FIGO Stages of Labor: A Critical Clarification
There is no FIGO staging system for labor—FIGO (International Federation of Gynecology and Obstetrics) staging systems are used exclusively for gynecologic malignancies, not for the physiologic process of childbirth.
What FIGO Actually Stages
FIGO develops staging classifications for:
- Cervical cancer - Clinical staging based on tumor extension, with stages ranging from IA1 (minimal invasion) to IVB (distant metastases) 1
- Endometrial (uterine) cancer - Surgical/pathologic staging system updated in 2009, with Stage IA (<50% myometrial invasion) through Stage IV (distant spread) 1
- Uterine fibroids - FIGO classification system (not staging) categorizes fibroids by location (Types 0-8) based on their relationship to the uterine cavity and serosa 2, 3
Common Pitfall: Confusing FIGO's Role
The confusion likely stems from FIGO's recent work on labor management bundles, which are clinical care protocols—not staging systems. FIGO has published "Prep-For-Labor" triage bundles covering four clinical scenarios: preterm labor, induced/spontaneous labor at term, cesarean delivery, and newborn care 4. These are 2-minute triage methods to distinguish low-risk from high-risk pregnancies, not stages of labor 4.
Traditional Stages of Labor (Not FIGO)
Labor is traditionally divided into three stages based on obstetric physiology:
- First stage: Onset of regular contractions to complete cervical dilation (10 cm)
- Second stage: Complete dilation to delivery of the baby 5
- Third stage: Delivery of baby to delivery of placenta
FIGO has published good clinical practice recommendations for managing the second stage of labor, emphasizing skilled birth attendants and appropriate resource allocation 5, but this does not constitute a "FIGO staging system for labor."
FIGO's Actual Contributions to Labor Care
FIGO provides evidence-based guidelines for intrapartum fetal monitoring, including cardiotocography (CTG) classification templates introduced in 2015 (FIGO-15) to assess fetal well-being during labor 6. However, these classify fetal heart rate patterns (normal, suspicious, pathological), not stages of labor 6.