First stage of labour
This 'stages of labour' article covers the following topics:
What do contractions feel like?
What can you do during early labour?
Your birth partner’s role during early labour
What happens as the first stage of labour progresses?
What can your birth partner do as first stage of labour progresses?
What happens at the end of the first stage of labour?
Your birth partner’s role at the end of the first stage
The second stage of labour
The first stage of labour is usually the longest. If you've not been in labour before, it could last from 6-20 hours, while women who've already had one or more babies usually have a shorter first stage (2-10 hours). Everyone is different though, and your labour may be longer or shorter than the average. Following any early signs of labour, your cervix begins to soften and open up (‘dilate’) with regular, rhythmic contractions. This is your body's way of preparing to push your baby out.
Labour contractions feel different for every person in pregnancy. Typically you may feel uncomfortable around your bump and your back as well as experiencing a feeling of fullness in your pelvis. If you are wondering 'how long do contractions last?', typically they occur for 10 to 40 seconds and start every 20 to 30 minutes. As your labour gets going, your contractions will usually get stronger, longer and closer together. This is a typical pattern but some women start their labour with strong, long contractions that are close together right from the beginning - remember everyone is different. Your midwife will measure the progress of your labour for you by gently examining your cervix and telling you how open it is. The medical definition of when the first stage of labour has begun is when your cervix has dilated or opened to 3cms and your contractions are regular and strong.
Labour can start any time of the day or night and you may feel unsure about whether you have really started the first stage of labour. Your midwife is an expert in normal labour so call her or the labour ward at any time for information or advice. She can tell a lot about the signs and symptoms of early labour from talking to you on the phone. There are also lots of things you can do at home to help you through the early first stage of labour:
- Time your contractions occasionally to see if they are becoming more consistent and frequent.
- Gentle exercise, such as a walk or stretching will help you relax.
- A warm bath or shower can be soothing.
- If you have a TENS machine, early labour is a good time to use it.
- Try to rest in a comfortable position (you could be kneeling, sitting or leaning on support) and think about positions you have learnt to encourage a straightforward birth.
- If you want, eat small light meals containing carbohydrates (such as bread, cereal and pasta), avoiding fatty food. Drink as much as you wish.
- Practise breathing techniques.
You should call your midwife if:
- you have a heavy ‘show’ of bright red blood,
- your feel your waters breaking (this is when the amniotic fluid leaks out through your vagina),
- your baby's movements slow down and/or
- you feel feverish or have severe headaches.
Your midwife is there to support you so get in touch when you need to.
During early labour, the support of your birth partner can really help. They can:
- Make sure you have everything you need if you are having the baby at home, birth centre or hospital.
- Try to create a relaxing and safe environment for you.
- Reassure you that you will be able to do this.
- Read through the birth plan with you and let any other birth supporters know that labour is starting.
- Take a last photo of your bump before the birth.
- Hold you or rub your back, if that's what you want.
- Prepare some food and drink for both of you.
Both of you may find that asking your midwife for information in advance helps get rid of the stress of the unknown. You could also consider antenatal classes to help you prepare for labour and birth in the weeks and months before your due date.
Your contractions will become stronger and more frequent, maybe lasting 20 to 40 seconds every 5 to 10 minutes. When you meet the midwife at hospital, or at your home, she may offer an internal examination to see how dilated you are. Be prepared for a stronger and perhaps more painful contraction after an internal examination.
Your midwife will want to check your baby’s heartbeat from time to time. This can be done with a hand-held device. If you do need any continuous monitoring of your contractions and your baby’s heartbeat, you can still wear the monitor while standing or kneeling. As your contractions get stronger, your cervix may open more rapidly.
Here are some things to keep in mind to help you through this stage of labour:
- An empty bladder is more comfortable and gives your baby more space to move down so try and take regular trips to the toilet.
- Ask someone to massage your back.
- Sometimes the monitor will need to be left on – leaning forward positions are often the most comfortable in this case.
- Breathing slowly can help release tension, so sigh out slowly (SOS) through a relaxed, open mouth. Sipping water or sucking ice or something cold will help keep your mouth moist.
- Drink if you feel thirsty and eat if you are hungry.
Upright, forward-leaning or kneeling positions tend to help your baby into a good position and can ease pain. There is evidence to show that remaining upright means less need for pain relief, and a shorter first stage in labour. It is a good idea to stay active if you can and try different positions to find what’s most comfortable for you.
During labour, much of the focus will be on you, of course, but your birth partner will also need to play their part in supporting you and feeling comfortable themselves. They can:
- Remind you to go to the toilet about every hour.
- Help you change positions, as this can help you both keep comfortable.
- Dim the lights or play some music.
- Encourage you to relax with slow, steady breathing and massage.
- Rub your back; making sure they are in a comfortable position too. They can always ask your midwife to help if they need a break.
- Provide you with reassurance and support.
- Support you in any decisions about pain relief – they could ask, for instance, whether an internal examination to assess progress might help with decisions about pain relief.
It's important that your birth partner is as relaxed as possible themselves and that they remember to eat and drink. They can always ask your midwife for any information you need.
At this point, your cervix will be opening up faster now and your contractions will be more frequent, stronger and last longer. If your waters have not broken yet, your midwife may suggest breaking them now. Here are some things that you can do at this stage:
- Deal with your contractions one at a time. Try to relax fully between them.
- Rocking your pelvis during contractions can help reduce the pain and be soothing.
- Whichever position you are in, check that all your muscles are as relaxed as they can be.
- Breathe in a way that is comfortable for you. Slow and steady is calming and remember to ‘sigh out slowly’ (SOS). Try to smile as each contraction fades.
- Change your position from time to time.
- Take your mind off the pain by singing, counting in threes or backwards from 10 or listening to some music – all these distraction techniques can help you cope with pain during labour.
At this stage, getting into a birthing pool or a deep bath can also be really relaxing.
At this point, your birth partner might feel shut out or uncertain about how to help you as many women focus inwards on what's happening to them, their contractions and breathing. This concentration actually helps you to produce endorphins to relieve the pain during labour so encourage your birth partner to understand this and let you focus if you need to. You can also suggest they:
- Encourage you as you cope with each contraction.
- Check that you're comfortable and help you change position if necessary.
- Give a you a massage – deep and firm at this point – may help to relieve pain. Gentle stroking may aid relaxation.
You and your birth partner may be feeling very tired by now so encourage each other to rest, eat and drink regularly.
The second stage of labour begins when your cervix is fully dilated and lasts until the birth of your baby. Your midwife will help you to find a comfortable position and will guide you when you feel the urge to push. Read more about the different stages of labour in our guide to labour.
NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth and life with a new baby.
You will also find useful information on NHS Choices in a guide to labour.