The three stages of labour and what to expect

You are now at a point in your pregnancy where labour is only a matter of weeks away and you are very likely to be wondering about what will happen. The first time you face labour may well be a time of great nervousness and anxiety, but also excitement at the prospect that this physical event will lead to you finally meeting your baby.

So, here’s how it should progress. Labour is marked by three stages. These are:

• First stage – early contractions that build in intensity as your cervix dilates ready for you to push
• Second stage – when your baby travels down the birth canal and is born
• Third stage – delivery of the placenta

Recognising the signs that labour has begun

The first stage of labour can be divided into its own three clear phases. The phases allow for your cervix to thin, shorten and change position (also known as effacement) in preparation for birth. These are:

• latent – first signs of contractions, which will be short in length with long intervals
• active – increased regularity and strength of contractions
• transitional – long, strong and regular contractions and feeling an urge to push

First stage – the early or latent phase

During the early/latent phase your contractions will be working to dilate your cervix to around 3cm. At first you may experience a feeling a bit like cramp, back-ache or menstrual pains, but you will probably be able to carry on with your usual routine and remain communicative throughout.

Contact your antenatal unit or midwife to let them know that you think labour has begun; unless you have complications you will be advised to stay at home and asked to monitor progress. You may find it helpful to keep a note of contractions and any other symptoms, such as vomiting or your waters breaking.

At this stage pain management methods you could use would be:

• a TENS machine
• a birthing ball
• a warm bath (unless you feel your waters may have broken)

Sometimes this phase can take days (yes days) and it is important that you continue to eat and drink and find ways to rest and relax.

First stage – the active phase

Once the active stage is in progress you will really be feeling your contractions because they will have increased in length and strength as the cervix continues to dilate to about 8cm. Your contractions could last for over a minute and occur at three to four minute intervals.

As the labour intensifies, you may find that you will only be able to focus on your contractions. Try to find ways to manage and control your breathing to cope with the increasing sensations of contractions on your labouring body. You may have learnt some pain management techniques at your antenatal class as well as ways to make yourself comfortable as your labour progresses.

Some women may also be sick too. This is quite common and provides a way for your body to clear the digestive system in preparation for the birth of your baby.

Once your contractions start to increase and get stronger you will need to move to your place of birth. Typically, if the contractions are so strong that you can no longer talk while they are happening, you could be close to birth.

If you are still at home, your midwife or the labour ward will need to be kept informed of your progress so that they can advise you when to come in to the hospital. Don’t forget to take your pre-packed hospital bag containing all you’ll need for you and your baby!

First stage – the transitional phase

When you arrive at the labour ward you will be asked if you have a birth plan. It is possible that you may want some pain relief to help you through the contractions. The midwives will talk this through with you and respond as you wish.

The contractions you are experiencing might be making you feel tired, shaky and shivery. As they intensify you will become fully dilated to 10cms and begin to feel the urge to push.

This is also typically the time at which your waters are most likely to break and sometimes there could also be a ‘show’ of blood and mucus.

This stage is generally the most intense and testing, and you may start to find the pain becomes unbearable or feel that you don’t want to carry on. You may also get into a zone during a contraction and your communication will be limited and not always polite.

Try not to worry; all this is normal. In fact, you are very close to the moment when you will meet your baby. Hang on in there.

The second stage of labour – delivering your baby

By now, you are fully dilated and the midwives will be present as you start to push.

This will be relatively quick part of the labour compared to the first stage, and the birth of your baby may take anywhere from a few minutes to a couple of hours. As each contraction takes place you will feel a strong urge to bear down and push. You will be helped to find a position in which you feel comfortable.

Your baby’s head will be low in your pelvis and, as each contraction takes place, will move further down the birth canal until the head starts to emerge. When the midwife sees your baby’s head (crowning) you may be asked not to push. This is to help control a careful delivery. The emergence of your baby’s head is the hardest part of the delivery, after which the rest of your baby’s body will usually follow in one contraction.

If all is well, your baby will quickly be passed to you for that first skin to skin contact. A wonderful, incredible and precious moment for both mother and the baby

The third stage of labour – delivery of the placenta

There is still one last part of labour to be completed; delivery of the placenta. Some mums prefer to give birth to the placenta naturally whilst others will choose to be given an injection by the midwife to speed its delivery. When this happens, you will start to feel a further contraction and another urge to push. This is the moment where the placenta detaches from your uterus wall and the placenta is released.

You may also be given vitamin K and any necessary attention to repair any tear to the perineum or vagina incurred during the delivery of your baby.

And that’s it – you and your baby will be checked over and soon, if all is well, you will be going home.