The 3 stages of labour

Labour has three stages:
First stage – this is where the cervix softens, thins and dilates to 10 cm. The first stage is split into the latent phase, early labour, established or active labour (considered to be 4/5/6cm depending on who you talk to!).
Second stage – this is when the uterus starts to push out the baby. Second stage starts when the cervix is dilated to 10 cm
Third stage – this is the delivery/birth of the placenta

But as you know, real life is not a textbook and every woman is different.

FOCUS on birth physiology  – understand, trust and listen to your body.
Stay home for as long as you can (if birthing in hospital or birth centre) obviously transfer in when you feel YOU need to. Slightly different if you are booked in due to an intervention or you plan to stay at home.

  • Cervical dilation is only part of the picture
  • The cervix is dilating the muscle mass is gathering on top of the fundus (this helps push/move the baby down & out)
  • Vaginal Examinations may not indicate that much has happened HOWEVER it’s always doing something
  • Be aware of emotional and behavioural changes, keep an eye on what is going on with the contractions, as this usually provides a much more accurate assessment
  • A mother will go through 3 major emotional stages as labour progresses.
 
These are:
 

These behavioural changes are all to do with the hormones of labour. When a woman is calm and feels safe, her body naturally takes her from one stage into the other.


Excited Mama
– Keep doing normal activities      Set yourself a pre-birth project     Set the scene     Inform those that need to know     Stay at home

  • Early/latent stage of labour.
  • Contractions can stop, start and be irregular. How long is a piece of string – who knows.
  • Be able to talk through your contractions (especially the early ones)
  • If you partner talks to you, you’ll be able to make eye contact with them.
  • Be able to speak in full sentences and hold a proper conversation.
  • If you have to stop because of a contraction, once it’s finished, you’ll be able to resume the conversation.
  • Labour can start at night (Melatonin boosting Oxytocin)
  • Women will, most likely, be in their own environment, with their partners, curled up in bed feeling relaxed and sleepy.
  • if partners are away or working a night shift, their bodies will tend to wait until daytime to start the process off.
  • Mothers of older children, labour won’t kick in until the older child/children have been taken care of.
  • If you’re asleep and the contractions wake you, pop on the TENS and go back to bed!
  • Distraction – box sets, 2000-piece jigsaw puzzles, going for a walk
  • Conserve energy; sleep, eat and rest as much as possible.
  • Take a nap/bath – especially if contractions stop, rest over a ball, or over cushions piled up on the sofa and nap in between.

Serious Mama

  • Oxytocin increases as labour progresses
  • Contractions become longer, stronger and closer together (or should)
  • Focused on your contractions USE YOUR breathing and relaxation techniques.
  • Rest between contractions
  • Your ability to talk will decrease, gradually become more and more monosyllabic.
  • Contractions get stronger, the Endorphins help you cope
  • Partner matches your mood. If you’re not talking, don’t engage her to disengage, offer a drink or a massage, don’t wake up the neo-cortex
  • Oxytocin levels increase, contractions intensify, move with each one.
  • Behaviour is likely to become repetitive, the 3 R’s – IF IT ISN”T BROKE DON”T FIX IT
  • Noise with your out breath, a noticeable exhalation every time you breathe.
  • Waters may break and you may start to lose your inhibitions.
  • Subsequent babies can be a bit quicker and you’ll obviously need to factor in how far away you’re from hospital and whether it’s rush hour or not.

3 – 4 long, strong contractions, lasting at least a minute, within a 10-minute period, happening consistently for an hour!

Contractions lasting around 45 – 60 seconds
Contractions around 3-5 minutes apart – increase in strength and intensity of contractions,
Focus on breathing, letting your body go completely limp
“Do not disturb” sign 

Could last many hours
Some women’s contractions never get this close (stronger & longer)

Doubtful Mama – Final part of the first stage

  • Commonly known as transition – adrenalin fueled – journeying deeper into labour – she is safe.
  • Be ‘high’ on the Endorphins – might be ‘other worldly’. The boost of Adrenalin cancels out (or lessens) the floaty effect of the Endorphins to ensure you’re alert enough to greet your baby and keep it safe.
  • Aware of the double-peaking contractions it may feel there are no breaks between them.
  • May become very vocal – shouting or making loud ‘mooing’ noises, some will say they’ve changed their mind about having the baby and want to go home, some will remain extremely quiet and her supporters will have no idea of the turmoil within, some will become needy and some will display signs of utter panic.
  • Flushed, nauseous or be sick, you could be shaking, vocalizing – “I’ve changed your mind” “I want to go home”
  • All to be expected – positive sign – need encouragement & reassurance
  • This can be alarming for some partners – it’s all completely normal

Contractions are much more intense.
Can happen around 7cm as well as 10 cm (with mini self-doubt at earlier stages of labour) “Don’t Know if I can do this”.
Extra encouragement, praise and support.

Physical responses – shaking, nausea, hot flushes.