First stage of labour
Before labour begins: Braxton Hicks contractions
- These are like practice contractions for your womb, when it tightens and relaxes
- They’re not as strong or painful as contractions in labour and are irregular
- You might get them for several weeks before labour
Before labour or as labour begins: Your ‘show’
- The plug of mucus that seals your cervix during pregnancy comes away
- It’s a slightly pink mixture of mucus and blood
- This can happen anywhere up to two weeks before labour begins, so don’t worry if you don’t go into labour right away
Signs of false labour
- Contractions are irregular. They might come every 3 minutes, but then every 10 minutes
- Contractions don’t get stronger over time
- They ease when you move around
- They’re not accompanied by increased mucus or bloodstained show
Signs of labour
- Contractions have a regular pattern – for example every 10 minutes
- They get progressively stronger
- They don’t ease when you move around
- They may be accompanied by a show or your waters breaking
- A vaginal examination shows your cervix is beginning to dilate
Contractions start
- Contractions are a tightening of the womb muscle. You can feel them in your front or back
- They usually start slowly and feel like period discomfort
- They’ll feel stronger than Braxton Hicks contractions and are regular and painful
- They help soften the cervix, which gradually opens
- This first stage of labour can take many hours, especially with your first baby
- Initially contractions will be more than 5 minutes apart. As labour progresses they’ll become closer together and longer
Your waters break
- The amniotic sac surrounding your baby breaks
- Your waters may suddenly gush out in one go. Or it may be a very slow trickle throughout labour
- It can happen before or after your contractions become strong and regular
- Contact your hospital even if you’re not having contractions
When do I go to hospital?
- Phone your hospital or birthing unit and describe your symptoms
- They’ll help you decide when you need to come in
- If you’re having a home birth, call your midwife
- If you’re experiencing any of the following, call the hospital immediately:
- You’re bleeding
- Your waters break
- You’re in pain
- You’re not feeling your baby move as much as normal
Labour slowing down
- If labour slows down, your maternity team may suggest breaking your waters
- This sometimes helps speed things up
- If it doesn’t work, you may be offered a hormone called syntocinon, via a drip in your arm
Monitoring your baby’s heartbeat
- Your midwife will monitor your baby’s heart on admission, intermittently in labour or continuously
- They may use a hand-held monitor. Or one that’s strapped to your tummy
- If it’s strapped to your tummy, it’ll also monitor contractions
Second stage of labour
This is the stage when your baby is born.
- This begins when your cervix is fully dilated to 10 cm
- You’ll now feel you want to push
- Your body will probably do this naturally. But don’t worry if this doesn’t happen: your midwife will guide you
- If this is your first baby, this part of labour can last an hour or more. If it’s your second or more, it may be much shorter
Tearing and episiotomy
- When your baby comes out, it may tear the perineum (the area between your vagina and your anus)
- To minimise tearing, your midwife will guide you as baby’s head is coming and ask you to breathe instead of pushing
- An episiotomy will only be performed if necessary
- This is where they anesthetise and cut the skin to make the opening bigger
- It’s sewn up straight after the birth
Forceps and Ventouse (Instrumental Delivery)
Sometimes the baby needs some help coming out, for example if they are in an awkward position or you’re exhausted. In this case, a doctor might use:
- Forceps. These are placed on either side of the baby’s head. The doctor gently pulls on them when you push, to help your baby out
- A ventouse. This is attached to your baby's head using suction. The doctor gently pulls when you push to help your baby out
- An episiotomy is usually necessary if forceps or ventouse are used
Don’t worry if this leaves a red mark on your baby's head. This is common and it won't last long.
Emergency caesarean
- If there are problems and the baby has to be delivered quickly, you’ll be offered an emergency caesarean
Third stage of labour
This involves delivering the placenta (afterbirth).
A Syntometerine injection as your baby is being delivered can be given to you to help the third stage speed up. This will be given via an IV (intravenous) drip containing the hormone syntocinon. This is an option to be discussed with your midwife.
You'll have more contractions as your womb shrinks, and it can take up to an hour. The good thing is, it shouldn’t be painful.
Going with the flow
Adjusting to events as they unfold.
- Every mum-to-be has ideas of how they want their labour to be
- Once labour has started, all you can do is adjust to things as they unfold. Take your birth plan with you and discuss it with your midwife
- For example, you may be very keen on having a ‘natural birth’ with as little medical intervention as possible. But sometimes events take over and you may want strong pain relief
- It’s important to ask your partner to remind you of your birth plan. But also to support you in whatever decision you need to make at the time
- Listen to your midwife and doctor. They’ll guide you and try to accommodate your needs