Stages of Labour
There are three stages of labour.
- First stage (which includes the latent and active phases) describes the time when labour starts, to when the cervix is fully dilated (10 centimetres). The first stage can be divided into two phases:
- The latent phase: the very first part of your labour. This is commonly defined as the time when there are contractions, and cervical thinning and dilation up to 4 centimetres. First time mothers tend to have longer latent phases than mothers who have laboured before
- The active phase: is usually categorised as the period after the latent phase of labour, whilst there are contractions and the cervix dilates to full dilatation (10 centimetres).
- Second stage describes the time between full dilatation of the cervix to the birth of your baby.
- Third stage describes the time after the birth of your baby until after the placenta (afterbirth) has been birthed/delivered.
The first stage: The latent/early phase
What happens during this phase?
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 will the latent phase of labour feel like?
During the latent phase of labour you may feel period pains, cramping, thigh pain, back ache and for many women, there may also be painful contractions during this time.
- 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 and most commonly will not 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.
- You may also need to empty your bowels more regularly than usual.
If you suspect your waters have broken, you are worried about baby's movements, or you have any bleeding, you should call us for advice. You can also call us for advice during the latent phase.
Everyone will experience this first part of labour differently, and you may experience all or very few of these symptoms.
What should I do in the latent phase?
If all is well with you, your baby and your pregnancy, you may be encouraged to remain at home during the latent phase, as research has shown there is an increased risk of intervention if women are admitted in this phase. Being at home, in familiar surroundings, feeling relaxed will encourage labour to progress naturally.
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.
There are things you can do to help yourself such as:
- Continue as normal!
- Eat and drink little and often to maintain your energy levels.
- Perhaps distract yourself by walking, spending time with family/friends, baking, watching a movie or listening to music. This will help boost Oxytocin - the happy/love hormone partly responsible for progressing labour.
- 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 painkiller 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 and commonly strong, painful or uncomfortable contractions (each lasting about 60-90 seconds) every three to four minutes for at least an hour, you are usually considered to be in established labour.
See here for what is available to support you and help you cope with the active phase of labour.
When to call a midwife
Please call 0300 013 2004 for advice if:
- You think you are in active labour
- You have any concerns about your baby's 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 to the Labour Ward if your labour is established/active.