Understanding the 3 stages of labour

Labour is often seen as a single event when there are, in fact, 3 stages of labour your body will go through as you bring your baby into the world. From that very first contraction to holding your baby skin to skin, let’s take a look. 

The first stage labour has two parts:

• The latent stage of labour (the latent phase)

• Active labour (established labour) 

The latent stage of labour is when your cervix starts to soften and open (dilate) as you prepare to give birth¹.

While you might experience contractions, they probably won’t follow any particular pattern and can range from mild and uncomfortable to painful¹. 

Decided on a home birth? Then this is a good time to call your midwife. If you’re giving birth at the hospital, maternity unit or birthing centre, it’s a good idea to call before you make the trip. If your waters haven’t yet broken, you’ll probably be advised to stay home until your contractions become more regular² - the last thing you need is to get there only to be told to go home again! 

It can feel a little frustrating to be told to stay home once your labour has begun, but the truth is that until things really get going, you’re much better off in the comfort of your own home. “Think about ways you can make your environment comfortable and calm at this point in your labour” advises our expert midwife: “Dim the lights, light some candles, and if you feel like it, play some music that makes you feel good. This kind of environment can help your body relax and help when you have a contraction.”

With that in mind, here are a few things you can do during the latent stage of labour to help you stay relaxed, ease discomfort, and help your labour progress¹:

• Get some rest. If your labour starts at night, take the opportunity to try and catch 40 winks. 

• Have a warm bath or shower. It will help you relax and help with any pain or discomfort.

• Stay active. While running your next 5k might have to wait for now, staying upright, walking around and using your birthing ball could help your labour progress. 

• Breathe. You might hear this a lot as your labour progresses, but doing some gentle breathing exercises in early labour will help to keep you calm and relaxed.

• Try to have something to eat and drink. As our expert midwife says: “This will help to provide the energy you need to manage your contractions. Labour is like running a marathon, so you’ll need to stay hydrated and fed, ready for when your body becomes tired.”   

Your cervix is dilated by around 4 cm when you reach active labour (also known as established labour) - your baby is well on the way. 

Your contractions will start getting stronger, with many women describing them as being like period pains but more intense and extreme. Keep an eye on the rhythm of your contractions. When they’re coming less than 5 minutes apart or more regularly, it might be time to grab your hospital bag and head to the hospital, maternity unit or birthing centre².

Once there, a midwife will most likely²:

• Monitor your baby’s heartbeat.

• Check your pulse, blood pressure, urine and temperature. 

• Check your baby’s position by feeling your abdomen. 

• Ask if they can do a vaginal examination to check your cervix and labour progress.  

The first stage of labour can take between 8 and 18 hours if this is your first baby. It can happen more quickly with second, third and subsequent babies - between 5 and 12 hours¹. 

The latent phase of labour is typically the longest, and if you’re having a vaginal delivery, it can take hours and sometimes days to progress from this stage to active labour¹. That’s why it’s a good idea to have plenty of healthy snacks for labour at the ready to keep your energy up!

You’ve probably given your pain relief options some thought and may well have made your choices clear in your birth plan. Make sure your birth plan is packed in your hospital bag and that your birth partner is up to speed with your preferences.

Once you’ve arrived at hospital, your midwife will talk to you about what your pain relief options are, and what will be suitable depending on how your labour is progressing and how you’re feeling.    

When your waters break, it’s not always exactly like what we see on TV and in films. Whilst your water can break before labour begins, it’s likely to do so during your labour³. Sometimes, a doctor or midwife will break your water for you, for example to speed up your labour if your contractions have slowed down³.

If your water breaks before this point, you may feel a ‘gush’ or a small trickle, and it’s one of the sure signals that your baby is on the way. Contact your midwife, who will advise you on the next steps³.  

If you’ve chosen your birthing partner, this is their time to shine. Apta-mum Helen has some top tips for birthing partners below:

• Offer support. This could be encouraging words or stroking your partner's back.

• Keep water at the ready. Your partner will probably get thirsty, so keep a sports bottle full of water ready and offer it as labour progresses. “The odd healthy snack wouldn’t go a miss, either. It will keep your partner’s energy up and earn you extra brownie points.” 

• Go with the flow. Don’t be offended if you’re told to be quiet or to step away. You’re not doing anything wrong; it’s just that sometimes, birthing mums just need to be in the zone! “Personally, I couldn’t get enough of the back rubs, but for some women, it’s a distraction they don’t need.”  

