The contractions pull on the thick tissues of the cervix, causing it to efface or get thinner and also dilate or open up, so then the fetus can leave the uterus and enter the world.
From the moment true contractions begin to the baby's delivery usually takes about 12 to 18 hours for a first-time pregnancy, and about half that time for subsequent pregnancies.
Once they start, true labor contractions progress in frequency, duration, and intensity, and they can feel like waves that build up to a peak intensity and then gradually decrease.