muscles. Contractions occur with a decreasing interval, while they themselves become longer and more frequent.
The dilation period is the time elapsed from the onset of regular contractions until the cervix is ​​fully dilated. During this period, the birth canal is prepared for the passage of the fetus through them with all the fetal formations. nine0008

Cervical dilatation occurs gradually: at first the cervix is ​​smoothed out, then the pharynx opens up to 3-4 cm and at the end of the first stage of labor up to 10 cm. This is already a complete dilatation of the cervix. With it, during contractions, the fetal bladder becomes tense and bursts at the height of one of them, the anterior portion of amniotic fluid is poured out.

The first stage of labor is the longest and consists of three phases:

1. Latent phase (lasts 5-6 hours). It is characterized by the establishment of regular contractions, with an interval between them of 10-15 minutes. Latent, or hidden, this phase is called because the contractions of the uterus during it are painless or slightly painful. By the end of the phase, the cervix is ​​definitively flattened and opens about 4 cm.

2. Active phase (lasts 3-4 hours). Contractions become more intense, last at least 20 seconds, and the interval between them is reduced to 5-6 minutes. Normally, during the active phase, amniotic fluid is poured out, which contributes to a faster full disclosure of the uterine pharynx. By the end of the phase, the uterus opens by 8 cm. This phase is not always clearly manifested, but it is nevertheless distinguished due to the usual weakening of contractions during disclosure from 8 to 10 cm. The child's head descends and stands in the narrow part of the small pelvis, which necessitates a slower and smoother process. Already in the transitional phase, the woman in labor feels the desire to push, to push the baby out. But in order for the head to pass through the birth canal without the risk of injury, it is necessary to achieve cervical dilatation up to 10 cm.

Second stage of labor (exile period)

The period of exile is the time from the moment of full opening of the pharynx until the birth of the fetus.

It is the second stage of childbirth that is their culmination, because for a short time (compared to contractions) the long-awaited birth of the baby takes place.

After the discharge of amniotic fluid, contractions temporarily stop. The volume of the uterine cavity decreases, the uterine cavity and vagina appear as a single birth canal. Contractions reappear and become more intense. They are joined by attempts - contractions of the muscle press (abdominal wall, diaphragm and pelvic floor). The frequency and intensity of contractions and attempts are constantly increasing. The head descends and compresses the nerves of the sacral plexus. A woman has a strong desire to squeeze the head out of the birth canal, she is looking for supports for her arms and legs to strengthen her efforts. nine0008

Pushing is a lot of physical work. During attempts, a woman experiences maximum physical stress (blood pressure rises, pulse and respiration become more frequent). During the attempts, the woman holds her breath, and in the intervals between them she rests and "gathers her strength for a new attempt. "

In the process of one of the attempts, the head is born. Next, the shoulders are born (first the front, then the back) and the torso. Following the fetus, the posterior amniotic fluid is poured out with an admixture of cheese-like lubricant. nine0008

A woman in labor, having experienced severe fatigue, rests after hard work (pulse and respiration rate decrease).

Third stage of labor (postpartum period).

The afterbirth period is the time from the birth of the fetus to the birth of the placenta. During this period, the placenta separates from the walls of the uterus and the birth of the placenta (placenta with membranes and umbilical cord).

In the process of separation of the placenta from the walls of the uterus, the uteroplacental vessels are damaged, which is normally accompanied by blood loss in the amount of 100-200 ml, without adversely affecting the woman's condition. After the birth of the placenta, the uterus contracts sharply, becomes dense, which is necessary to stop bleeding in the area of ​​the placental site; its bottom is in the middle between the womb and the navel. nine0008

During this period, the woman's pulse and respiration normalize. Her demeanor is calm. Chills can sometimes be observed (as a reaction to the transferred strong physical stress).

The third period is no longer as exciting and tense as the previous two. The child was born and the matter remains for the small - the separation of the placenta, or placenta. Nature provides for the resumption of contractions a few minutes after the birth of the baby, necessary for effective exfoliation from the uterus of tissues that nourished the fetus during pregnancy (placenta, membranes, umbilical cord). nine0008

Three periods of physiological labor - the natural end of a nine-month wait. Most likely, during the birth process itself, the woman in labor will not care what the period or phase of childbirth is now, but it is still desirable to know about them, at least for greater certainty before going to the hospital.

Cervix: general information, structure

Consultation with a specialist:

The structure of the cervix and its functions

nine0006 The organ has a cylindrical shape, and its inner part is a hollow “tube” lined with epithelial tissue.

The cervix is ​​divided into two regions:

  1. Vaginal. Enters the vaginal cavity. It has a convex shape. Lined with stratified squamous epithelium.
  2. Supravaginal. Lies above the vagina. Lined with columnar epithelium.

