The Latent Phase
It may take some time for your body to be ready to establish labour. This time period will vary from person to person.
This stage may present with back pain, or irregular contractions. These can often stop and start.
As well as the contractions you may also noticed a bloody mucus in your underwear or upon wiping after going to the toilet, this will be your show which is normal.
Subtle and important changes are beginning to happen, and your contractions have started, which will make your cervix gradually shorten, thin and start to open up (dilate). Usually, this is the longest stage (more so if this is your first baby) and can last longer than 3 days.
If you are booked for a home birth it is a good idea to let the midwifery team know that you have started having some contractions. The midwife will have a chat with you to help you decide when is best for the midwife to come to your home or for you to come to the birth centre or hospital. It's recommended that you do stay at home for as much of this stage as you can, this way you will be more relaxed and there is lots of research to show that you are more likely to go into labour ore quickly.
Being at home also encourages the hormone production that promotes your labour to progress. We would encourage you to stay at home until:
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- Your waters break OR
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- Your contractions have increased in strength and frequency OR
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- Your need further pain management OR
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- Your baby's movements have reduced or stopped OR
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- If you have any fresh red bleeding OR
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- You have any concerns.
If you have ANY of the above, you will need to contact your midwife or maternity unit {Link to Contact page} as soon as possible, so we can assess your needs over the phone and reassure you or invite you into your chosen place of birth.
- A warm bath (you can have a warm bath even after your waters break but avoid bubbles/soap)
- Paracetamol (following the instructions on the packet; no more than 8 tablets in 24hrs)
- Massage
- Movement using positions and your birthing ball
- Distractions
- Rest
- Stay hydrated and eat small and regular meals
- drink plenty of fluids, such as non fizzy isotonic drinks and water
- try to eat small regular snacks, such as toast, biscuits or a banana
- make sure you are emptying your bladder every couple of hours, sometimes you may not feel like you need to but it is important to do so
- using a birthing ball or keeping upright and mobile can really help, but in between having some rest, so do have a lay down if you can or a warm bath.
- hot water bottles can also really help especially with the period type aches and pains.
- you can also take paracetamol as per the recommended dose of at least 4 hours in between tablets with no more than 4g in 24 hours
The First Stage of Labour
The first stage of labour is the time from the beginning of labour till you are ready to start pushing.
Labour has started when your cervix has dilated to more than 3cm and you have regular contractions.
When you labour starts try to stay comfortable and relaxed.
Breathing exercises, massage and having a warm bath or shower may help to ease pain during this early stage of labour.
Contact your midwifery team if:
- your contractions are coming at regular intervals, or
- your waters break, or
- your contractions are very strong and you feel you need pain relief, or
- You have a change in your baby's movements, or
- you are worried about anything
Once labour is established, your midwife will check from time to time to see how you are progressing and to offer you support, including pain relief if you need it. You can either walk around or get into a position that feels comfortable to labour in.
Your midwife will offer you regular vaginal examinations to see how your labour is progressing.
Your cervix needs to open about 10cm for your baby to pass through. This is what's called being "fully dilated".
In a first labour, the time from the start of established labour to being fully dilated is usually 6-12 hours. It's often quicker in second or third pregnancies.
When you reach the end of the first stage of labour, you may feel an urge to push.
The Second Stage of Labour
This is when you are ready to start pushing.
When your cervix is fully dilated, your baby will move further down the birth canal towards the entrance to your vagina. You may get an urge to push that feels a bit like you need to have a poo.
You can push during contractions whenever you feel the urge.
If you have an epidural, you may not get an urge to push at all, but the midwife will instruct you how and when to push.
If you are having your first baby, this pushing stage should last no longer than two hours. If you have had a baby before, it tends to take less time.
This stage of labour is hard work, but your midwife will help and encourage you. Your birth partner can also support you.
Your midwife will help you find a comfortable position to give birth in. You may want to sit, lie on your side, stand, kneel, squat or kneel on all fours.
Try out some of these positions before you go into labour.
Talk to your birth partner, so they know how they can help you.
The Third Stage of Labour
There are two ways to manage this stage of labour:
- active - when you have treatment to speed things up
- physiological - when you have no treatment and this stage happens naturally
Your midwife will explain both to you while you are still pregnant or during early labour, so you can decide which you would prefer.
Your midwife will advise which type of management is recommended. There are situations where active management is the safest option. Your midwife or doctor can explain if this is the case for you.
- Your midwife gives you an injection of oxytocin in your thigh as, or shortly after, you give birth. This makes your womb contract.
- Evidence suggests it's better not to cut the umbilical cord straight away. This is called optimal cord clamping. It is better for your baby's early health.
- Once the placenta has come away from the womb, the midwife helps deliver the placenta out through your vagina. This usually happens within 30 minutes of your baby being born.
Active management speeds up the delivery of the placenta and lowers your risk of having heavy bleeding after birth (by a half)
Side-effects can be feeling nauseous and vomiting.
- No oxytocin injection is given and the third stage of labour happens naturally.
- Again the cord is not cut immediately as above (optimal cord clamping).
- Once the placenta has come away from the womb, you should feel some pressure in your bottom and contractions, and you will need to push the placenta out. It can take up to an hour for the placenta to come away, but it normally only takes a few minutes to push it out.
If the placenta doesn't come away naturally, or if you begin to bleed heavily, you will be advised by your midwife or doctor to switch to active management. You can do this at any time during the third stage of labour.
Videos on Equipment and Positions for Labour and Birth
NICE Guidance
Care regarding of women and babies during labour and birth