What happens during labour?

Your labour has three stages, from the first twinges to delivering the placenta.

Every labour and birth is different but labour is generally split into three separate stages. You may not notice when you’re moving from the first to the second though.  

Before labour gets going: the latent phase

If this is your first baby you may get backache and bouts of painful contractions that last for hours, or even days, before proper labour begins. This is called the latent phase of labour.

You may be convinced that your baby is on his way only to find that all the signs wear off again or your midwife says your cervix is still closed when it's checked. This is more common if your baby is lying with his back towards your back - often called a posterior position.

If you can, stay at home during the latent phase as you're more likely to feel comfortable there. Try to keep active to take your mind off the discomfort.

A warm bath, the recommended dose of paracetamol or a back massage from your partner may help. This is a good time to practise any breathing or relaxation exercises you have learned in your antenatal classes or pregnancy exercise sessions.

Rest as much as you can between contractions and don't forget to eat. You'll need to keep your energy up for when labour starts properly.

The first stage of labour

This is usually the longest stage and, with a first baby, it can last between ten and 18 hours, although some first stages are longer or shorter than this.

The first stage is when contractions make your cervix (the ring of muscle at the bottom of your womb) gradually open up, or dilate, until it is about ten centimetres across (this is about the size of a Dairylea box!).

You'll hear the midwives talking about how many centimetres dilated you are and this is what they mean.

Transition

Towards the end of the first stage, when the cervix is nearly open, contractions get stronger. This is known as 'transition'.

The second stage of labour

The second stage starts when your cervix is fully open. This is the part of labour where you will be actively working to help the baby move through your vagina. The muscles of your womb will be tightening and loosening to push the baby down and out.  You will help the contractions by pushing the baby out.

The second stage can last from around 30 minutes to a couple of hours for first babies and ends with the birth of your baby.

The second stage if you're having twins

If you have your babies vaginally, the first twin will take the same time to push out as a single baby would. After your first baby has been born, doctors will check on the position of the second.

If your second baby is in a good position, he or she will usually arrive much more quickly than the first. If the second baby is in a trickier position, you may need extra help for the birth.

The third stage of labour

After your baby is born, your womb contracts some more, causing the placenta to come out through the vagina.

You will be offered an injection after the birth of your baby that causes the placenta to come away from the wall of your womb quickly, allowing the midwife to deliver it.

You can also choose to have a 'passive' or natural delivery of the placenta (sometimes referred to as ‘physiological third stage’), where you push it out once it has separated from the wall of your womb without an injection or other intervention. This can take between ten minutes to an hour after the birth of your baby.

Your midwife may prefer to wait until the umbilical cord has stopped pulsating before clamping and cutting it if there is no risk to mum or baby. This has been shown to increase the amount of iron and haemoglobin in the baby’s blood. There is a small increased risk of jaundice in the baby.

Sometimes you will need help in labour

You and your baby will be monitored throughout your labour to make sure everything is OK. Sometimes labour slows right down or there may be problems. You might need help because the labour has been prolonged and you are exhausted. Or your baby’s heart rate might drop and the doctors might want them to be born quickly.

When this happens there are a few different ways that the hospital can help you deliver the baby safely. This is called an assisted birth.

Sources

  1. TAMBA (accessed March 2015) Pregnancy, birth plans http://www.tamba.org.uk/Pregnancy/Birth-Plans
  2. NHS choices (accessed March 2015) Giving birth to twins or more: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/giving-birth-to-twins.aspx
  3.  RCOG (2013) RCOG statement on Cochrane Review on the timing of cord clamping, Royal College of Obstetricians and Gynaecologists https://www.rcog.org.uk/en/news/rcog-statement-on-cochrane-review-on-the-timing-of-cord-clamping/
  4.  NHS Choices (accessed Jan 2015) News release on cord clamping http://www.nhs.uk/news/2007/August/Pages/Justafewminuteswaitmightmakeahealthierbaby.aspx
  5. NICE (2014) Clinical guideline 190: Intrapartum care: care of healthy women and their babies during childbirthhttps://www.nice.org.uk/guidance/cg190/chapter/key-priorities-for-implementation
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Last reviewed on April 1st, 2015. Next review date April 1st, 2018.

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