Labour and the pathway to birth is unique and different for everyone – there isn’t a set formula that can be applied to this complicated, exhilarating and amazing process of giving birth.
However, what we do know is that there are changes that happen with your body, your behaviour, with your baby’s position and lots of other factors that can be used as a guide to see how your labour is progressing – different stages of labour essentially.
How many stages of labour are there?
The labour process is often described as being in three stages. Whilst this may be true for some, it’s actually a lot more complicated and can vary for lots of people. It may be that you have 4 stages or even 5 stages of labour, or for others it may feel like just one process.
What is important to remember is that labour and birth is a whole process – the stages are indicators of things progressing but will ebb and flow into each other.
Labour is not a linear process that fits into neat boxes of stages – it’s a physiological, bodily process that is governed by so many factors such as the position you are in, the position your baby is in, hormones, the environment around you, how you are feeling to name a few.
So rather than think of labour in three, four or even five distinct stages, try looking at labour as more of a journey or a pathway that leads to the birth of your baby.
Prodromal or pre-labour
This is a stage of labour that is often ignored or dismissed by many – but just as important to your labour pathway as later stages.
Prodromal means early signs – in this case of labour – or pre labour which is the beginning of the signs and changes that will occur in the weeks and days before your labour starts properly. This stage is about changes happening gently that will morph into early labour over time.
It’s very gentle and you won’t notice some or all of these changes – which is ok, because it means your body is making the changes needed for labour without affecting you too much.
Some signs or changes you may notice are:
- A heavy feeling in your pelvis as your baby’s head engages.
- The mucus plug in your vagina passing out – often called a show
- More frequent bowel movements
- Lower Backache
- PMT symptoms
- Nesting’ instinct
- Braxton hicks contractions
As already discussed this may happen days or even weeks before – but there is no need to worry or rush. If you do notice these signs, be confident in the knowledge that your body is getting ready and so is your baby for birth.
Latent phase of labour
This is the phase of labour which is focused on your cervix – which is the entrance to your uterus, and usually long, closed, and tough – like the end of your nose. For birth your cervix needs to change by softening and gently stretching / thinning out – to something that feels like the consistency of your lips. Have a feel of the end of your nose and lips to get an idea of how much your cervix will soften and change!
The latent phase starts off gently and maybe a continuation of the pre labour signs you have been feeling for a while. You may only realise it as the latent phase when you notice that your Braxton Hicks contractions feel a bit more frequent and wonder if this is actual labour and real contractions!
Don’t worry – at this stage the contractions will be varied in length, strength and frequency and they won’t be regular either.
The latent phase of labour can last anything from a few hours to a few days – what is key is to try and ignore it as much as you can and find ways of remaining calm and comfortable. This is not the time to panic or rush around as adrenaline can slow the process down! Tips on relaxing in labour can be found here: https://www.nowbaby.co.uk/relax-youre-in-labour
If you and baby are well and there are no complications with your pregnancy, and you are 37 weeks or more pregnant, the best place for you is to be at home for as long as possible until your contractions become longer, stronger and find a regular pattern.
Prepare ahead for this stage of labour – during our live and interactive antenatal classes we explore in depth how to prepare for labour and things you can do to stay relaxed and help those birth hormones surge up ready for the next stage of labour.
Relaxing, taking a nap, gently bouncing on a birth ball, watching films, taking a warm shower are all things that can help – but there are plenty more too!
If you allow yourself to relax and submit to the process you’ll find yourself in the next stage of labour.
Find out more about the latent stage of labour.
First stage of labour or Established labour
It might surprise you that after all this you are only now at the first phase of labour! However, remember that labour and birth is a journey, and each stage is part of that, not a destination in itself! This is the stage of labour that is all about your cervix dilating (opening) and your contractions are key in that as they become longer, stronger and more frequent.
Labour and birth is unique to you and every pregnancy has its own journey, so it is hard to determine how long the first stage of labour can be. It’s thought that it can be longer for first time mums as your cervix has never dilated before and this is all new to your body, so expect anywhere between 7–19 hours, if this isn’t your first baby then it may be a little shorter around 6–13 hours, but that is all just a very rough estimate!
Whilst those timings may seem long, if labour is progressing well and you and baby are both doing ok, there is no need to speed up labour – your body and baby both know what they are doing so trust in your ability to do this. Time changes and distorts when you are in labour, so ignore the clock and time limits – as long as you and baby are well there is no need to rush the process.
If there is a concern about your wellbeing or baby’s your midwife should explain why and then discuss with you options to either help labour along with interventions such as breaking your waters (artificial rupture of membranes) or a hormone drip of artificial Oxytocin. These are all options that need to be discussed with you in detail before you can make the best decision for you. Our class on Birth Management explores all of these options in more detail.
Find out more about Augmentation of labour.
The first phase/stage of labour ends when your cervix is fully dilated, so open to 10cms.
The transition stage of labour is not often discussed but can be a powerful phase that marks movement of your labour from the first to the second stage of labour. Transition is best thought of as either a pause – when everything seems to slow down and almost stop, giving you time to rest and recover a little. Midwives call this the rest and be thankful phase – giving you a chance to snack, go to the toilet or even have a little snooze.
Or transition can be the opposite – with your contractions feeling like they are coming all at once, on top of each other which can be very intense for you! Either way, transition does not last for long and is another sign that you are much closer to the birth of your baby.
Second stage of labour
The second stage is when your labour journey moves to the birth of your baby. With your cervix fully dilated, now the focus is on your baby’s head moving down ready for birth. This stage can last anywhere between 10 mins to 3 hours depending on the circumstances of what is happening.
During this stage your contractions change in how they feel – many women describe them as feeling expulsive and you feel a strong urge to bear down or push with the contraction. Ideally you would want to be in an upright position for this as gravity will help lots. Staying off your back is key – which your midwife can support you with even if you would rather stay on a bed instead of standing up. There are lots of positions you can try whatever kind of labour you are having or what pain relief you are using – which is covered in more detail here: Optimal positions for labour.
The second stage of labour ends with the greatest moment of all – the birth of your baby. It’s the most amazing moment when after all the hard work and effort your baby arrives and is handed to you.
Need for a quick birth
Labour and birth doesn’t always go as expected and there are times where you may need help with speeding up your labour or for baby to be born quickly. In these circumstances your midwife will explain to you why this needs to happen and discuss what to expect such as an assisted birth or birth by c-section.
Find out more about birth management in our birth management classes.
Find out more about c-section in our on-demand caesarean classes.
Third stage of labour
The third stage of labour seems a bit of an anti-climax after the birth of your baby. You’ll be at this stage enjoying your baby and getting to know them – in a lovely post birth oxytocin bubble! However, your placenta – that lovely organ your amazing body has grown and which fed and nourished your baby all these months is now no longer needed and needs to be born too.
The good news is that there isn’t a lot of effort required from you – in fact it happens often without you even being aware!
This stage of labour is commonly managed in one of 2 ways – and how long it takes can depend on which method of management you decide on. Active management is where you are given an injection of artificial oxytocin after baby has been born to help your uterus contract. Physiological management is where your body is left to birth the placenta naturally without any medical help.
Whatever management method you choose, you may also want to consider delayed cord clamping which is where the umbilical cord is not clamped and cut until all the blood from the cord has passed to your baby.
The third stage and your labour and birth journey ends with the birth of the placenta for your midwives, for you this was with the birth of your precious baby and your new family.