The area where the squamous epithelium of the vaginal part changes to the cylindrical epithelium of the cervical canal is called the transformation zone. nine0008

The cervical canal is the central part of the cervix. It has an internal pharynx that goes to the body of the uterus, as well as an external one facing the vagina - it is seen by the gynecologist when examining the patient. In nulliparous women, the external os has a round or oval shape, in those who have given birth, it is slit-like. The channel always contains a certain amount of mucus.

Cervical mucus is a biological fluid, the importance of which in a woman's reproductive health can hardly be overestimated. nine0008

It has antibacterial properties and prevents penetration into the uterine cavity infection. When a woman becomes pregnant, the cervical canal is closed with a dense mucous plug, which reliably protects the fetus from pathogenic microorganisms.

The rheological characteristics of cervical mucus change depending on the woman's monthly cycle. During ovulation and menstruation, it becomes more fluid. In the first case, it helps the sperm to move through the canal, which means it promotes conception. In the second, it facilitates the outflow of menstrual blood. nine0008

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Cervix during pregnancy

The task of the cervix during this period is to protect the fetus from infection and prevent abortion or premature birth.

Shortly after conception, the following changes occur in it:

  • The pink surface of the channel takes on a bluish tint due to the increased pattern of blood vessels. This is facilitated by intensive blood circulation in the uterus. nine0074
  • The mucous membrane becomes softer. This is also due to increased blood circulation and mucus secretion.
  • The cervix descends lower, and the lumen of the canal narrows and is tightly “sealed” with a cork.

According to these changes, the gynecologist can visually determine pregnancy a few weeks after conception.

As the fetus develops in the womb, the length of the cervix gradually decreases. It is very important that it matches the gestational age, since a too short neck can threaten miscarriage or premature birth. nine0008

In the third trimester, the cervix becomes shorter, softer, and closer to childbirth, it begins to open slightly. The mucus plug may come off within a few weeks of labor.

Cervix and childbirth

Before the onset of active labor activity, the organ shortens to 1 cm and its anatomical position changes. The neck, previously directed slightly backward, moves to the center and is located under the head of the child. nine0008

As labor proceeds, the cervix shortens and smoothes, and its lumen gradually opens so that the baby's head can pass through it. Full dilatation of the cervix - about 10 cm.

At the first birth, the internal os opens first, and then the external one. With subsequent disclosure occurs at the same time, so childbirth is faster.

Diseases of the cervix

Diseases of this organ are divided into the following types: nine0008

  1. Background - not associated with malignant processes.
  2. Precancerous (dysplasia) - there are areas with damaged cell structure (atypical cells), but without malignant changes.
  3. Cancer - malignant changes in the cellular structure.

Most of the diseases of the cervix occur without symptoms. In some cases, they may be accompanied by increased discharge, discomfort during sexual contact, bloody discharge. But even cervical cancer can give severe symptoms only at a late stage, when the disease is difficult to cure. nine0008

Cervical pathology can only be detected by specialized methods during a gynecological examination.

These methods include:

  • Pap smear. Allows you to suspect the presence of atypical cells and the degree of their damage, to identify the inflammatory process in the cervix. Based on the results of the Pap test, further examination of the patient is performed.
  • Colposcopy. Visual examination of the mucous membrane of an organ using an optical device - a colposcope. During colposcopy, various tests can be performed to identify damaged areas, as well as a tissue fragment (biopsy) is taken to perform a histological examination. nine0074
  • Histological analysis. The study of the cellular structure of the selected biomaterial under a microscope. The diagnosis of "dysplasia" and "cervical cancer" can only be made based on the results of histology.
  • Flora smear. It is performed to identify pathogenic flora and determine its sensitivity to antibiotics and antimycotics (antifungal drugs). The analysis is necessary for organizing the treatment of inflammatory processes.

Your doctor may also order blood tests for sexually transmitted diseases (STDs) and human papillomavirus (HPV). Some strains of HPV are oncogenic and provoke dysplasia and cervical cancer. nine0008

Oncological processes of the cervix are formed rather slowly, passing through three stages of dysplasia - mild, moderate and severe. And even the third degree of dysplasia can be treated with full preservation of the reproductive function of a woman.

Early stage cervical cancer also has a favorable prognosis for the patient if treatment was started on time. Whether the organ will be preserved at the same time, the doctor decides according to indications.

At later stages, a radical hysterectomy is practiced - removal of the uterus with appendages, pelvic lymph nodes and the upper region of the vagina. nine0008

We repeat that dysplasia and subsequently cervical cancer develop slowly, almost asymptomatically, but are easily diagnosed during a medical examination. Whether a woman gets this type of cancer or not is largely a matter of her personal responsibility. An annual visit to a gynecologist for preventive examinations will protect you from this serious illness and preserve your reproductive health.

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