Three stages of labour
First stage: Regular contractions begin dilating the cervix (neck of the uterus) to open, soften, shorten and thin. This stage can be further broken down into the early (or latent) phase, the active phase and the transition phase.
Second stage: When the cervix is fully dilated, pushing contractions move the baby through the vagina.
Third stage: After the birth, the uterus contracts and causes the membranes and placenta to be expelled.
Early labour - latent phase
This is your body starting the labour process, and it all begins hormonally with oxytocin – the love hormone. This stage can be quite slow and lasts several days for some people. Try to stay relaxed. To make this stage a bit more comfortable, you might find it helpful to:
● go for a walk or gentle exercise
● meditate or do relaxing breathing techniques
● take a shower or bath
● change positions
● keep hydrated and eat if you feel able
● listen to your body - rest when you need, active when you like
What do contractions feel like?
● your tummy tightens and goes hard and then relaxes
● at the start, contractions feel a bit like period cramps, and last about 20-40 seconds. You might also get pain in your lower back
● as labour goes on, your contractions will go for longer and get more intense/painful
The first stage of labour
The first of the three stages of labour is usually the longest, but it builds up over time so your body can adjust. The latent phase begins with mild, irregular contractions that might feel like backache, or period cramps. They can be 20-30 seconds long and maybe about 20 minutes apart. You might also experience low pressure, diarrhoea, bloody show, or waters breaking. This phase of labour can happen over a period of weeks or days and you might not even be aware of the contractions, thinking they are more intense Braxton Hicks. During the latent phase, your cervix will soften, shorten and thin (efface). Over a period of time, it will open (dilate) to about 3cm.
The active phase of the first stage begins when contractions become longer and more regular, dilating the cervix more rapidly to about seven centimetres. There will be a shorter space between your contractions, which will become more intense. They will begin to require your focus and coping techniques will help hugely. You might experience more backache, aches in your bum and tops of thighs, tiredness, more bloody show, and possibly your waters breaking (if they haven't already).
The transitional phase is the last and most intense part of the first stage of labour. It is generally the shortest phase and usually lasts between 30 and 90 minutes. Your cervix completely dilates to 10cm, and contractions can become very intense and about 60-90 seconds in length. They will feel as though they are coming thick and fast, with perhaps a one minute rest period in between. During the transitional phase, you will probably experience intense pressure in your back and bottom, and there'll be increased bloody show as the dilation of the cervix increases. You may feel hot and sweaty, or cold and shaky, nauseous, extremely drowsy between contractions, and probably quite exhausted.
The second stage of labour
The longest stage of labour is complete. The second stage of labour lives up to the word "labour" as pushing takes more effort than the first stage, which happens without much physical input. During this stage contractions will change again and become involuntary and expulsive, pushing your baby through your cervix and into your vagina. You will feel an overwhelming urge to push (if there's no pain-blocking medication), with pressure on your rectum as well as your perineum (the area between your vagina and anus). You might also feel a stretching, tingling or burning sensation as the tissues of your perineum are stretched — perineal massage may help.
Once your baby's head is on your perineum, it will continue descending instead of moving back up your vagina after each contraction. The top of your baby's head is first, then the nose, mouth and chin. The burning sensation you might be feeling will probably ease as the head is born. Contractions might halt for a moment while your baby's head rotates, allowing their shoulders and body to be born, in a wet slippery gush.
The third stage of labour
Congratulations, your baby has been born and begins the amazing transition from the uterus to the world. You are probably feeling an immense sense of relief and might be in a daze, hardly taking notice of anything around you. Your baby will most likely be placed on your belly or chest, depending on the length of the umbilical cord, and you and your baby will be covered, keeping you warm. The third stage of labour lasts from the moment your baby is born to the expulsion of the placenta and membranes.
A huge surge of oxytocin at the moment of your baby's birth causes the uterus to contract, and the placenta begins to sheer off your uterine wall. Further contractions clamp down on the blood vessels and push the placenta out. Some women need to push actively with the contractions, others might find that simply moving into an upright position or a squat will help push the placenta out. If there are no complications your carer will wait until the umbilical cord stops pulsating - delayed cord clamping. This will help your baby's circulation and will transfer a large volume of placental blood into his body, increasing his own blood volume by about a third, red blood cells and antibodies.
This final stage of labour can last between 10 and 30 minutes but can extend up to an hour.
Women's bodies have been perfectly designed to birth babies; evolution has honed the process over millennia. There are certain situations where medical assistance is needed for birth to be safe for mothers and babies, but the normal process of labour has its own rhythm.
• For information about antenatal classes near you, check out From Bellies to Babies www.hbantenatal-classes.co.nz or phone 022 637 0624.
Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians.
