Labour – is this the real deal or just the rehearsal?
Every labour is very different, but as a midwife we see patterns of how labour starts, and we learn how to read a woman and her body to assess what stages of labour she is in. Women often ask in our prenatal classes how they will know when labour is really labour, and not just practice contractions. So I thought I would share with you the answer!
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Labour is divided into 3 ‘stages’, the first, second and third stage of labour. The first stage is from the start of your contractions to when you are ‘fully dilated’ and pushing your baby out.
There are two parts to the first stage of labour – with first time mums this stage can generally last a long time – anywhere from hours to a few days.
The Latent Phase of Labour – Your cervix needs to open to 10cm before the baby can pass through. This is called ‘Fully dilated’. Each contraction helps to soften the cervix and then to dilate it. With your first baby this softening process may take some time, possibly a few days of ‘irregular’ contractions. These will start as feeling similar to period pains or could be nausea, back pain, ‘not feeling right’ and you may or may not lose a ‘show’.
What is your cervix doing? At this stage the cervix is changing from a long ‘tube’ to a ‘paper thin’ cervix. This is called effacement. When your cervix is ’fully effaced’ and 3-4cm dilated with regular contractions you are then entering the Active phase of Labour.
During this time, try to stay at home, as this phase can last a long time (especially for first time mums), and if you went to hospital there is not much they can do for you. If you are finding it really hard to cope and it has been going on for awhile, then keep your Doctor updated – they may invite you in to check that the baby is coping well, and if you need it, offer some mild pain relief.
The Active Phase – This is when you will start to sound like you are on a run. Your breathing will become heavier and you’re unlikely to be able to hold a conversation whilst they’re happening. Your contractions will be every 3 minutes and lasting about 40-60 seconds and really take your breath away. The period pain sensation will now change to contraction pains and you will notice a difference. Once these contraction shave been like this for at least one hour, but if you can manage two then great, then normally it will be time to head into hospital/ call your doctor.
What is your cervix doing? Every contraction is pushing the baby’s head onto your cervix and helping it to dilate. The active phase starts once you have regular contractions, and are about 3-4cm dilated. Once you have become ‘fully dilated’ you enter the Second stage of Labour.
As mentioned before, this can all take a long time – for first time mums, we would be happy with a progress of 0.5cm an hour…so from when you are in the active phase of labour, it could still be another 14 hours! Try and remain upright and mobile, as the pressure of the babies head on your cervix can aid dilation. Use your breathing techniques, and anything else that normally helps you relax (music, lighting etc), to stay calm and focus on your contractions pushing your baby down.