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Pregnancy - stages of labour
Labour is divided into three stages - the dilation of the cervix, the delivery of the baby, and the delivery of the placenta. For first-time mothers, labour takes around 12 to 24 hours. Women who have undergone childbirth before can expect about seven hours of labour.
Recognising the start of labour
Braxton-Hicks contractions are sometimes mistaken for labour. These ‘false’ contractions usually start halfway through the pregnancy and continue for the duration. You may find these contractions visibly harden and lift your pregnant belly. It is not known what triggers the onset of labour, but it is thought to be influenced by the hormone oxytocin, which is responsible for causing uterine contractions. Some of the signs and symptoms of going into labour may include:
- Period-like cramps
- Backache
- Diarrhoea
- A small bloodstained discharge as your cervix thins and the mucus plug drops out
- A gush or trickle of water as the membranes break
- Contractions.
The first stage of labour is concerned with the thinning of the cervix and its dilation to around 10cm. The different phases include:
- The latent phase - generally, this stage is the longest and the least painful part of labour. The cervix can thin out over weeks, days or hours and be accompanied by mild contractions. The contractions may be regularly or irregularly spaced, or else you might not even notice them at all.
- The active phase - the next phase is marked by strong, painful contractions that tend to occur around three or four minutes apart and last up to a minute or so. The cervix dilates to around 7cm.
- 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.
Once the cervix is dilated to around 10cm, the second stage of labour can begin. The contractions should now be regular and spaced apart, so that you can relax between them (as best as you can). As each contraction builds to a peak, you may feel the urge to bear down and push. The sensation of the baby moving through the vagina is described as a stretching or burning, particularly as the baby’s head crowns (appears at the vaginal entrance). Once the head has emerged, the delivery staff will turn the body to deliver the shoulders. The rest of the baby will then slip out. The second stage of labour typically lasts around 15 minutes to one hour.
The third stage of labour
The placenta is then delivered, usually five to 30 minutes later. Your uterus gently contracts to loosen and push out the placenta, although you may not be able to feel these contractions.
Suggestions for the early stages of labour
Be guided by your doctor or midwife, but general suggestions for a woman approaching labour include:
- Once you go into early labour, take the opportunity to rest and relax at home. There is no need to be in hospital until the contractions are regular and painful.
- Once the contractions are around seven to 10 minutes apart, you might like to start timing them. You do this by noting how many minutes elapse between the start of one contraction and the start of the next.
- If you are unsure whether to stay home or head to the hospital, ring and speak to one of the midwives. They will ask you a number of questions and help you decide what to do.
- Once your contractions are five minutes apart, or if you no longer feel comfortable being at home, go to the hospital.
- If your waters break or if you start bleeding from the vagina, go immediately to hospital.
Suggestions include:
- Resist any urge to push until your cervix is fully dilated.
- The pressure of your baby’s head helps to widen your cervix, so use gravity and walk around, stand or sit upright.
- Don’t feel embarrassed or inhibited by your appearance or behaviour - the medical team have seen it all before. If you want to grunt, yell or swear - go ahead. Remember that passing a bowel motion during labour is normal and nothing to be concerned about.
- Your doctor
- Obstetrician
- Midwife
- Family Planning Victoria Tel. (03) 9257 0100
- Labour is divided into three stages - the dilation of the cervix, the delivery of the baby, and the delivery of the placenta.
- Some of the signs and symptoms of going into labour may include period-like cramps, backache, diarrhoea and contractions.
Related articles:
Breastfeeding - when to start.
Childbirth - help for women from overseas.
Childbirth - medical interventions.
Childbirth - pain relief options.
Pregnancy - signs and symptoms.
Pregnancy - week by week.
Pregnancy and diet.
Pregnancy birth and parenting.
Premature babies.
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Article publication date: 06/11/2002
Last reviewed: 30/06/2004
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