Pregnancy - stages of labour

Labour is divided into three stages. The first stage is the dilation of the cervix, second stage is the birth of the baby, and the third stage is the birth of the placenta. For first-time mothers, labour takes around 12 to 14 hours. Women who have undergone childbirth before can expect about seven hours of labour.

Recognising the start of labour

Braxton-Hicks contractions are sometimes mistaken for labour. These ‘false’ contractions usually start halfway through the pregnancy and continue all the way through. You may find these contractions visibly harden and lift your pregnant belly.

It is not known what triggers the onset of labour, but it is thought to be influenced by the hormone oxytocin, which is responsible for causing uterine contractions.

Symptoms of going into labour

Some of the signs and symptoms of going into labour may include:

• Period-like cramps
• Backache
• Diarrhoea
• A small bloodstained discharge as your cervix thins and the mucus plug drops out. This is called “a show”
• A gush or trickle of water as the membranes break
• Contractions.

The first stage of labour

The first stage of labour involves the thinning of the cervix and its dilation to around 10 cm. The first stage is made up of three different phases. These are:

• The latent phase – generally, this stage is the longest and the least painful part of labour. The cervix thins out and dilates 0–3 cm. This may occur over weeks, days or hours and be accompanied by mild contractions. The contractions may be regularly or irregularly spaced, or else you might not even notice them at all.
• The active phase – the next phase is marked by strong, painful contractions that tend to occur three or four minutes apart, and can last from 30–60 seconds. The cervix dilates to from 3 cm to 7 or 8 cm.
• The transition phase – During transition, the cervix dilates from 8–10 cm (or fully dilated). These contractions can become more intense, painful and frequent. It may feel like the contractions are no longer separate, but running into each other. It is not unusual to feel out of control and even a strong urge to go to the toilet as the baby’s head moves down the birth canal and pushes against the rectum.

The second stage of labour

The second stage of labour is from when your cervix is dilated to 10 cm to the time your baby is born. The contractions during this time are regular and spaced apart. As each contraction builds to a peak, you may feel the urge to bear down and push. The sensation of the baby moving through the vagina is described as a stretching or burning, particularly as the baby’s head crowns (appears at the vaginal entrance).

Once the head has emerged, your midwife or doctor will help guide your baby’s body to help birth the shoulders. The rest of the baby will then follow. If this is your first baby, the second stage of labour can last up to one to two hours, particularly if you have had an epidural. If you have had a baby before, this stage if often much quicker.

The third stage of labour

The placenta is then birthed, often with the assistance of the midwife or doctor, usually five to 30 minutes later. Your uterus gently contracts to loosen and push out the placenta, although you may not be able to feel these contractions. With your consent, you may be given an intramuscular injection of an artificial hormone, oxytocin to assist this process.

Suggestions for the early stages of labour

Be guided by your doctor or midwife, but general suggestions for a woman approaching labour include:

• Once you go into early labour, take the opportunity to rest and relax at home. There is no need to be in hospital until the contractions are regular and painful.
• Once the contractions are around seven to 10 minutes apart, you might like to start timing them. You do this by noting how many minutes elapse between the start of one contraction and the start of the next.
• If you are unsure whether to stay home or head to the hospital, ring and speak to one of the midwives. They will ask you a number of questions and help you decide what to do.
• Once your contractions are five minutes apart, or you live a long distance from the intended place of birth (often the hospital), or if you no longer feel comfortable being at home, go to the intended place of birth.
• If your waters break or if you start bleeding from the vagina, go immediately to hospital.

Once in hospital

Suggestions include:

• Resist any urge to push until your cervix is fully dilated.
• The pressure of your baby’s head helps to widen your cervix, so use gravity and walk around, stand or sit upright.
• Don’t feel embarrassed or inhibited by your appearance or behaviour – your midwife has seen it all before. If you want to grunt, yell or swear – go ahead. Remember that passing a bowel motion during labour is normal and nothing to be concerned about.

Where to get help

• Your hospital or birth centre
• Your doctor
• Obstetrician
• Midwife
• Family Planning Victoria Tel. (03) 9257 0100

Things to remember

• Labour is divided into three stages – the dilation of the cervix, the birth of the baby and the birth of the placenta.
• Some of the signs and symptoms of going into labour may include period-like cramps, backache, diarrhoea and contractions.

You might also be interested in:

• Breastfeeding.
  
• Breastfeeding - when to start.
  

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Fact sheet currently being reviewed.
Last reviewed: February 2012

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<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Pregnancy_stages_of_labour?open">Pregnancy - stages of labour - Better Health Channel</a><br/>
Labour is divided into three stages – the first stage is dilation of the cervix from 0–10 cm, the second stage is birth of the baby, and the third stage is delivery of the placenta. Labour typically takes between 12 and 14 hours for first-time mothers and seven hours for women who have had a baby before. Braxton-Hicks contractions or false contractions are sometimes mistaken for labour.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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