‘Push’, ‘breath out’, ‘bear down’ - with vaginal delivery, these are all terms for what you might have the urge to do during the second stage of labour. By now, your cervix is fully dilated, and your baby is making their way down the birth canal¹. 

The urge to push can feel as though you need to go for a poo (there’s nothing like keeping it real). If you’ve had an epidural, you might not feel this, but don’t worry, your midwife will be on hand to guide you through your contractions either way.

You might be asking yourself the question all pregnant women ask; will I do a poo during labour? Our expert midwife is here to help: “If you do poo during labour, don't worry, this is a key sign you're pushing effectively, and your baby is moving down the birth canal. Midwives are very good at keeping things discreet in the birthing space and often clean it away without anyone even noticing! We’ve always got your back.”

To give your body time to stretch and ease your baby out, your midwife will probably ask you to stop pushing and take short breaths. Once your baby’s head is out, it’s likely to take just 1 or 2 contractions more for them to arrive. 

Provided all is well, it’s time for you to cuddle your baby and enjoy some skin-to-skin contact. You can also offer your baby their first breastfeed. At this point, your midwife will offer you a cup of tea and some toast – a famous post-birth energy-boosting treat. Enjoy, and don’t forget to give yourself a massive pat on the back - you did it!  

There are several reasons why you might be advised to have a C-section, including⁴:

• Your labour being slow to progress. 

• Not enough oxygen or nutrients getting to your baby. 

• Your baby being breech (feet-first).   

Whether you’re giving birth at home, a hospital or a birthing centre, the midwives you meet will be there to help you at every step. 

Midwives perform a vital role during labour and birth, providing lots of encouragement and doing everything possible to keep you and your baby safe. They’ll also be on hand after you’ve given birth to give advice and guidance on all things baby and parenting.

After birth, your womb will contract so that you can birth your placenta. You have two options here¹:

• Active management. This is where you’ll be given an injection of oxytocin into your thigh, making your womb contract and your placenta come away from your uterus. Your midwife uses the umbilical cord to bring the placenta out through your vagina. 

• Physiological management. Here, the placenta comes away from your uterus without having an injection, which typically happens within an hour of giving birth. If it doesn’t, your midwife will advise you to have an injection of oxytocin. 

Cutting the umbilical cord separates your baby from the placenta. Sometimes, this will need to be done straight away - your midwife will tell you if that’s the case. Otherwise, guidelines state that the umbilical cord shouldn’t be cut until at least 1 minute after birth⁵.

You can choose to delay clamping the cord even longer, which can have many benefits, including⁵:

• Ensuring that your baby has a full blood volume and an increased iron level⁵. 

• Additional stem cells to help with their growth and immunity⁵.

• Stabilising your baby’s blood pressure, helping them to breathe and adapt to the world outside the womb⁶.

After you’ve given birth, your body will need some time to recover. Below, you’ll find advice and experience from our mums and baby experts to help you in those early first hours and days. 

• Rest and sleep. Whilst it might not be the first thing you’d expect to do with a newborn, rest is vital. You’ve just brought another human into the world; you’ve earned it. 

• Try to eat. Giving birth uses a lot of calories, so having something to eat will give you a much-needed energy boost. Eating plenty of fresh fruit and vegetables in the first few days after birth will help avoid constipation and make that first post-birth poo a little easier. According to our expert midwife oats are also a great addition to your diet: “Oats can help to increase your prolactin levels and support breast milk production, so perhaps enjoy a warm bowl of porridge for your breakfast or as a healthy snack in those early days after giving birth.”

• Drink plenty of water. Lots of new mums worry about going to the toilet after giving birth. If you’ve had a vaginal birth, drinking plenty of water can help to dilute your urine and take the sting out of going for a post-birth wee⁷. 

• Breastfeeding. Breastfeeding has lots of benefits, including helping your uterus contract and return to its normal size. It also encourages the release of that ‘happy hormone’ oxytocin, which will help you to bond with your baby⁸. 

• Keep an eye on how you’re feeling. Many women report feeling on a ‘high’ in the hours following their baby’s arrival. As your hormones fluctuate after giving birth, you might notice a dip in your mood. This could be the ‘baby blues’ and should pass within a few days⁹. Don’t hesitate to reach out for support during this time, and if you don’t start to feel any better, have a word with your GP or midwife. 

• Stay warm. Some women experience feeling cold and shaky after giving birth.  This is common and all down to the adrenaline racing through your body¹⁰. Wrap up and keep warm until it passes; take it as confirmation that you’ve just done something incredible.