No one can tell you what your experience of labour will be like or how
long it will last. There's plenty you can do to prepare yourself,
though. It helps if you know what to expect. We take you through the
stages of labour, from the first hints that things are on the move to the birth of your baby.
In the first stage of labour your cervix has to open so that your baby can be born. By the end of this stage your cervix will be fully dilated, or open to about 10cm in diameter.
First, your cervix has to shorten and soften. Feel your nose: it's firm and resists your touch. Now feel your lips: they're soft and stretchy. Your cervix starts out firm like your nose, and has to become soft and stretchy like your lips.
These changes may start in late pregnancy, before labour has begun, particularly if this is your first baby. Days or hours before labour starts your cervix may start to open a little, and the mucus plug may come out. This is called a show. It looks a bit like jelly and can be stained with blood.
If you've had a baby before, a show could be a sign that labour has started.
Early labour?
During early labour, your cervix starts to open and widen. It'll go from being closed to about 3cm or 4cm dilated. You may not notice this starting, as your uterus may be contracting very gently. It may feel like the mild cramps you get with your period, or a dull ache or backache. You may even be several centimetres dilated before you realize you're in labour.
Many women, however, notice that they're getting increasingly painful contractions and that they're coming regularly. These are different to Braxton Hicks contractions, which are irregular and painless.
You'll have your own rhythm and pace of labour. As a rough guide, early contractions are more than five minutes apart and short, perhaps only 30 or 40 seconds long. You'll be able to talk through them and carry on with your normal routine, if you want to.
For some women, early labour starts and stops. For others, it progresses smoothly into active labour.
Active phase of labour
As labour progresses your contractions usually become longer and more frequent. You've moved into the active phase of labour. This is when your cervix opens from 3cm or 4cm to 10cm.
Contractions are more powerful now. A contraction usually starts gradually, building up to a peak of intensity before fading away. You probably won’t be able to talk through these contractions. You may have to stop and breathe through them. Relaxation techniques will help you to keep calm and control your breathing.
Contractions may come as often as every three to four minutes and last 60 to 90 seconds. They'll feel very intense. Between contractions, you'll be able to talk, move around, have a drink or something to eat, and prepare yourself for the next one. Contractions in the active phase open your cervix more rapidly, but it may still be many hours before your cervix is fully dilated.
Transitional phase of labour
The transitional phase happens when you move from the first stage of labour to the second, pushing stage. It often starts when your cervix is about 8cm dilated. It ends when your cervix is fully dilated, or when you get the urge to push.
You may have less frequent, but much stronger and longer lasting contractions. Sometimes they come in a double wave. Each one may peak, start to fade but then increase in intensity again before fading away completely. It's common for your waters to break just before or during transition.
Women feel this stage in different ways. It can be intense and overwhelming. You may feel zoned in to your labour and only able to make abrupt demands. You may shout and feel impatient with everyone. You might feel shaky, shivery and sick. Or you may feel none of these things!
If you're planning to give birth without pain relief, this might be the most intense part of labour for you and your birth partner. You may want to tear up your birth plan. You may demand an epidural, when you'd hoped to avoid one. Or if you'd planned a home birth, you may want to go to hospital.
Transition means that you're nearly there. With support you can get through this stage. Thankfully, there's often a lull at the end of transition when the contractions pause and you and your baby can rest.
Tips for the first stage of labour
You'll feel the pressure of your baby's head between your legs. With each contraction you may get two or three strong urges to push. Listen to your body and push when you get a strong urge. With every push, your baby will move through your pelvis a little, but at the end of the contraction, he'll probably slip back again!
Don't despair. As long as your baby keeps on moving a little further each time, you're doing fine. When your baby's head is far down in your pelvis, you'll probably feel a hot, stinging sensation. This will happen as the opening of your vagina starts to stretch around your baby's head.
Your midwife or Obstetrician will tell you when she can see your baby's head, and he is no longer slipping back between contractions. Your midwife may ask you to stop pushing and take short, panting breaths for the next two or three contractions. This helps make sure that your baby is born gently and slowly, and helps you avoid tearing or needing an episiotomy.
If you've had a baby before, the second stage may only take five or 10 minutes. If this is your first baby, it may take several hours.
Tips for the second stage of labour
Many hospitals routinely give you an injection which makes the placenta come out. This is called a managed third stage. This speeds up the third stage and you won't have to do any pushing.
Your midwife ordoctor will examine the placenta and membranes to make sure that nothing has been left behind. She will also feel your tummy to check that your uterus is contracting hard to stop the bleeding from the place where the placenta was attached.
You may want to have a look at the placenta. After all, it has been your baby's lifeline through your pregnancy.
Tips for the third stage
What are the stages of labour?
Labour moves forward in three clear stages:- First stage: when contractions gradually open up the neck of your uterus (cervix). The first stage of labour consists of early labour, active labour and the transitional phase.
- Second stage: when you push your baby out into the world.
- Third stage: when you deliver the placenta.
What happens in the first stage of labour?
During pregnancy your cervix is closed and plugged with mucus, to keep out infection. Your cervix is long from top to bottom and firm, giving a strong base to your uterus (womb).In the first stage of labour your cervix has to open so that your baby can be born. By the end of this stage your cervix will be fully dilated, or open to about 10cm in diameter.
First, your cervix has to shorten and soften. Feel your nose: it's firm and resists your touch. Now feel your lips: they're soft and stretchy. Your cervix starts out firm like your nose, and has to become soft and stretchy like your lips.
