Stages of Labour

There are three stages of labour:

First Stage

The first stage of labour includes early labour, active labour and a transitional phase, which occurs just before the baby is born.

During the early phase of first stage labour, you will start to experience contractions, which help to soften the cervix so that it can start to dilate. The cervix must dilate to around 10 centimetres in order for the baby to be born; this process can take a long time. The midwife will assess your condition when you arrive at hospital; if you have reached 3 centimetres, this will be classified as established labour and you will stay in hospital; if you have not yet reached this stage, you may be advised to go home, as it is a more relaxing environment than the hospital and you will feel more comfortable.

Every woman is different and the time it takes for the cervix to become fully dilated varies according to the individual; typically, it takes between 6 and 12 hours for the cervix to fully dilate from the start of established labour for the first baby; women who have already had children will usually experience shorter labour. During established labour, you may be encouraged to eat light snacks and drink water; most women find they don’t feel like eating much but you should try to keep your energy levels up as the labour will be physically demanding and may last a long time.

As the cervix becomes dilated you may find that you experience an urge to push; your midwife will keep a close eye on you and will tell you when you should push; to stop yourself from pushing you can try specific breathing exercises, which you may have learnt during pregnancy in antenatal classes. Many women find it beneficial to move around and find a comfortable position during the first stage of labour.

During labour, the baby’s heart rate will be monitored closely (this is known as foetal heart monitoring); there may be changes in the baby’s heart rate if the baby starts to become distressed; if this is the case, the midwife may try to speed up the labour so that the baby can be delivered quickly.

If the labour is failing to progress at an appropriate rate and the baby is becoming distressed, doctors or the midwives may take steps to speed up the labour. They may break the waters (if this has not happened naturally) or give you a hormone, which will speed up contractions, via a drip.

Second Stage

During the second stage of labour, the baby will be born. The second stage begins when the cervix is fully dilated and ends when the baby is born. During this stage your midwife will guide you and tell you when to push.

During the early part of this stage you may find it beneficial to try out positions so that you are more comfortable; you may have already found a position during antenatal classes which you find comfortable. Some women prefer to lie on their side, while others prefer to stand, sit or squat (this may require a bit of practice).

During this stage, your body will encourage you to push; your midwife will talk you through this phase. You should take two deep breaths with each contraction and push throughout the contraction.

This stage is physically demanding and may be very painful; try to stay relaxed and calm and remember that your birthing partner and the midwife are there to support and encourage you.

Once the baby’s head starts to appear, the midwife will tell you to stop pushing or push very gently; this helps to prevent tearing. If the skin of the perineum cannot stretch wide enough, it may start to tear; if this is the case, the midwife will give you a local anaesthetic (they will ask your permission first) and cut the skin (this is known as an episiotomy); the incision will be stitched up after the placenta has been delivered and it should heal naturally.

After the baby’s head is out, the hard work is done and the rest of the body should follow very quickly. Most women ask to hold their baby before the cord is cut; once the cord has been cut, the baby will be cleaned up, dried and weighed. Sometimes the baby will be covered in mucus and this may cause slight breathing difficulties; if this is the case, their nasal passages and mouth will be cleared to help them breathe easily and then you can hold your baby.

Third Stage

During this stage, the placenta will be delivered. This stage can take between 20 minutes and an hour; most women will be given an injection of Syntometrine in their thigh once their baby has been born to speed up this process. The injection causes the womb to contract and helps to prevent bleeding.

The placenta will be pushed out by contractions; these will not be as strong or painful as those associated with the first and second stages of labour.

If you have had an episiotomy, the incision will now be stitched up; most wounds heal naturally over the course of time and will not require further attention. The local anaesthetic should prevent you from feeling pain but tell your midwife or doctor if you are in pain and they can help you.

Once this stage is over, you will be able to spend time with your baby; most women ask to have a wash and the midwives and nurses will help you to do this. Your baby will be cleaned up, measured, weighed and given a band with your name on around its wrist. Labour is exhausting and you may feel like you need a rest before you start seeing friends and relatives. Your midwife will help you to look after and feed your baby during the first few hours and if you have any questions or concerns you can discuss these with her or any of the care team.