The 3 Stages of Labour and Birth

Labour is a continuous process but it has been divided into stages by medics to make it easier to understand.  Most women experience it as a continuum that increases in intensity to the moment of birth, but there are many different patterns.  Progress may be rapid and incessant, it may be slow and calm or variable.

The First Stage: 2-20 hours

Is marked by progressive dilatation of the cervix until its opening reaches 10cm.  There are

two phases, the latent phase (0-3cm) and the active phase (3-10cm).

Latent Phase: 1-12 hours

While the cervix opens to a diameter of 3 cm is called pre-labour.  Usually, but not always contractions are mild, building up in intensity and frequency.  Sometimes the cervix begins

to dilate before labour, this is more common in second or subsequent labours.

Active Phase: 1-6 hours

Contractions usually become more frequent.  This is commonly the most intense part of the process.

Transition: 5 min – 2 hours

This is the phase when a lot of women feel they can’t go on.  It is the bridge between the first and second stage, when the cervix reaches full dilatation.  At the end of the transition descent of the baby’s head on to the pelvic floor and powerful contractions stimulate the reflex urge to bear down (push). Don’t panic. If things slow down at the end of the first stage and you don’t feel ready to push – have a break! Wait for the urge to push, work with your body, it’s going to do 80% of the work for you.

The Second Stage: 5 minutes – 2 hours

Involves bearing down and pushing and culminates with the birth of your baby.

Make a noise. Singing or making sounds with your out breath will keep your mouth open and relaxed – this has a direct effect on the vagina and pelvic area.

Don’t push before you’re ready. If you think you are fully dilated but your midwife is telling you you’re not – pant slowly or blow.  Pushing against a cervix that isn’t completely dilated can cause it to swell, delaying delivery.

The Third Stage: 5-60 minutes

Is a time for the first skin to skin moment with your baby and ends with the placenta and membranes being delivered.  This maybe ‘managed’, the cord is clamped and cut and injection given into the mother’s thigh to encourage a speedy delivery of the placenta.  Or ‘physiological’ when baby is left attached to the cord, placenta and mummy until cord has stopped pulsating and placenta is removed.

How Labour May Begin and When to Call for Help

Stay at Home

A Show: A mucus plug seals the entrance to the cervix this can be released via the vagina when the cervix begins to ripen.  The mucus should be jelly like, clear or opaque, may be streaked with old (brownish) blood).  Possibly the size of a tea spoon.

Things to check: If there is fresh, red blood, phone the midwife/birth centre centre/hospital.

Contractions may be intermittent to begin with, come and go, some strong some weak, can

go on like this for a couple of days or so in a long latent phase.

Menstrual like cramp in your lower belly, lower back, thighs or all 3.  Contractions may make you feel nauseous.

Usually become longer, stronger, closer together.  The time is measured from the beginning

of one contraction to the beginning of the next.

Powerful contractions usually begin at spaces of 15 or 20 minutes and gradually become more frequent.

Phone the Midwife when…

When you know you are having regular contractions call to let her know you are in labour.  

She may ask the intervals of the contractions.

- If pain is constant, doesn’t come and go.

- If your waters break (spontaneous rupture of the membranes – SROM).  The amniotic fluid should be clear or straw coloured.  It usually has a sweet smell unlike urine.  Tell mid wife if you see flecks of brown/greenish-black in the waters.

-If you feel anxious, panicky or stressed.

- If the timing of your contractions changes very quickly.

- If you are bleeding

- If there haven’t been any fetal movements for a few hours and you are worried.

- If you feel the urge to push.

Go to Hospital when …

Strong regular contractions coming 4 minutes apart and lasting up to 45 seconds in length – remember if you go too early you may be sent home.  You may have to book into the labour ward via the triage desk; where they will assess whether or not you are in ‘true’ labour (at least 3cm dilated).  Some hospitals say contractions need to come 3 in every 10 minutes.

Moving from your home to the hospital may alter your state of mind considerably and you may take time to adjust.  Contractions may diminish when you move and could take an hour

or two to speed up.

Suggested Activities for Birthing Partner

If pre labour is prolonged you will need both commitment and patience.  Here are some

ways to help yourself and your partner.

What You Can do for Her

- Be there and listen: at times she may need nothing more than your quiet presence.

- Choose appropriate music and make soothing drinks and snacks.

- Help her stay calm by being calm yourself; how you feel will translate in your words, your attitude, your body language and your touch.

- Help with breathing and visualisation techniques to encourage the cervix to open.

- If she feels like a light massage, giving her one may relax you at the same time.

- Encourage her to relax and reserve energy.  If might help to make the sitting room cosy or remake the bed, choose a video to watch or walk around the house or out in the fresh air

with her.  If her contractions are widely spaced she may enjoy playing a simple game.

- Do what you can to help her see the funny side: a sense of humour and a few giggles can

be wonderfully therapeutic at what is potentially a very tense time.

- If she feels like having a bath, run the water and light candles in the bathroom to create a soothing atmosphere.

- One of your roles may be to time the contractions every now and gain.

- If she wants to use aromatherapy or homeopathy, she may ask your help.

What You Can do for Yourself

- DO what you need to stay calm and rest and sleep to preserve your energy for labour.

- REST as much as possible, you will need energy for labour and birth, if you can, get some sleep.

- EAT nutritious food to keep your energy levels up.

- A session of light EXERCISE or a quick run and a shower may help boost your energy and lift your spirits.

- Pack a BAG for hospital, including some light snacks or a sandwich.

- If you are nervous, CALL a friend or your midwife.  It is essential to keep in touch with the birth team.

- If labour becomes intense unexpectedly, take 5 minutes to DELEGATE task so you can focus on your partner.