These changes may start in late pregnancy, before labour has begun, particularly if this is your first baby. Days or hours before labour starts your cervix may start to open a little, and the mucus plug may come out. This is called a show. It looks a bit like jelly and can be stained with blood.
If you've had a baby before, a show could be a sign that labour has started.
Early labour?
During early labour, your cervix starts to open and widen. It'll go from being closed to about 3cm or 4cm dilated. You may not notice this starting, as your uterus may be contracting very gently. It may feel like the mild cramps you get with your period, or a dull ache or backache. You may even be several centimetres dilated before you realize you're in labour.
Many women, however, notice that they're getting increasingly painful contractions and that they're coming regularly. These are different to Braxton Hicks contractions, which are irregular and painless.
You'll have your own rhythm and pace of labour. As a rough guide, early contractions are more than five minutes apart and short, perhaps only 30 or 40 seconds long. You'll be able to talk through them and carry on with your normal routine, if you want to.
For some women, early labour starts and stops. For others, it progresses smoothly into active labour.
Active phase of labour
As labour progresses your contractions usually become longer and more frequent. You've moved into the active phase of labour. This is when your cervix opens from 3cm or 4cm to 10cm.
Contractions are more powerful now. A contraction usually starts gradually, building up to a peak of intensity before fading away. You probably won’t be able to talk through these contractions. You may have to stop and breathe through them. Relaxation techniques will help you to keep calm and control your breathing.
Contractions may come as often as every three to four minutes and last 60 to 90 seconds. They'll feel very intense. Between contractions, you'll be able to talk, move around, have a drink or something to eat, and prepare yourself for the next one. Contractions in the active phase open your cervix more rapidly, but it may still be many hours before your cervix is fully dilated.
Transitional phase of labour
The transitional phase happens when you move from the first stage of labour to the second, pushing stage. It often starts when your cervix is about 8cm dilated. It ends when your cervix is fully dilated, or when you get the urge to push.
You may have less frequent, but much stronger and longer lasting contractions. Sometimes they come in a double wave. Each one may peak, start to fade but then increase in intensity again before fading away completely. It's common for your waters to break just before or during transition.
Women feel this stage in different ways. It can be intense and overwhelming. You may feel zoned in to your labour and only able to make abrupt demands. You may shout and feel impatient with everyone. You might feel shaky, shivery and sick. Or you may feel none of these things!
If you're planning to give birth without pain relief, this might be the most intense part of labour for you and your birth partner. You may want to tear up your birth plan. You may demand an epidural, when you'd hoped to avoid one. Or if you'd planned a home birth, you may want to go to hospital.
Transition means that you're nearly there. With support you can get through this stage. Thankfully, there's often a lull at the end of transition when the contractions pause and you and your baby can rest.
Tips for the first stage of labour
- Listen to your body and try different positions.
- Empty your bladder often.
- Take a warm shower or bath or use a birth pool to ease the pain.
- Use Entonox (gas and air) to take the edge off the contractions.
- If you need something stronger, ask your midwife for Demerol or an epidural.
- If your labour slows, follow our tips for speeding up labour yourself.
What happens in the second stage of labour?
This is the stage of labour when you push your baby down your vagina (the birth canal) and, at long last, you meet him or her for the first time.You'll feel the pressure of your baby's head between your legs. With each contraction you may get two or three strong urges to push. Listen to your body and push when you get a strong urge. With every push, your baby will move through your pelvis a little, but at the end of the contraction, he'll probably slip back again!
Don't despair. As long as your baby keeps on moving a little further each time, you're doing fine. When your baby's head is far down in your pelvis, you'll probably feel a hot, stinging sensation. This will happen as the opening of your vagina starts to stretch around your baby's head.
Your midwife or Obstetrician will tell you when she can see your baby's head, and he is no longer slipping back between contractions. Your midwife may ask you to stop pushing and take short, panting breaths for the next two or three contractions. This helps make sure that your baby is born gently and slowly, and helps you avoid tearing or needing an episiotomy.
If you've had a baby before, the second stage may only take five or 10 minutes. If this is your first baby, it may take several hours.
Tips for the second stage of labour
- Empty your bladder, if you haven't done so recently.
- Don't hold your breath when you're pushing.
- Try an upright position, if possible, so gravity can help your baby be born.
- If you're very tired or have had an epidural and have to lie down, lie on your left hand side. Ask your birth partner to support your upper leg. This will take the pressure off your lower back and open up your pelvis.
- If you've had an epidural and can't feel the urge to push, listen to your midwife or doctor. She'll tell you what to do.
What happens in the third stage of labour?
Once your baby is born, the third stage begins. Contractions, weaker this time, will start up again. These will make the placenta gradually peel away from the wall of your uterus. You may get the urge to push again. The placenta, with the membranes of the empty bag of waters attached, will drop to the bottom of your uterus and out through your vagina.Many hospitals routinely give you an injection which makes the placenta come out. This is called a managed third stage. This speeds up the third stage and you won't have to do any pushing.
Your midwife ordoctor will examine the placenta and membranes to make sure that nothing has been left behind. She will also feel your tummy to check that your uterus is contracting hard to stop the bleeding from the place where the placenta was attached.
You may want to have a look at the placenta. After all, it has been your baby's lifeline through your pregnancy.
Tips for the third stage
- Hold your new baby next to your skin and, if you're going to breastfeed, offer your breast as soon as possible. This will stimulate hormones to make the placenta separate.
- Have a snack, or lie back and rest as your partner cracks open the champagne!
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