Latent Phase of Labour
The start of labour is called the latent phase. This is when your cervix becomes soft and thin as it gets ready to open up (dilates) for your baby to be born. During the latent phase of labour, you will begin experiencing contractions which may be irregular and vary in frequency, strength and length. You may start to have regular contractions and then over time they slow down or stop completely. When you have a contraction, your womb tightens and then relaxes. For some people, contractions may feel like extreme period pains. Some women say they feel pain in their back and thighs instead of, or as well as, pain in the front of their bump.
During pregnancy, your cervix is closed and plugged with mucus, to keep out infection. But when labour starts, the mucus plug may come out. This is called your show and you may notice it in your underwear or when you wipe after going to the toilet. Some women don’t have a show. This small, sticky, jelly-like mucus may come away in one blob or in several pieces. It’s normal to lose a small amount of blood with the mucus and you may notice this as fresh red or brown but contact your hospital or midwife straight away if you’re losing more blood.
Every woman’s labour is different, so it can be difficult to say how long the latent phase will last. It can take hours or, for some women, days. The latent phase tends to be longer in a first pregnancy.
The aim during the latent phase of labour is to stay as calm and comfortable as possible. It’s a good idea to contact your midwife at this point so they can assess you. If you are more than 37 weeks with an uncomplicated pregnancy, you’ll probably be advised to stay at home until your labour is ‘established’'. This is when your cervix opens (dilates) to at least 4cm and your contractions become stronger and more regular.
What can I do to ease the pain?
The aim during the latent phase of labour is to stay as calm and comfortable as possible. You may find it helpful to:
- Keep mobile
- Rest and sleep between contractions, particularly if this labour starts at night or your feeling tiered.
- Drink fluids, such as water. Sports (isotonic) drinks may also help keep your energy levels up.
- Have small, regular snacks, such as toast, biscuits or a banana (although be aware that many women don't feel very hungry and some feel, or are, sick).
- Try any relaxation and breathing exercises you've learned.
- Have a massage – your birth partner could help by rubbing your back.
- Take paracetamol according to the instructions on the packet – paracetamol is safe to take in labour.
- Have a warm bath or shower.
- Gently bounce or rock on a birthing ball.
- use a TENS (transcutaneous electrical nerve stimulation) machine, which attaches to your back with sticky pads and sends out tiny electrical impulses to block pain signals sent from your body to your brain. This will make you less aware of the pain.
Contact your midwife, maternity unit or labour ward if:
- Your contractions are regular and coming about 3 times in every 10 minutes
- Your waters break
- Your contractions are very strong, and you feel you need pain relief
- You have any bleeding
- You're worried about anything.
Your baby’s movements
You should continue to feel your baby move as normal for you right up to the time you go into labour and during labour. Contact your midwife or maternity unit if you have any concerns about your baby’s movements during the latent phases of labour.
Reference
Here is a link to a video on the Tommy’s website regarding how your cervix dilates in labour
First stage of labour
The first stage of labour is also known as established labour. This is when your cervix opens (dilates) to at least 4cm and your contractions become stronger and more regular.
Your midwife will talk to you throughout the first stage about how you’re feeling and whether you need any pain relief. They will also:
- listen and monitor your baby's heartbeat every 15 minutes
- check how often you are having contractions
- measure your pulse every hour
- measure your temperature and blood pressure every 4 hours
- check how often you empty your bladder
- your midwife will offer you regular vaginal examinations to see how your labour is progressing. If you do not want to have these, you do not have to – your midwife can discuss with you why she's offering them.
If your labour is going well, you shouldn't need any more monitoring, though your midwife will also be there to support you emotionally throughout your labour and birth.
If you’re having your first baby, this stage will probably last about 8–12 hours. If you’ve had a baby before it may last 5–12 hours.
Towards the end of the first stage, when the cervix is nearly open, contractions may become stronger, and you may feel a heightened sense of panic. This is known as 'transition'. You may not notice when you’re moving from the first to the second stage.
Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated. When you reach the end of the 1st stage of labour, you may feel an urge to push.
References
NHS Choices. What happens during labour and birth
NICE (2017). Intrapartum care for healthy women and babies National Institute for health and care excellence https://www.nice.org.uk/guidance/cg190
The second stage of labour
The second stage starts when your cervix is fully dilated (10cm) and your contractions continue to be regular and strong.
You may not feel an urge to push straightaway, which is called the passive second stage. If this is your first baby the passive second stage can be up to 2 hours, if you’ve had a baby before this can be up to 1 hour. It becomes the active second stage when you have the urge to push and you actively start pushing. It ends when your baby is born. The urge to push is often described as feeling a bit like you need to poo.
Your midwife will monitor you and the baby closely at this stage, as well as support you as you push. They’ll also help you to find a comfortable position, you may want to sit, lie on your side, stand, kneel, or squat.
If you experience backache whilst in labour, kneeling on all fours may help. It's a good idea to try some of these positions before you go into labour. Talk to your birth partner so they know how they can help you.
Your midwife will also:
- listen and monitor your baby's heartbeat every 5 minutes
- check how often you are having contractions
- measure your pulse every 30 minutes
- measure your temperature and blood pressure every hour
- check how often you empty your bladder
- your midwife will offer you a vaginal examination every hour during the active second stage. If you do not want to have this, you do not have to – your midwife can discuss with you why she's offering them.
Every labour is different. But, on average, once you start actively pushing you’ll probably deliver within 3 hours if it’s your first baby and within 2 if you’ve had a baby before. The second stage of labour is hard, your midwife will support you fully during this stage and encourage and counsel you throughout. Your birth partner can also be an excellent source of support during this stage.
References
NHS Choices. What happens during labour and birth
NICE (2017). Intrapartum care for healthy women and babies National Institute for health and care excellence https://www.nice.org.uk/guidance/cg190
The third stage of labour
You’re in the third stage of labour when you’ve had your baby but need to deliver the placenta. Your midwife will speak to you during your pregnancy about the 2 options for delivering the placenta and the pros and cons of each.
You can have active management, which means you’ll have an injection that helps you deliver the placenta or you can try physiological management which means that you will deliver the placenta without any injection. There are some situations where physiological management is not advisable. Your midwife or doctor can explain if this is the case for you.
It’s a good idea to write your choice in your birth plan. If you want to try to deliver the placenta without the injection, you can change your mind and have the injection at any time if you want to.
NICE guidance recommends that the umbilical cord, which links your placenta to the baby, is not clamped and cut until at least 1–5 minutes after you give birth. This allows the blood from the placenta to continue being transferred to the baby even after they are born, which helps with their growth and development, this is known as delayed cord clamping.