The Stages of Labour and What To Expect

Labour can be quite daunting if you don’t know what to expect, but fortunately there is plenty of support available to you from the NHS and various other sources to prepare you mentally for the process of childbirth.

What happens during labour?

Labour can be split up into three stages, each one characterised by certain events which are necessary for the healthy and successful birth of a baby. In summary, labour involves the slow opening of the end of the womb (the cervix) to allow for the passage of your baby, followed by the pushing stage during which a child is born, and finally the afterbirth stage. Each of these will be described in more detail in the following sections of this article.

The signs of labour are regular contractions that increase in strength, length, and frequency, as well as the release of amniotic fluid surrounding the baby (referred to as your water breaking), and the loss of the mucus plug sealing the cervix (called the show).

The First Stage of Labour

In order for a baby to safely pass out of the womb, the cervix needs to have dilated (opened) by approximately 10cm. This can vary of course, but generally speaking this is the point at which the second stage of labour begins and you will be asked to push.

At 10cm the cervix is considered fully dilated, and the process of widening the cervix begins with the regular contractions that are the characteristic sign of labour. Each contraction softens the cervix a little bit more, and labour is considered to have begun in earnest (what is called established labour) when these contractions have caused the cervix to dilate by a minimum of 4 cm.

You may have to go through several hours of contractions before labour is considered ‘establish’, and this is the point at which you should arrange to go to your hospital or have your midwife attend to you if you are having a home birth. To help your cervix dilate you should maintain a gentle level of activity and try and relax as much as possible.

Once your labour is considered established, you can expect your doctor or midwife to monitor your progress, and you can expect it to take up to 12 hours for your cervix to fully dilate from the point of establishment. You will be told not to push until you are fully dilated, even though you may feel compelled to do so.

The Second Stage

As mentioned above, your labour will move on to its second stage once you are fully dilated. This is the stage where you actively push alongside your contractions to move the baby along the birth canal (running from the cervix to the vagina).

Your midwife will help you find a position in which you feel as comfortable as possible. This varies a lot as no two bodies are alike, but finding the right position for you will make pushing a lot easier. Some women like staying on a bed but with some back support from pillows, others prefer squatting or kneeling, and others standing, it really is a matter of personal preference.

Labour can be extremely exhausting, which is why some women are more comfortable lying on their side when tired. If you have had back pain issues than kneeling on all fours can be a great way to alleviate that pain.

This is the most trying stage of labour because you will need to push when your midwife tells you too. How long you are in the second stage for will vary, but typically it takes about an hour for you to successfully push your baby out.

Your midwife will help you throughout this stage, and will instruct you to take deep breaths and push as each contraction begins. You will be asked to push a number of times until the contraction passes, and then rest until the next one begins.

Labour’s Third Stage

Compared to the first two stages, the third and final stage of labour is relatively easy. Many people are surprised to find that there is still some work to do after the second stage of labour, namely the delivery of the placenta. After your child has been delivered, you will feel a few more contractions which aim to push out the placenta. This is the organ which forms at the beginning of a pregnancy and aims to provide nutrition to a growing unborn child and take away any waste products.

You might be offered a Syntocinon injection straight after your child has been born. This drug helps deliver the placenta (also called the afterbirth), and works to prevent the heavy bleeding that sometimes follows.

General points

Your baby’s heart rate is closely monitored throughout labour to keep an eye out for any complications or distress. If there are any serious complications during labour, for instance if your baby’s heart is in distress, your midwife or doctor will take steps towards speeding up labour.