The 3 Stages of Labour
The first stage of labour begins with the first contraction and ends when your cervix is fully dilated. The stage is split into two phases; the latent phase and the active phase. The latent phase can stop and start, even over the course of days. The active phase is where we see the cervix opening consistently, contractions becoming regular, more intense and lasting for around 60 seconds.
The latent phase of the first stage of labour is best managed at home where you are more comfortable and relaxed. If pain relief is needed at this stage then paracetamol, heat packs and warm baths are usually sufficient.
The active phase of the first stage of labour is usually noticeable as the contractions begin to have have more of a pattern, becoming stronger, more frequent and last longer. It’s also at this point that women tend to request stronger pain relief and it is usually this that triggers their wish to go to hospital. If a homebirth is planned it is usually at this point that you would be requesting a midwife to visit you at home and assess both you and baby.
The second stage of labour begins when the cervix is fully dilated and ends with the birth of your baby. It too is split into two phases; passive second stage and active second stage. The main difference between the two phases is the urge to push. During the passive phase of second stage you will probably feel no different to how you felt during the first stage of labour.
During the active phase of second stage of labour you will have an uncontrollable urge to push, providing you have not used an epidural for pain relief. If you’ve used an epidural for pain relief you won’t be aware of that urge to push and will normally need assistance from your midwife as to when and where to push.
For you though the first and second stages of labour will merge. There will be the first contraction; increased intensity of those contraction; pressure in your back passage and finally; urges to push.
The third stage of labour is delivery of the placenta. It starts after the birth of your baby and is completed when your placenta has been delivered and any bleeding from the site of the placenta is under control. There are two ways in which you can deliver your placenta; active management and physiological.
With active management a drug is given shortly after your baby is born (but allowing enough time for delayed cord clamping to occur). This drug encourages the placenta to detach from the wall of your uterus and your midwife or doctor will then gently pull on baby’s cord to deliver the placenta. This usually takes around 10 – 20 minutes from when baby was born, but can take up to a few hours.
With physiological delivery of your placenta the cord is usually left intact. You will be encouraged to breastfeed your baby as this encourages your body to release the same hormones as the drug given with active management. Again this can take anywhere from 10 minutes to a few hours to deliver your placenta. With both methods you will be encouraged to empty your bladder and be upright to let gravity assist.
Once the placenta has been delivered your midwife or doctor will approximate the amount of blood that was lost during the birth and also ensure than any bleeding has settled. It’s at this point that they will also wish to assess your vagina, labia and perineum for any tears that may need to be stitched.