Labour is divided into three stages. These are:
- The First stage: this is when contractions gradually open your cervix (the neck of your uterus) and your cervix dilates.
- The Second Stage: this is when the baby is pushed down the vagina and is born
- The Third Stage: this is when the placenta is delivered through your vagina
First Stage of Labour
Throughout your pregnancy your cervix has been closed and plugged with mucus in order to protect your baby. During the first stage of labour your cervix needs to open or dilate to 10cms in diameter in order to allow the baby to pass through. Before your cervix begins to dilate it needs to soften. Your cervix starts out firm like your nose but needs to become soft and stretchy like the texture of your lips. This sometimes begins to happen during late pregnancy before labour has actually started. Sometimes your cervix may also begin to open a little either days or hours before labour, if this happens your mucus plug may fall out. This is called your ‘show’ and may be a sign of labour.
The First stage of labour consists of three more stages, early labour, active labour and the transitional phase.
Early Labour
You may not even notice that you are in early labour as your uterus will be contracting very gently to open your cervix to about 3 or 4 centimetres. You may feel a dull backache or mild period-like cramps. However, some women may notice that the gentle contractions are getting more painful and that they are coming more regularly and frequent. These are different to Braxton Hicks contractions which are usually painless and very irregular.
Although every woman labours differently, as a rough guide early labour contractions are more than 5 minutes apart and only up to 30 or 40 seconds long. You should still be able to talk through them and carry on with your usual routine. Sometimes early labour can start and stop and for others it gradually progresses into active labour.
Active Labour
This stage of labour is when your cervix opens from 4 centimetres to 10 centimetres. This usually takes less time than going from closed to 4 centimetres but it may still take a few hours.
Your contractions will be much more powerful now and will build up to a peak before fading again. It is unlikely that you will be able to talk through your contractions now and you may need to start using your breathing techniques through them.
Your contractions may be lasting between a minute and 90 seconds and may be coming as often as every three or four minutes. The contractions will be very powerful and intense and you should use the time between them to move around, get comfortable, have something to eat or drink and prepare for the next one.
It is quite likely that as you progress through this stage the contractions will become painful enough for you to consider pain relief, though many women are able to carry on with none.
Transitional Phase
This is the stage where you move from the First stage of labour into the second stage. The transitional phase usual starts when you are about 8 centimetres dilated and ends when you begin to get the urge to push.
Your contractions will last longer and feel stronger. It is quite common for your waters to break in this stage, if they have not already.
How to cope with the first stage of Labour
- Stay at home as long as you can
- Make yourself comfortable
- Empty your bladder whenever necessary
- Listen to your body
- Try different positions and moving around
- If you feel the need to scream or shout do not feel embarrassed to do so
- Stay hydrated by drinking fluids. You may find isotonic (sports) drinks are useful to keep your energy levels up
- You may want to snack although many women prefer not to
- Use your breathing and relaxation techniques
- Ask your birthing partner to rub or massage your back
- Take a warm bath or try using a birthing pool to help ease the pain
- Use a TENS machine
- If you need further pain relief, talk to your midwife
Second Stage of Labour
During this stage you will push your baby down through the birth canal and your vagina.
It is important to listen to your body as with each contraction you may get one or two strong urges to push. As you push, your baby will move through the birth canal but at the end of each contraction, your baby will probably slip back a little. If you feel this happening do not worry, your midwife will ensure that baby is progressing forwards. When your baby is near your vagina, you may feel a stinging and hot feeling: this is normal and it is caused by your vagina stretching around your baby’s head. When this happens, your midwife will tell you that she can see your baby’s head crowning and some women may want to reach down and feel their baby’s head.
At this stage, your midwife may ask you to stop pushing for the next couple of contractions as this helps the baby glide out more gently and slowly and helps to avoid you tearing or needing an episiotomy and requiring stitches.
A baby is usually born head first facing towards your back. The baby’s shoulders and head then turn sideways and the baby is born. At this stage the baby’s umbilical cord is clamped and cut. Your midwife will then need to carry out some newborn checks on your baby.
The second stage of labour is can take several hours although is usually quicker if this is not your first baby.
How to cope in the Second stage of labour
- Ensure your bladder is empty as if it is full it can block your baby from exiting
- Do not hold your breath when you are pushing
- Try not to lie on your back
- If you need to lie down, try and lie on your left side and lift your upper leg to open your pelvis.
- If you have had an epidural, you may be unable to feel the urge to push. Make sure you listen to and follow the instructions given by your midwife
Third Stage of Labour
Once your baby has been born, the third stage of labour immediately begins. The third stage is the delivery of the placenta. Gentle contractions will begin which you may not even be aware of. These contractions help the placenta come away from your uterus and together with the membranes of the empty bag of waters, will drop to your uterus and out through your vagina. You may feel the urge to push it out.
Most hospitals will offer you an injection in your thigh immediately after your baby has been born which speeds up the delivery of the placenta. This is a drug called Syntocinon which can also stop women from experience very heavy bleeding known as post-partum haemorrhage.
After the placenta and membranes have been delivered, your midwife check it to make sure it has all come away cleanly and will check your tummy to ensure that your uterus is contracting to stop excess bleeding
by Jenny, mum to William and James
