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Early labour - the first stage

labour; stage; cervix; contractions; dilated; dilating; stage; latent; active; transition; support; home; birth; water;

Labour is divided into 3 stages.

  • The first stage of labour is the slow opening of your cervix (neck of the womb), which happens with regular contractions of your uterus.
  • When your cervix is fully opened (dilated) the delivery (birth) of your baby follows. This is known as the second stage of labour.
  • The third stage of labour is the separation and delivery of the placenta from your uterus.

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Early labour

Most of the time you are in early labour you can usually be at home. You can ring the hospital at the beginning of your labour to discuss a plan rather than waiting for contractions to become strong and regular - especially if your labour is happening earlier than expected (premature labour) or you have had an operation on the uterus - such as a previous Caesarean section.

  • Phone the hospital where you are booked in to have the baby and speak to a midwife.
  • The midwife will ask about your pregnancy, your baby’s movements and what is currently happening with your labour.
  • Usually you will not need to be in hospital during the early stages of labour.

When your labour starts, it's important to try to keep calm and encourage your partner or the people with you to feel calm. A calm and relaxed environment will help you to deal with discomfort or pain you may be feeling and to make the best decision about when to go hospital.

Is it labour?
You may have felt tightening of your uterus during your pregnancy. This tightening can happen more often and more strongly in the last few weeks of your pregnancy. They can be quite regular, last for one to two minutes and may or may not be painful. They are known as Braxton Hicks contractions and are not labour. Talk about contractions with your midwife or doctor to work out what type of contractions you are feeling. Labour contractions tend to build up and then ease off.

The beginning of labour
One of the signs that labour may be about to start is having a bloodstained mucus discharge from your vagina. This discharge is called a ‘show’ and is quite normal.

When your contractions start they may be quite irregular in length and strength.

It is a good idea to keep yourself busy in early labour.

  • Distract yourself with a relaxing activity such as watching TV, reading a book or going for a walk.
  • Contact someone to keep you company.
  • If you go into labour at night, try to relax and get some sleep while your contractions are still irregular.
  • When your contractions are becoming more uncomfortable, you may find a warm bath very soothing. If you do not have a bath, you may like to try a warm shower. Make sure someone is with you, in case you feel faint or need help getting out of the bath or shower.

Some women find keeping active and moving around helps with pain. It also helps your baby move into position ready for the next stage of labour.

In this first stage of labour you may feel the contraction pains in your abdomen or back, or both.

  • A hot water bottle or hot pack placed on your back or lower abdomen may give some relief.
  • You may find that a back massage will help.
  • Leaning forward over a beanbag or sitting back-to-front in a chair with some support pillows may take some of the pressure off your back and abdomen.
  • Try different positions such as lying on your side, walking, rocking on all fours or squatting.

If your waters break

Sometimes one of the early things that happen in labour is a large loss of fluid from the vagina - waters breaking. This fluid is the fluid that surrounds the baby in the uterus during pregnancy - amniotic fluid. You cannot stop this fluid from coming out.

If this happens call your hospital to work out what to do. Usually you will be asked to come to the hospital even if you are not yet having strong contractions. Call the hospital before you go there.

What to do next

When your contractions are becoming stronger and regular you may like to start timing them and writing down the time (over half an hour or so).

  • See how many minutes there are from the beginning of one contraction until the next one begins.
  • You can also time how long the contractions last.

As your contractions become more regular (approximately 7-10 minutes apart), it is a good idea for you or someone else to phone the hospital.

  • Phone the hospital where you are booked in to have the baby and speak to a midwife.
  • The midwife will ask about your pregnancy, your baby’s movements and what is currently happening with your labour.
  • You will be advised to come in or stay at home for a little longer.

Usually, it will be time to go to hospital when:

  • Your contractions are about 5 minutes apart, or
  • You no longer feel comfortable being at home, or
  • Your waters break (it doesn’t matter whether or not you are having contractions).

When you do decide it is time to go hospital, it is important to call the hospital and let them know you are coming in.

  • At some hospitals, you may find that you need to go the maternity section and others to the emergency section. You can ask your doctor or midwife where you should go.

It may be wise not to tell all of your friends that you are in labour, as you may become bothered by their phone calls once you go to hospital.

The role of your support person

Your labour and the birth of your baby are a very personal and special time for you.

  • Although the midwife will support you throughout labour, it is good to have another support person with you, your partner or another person you are close to.
  • Your support person should know what is in your birth plan, if you have one, and be aware of your wishes for the birth.

Some women have more than one support person. Choose support people who you will be comfortable with, and who will help you rather than distract you during the different stages of labour. If you have too many people with you it may affect your ability to cope with the progress of your labour and may affect your comfort.

Your support person(s) can:

  • Stroke and massage you
  • Support you in various positions
  • Help to make you physically comfortable
  • Help with breathing techniques
  • Offer comfort and emotional support
  • Hold your hand
  • Provide encouragement
  • Get ice for you to suck if you are thirsty
  • Place cool face washers on your forehead
  • Place a hot pack or hot water bottle on your back or abdomen.

How long does labour last?

  • The latent phase - generally, this stage is the longest and the least painful part of labour. The cervix can thin out over hours or even a few days. This is not considered labour. During this phase you may experience some pain and discomfort, but often the pattern of contractions is not regular. Most people stay at home during this time.
  • The second or active phase of the first stage of labour is when your cervix starts to open. At the same time your contractions usually become more regular, around three or four minutes apart and last up to a minute or so. The cervix dilates to around 7cm. This is usually considered to be the start of true labour.
  • The transition phase - the contractions become more intense, painful and frequent. It may feel like the contractions are no longer separate but running into each other. The cervix may take around an hour or so to dilate the final 3cm. It is not unusual to feel a strong urge to go to the toilet as the baby’s head pushes against the rectum. The birth of your baby will occur soon.

For women having their first baby, an average first stage of labour usually lasts around 12 - 14 hours, but it can be many hours longer. This stage of labour for women having second or later babies averages about 7 hours. This is only a guide and you may find that your labour is shorter or longer than these times.

If your labour is going slowly or problems develop, your doctor or midwife may want to discuss options for helping with your labour.

Help with pain during labour

This will be something that you discuss with your doctor or midwife during your pregnancy and you may work out a plan for managing labour. But things may not go as planned.

There are several ways that you can get relief from pain during labour - have a look at the topic Pain relief during labour and birth.

The birth

More information about the birth is in the topic 'When you baby is born – the second and third stages'.

Labour at home or in water

A few women wish to have their labour and birth at home, or in water. There is more information about these options in the following documents.

 

Further reading

Pregnancy, birth and baby Pregnancy, Birth and Baby is a national Australian Government service providing support and information for expecting parents and parents of children, from birth to 5 years of age.
http://www.pregnancybirthbaby.org.au/ 

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see your doctor or midwife.

 

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