Stages of labour – first stage

First stage

This is usually the longest stage (it can last for up to 24 hours and this is absolutely normal) and is when the cervix continues to efface  (stretch and get thinner) then dilate to around 4cm. Thats about the size of the oval next to this paragraph.

Early labour is the initial phase and can last for hours, days or even weeks.  It can be difficult to detect and whilst some women feel excitement others want to nest and get things ready for the baby. Contractions are usually short and you may even be able to sleep through them. They will gradually increase in strength as well as get closer together. At this stage you may be more comfortable labouring at home and that is one of the best tips for a natural birth – to stay at home for as long as possible.

What you may feel

  • Manageable contractions like period pain
  • Indigestion
  • A sense of warmth in the abdomen
  • Your waters may break
  • Low backache
  • Loose bowel movements
  • Loose mucus vaginal discharge.  This is perfectly normal and may even have a tinge of blood – more than a little bit of blood than contact your hospital.
  • Lightening as the baby drops into position
  • You may feel excited or nervous.
  • You may have a surge of energy or feel restless

Management strategies

The important thing to do in this stage is to relax. I know that it is easier said then done but you need to think about saving your energy.  Make sure that you stay active and relaxed.  

  • If your husband isn’t there – then tell him what is happening.
  • Take a walk
  • If you have a birthing ball (a large exercise ball will do) then sit on this as it is great for helping your posture but also opening your pelvis.
  • Take a shower
  • Time your contractions – not every one but just to keep track
  • Go to the toilet – a full bladder can slow labour down
  • Finish packing your bags
  • Take some last pregnancy photos
  • Play cards
  • Go to the movies
  • Watch a film at home
  • Go out for dinner
  • Avoid a bath as full immersion in water can lower your oxytocin levels and slow birthing down. 
  • Stay in the moment – don’t worry about things to come

You do not need to go to hospital until you are ready.  If you have had no bleeding, can manage any discomfort then stay at home for as long as you can. Trust your instincts.  You can do this.

Let’s have a quick talk about language and how changing the way we talk about labour and birth may have a positive impact on your mindset.  A contraction is a squeezing, a tightening of the muscles so don’t think of it like that.  Imagine an opening, a wave, a surge, a drawing down, a release.  Don’t think of tightness – think of freeing.  Don’t think of pain – think of the joy to come. Remember that birth is a process to make you a mother. Every breath brings your baby closer to you – let your breath guide you together.

As  labour progresses you will go into Active Labour which is when the contractions will become stronger, usually 3-5 minutes apart and lasting about 60 seconds.  Remember that not all contractions will have the same intensity you may have a strong one followed a weaker one that doesn’t last as long. Also remember that not every woman experiences labour in the same way – for some it is just like a mild, dull ache, others its like period pain.  Your labour and contractions  will be unique to you.

Your earlier relaxation will be really important here as it will have given you energy.  Your cervix will have dilated to between 5 and 7 centimetres.

Your baby may have started to descend (but that can happen earlier or later – remember no two labours are the same). This phase can last between 4 – 8 hours for the first labour but it can also be as short as an hour.

If you are having regular painful contractions lasting about a minute each, every five minutes for an hour then it is time to head to the hospital.

If you do not need to be monitored regularly then move as much as you can during labour.  Many of the pain management and relaxation techniques that you have been using such as deep breathing, visualising can help you in this stage.  

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This is a representation of what your body is doing in the first stage of labour.  Once you are fully dilated and effaced then you will enter into transition which when your baby will go through your pelvic opening and into your birth canal to be born.

Transisition

This where your cervix dilates to the full ten centimetres which is the size of a starbucks coffee cup lid! It can be the most painful part of labour and for some women they feel that they are failing if they are not coping well.  This is completely natural and you will get the energy from somewhere to help you. Remember you will be seeing your baby very soon! Here is what it  may feel like:-

  • Hot and sweaty
  • Cold and shaky
  • Crying
  • Nausea and vomiting
  • Unable to find a comfortable position
  • Contractions increase when changing positions
  • Afraid to move
  • Looking for a way out
  • Asking for help
  • Water breaking
  • Discouragement and/or giving up
  • Irrational thoughts and behaviour 
  • Asking for pain medication
  • Women feel like they’re not getting a break. 
  • Very long contractions lasting around 90 seconds (in comparison, the average active stage contraction is around 60 and early at 30 seconds)
  • Contractions are closer together, around 2-3 minutes apart
  • Pressure in the lower back or bowels or perineum
  • Instead of completely going away contractions sometimes “double peak”
  • There may be some bloody discharge

This is the most intense part of labour.  Changing position is also the most painful thing to do at this time but can really help move your labour along.  Your baby needs to come out and sometimes you just need to surrender to the innermost primal parts of you.  

But the reality of all this preparation is that you don’t know how you will feel, how you will react and there is every chance that you could be like the lady in the attached clip.  You don’t need to be scared – just get your dance on!

Brazilian Dancing Doctor