Stages of Labour
There are three stages of labour.
- First stage - (which includes the latent and active phases) it is characterised by the onset of strong, painful, regular contractions, up to your cervix (neck of the womb) being fully dilated (10 centimetres)
- Second stage - from full dilatation of the cervix to the birth of your baby.
- Third stage - from the birth of your baby until after the placenta (afterbirth) has been delivered.
The first stage
This information is designed to help you recognise the start of your labour and offer you advice and tips for coping with the latent (early) phase. You will be encouraged to remain at home during the latent phase, as research has shown that fear and anxiety often inhibit labour and, in turn may lead to a cascade of intervention; so the best place for most woman in this stage of labour is at home with familiar people and surroundings.
Labour is as much a psychological process as a physical one, so relax, create an air of calm, be prepared and informed. Remember that labour is a normal process; it is a journey that can take a long time and all labours are different, even if you have laboured before. The onset and duration of labour varies widely from one woman to another.
The first stage of labour can be divided into two phases:
- The latent phase: the very first part of your labour. First time mothers tend to have longer latent phases that mothers who have laboured before.
- The active phase: established labour.
Prior to labour starting , the cervix is long and firm. During the latent phase, the muscles of the uterus (womb) contract and make the cervix shorter, thinner and softer. The cervix also moves forward to an anterior position in the pelvis and then gradually dilates. The latent phase is slow and steady; it can take from 12 hours to three days, although it is often considerable shorter for second and subsequent babies.
What it feels like
- You may experience backache, or period type tightenings, which are uncomfortable but not painful. These may go on for some hours and then fizzle out completely. They may even return again the next day. This is normal and is just your body's way of preparing itself for labour.
- Your contractions may be irregular in strength, length and duration but won't be as strong as those in established labour.
- You may find that you can still talk through your contractions and potter around the house.
- Sometimes the contractions in the latent phase can be quite painful, though they may be dilating your cervix slower than you would like. If this happens, do not worry- each woman has her own rhythm and pace of labour. Some women may not even be aware of these early contractions and may proceed directly to the established stage of labour.
- You may or may not pass a show (a mucousy plug) from the cervix. It is not uncommon for this to contain a small streak of blood within it. If the blood loss is more than a streak or you are concerned about the amount, you should contact your midwife or the hospital for advice immediately.
Self help tips
We recommend that you stay at home for as long as possible. There is evidence that the further on in labour you are when you come in to hospital, the more likely you are to have a normal birth. There are things you can do to help yourself such as:
- Eat and drink little and often to maintain your energy levels.
- Try having a warm bath or shower.
- Find a balance between resting and mobilising - both are very important.
- Practice relaxation and hypnobirthing techniques.
- Take a mild pain killer such as Paracetamol.
- Try massage.
- Apply a TENS (transcutaneous electrical nerve stimulation) machine if you have hired or purchased one.
The first stage of labour - the active phase
The active phase begins when your cervix is four centimetres dilated and progress becomes quicker. Your contractions will become more frequent, longer and stronger, and your cervix will begin steadily dilating. As a general rule, once you have had regular, painful contractions (each lasting about 60 seconds) every three to four minutes for at least an hour, you are usually considered to be in established labour.
When to call a midwife
Please call the hospital for advise if:
- You think you are in active labour
- You have any concerns about your babys movements
- Your waters break
- You feel unwell
- You have any other concerns
Following a discussion with the midwife you may be asked to attend labour ward triage/maternity assessment centre where the wellbeing of you, your baby and the stage of your labour will be assessed. If you are planning a homebirth the community midwife will be contacted and attend if appropriate. Following assessment you may be advised to return home to relax to help speed up labour, be admitted to the Antenatal Ward or come in to the Labour Ward if your labour is established/active.
|Frimley Park Hospital - Labour Ward Triage||Wexham Park Hospital - Maternity Assessment Centre|
|01276 604527||0300 615 4520|