The stages of labour
Knowing exactly what your body goes through will help you to make informed decisions as well as preparing you for the birthing process.
The first stage
The initial stage of labour is when your cervix gradually opens. It is divided into three different stages: early labour, active labour and the transitional stage. The first stage of labour can last 6-20 hours or 2-10 hours if it isn’t your first time giving birth.
In the first stage of labour your cervix will open until it is fully dilated (10cm in diameter). Your cervix starts off in a posterior position (pointing towards your back) during early labour it will move to an anterior position (facing forwards). It will also soften and shorten. It is common for these changes to start taking place late in your pregnancy. As your cervix softens and adjusts position you may feel a slight backache or mild abdominal aches, you may even have loose bowels. This stage is sometimes referred to as prelabour.
During pregnancy a mucus plug forms over the cervix to keep infection out. This is released prior to labour, it is a jelly like substance that may be a little blood stained. It is known as a show. For first labours the show usually signifies that labour is coming within hours or days. If you’ve given birth before then your show could be a sign that you are already in labour.
This is the stage in which your cervix goes from being closed to 3-4cm dilated. Some women don’t realise it has started, though the intensity of contractions will increase. It often feels like a period pain, with mild cramps and/or a dull backache. At this stage it is worth timing your contractions. In early labour they are often more than five minutes apart and only last 30-40 seconds.
During this stage you should be able to talk and move around. You might want to phone parents or close friends and make any last minute arrangements, ensure other children are taken care of and gather your hospital bag together. If you are planning a hospital birth, it is advisable to stay at home during the early stages. Early labour can stop and start, going to hospital can actually delay the labour. You are better off staying at home and trying to keep relaxed. This is a good time to drink plenty of water and eat something. You may not feel like eating much, but your body will rely on the energy and you may not be able to eat for a while. Complex carbs, protein and minerals are all important. So even a slice or two or wholemeal toast, a glass of milk and some fruit would be helpful.
This is a great time to engage in something really relaxing, perhaps a warm bath or some meditation or mindfulness exercises. Some women find that staying upright helps with the discomfort, so you might like to keep walking.
The active phase
This is the phase when your cervix opens to 10cm. Your contractions will be stronger, longer and more frequent. It is likely that you won’t be able to talk through them. Instead, focus on your breathing. You may find some comfort in rocking gently on a birthing ball. This will not only ease the pain but can also help to keep the pelvis supple and open. It is likely that the contractions will come every three to four minutes and will last 60-90 seconds. This can seem quite intense for many women as there is little time to rest between them. Focus on the idea that each contraction is helping your baby out into this world. Use controlled breathing and keep your body as relaxed as possible.
During this stage you will want to go to hospital if that is where you are having your baby.
The transitional phase
This is the stage between your cervix becoming fully dilated and the urge to push. Contractions tend to be less frequent but last longer and may be more painful. Sometimes a contraction will start before the last one has fully faded. It is common for your waters to break during or before this phase. Some women find this phase to be very overwhelming, it is often the point when women feel that they can’t go on. It is really important to remind yourself that this phase signifies the end of the opening of the cervix. Often there is a break from contractions before the pushing stage. This stage is often the hardest stage of labour. Remind yourself why you are opting for a natural birth. Also, give yourself permission to use pain relief if you need it. Focus on the transience of this stage.
The second stage of labour
This is the stage in which you will push your baby down the birth canal. Keeping your pelvis open is essential so avoid lying on your back. It is also important to stay upright and let gravity assist you. Squatting positions are really helpful, so is kneeling on all fours. Whichever position you are in, it is helpful to move around. Rotate your hips in a figure of 8 shape, sway and keep active. This will give your baby the space to find a suitable position.
If you do need to lie down (because you need to rest or have had an epidural) lie on one side and ask your birth partner to support your upper leg to relieve any pressure on the lower back.
The second stage of labour usually doesn’t last more than a couple of hours. Sometimes it takes minutes. Often with subsequent babies it is only 5-10 minutes.
When you feel the urge to push you can bear down, listen to your body and work with your contractions. In between contractions be sure to breathe deeply and slowly. It is common to make noise when you are pushing. Go with it. Follow your primal instincts. With each push your baby will slowly move a little bit further down your vagina.
Crowning is when your vagina stretches over the baby’s head. Your midwife will be looking out for this. You will feel a hot, stinging sensation. At this point you need to stop pushing and pant lightly. This will allow your baby to be born gently. Making it less traumatic for them, and less likely that you will tear. Sometimes the head is born in one contraction and the body in the other. Other times it is all done in one movement.
The third stage of labour
This stage is when you deliver the placenta and membranes. Once the baby is born you may have a few moments rest before your body starts to contract again in order to expel the placenta and membranes. You can have an injection that will mean you don’t need to push, it will cause contractions for you. Some women opt for this as they believe that a drug-free birth has given their baby the best possible start and they simply want to get the third stage over with quickly, so they can bond with their baby. The injection can also mean less risk of post-natal anaemia and less bleeding as the placenta is delivered. However, it can also cause nausea, vomiting and heavier blood loss. Skin-to-skin contact and breastfeeding can encourage the third stage. Usually an assisted third stage and a natural one last the same amount of time.
Ideally, if there have been no complications, you will keep the umbilical cord attached for a few minutes. This will keep the blood flowing to your baby for a few extra minutes after the birth.
I found giving birth to be the most exhilarating experience of my life. Tapping into my primal instincts meant I moved around a lot and used a lot of deep squats. My daughter was born when I was on all fours, rocking my pelvis meant she easily found the space to move through.
Taken from ‘The Natural Baby: A gentle guide to conception, pregnancy, birth & beyond’ by Holly Daffurn and Samantha Quinn.